[Urologic complications in pelvic injuries]. / Urologické komplikace úrazu pánve.

OBJECTIVE: Urological complications of pelvic fractures include in particular rupture of the urinary bladder (RUB), injury of the posterior urethra (IPU) and erectile dysfunction (ED). The authors present their own group of patients and in particular the diagnostic and therapeutic algorithm in IPU. MATERIAL AND METHODS: In the Plzen Faculty Hospital in 1/1998 to 8/2002 a total of 19 patients were treated with serious urological complications of pelvic fractures--9x RUB, 11x IPU (once with RUB). RUB was in one instance intraperitoneal, in the remainder extraperitoneal. RESULTS: IPU was without dislocation 6x, with dislocation 5x. Primary "realignment" of the urethra was made in 6 patients (in dislocations and in concurrent rupture of the bladder). In the remaining 5 an epicystostomy was established. In 4 after an interval of 3 months a posterior resection urethroplasty was made because of a distraction defect. One patient with a distraction defect was referred to the urological department of the catchment area and in another patient after-treatment is planned. Severe ED developed in 6 IPU of 10, always in dislocations of the urethra. In one patient we lack information on erections. CONCLUSION: When IPU is suspected (urethrorhagia), dislocation of the prostate on examination p.r.) ascendent urethrography and IVU are essential. Do not catheterize before completed examination. Then needle epicystostomy is performed, in major dislocations of the urinary bladder or in associated injuries primary "realignment" of the urethra open on a catheter or endoscopically. In distraction defects after 12 weeks a posterior resection plastic operation follows.

[Rhinogenous phlegmons of the orbit]. / Rínogenné flegmóny orbity.

During the past 15 years we treated at the ENT department and ophthalmological department of the hospital with policlinic type III in Nitra 10 patients with orbital phlegmons or an abscess of the eyelid after an eye injury treated and cured by antibiotic treatment and external drainage. Twelve patients had a rhinogenic phlegmon or abscess in the orbit (one patient had a dentogenic aetiology of the inflammation). This group of 12 patients were treated in addition to antibiotics in different combinations also surgically (in one case also by drainage of the abscess from a lateral quadrant of the orbit). In five instances the authors found in addition to the phlegmon of the periorbital tissue also an abscess in the depth of the orbit and six times an abscess of the eyelid. Despite the radical approach to the inflammation of the paranasal sinuses and inflammation of the orbit, two patients developed blindness of the damaged eye and one patient died from rhinogenic suppurative meningitis.

[Myringoplasty]. / Poznámky k myringoplastikám.

In the course of eight years the authors made several types of myringoplasties. In 97% a fascial graft was used with a premyringeal or retromyringeal approach. In small central perforations stepp plasty proved useful, in major defects a combination of stepp plasty and placement of the graft beneath the tympanomeatal lobe or beneath the skin of the auditory meatus resp. Anatomical healing was achieved in a total of 90%. Eight per cent of the patients were re-operated with satisfactory results. After simple myringoplasties the auditory gain was 15-20 dB in 90%, after reconstruction of the entire conduction system hearing improved markedly in 64%. Hearing did not deteriorate after operation in any of the patients.