Fibroepithelial polyps of the ureter. Etiology, diagnosis, treatment and pathology.

In order to draw attention to this rather rare condition affecting all age groups, 4 cases of fibroepithelial polyps of the ureter are reported. Conservative surgery is mandatory after adequate preoperative work-up. The pathological findings, incidence and diagnostic and therapeutic modalities are discussed and some etiological factors proposed.

Clinical evaluation of 99mTc-DMSA renogram.

Two hundred-two 99mTc-DMSA renograms for urologic problems were evaluated. Some technical aspects of the examination and the value of the scintigraphic depth estimation are discussed. Pre- and postoperative uptake values in patients with renal surgery and sequential postoperative examinations are considered. The value of DMSA renograms in predicting recovery in obstructive uropathy and in deciding to opt for conservative therapy or nephrectomy is discussed.

A review of 357 bilateral vasectomies for male sterilization.

A series of 357 bilateral vasectomies for male sterilization performed over a period of 18 months was reviewed to assess the safety of the surgical procedure, the onset of sterility, and the acceptability of the procedure. The surgical procedure proved to be safe with few complications, the patients became sterile after approximately 82 days, and the acceptability was very good. A group of 34 patients (10.8%) had a delay in the onset of aspermia. This is discussed in relation to the findings of other investigators.

PIP: A series of 357 bilateral vasectomies for male sterilization performed over a period of 18 months was reviewed to assess the safety of the surgical procedure, the onset of sterility, and the acceptability of the procedure. Before the procedure a preoperative interview of the applicant and his wife was done. 315 of the patients were suitable for follow-up. One group of men produced negative semen samples within 180 days and the second delivered the sample only after 180 days. The operation proved to be very safe with minor complications in less than 1% and epididymitis in 1.5%., hematoma in 0.2%, and scrotal abscesses in 0.4%. Psychosexually, all patients were satisfied with the procedure and would recommend it to friends. 281 patients, or 89.2% became sterile within a reasonable period of about 82 days and most resumed sexual intercourse 2-14 days after the intervention with a frequency of 2-3 times per week. No patients presented any symptoms of spermatic granuloma.

[Ileo-ureteral reflux after urinary diversion through an ileal conduit]. / Ileo-ureteraler Reflux nach Harnableitung durch ein Ileum-Conduit.

The authors made a comparative study (intravenous urography, loopography and loopomanometry) between patients with inverted antireflux anastomosis, as proposed by Melchior, and 12 patients with classical uretero-ileostomy (Bricker bladder). Inverting the anastomosis results in greater incidence of obstruction, while less complications were seen using the classical technique. The importance of reflux in ileal loops and the validity of the classical and manometry loopogram is discussed. Antireflux procedure is only indicated in cases with dilated ureters.

Urinary carcinoembryogenic antigen (CEA) in the diagnosis and follow-up of bladder carcinoma.

The level of urinary carcinoembryogenic antigen (CEA) was evaluated in the diagnosis and follow-up of urothelial carcinoma of the bladder. Urinary CEA concentration, cystoscopic findings and the histopathology of an eventually resected bladder tumour were correlated in 177 cases. The sensitivity proved to be 34%, the specificity 82%. Possible correlations with sex, infection, primary tumour or recurrence, differentiation and invasion of an eventually resected tumour and influence of adjuvant therapy were also evaluated. A comparison was made with the results of other authors and different factors which may influence urinary CEA levels are discussed.

Hemospermia owing to utricular cyst: embryological summary and surgical review.

We report the first case of hemospermia owing to a utricular cyst. The embryologic distinction between utricular cysts, which are of endodermal origin, and müllerian duct cysts, which are of mesodermal origin, is described. The surgical management of utricular and müllerian duct cysts is reviewed, stressing the difficulty and hazards of attempts at complete excision and the efficacy of less heroic surgical procedures.

Is the intrinsic bladder pressure a reliable parameter?

Simultaneous pressure recording in different organs shows that voluntary movements as straining, Valsalva maneuver, cough, are easy recognizable. Spontaneous pressure waves in the rectum may give the impression of uninhibited bladder contractions if subtracted from the total bladder pressure.

Electromyography of the perineal striated muscles during cystometry.

The electromyographic patterns of the external urethral sphincter, the anal sphincter, and the levator ani during cystometries have been analyzed. Synchronized activity changes occur during abdominal straining. Muscle fatigue is very pronounced. Activity may be less synchronized during bladder filling and micturition, even in normal cystometries. In neurogenic diseases, true dyssynergia between the striated muscles may be observed.