ABSTRACT
The treatment of infertility caused by retrograde ejaculation has often been ineffective. The unphysiological composition of the urine is the main reason complicating the recovery of motile sperm. We describe a case of retrograde ejaculation caused by a congenital defect of the internal sphinchter muscle of the urinary bladder. In this case, motile sperm were only recovered if the bladder had been filled previously with artificial culture medium (Ham's F-10) supplemented with the patient's own serum. Two pregnancies followed intrauterine insemination with sperm recovered in this way.
Subject(s)
Catheterization , Ejaculation , Fertilization in Vitro , Infertility, Male/therapy , Adult , Blood , Cell Separation , Female , Humans , Infertility, Male/etiology , Infertility, Male/physiopathology , Male , Pregnancy , Spermatozoa , Urinary Bladder/abnormalities , Urine/cytologyABSTRACT
A-22-year-old woman with long-standing rheumatoid arthritis and secondary amyloidosis of the bladder had recurrent profuse macroscopic hematuria. She was treated with intravesical dimethyl sulfoxide instillation every 2 weeks for 1 year. She remained asymptomatic during the treatment and at 6 months. Progressive disappearance of amyloid from the superficial mucosa of the bladder was demonstrated in sequential histological examinations.
Subject(s)
Amyloidosis/drug therapy , Dimethyl Sulfoxide/administration & dosage , Urinary Bladder Diseases/drug therapy , Administration, Intravesical , Adult , Amyloidosis/complications , Amyloidosis/pathology , Dimethyl Sulfoxide/therapeutic use , Female , Hematuria/complications , Humans , Urinary Bladder Diseases/complications , Urinary Bladder Diseases/pathologyABSTRACT
During a period of 13 years, 84 patients underwent total cystectomy for transitional cell carcinoma of the bladder. The corrected 5-year survival rate was 58%. The operative mortality was 5 patients (6%). The 5-year survival rate of 42 patients who were treated by surgery alone was 53%, whereas that of 42 patients who received preoperative radiation of 30-40 Gy was 65%. The prognoses of the patients were dependent on the histological differentiation and the extent of the primary tumour within each treatment group.
Subject(s)
Carcinoma, Transitional Cell/therapy , Cystectomy , Urinary Bladder Neoplasms/therapy , Adult , Aged , Carcinoma, Transitional Cell/mortality , Carcinoma, Transitional Cell/secondary , Combined Modality Therapy , Female , Humans , Male , Middle Aged , Radiotherapy Dosage , Survival Rate , Urinary Bladder Neoplasms/mortalityABSTRACT
Secondary amyloidosis of the bladder is a rare cause of hematuria, with only 10 previous reports. Findings and treatment in 5 patients with histologically verified bladder amyloidosis secondary to long-standing rheumatoid arthritis are presented. All patients were hospitalized for massive hematuria. One patient died before cystoscopy. Clot evacuation and fulguration through a cystoscope stopped the bleeding in 1 patient. In the other 3 patients hemostasis was achieved by cystotomy, bilateral percutaneous nephrostomy and continuous alum irrigation of the bladder, respectively.
Subject(s)
Amyloidosis/etiology , Arthritis, Rheumatoid/complications , Hematuria/etiology , Urinary Bladder Diseases/etiology , Aged , Female , Humans , Male , Middle Aged , Time FactorsABSTRACT
A series of nine patients surgically treated for histologically verified renal angiomyolipoma is presented. Only one patient had extrarenal stigmata of tuberous sclerosis. No evidence of malignancy was found. In three cases a preoperative diagnosis was achieved with computed tomography (CT), use of which is recommended in evaluation of renal tumours. Six angiomyolipomas were solitary and three bilateral. Abdominal or flank pain was present in eight cases and perirenal haemorrhage in four. Solitary tumours were treated with nephrectomy. For bilateral tumour, nephrectomy and conservative renal surgery were used in two cases and bilateral nephrectomy and kidney transplantation were performed in the third case. When adipose tissue containing renal tumour is demonstrated at CT, conservative surgery should be considered.
Subject(s)
Hemangioma/diagnostic imaging , Kidney Neoplasms/diagnostic imaging , Lipoma/diagnostic imaging , Adult , Aged , Female , Hemangioma/pathology , Hemangioma/surgery , Humans , Kidney Neoplasms/pathology , Kidney Neoplasms/surgery , Lipoma/pathology , Lipoma/surgery , Middle Aged , Nephrectomy , Tomography, X-Ray Computed , UltrasonographyABSTRACT
The results of 178 transabdominal and 79 lumbal nephrectomies were compared, based on a consecutive series of patients with renal adenocarcinoma. The corrected 5-year survival rate for patients without distant metastases was 64% for transabdominal and 57% for lumbar nephrectomy. This difference is not statistically significant. The transabdominal approach made possible a more extensive operation in patients with tumours extending to neighbouring organs, but none has survived as long as three years. Duration of surgery, need for blood transfusion and duration of postoperative hospital care were similar. Splenic injury occurred in 9.6% of the patients with transabdominal nephrectomy, but this did not result in additional morbidity or mortality. There were a few other sporadic complications.
