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Ciprofloxacin, one of the fluoroquinolone antibiotics, has become one of the most widely prescribed antimicrobial agents. It is generally well tolerated with a low incidence of side effects, which are mild in nature. There is a distinct incidence of neuropsychiatric adverse effects, which include psychotic reactions. We describe a case of a woman who experienced an acute psychosis secondary to ciprofloxacin...
Objectives. This work demonstrates a simple technique utilizing a fiberoptic microtransducer that provides statistically reproducible stress leak point pressure (SLPP) results without the use of fluorourodynamics.Methods. Nineteen stress incontinent patients with varied clinical histories underwent two SLPP measurements on 2 separate days, totaling four data points. A 14 F catheter sheath was inserted...
We report on a 33-year-old man with primary erectile dysfunction, isolated cavernous bodies, corporeal veno-occlusive dysfunction, and hypoplastic cavernous arteries. To our knowledge, this is only the second reported case of absence of communication between the corpora cavernosa.
Objectives. Prostate cancer (PC) is a major health problem for American black males. Blacks experience higher PC incidence and mortality compared to whites. Although the racial difference in PC incidence remains unexplained, the difference in PC mortality has been largely attributed to the late stage of disease at presentation. By using the incidence data on District of Columbia residents, this...
Objectives. The purpose of this study is to examine the feasibility of performing a laparoscopic bladder autoaugmentation and to assess the urodynamic characteristics of an autoaugmented bladder.Methods. Laparoscopic bladder autoaugmentation was performed in 9 female canines (20 to 30 kg). Following laparoscopic access to the peritoneal cavity, a midline bladder seromyotomy was performed using the...
A technique is described that enables successful urethral catheterization in difficult cases using a variety of catheter types and sizes. This method utilizes a urethral catheter that is loaded over a hydrophilic guide wire with the aid of an intravenous catheter. The devices utilized are routinely available to the urologist; therefore, the need for obtaining or stocking special equipment is obviated.
Primary adenocarcinoma of the bladder accounts for less than 2% of all bladder cancers. There is no report of such a case in a defunctionalized bladder. All reported cases of carcinoma in defunctionalized bladders were either squamous cell, signet ring cell, or transitional cell carcinoma, detected within an average of 5 years after urinary diversion, and all have been associated with chronic inflammation...
Objectives. Anecdotal reports of increased libido and sexual function in patients taking trazodone have led to its empirical use in patients with erectile dysfunction. A retrospective review of patient-reported responses to trazodone was performed to outline the efficacy and side-effect profile of this agent.Methods. Between 1989 and 1994, 182 patients were placed on oral trazodone as empirical...
Objectives. To determine the relationship between endogenous total serum testosterone levels and serum prostate-specific antigen (PSA) concentrations. If a correlation exists between these two parameters, then use of testosterone-specific reference ranges may enhance the utility of PSA as a marker for prostate cancer.Methods. Data were obtained from 150 men without previous history of prostate...
Closure of renal parenchymal defects created by partial nephrectomy can be difficult. We describe a method of using exogenous material to bolster the strength of the parenchymal closure. The horizontal mattress sutures closing the renal parenchyma are less likely to tear through the parenchyma as the result of the application of a more uniform tension across a broad front. This technique is particularly...
Objectives. To determine if the serum testosterone (T) concentration influences the ability of prostate-specific antigen (PSA) to predict prostate cancer volume and stage.Methods. One hundred consecutive patients with clinically localized prostate cancer who underwent radical prostatectomy were examined prospectively. Each patient was evaluated preoperatively with a serum PSA, total T, free T,...
A patient with an ectopic, pelvic kidney with congenital ureteropelvic junction obstruction was treated by retrograde, ureteroscopic endopyelotomy without percutaneous access. Preoperative ureteral stent placement and angiography facilitated the procedure. The patient had an uneventful recovery with improved drainage from the involved collecting system demonstrated by renal scintigraphy 6 months...
Objectives. Although balloon dilation is a successful and widely accepted minimally invasive method of treating vascular, esophageal, and colonic strictures, it has not been reported in the management of ureteropelvic junction (UPJ) obstruction in infants. We investigated the role of retrograde balloon dilation as the primary treatment of UPJ obstruction in infants, and we report the technique and...
Objectives. The role of the bulbocavernosus (BC) and ischiocavernosus (IC) muscles in erection and ejaculation was studied.Methods. The response of the urethral and intracorporeal pressure to cavernosus muscle stimulation was evaluated in 18 male volunteers (mean age, 36.6 years). A two-channel microtip catheter was placed in the prostatic and bulbous urethra. Muscle stimulation was done by two...
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