[Penile fracture]. / Fraktura na penisa.

The aim of the present review is to summarize the world experience and to analyze the main principles of the current diagnosis and treatment of penile fracture. The fracture of the penis is a rare blunt penile trauma, with an annual frequency of 0.33 to 1.36 per 100,000 inhabitants. Till now, there is less then 2000 cases described in the literature. The etiology varies, but the trauma mainly occurs during coitus. The fracture of the penis is an emergency entity with pathognomonic clinical symptoms. The data from the history and from the physical examination are essential for the correct diagnosis. In obscure and atypical cases some additional methods are used: cavernosography, urethrography, ultrasound, MRI. The immediate surgical treatment gives the only chance for a complete recovery of the patient and guarantees the achievement of good functional results.

[The treatment of bladder tumors with the Nd:YAG laser]. / Lechenie na tumorite na pikochniia mekhur s Nd:YAG lazer.

This is a review of literature dealing with Nd:YAG laser application in the treatment of bladder tumors. The clinical characteristics of the laser, technique of application and the likely complications are described in details. The advantages and shortcomings of the method are also summed up. The updated clinical results are analyzed, and inferences on the effectiveness of Nd:YAG laser photocoagulation are reached, mainly with regard to reduction of the local recurrence rate.

[Endovesical surgery via the suprapubic approach]. / Endovezikalna khirurgiia chrez suprapubichen dostup.

Experience had with suprapubic cystoscopy and endovesical surgery, performed in a series of twenty-two patients presenting various diseases of the bladder--tumors, mainly of the anterior wall, calculi, foreign bodies, bladder neck sclerosis, defective Foley catheter--is shared. As a sole complication a case of penetrating the abdominal cavity without inflicting lesion to the intestine, is described. The suprapubic approach significantly broadens the scope of transurethral surgery, preserves its advantages, and is furthermore free of the shortcomings associated with open operations.

[A case of bilateral kidney tumor combined with staghorn calculi and skin cancer]. / Sluchai na dvustranen tumor na bubreka, suchetan s koralovidna kalkuloza i rak na kozhata.

A rare case of bilateral renal tumor with benign clinical evolution, associated with staghorn calculosis and skin cancer, is reported. Delayed operative treatment was due to difficulties in establishing the diagnosis, controversial results of the sonographic and X-ray examination and lack of cooperation by the patients. The right kidney and regional lymph nodes were removed; metastases were verified on histologic examination of the lymph nodes. After the operation the patient received complex radio-, chemo- and hormonal therapy. Basocellular skin cancer which later developed was cured by contact radiotherapy.

[Granulomatous orchitis]. / Granulomatozen orkhit.

Granulomatous orchitis is a rare inflammatory disease of poorly understood etiology. Its differentiation from testicular tumor is difficult and is resistant to antibiotic therapy. Five cases of this disease are reported. In 3 of them orchiectomy was performed and in 2 the testis was preserved after biopsy specimen examination. Relapses or injury to the contralateral testis were not recorded during the follow-up period. A review of the literature is made and the etiopathogenesis, clinical and therapeutic aspects of this disease are discussed.

[A case of a congenital diverticulum of the urethra combined with calculosis]. / Sluchai na vroden divertikul na uretrata, suchetan s kalkuloza.

A rare case of congenital diverticulum of the urethra of a 14-year-old boy associated with numerous calculi is reported. The clinical symptoms were pain during micturition and dysuria. Physical examination was complemented by instrumental, of which most important for the diagnosis was retrograde urethrography and urethrocystoscopy. Diverticulotomy and suprapubic derivation of urine were made.

[Fracture of the penis]. / Fraktura na penisa.

Fracture of the penis is a rare traumatic lesion with typical clinical symptoms. Six cases treated at the Clinic of Urology in the city of Varna from 1985 through 1989 are presented. Five patients were operated and one patient received conservative treatment. There were no significant complications, except one pseudodiverticulum and one slight deformity of the penis; none of them affected normal sexual activity. A review of the literature is made. Immediate surgical treatment is recommended.

[A method for external and internal fenestration in the surgical treatment of idiopathic hydrocele]. / Metod na vunshna i vutreshna fenestratsiia pri operativnoto lechenie na idiopatichnoto khidrotsele.

A method is described for operative treatment of idiopathic hydrocele, which consists of tunnelling at 01 o'clock by the clock-dial to the right (11 o'clock to the left) with Payr's probe and from cupula to bottom of the space between the hydrocele sac and fascia spermatica interna and trans section of the thus created tunnel pass in the sac. Through the approach created in this way and at 180 degrees from the first incision (at 07 and respectively at 05 o'clock) from within outward a second incision of the sac is performed. The serous surface of the edges of the fenestrated openings is everted with three catgut sutures as a lapel. The method was applied on 7 patients 10 to 86 years of age. In the early postoperative period within an observation period from 3 to 19 months the characteristic and rather common complications in patients operated for hydrocele did not occur (hematocele, chylomas, which are mostly of ex vacuo type because of impaired blood supply and lymph system of the scrotum, abscesses, indurations of the scrotal and testicular tissues, relapses of the hydrocele, etc).