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.

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.

Discontinous splenogonadal fusion mimicking testicular tumor.

Full text is available as a scanned copy of the original print version.

Laparoscopic varicocelectomy for infertility. An initial report from Saudi Arabia.

OBJECTIVE: To evaluate laparoscopic varicocelectomy for the treatment of infertility in Saudi males. METHODS: Between January 1992 and July 1994, laparoscopic varicocele repair was performed at Saudi Aramco Dhahran Health Center, in 48 patients, 8 for pain and 40 for infertility. RESULTS: The 8 patients with pain improved postoperatively. As for those with infertility, 63% had an improved sperm count and 66% showed increased sperm motility. Thirty percent had no change in motility or count. CONCLUSION: Laparoscopic varicocelectomy is a simple and safe technique with good results and can be performed as day surgery with early return to normal activity.

Laparoscopy for the impalpable testes. Initial experience of one center.

Twenty three patients with impalpable tests underwent diagnostic laparoscopy in our hospital between 1988 and 1991, in an attempt to evaluate this modality of investigation. Four of them had bilateral undescended, i.e. total of 27 tests, 12 on the right side and 15 on the left. Eight patients were adults, age between 23 and 38, average 30 years, 15 were children, age between 1 and 9, average 5 years. Twenty testes were intraperitoneal (74%), 6 intracanalicular (22.2%) and one absent (3.8%). Thirteen testes were removed and 2 were diagnostic only, the rest had successful orchiopexy. No operative or postoperative morbidity. Laparoscopy was diagnostic in all cases, assisted in planning the surgical procedure in 21 testes and saved one patient the surgical incision. Laparoscopy is a safe procedure, has a definite role in the management of impalpable testes, for diagnosis and planning of surgery. Future prospects of operative laparoscopy needs to be developed and evaluated.

Urine cytology in bladder tumors.

A review of experience with urine cytology in the diagnosis and follow up of bladder cancer at Roswell Park Memorial Institute from 1971 to 1981 is reported. All patients had biopsy-proven transitional cell carcinoma of the bladder. A total of 677 patients underwent 2,877 cytological evaluations. Of these, 317 patients had concomitant cystoscopy, cytologic evaluations and bladder biopsies. A total of 1,091 evaluations were performed in this group. The overall incidence of positive cytology in the presence of biopsy-proven bladder tumor (all grades included) was 74.4%. A linear correlation is present with grade, stage and positive cytology; high-grade tumors and carcinoma-insitu showed 89.9% and 96.9% incidence of positive cytology, respectively. Grade II tumors showed a 64% incidence of positive cytologies. Regarding correlation with the pathological stage, submucosal involvement of the urothelium was associated with a 62% incidence of positive exfoliative urine cytology, while 80% of tumors invading the bladder muscle were found to have a positive cytology.