摘要:

Three methods for surgical repair of membranous and bulbomembranous strictures of either complete or incomplete varieties are described, all of them applied by the author through an anterior approach. The entrance into the patient’s perineum is carried out by following the ‘path’ of the bulbous urethra rather than by following the rectal wall as is customary in performing perineal prostatectomy. The type of operation is chosen according to the severity of the trauma sustained and the amount of fibrous tissue accompanying healing of the lacerated membranous urethra. A new technique for repair of the marsupialized urethra, that is for performing the second stage of Turner-Warwick’s, Guy Leadbetter’s, and Well’s operation, is presented in

ISSN:0042-1138    

DOI:10.1159/000279769

出版商:S. Karger AG    

年代:1972

数据来源: Karger

摘要:

Surgical repair of strictures of the membranous urethra by the posterior approach (i.e., with the patient in the reverse lithotomy position) is described. The author uses this technique for those cases in which a long urethral segment is to be excised, with repair of the defect by the Wells method. This type of repair is reesrved for very difficult cases, such as those following failure of other methods (Solovov-Badenoch operation or the Kishev diaphragm excision operation). The author’s ‘thumb’ urethroplasty procedure, ordinarily used for repair of stricture of the penile or bulbous urethra, can also be employed using this approach, but only for repair of so-called bulbomembranous stric

ISSN:0042-1138    

DOI:10.1159/000279770

出版商:S. Karger AG    

年代:1972

数据来源: Karger

摘要:

3H-Thymidinautoradiographic studies were carried out on the hyperplastic and metaplastic changes of urinary tract epithelium in the human bladder and after their experimental induction in the rat bladder. The following findings were established: 1. Considerably increased cellular proliferation is recognized in hyperplastic changes. 2. Following foreign body irritation of the animal bladder, hyperregeneration remains limited to the basal cell layers. 3. Study of biopsied human urinary tract epithelium from patients with chronic inflammatory and proliferative mucous membrane changes demonstrated, in some of the cases, a loss of physiologic growth-regulation (as seen in dividing cells in the intermediate and superficial cellular layers outside the regeneration-zone), as may be established experimentally in the early stages of the cancerous process. The significance of these findings for the early comprehension of the malignant potency of facultative precancerous states of the urinary bladder is discussed.

ISSN:0042-1138    

DOI:10.1159/000279771

出版商:S. Karger AG    

年代:1972

数据来源: Karger

摘要:

We report about 6 patients with retroperitoneal fibrosis and ureteral obstruction, who were treated for migraine headaches by an average dose of 3 mg per day of methysergide for 3 years. After methysergide therapy was discontinued, the dilated upper urinary system became normal in 2 patients. Because of marked pyeloureteral dilation, which was combined with renal insufficiency in 3 cases, ureterolysis and intraperitoneal or lateral displacement was done in 4 patients. After an average observation period of 21 months, the urianry system and kidney function are normal in all 6 patients. The etiology of methysergide-induced RPF, and preventive measures during employment of this drug, are discussed.

ISSN:0042-1138    

DOI:10.1159/000279772

出版商:S. Karger AG    

年代:1972

数据来源: Karger

摘要:

(1) The authors have reported the results of intermittent catheterisation in 42 paraplegics and tetraplegics who were hospitalized in the Centre during the acute stage of their injury, i.e., within the first 2 months. 26 of these patients were admitted within a fortnight after their injury and among them 10 within the very first hours. (2) The authors have shown that with catheterised urine a bacterial count of 104 per ml is closest to the clinical standard of sterile urine. (3) 41 of 42 patients (98%) were discharged catheter-free, with a balanced bladder function. In this study 7 of 8 patients (88%) left the Centre with sterile urine. (4) If we take into account the single daily catheterisation which is needed at the end of most bladder rehabilitation cases, the average period of time for achieving a balanced bladder function was 80 days. (5) During the period of intermittent catheterisation in the same patient, infection rate was 16 of 100 days. After discontinuing catheterisations the probability of re-infection in a patient with sterile urine remained within the same limits. (6) 23% of the patients who entered the centre with sterile urine remained sterile throughout the period of intermittent catheterisation. (7) In 10 of the 12 patients who were admitted with infected urine, myelopathy was older than 3 weeks. This underlines the importance of sending a patient with an acute spinal cord injury as quickly as possible to a specialized centre. (8) Patients who were admitted with an indwelling catheter and with infected urine became sterile after an average period of 10 days of intermittent catheterisation associated with a general and local antibiotic treatment. (9) 1 of 3 patients who left the Centre with a balanced bladder function and with sterile urine was found to be infected at the next check-up. This shows that it is necessary for any rehabilitated patient who has left the Centre to have a periodic bacteriological urinary control. (10) The authors have shown that when intermittent catheterisations are done by well-trained and competent nurses, the results are as good as when they are performed by physicians.

ISSN:0042-1138    

DOI:10.1159/000279773

出版商:S. Karger AG    

年代:1972

数据来源: Karger

摘要:

Two cases of primary malignant melanoma of the penis are described, bringing the total number of cases reported in the literature to 36. The clinico-pathological aspects of this lesion have been discussed and the literature has been reviewed. Both patients presented with lesions involving the glans penis. The duration of symptoms was 2 and 3 months, respectively. Both patients were treated by total amputation of the penis and by dissection of the inguinal lymph nodes. Metastatic deposits were present in the inguinal lymph nodes in both cases. One patient died 6 months after presentation with local recurrence and evidence of distant metastases, while the other is alive and well 13 months after leaving hospital. Malignant melanoma of the penis usually occurs between the age of 50 and 80 years. The duration of symptoms, as well as the behaviour of the lesion, are variable. The most common presenting symptom is the presence of a dark nodule on the glans, which is enlarging and ulcerating. Histologically the lesion shows typical appearances of pigmented malignant melanoma. Spread of the tumour occurs via the lymphatics to the inguinal lymph nodes, and often occurs early in the course of the disease. Haematogenous spread to distant organs tends to occur later. The recommended treatment is surgical, governed by the site and extent of the lesion. Patients who do not have metastases at the time of presentation appear to have better prognosis, although the behaviour of the lesion may be unpredictable. The prognosis on the whole is not good, but may be improved by earlier diagnosis and adequate treatment.

ISSN:0042-1138    

DOI:10.1159/000279774

出版商:S. Karger AG    

年代:1972

数据来源: Karger