Correction of intrinsic penile chordee with a ventral penile graft of fascia lata.

Chordee is an abnormal curvature of the penis detected on erection. Congenital or primary curvature of the penis without hypospadias is, however, rare. There are two kinds of primary curvatures; those associated with a normal corpus spongiosum and those with a hypoplastic spongiosum. Secondary curvatures associated with Peyronie's disease or periurethral fibrosis associated with urethral stricture are more common in adults. Four nonhuman primates had successful correction of artificially induced chordee with a graft of fascia lata.

Lymphatic neovascularization after orchiopexy.

Lymphatic neovascularization after transseptal and ipsilateral orchiopexy was studied in dogs. After the former, massive scrotal and inguinal lymphatic neovasculature developed on the side of the subcutaneous pouch; the lymphatic vessels drained into both right and left superficial inguinal, iliac, and paraaortic lymph nodes. After ipsilateral orchiopexy, neovascularization was confined mainly to the scrotum and inguinal areas of the affected side, although crossing to the opposite inguinal nodes was also seen. In the unoperated animal the lymph of the testicle was partially drained through the lymphatics of the epididymis and vas deferens into the iliac nodes.

Evaluation of the surgical management of Peyronie's disease.

Our experience in the management of patients with Peyronie's disease is reviewed. The cure rate with conservative treatment was insignificant and the results of dermal graft procedures were disappointing. Best results and sexual rehabilitation were achieved in patients treated with a penile prosthesis.

Primary surgical repair of the fractured penis.

Two cases of fracture of the penis occurring during intercourse were treated with immediate surgical exploration and primary repair. Functional recovery was excellent. The pathophysiology, diagnosis, and treatment are reviewed. Although not common, penile fracture is an entity which may be seen and must be recognized in the emergency department.

Renal quantitative scintillation camera studies in the management of myelodysplasia.

The renal quantitative scintillation gamma camera study has been used in the evaluation and management of 95 children with myelodysplasia. This study has been helpful in assessing renal function. The precise information, reproducibility of results, high correlation with excretory urography and a minimal amount of irradiation exposure to the patient make this procedure an ideal technique to evaluate and follow a population that needs continuous monitoring of individual as well as total renal function.

Cerebrospinal fluid pseudocyst after urinary diversion.

The development of an abdominal mass after urinary diversion in a patient with a ventriculoperitoneal shunt should alert the physician to the possibility of a cerebrospinal fluid pseudocyst. Two pediatric cases of cerebrospinal fluid pseudocysts are presented to illustrate this complication. The etiology, diagnosis and management of the pseudocyst are discussed and the literature is reviewed.

Subcutaneous nodules as a manifestation of onchocerciasis. A rare condition in the United States.

Although infection with tissue nematodes is a significant health problem in many parts of the world, such cases are unusual in the continental United States. This report describes a case of Onchocerca volvulus infection, acquired by a 38-year-old female missionary in northern Brazil, that manifested as subcutaneous nodules in the groin and flank two years after the patient's return to the United States. A year previously, a wrong diagnosis of Wuchereria bancrofti was made at biopsy. At that time, treatment with diethylcarbamazine citrate had to be discontinued because of intense pruritus. Examination of a wet saline impression smear of a new biopsy specimen showed the adult worms to have regularly arranged outer annular ridges, which, together with the pruritus after treatment with diethylcarbamazine (a positive Mazzotti test), led to the diagnosis of onchocerciasis. Retreatment with diethylcarbamazine again caused pruritus, but this was tolerated as were subsequent treatments.