ABSTRACT
Cancer of the penis is the rarest male genital tract tumour, accounting for only 1% of all cancers in men. It is highly lymphophilic. Complex diagnostic problems are posed by both the primary tumour and lymph nodes. The prognosis depends on the degree of lymphatic spread. This cancer occurs in uncircumcised men with poor personal hygiene. The diagnosis is based on biopsy of all persistent lesions on the glans. In every case, treatment requires complete removal of the prepuce. Small noninvasive cancers can be treated by application of radioactive iridium wire. Inguinal lymph node biopsy is performed on a palpable node. Small cancers with lymph node involvement requires extensive inguinal lymph node dissection. Adjuvant irradiation is only indicated when the tumour has extended beyond the lymph node capsule. Cancer invading the corpora cavernosa has a poor prognosis (T3). It justifies large amputation of the penis with perineal urethrostomy and extensive lymph node dissection in the presence of positive nodes. Advanced cancers with unresectable lymph nodes (inguinal and iliac) and/or metastases (pulmonary) require combination chemotherapy with MTX-cisplatin-bleomycin.
Subject(s)
Penile Neoplasms/history , Brachytherapy/history , History, 20th Century , Humans , Male , Penile Neoplasms/therapyABSTRACT
Based on a personal series of 310 observations, the authors have studied the presenting signs, the etiology, the urinary bacteriology and the localization of the stone in children with urolithiasis. Urinary tract infection is the presenting sign in 55% of the cases, hematuria in 23% and abdominal pain in 20%. Urinary malformation is associated in 26% of cases, whatever the age at diagnosis. The urinary bacteria found in 55% of cases is Proteus. Localization was in the kidney in 228 cases, in the ureter in 71 cases, the bladder in 45 cases and in the urethra in 5 cases.
Subject(s)
Urinary Calculi , Adolescent , Child , Child, Preschool , Female , Hematuria/etiology , Humans , Infant , Male , Urinary Calculi/complications , Urinary Calculi/diagnosis , Urinary Calculi/etiology , Urinary Calculi/microbiology , Urinary Tract/abnormalities , Urinary Tract Infections/etiologyABSTRACT
A total of 16 cases of urethral duplication in boys have been treated over a period of 20 years. Applying the classification described by Innes Williams cases could be divided into: epispadial urethral duplications, hypospadial duplications, spindle urethras, bifid urethras with an accessory preanal branch, and finally collateral duplications. The 16 cases reported were an epispadial double urethra (3 duplicated and 2 bifid) in 5 cases, a hypospadial duplication (4 bifid and 6 blind urethras) in 10 cases, and a bifid urethra with an accessory preanal branch in one case. Not one of the other forms was observed. Treatment of epispadial double urethras consisted mainly of almost total ablation of the supernumerary urethra with freeing of the corpus cavernosum when dorsal incurving developed during erection. The blind forms associated with the hypospadias in hypospadial duplications have no incidence on treatment. In the incomplete forms, treatment is based on four principles: the impossibility of using the superior urethra which extends to the end of the penis, as it is to narrow, implying its opening up to the region facing the hypospadial meatus and the transformation of this incomplete urethral duplication into a single orifice hypospadias; endoscopic resection of the mucosal folds producing a valve effect at the junction between the 2 urethras; the need to straighten an angled penis; and finally the performance of a urethroplasty using the same rules as for surgery of hypospadias. Treatment of bifid urethras with accessory preanal branches depends on the condition of the principal urethra. When this is normal it is sufficient to excise the accessory branch.(ABSTRACT TRUNCATED AT 250 WORDS)
