Myelolipoma of the adrenal gland diagnosis and management.

Myelolipoma of the adrenal gland is a rare benign tumor. It is diagnosed incidentally in most cases because of its non-functioning nature, unless it causes symptoms due to its size. It has specific sonographic and computed tomographic features. A case is presented, magnetic resonance findings are reported for the first time and a review of the literature is conducted.

Penile implants in the treatment of organic impotence.

OBJECTIVE: To evaluate the reliability and safety of penile implants in the treatment of organic impotence at the Saudi Aramco - Dhahran Health Center. METHODS: A series of 108 cases of organic impotence that underwent 125 penile implantation procedures between 1988 and 1997 was reviewed. The follow-up period ranged between 6 months and 10 years. The mean age was 57.9 years (range 26-76). The prostheses used were AMS (American Medical System) inflatable (92 cases) and malleable (16 cases). RESULTS: There were no complications in 86 patients, (80%) who had functioning prostheses all through the follow-up period. Revision of the implants was required in 13 patients (14%). The causes of revision were severe infection, intolerable pain from an oversized malleable prosthesis, and dysfunction of the inflatable prostheses. Removal of the implant was necessary in severe infection, intolerable pain, and extrusion of the prosthesis. All 9 patients (8%) had inflatable prostheses and refused a second implant. There was no single mortality among our series. The overall procedure complications involved 26 out of 125 procedures (21%). It was shown that malleable penile prostheses have significantly lower procedure complications than the inflatable ones (p<0.05). CONCLUSION: Penile implants are reliable and safe modality of treatment for organic impotence with acceptable morbidity.

An increased number of replaced embryos counteracts the adverse effect of hydrosalpinges on IVF/ET outcome.

PURPOSE: The relationship between the number of replaced embryos and the outcome of IVF-ET in patients with hydrosalpinges was investigated in a retrospective, nonrandomized study performed at a governmental IVF center. METHODS: One hundred patients undergoing 161 IVF cycles ending in embryo transfer were studied. Previously diagnosed hydrosalpinges were evident on transvaginal sonography in 48 cycles in 26 patients (group I) and not evident in 15 cycles in 10 patients (group II). The control group included 98 cycles in 64 patients with tubal lesions other than hydrosalpinx. Pregnancy and implantation rates were the main outcome measures. RESULTS: Replacement of three or fewer embryos was associated with significantly lower implantation rates in group I compared to controls. Despite the difference in the rank of IVF trial within the same group, significantly lower implantation rates were found when four or fewer embryos were replaced in the control group and not in group I. CONCLUSION: An increased number of replaced embryos counteracts the adverse effect of hydrosalpinges on IVF/ ET outcome.