ABSTRACT
The therapeutic surgical approach to cystourethrocele and pelvic organ prolapse with or without urinary incontinence usually involves hysterectomy and anterior colporrhaphy. This is associated with a high degree of failure and may cause the appearance of de novo urinary incontinence because of functional disturbances of the lower urinary tract. We report a new combined needle suspension of bladder neck and uterine isthmus to correct uterovaginal prolapse and urinary incontinence without the need for hysterectomy. This endoscopic procedure is minimally invasive, safe, effective and simple. The operative approach is flexible, well tolerated and could be adapted to an outpatient setting. It is designed to restore the functional pelvic anatomy without extensive operative dissection and anterior colporrhaphy.
Subject(s)
Ureterocele/surgery , Urinary Bladder Diseases/surgery , Uterine Prolapse/surgery , Endoscopy , Female , Humans , Hysterectomy , Ureter/surgery , Ureterocele/complications , Urinary Bladder Diseases/complications , Urinary Incontinence/etiology , Uterine Prolapse/complications , Vagina/surgeryABSTRACT
The magnetic resonance (MR) appearance of a case of xanthogranulomatous pyelonephritis is described and compared with CT and surgical findings. Both CT and MR were comparable in displaying the morphology of this uncommon renal abnormality.
Subject(s)
Magnetic Resonance Spectroscopy , Pyelonephritis, Xanthogranulomatous/diagnosis , Female , Humans , Middle AgedABSTRACT
The majority of patients with advanced prostatic cancer respond either to castration or estrogen therapy. In an attempt to identify an alternative hormonal therapy, 25 symptomatic stage D prostate cancer patients were treated with megestrol acetate as initial hormonal therapy. Thirty-three patients were evaluable for response as defined by the National Prostatic Cancer Project criteria. Partial remission was observed in 11 patients and stable disease in 5, with an overall response rate of 70%. The projected median duration of response and survival were 10 and 20 months, respectively. Weight gain was common, but only two patients showed evidence of fluid retention. Gynecomastia, thromboembolic episodes, and gastrointestinal side effects were not observed in this group of patients, though two patients had increased pain shortly after therapy was initiated. Thus, in advanced prostatic cancer, megestrol acetate is effective primary therapy with minimal side effects.
Subject(s)
Megestrol/analogs & derivatives , Prostatic Neoplasms/drug therapy , Aged , Humans , Male , Megestrol/adverse effects , Megestrol/therapeutic use , Megestrol Acetate , Middle Aged , Prognosis , Prostatic Neoplasms/mortalityABSTRACT
We treated a patient who had acute renal failure secondary to obstructive uropathy from metastatic breast carcinoma. Attempts at ureteral catheterization and nephrostomy failed. Bilateral ureteral irradiation was given, followed immediately by chemotherapy, with relief of obstruction and normalization of renal function. Nineteen months later, the patient died; at that time, her serum urea nitrogen and serum creatinine levels were normal.
Subject(s)
Acute Kidney Injury/etiology , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Breast Neoplasms/pathology , Carcinoma, Intraductal, Noninfiltrating/secondary , Ureteral Neoplasms/secondary , Carcinoma, Intraductal, Noninfiltrating/drug therapy , Carcinoma, Intraductal, Noninfiltrating/radiotherapy , Combined Modality Therapy , Female , Humans , Middle Aged , Ureteral Neoplasms/drug therapy , Ureteral Neoplasms/radiotherapy , Ureteral Obstruction/etiologyABSTRACT
Nine previously untreated patients with stage D prostatic carcinoma received megestrol acetate 40 mg orally three times daily. Responses included five partial regressions, two stabilizations, and two progressions. Duration of response ranged from 3+ to 33+ months, with a mean of 11.7 months and a median of 12 months. Three of five patients who had failed prior hormonal therapy remained objectively stable while receiving megestrol acetate. No gastrointestinal toxicity, gynecomastia, fluid retention, or thromboembolic complications were observed during treatment. Weight gain of 5 to 51 pounds occurred in seven of 14 patients.
Subject(s)
Megestrol/therapeutic use , Prostatic Neoplasms/drug therapy , Aged , Humans , Male , Middle Aged , Neoplasm MetastasisABSTRACT
The leukocyte adherence inhibition test was used to evaluate the cellular immune status of 16 patients with a histological diagnosis of transitional cell carcinoma of the bladder. The reactivity of the leukocytes was measured against extracts of transitional cell carcinoma as well as renal cell carcinoma. The leukocytes of age and sex-matched control subjects, as well as patients with urinary tract infection, also were studied. The leukocytes of patients with transitional cell carcinoma were more reactive to extracts of transitional cell carcinoma. These results suggest that a response to tumor-associated antigens is present in transitional cell carcinoma patients.
