The treatment of ureteral obstruction in Gardner's syndrome: renal autotransplantation.

We report a case of successful renal autotransplantation for the treatment of ureteral obstruction owing to retroperitoneal desmoid tumors in Gardner's syndrome. Our patient has survived 2 years postoperatively and represents to our knowledge the only long-term success recorded.

Multiple primary neoplasms in association with prostate cancer in black and white patients.

The current study follows up the 983 patients who were diagnosed as having prostate cancer at the Columbia-Presbyterian Medical Center in New York City between 1970 and 1979 and of whom 106 (11.5%) developed a multiple primary malignant neoplasm (MPMN) in addition to their prostate cancer by January 1, 1986. Of the 283 black patients, 32 (11.3%) developed an MPMN involving 35 sites excluding prostate. Of the 636 white patients, 74 (11.6%) developed an MPMN in association with their prostate cancer. Comparing observed incidence rates to expected on the basis of SEER incidence data, two malignant tumors, urinary bladder cancer and malignant lymphoma, appeared to occur in excess in the present series of patients. The excess of urinary bladder cancer in our series could be explained by detection bias due to the routine use of cystoscopy. The excess incidence of lymphoma in our series appears significant but its etiology is unexplained.

Common iliac artery-ureteral fistula: case report and literature review.

Arterial-ureteral fistulas are rare complications of iliac artery reconstruction or ureteral manipulation. The diagnosis should be considered in patients with intermittent hematuria who have had ureteral catheterization, arterial bypass, or nephrectomy. The following case demonstrates the difficulty in making the diagnosis preoperatively. A review of the literature and alternative methods of surgical management are described.

Hormone response of benign hyperplastic prostate tissue in organ culture.

Glandular benign prostatic hyperplasia specimens from 10 patients were culutured for 4 days in media containing either insulin alone, insulin plus estradiol, insulin plus testosterone, insulin plus human placental lactogen, insulin plus human placental lactogen plus testosterone, or insulin plus human growth hormone plus testosterone. Growth of the specimens was defined by pulsing 3H-thymidine on day 3, terminating on day 4, and determination of acid-insoluble radioactivity by scintillation counting. The response of each specimen was related to its base line response to insulin media. Six of nine specimens were stimulated 80 per cent or more by insulin plus placental lactogen plus testosterone, but only one of seven was stimulated by insulin plus testosterone. Four of 10 were stimulated by insulin plus estradiol. Histologic and autoradiographic results indicated that all growth occurred in the epithelium.

Urinary fistulas: vaginal repair using a labial fat pad.

A technique is recommended to repair urinary fistulas vaginally using a pedicle of labial fat to separate the urothelial and vaginal layers. The technique was used in 6 patients with vesicovaginal and 4 patients with urethrovaginal fistulas. Anatomic results were successful in all cases and stress incontinence was cured in all patients who had this coexistent condition.

Herpes simplex virus type 2 and cancer of the prostate.

A seroepidemiologic study was performed to determine if there was an association between antibodies to herpes simplex virus type 2 and cancer of the prostate, similar to that reported for herpes simplex virus type 2 and cervical carcinoma. No significant difference in herpes simplex virus type 2 antibodies was seen between patients with cancer of the prostate and those with benign prostatic hypertrophy. Further studies are needed to define the possible role of herpes simplex virus type 2 in the etiology of cancer of the prostate.

Natural history of benign prostatic hypertrophy and acute urinary retention.

Twenty-six patients with prostatism due to benign prostatic hypertrophy were evaluated prospectively every three to six months for three years. Using both subjective and objective criteria significant deterioration was demonstrated. The rate of deterioration appeared independent of prostatic size. In the individual patient progression was variable. More than half of the patients were unchanged or improved after two years. Acute urinary retention appeared independent of the degree of prostatism and therefore unpredictable. The methods can be used to evaluate medical treatments of benign prostatic hypertrophy.