Paratesticular multicystic mass of Wolffian, probably paradidymal, origin.

A unilateral multicystic mass in the connective tissue adjacent to the vas deferens in a 46-year-old man is reported. Anatomically, it was distinct from the epididymis and vas and contained no sperm. The epithelial lining was simple, ciliated, and cuboidal to columnar. The cysts were surrounded by connective tissue collars containing smooth muscle. The authors postulate that this lesion represents a cystic hyperplasia of vestigial Wolffian duct remnants, based on its unique histologic features and the exclusion of other plausible explanations. The supraepididymal, paravasal location suggests origin in the paradidymis.

Laser-assisted partial nephrectomy in children.

The authors present three case reports showing the efficacy of laser surgery in performing partial nephrectomies in children who had bilateral Wilms' tumors and duplicated systems with obstructed nonfunctioning upper pole moieties. Using both the KTP laser (for cutting) and the YAG laser (for coagulation of large vessels) allows for fast removal of kidney tissue, with minimal blood loss and minimal loss of renal parenchyma.

TGF-beta mRNA expression in the renal pelvis after experimental and clinical ureteropelvic junction obstruction.

PURPOSE: The renal parenchymal expression of transforming growth factor-beta (TGF-beta) is increased in experimental obstructive uropathy. To better understand the pathophysiology of hydronephrosis, we pursued this observation by determining if the expression of TGF-beta is also increased in the obstructed renal pelvis. MATERIALS AND METHODS: The expression of TGF-beta mRNA was evaluated in experimental and clinical ureteropelvic junction obstruction by reverse transcriptase polymerase chain reaction (RT-PCR). Southern blot analysis with labeled human cDNA probes for TGF-beta was then done to verify the results. RESULTS: Experimentally, pelves subjected to ureteral constriction showed significantly higher TGF-beta mRNA expression than normals. After reversal of obstruction, the expression of TGF-beta remained significantly higher than normals but was not different from pelves with ongoing obstruction. Clinically, there was a significantly higher level of TGF-beta mRNA expression in obstructed pelves than in nonobstructed ureters. High levels of TGF-beta mRNA expression correlated significantly with good clinical outcome, good renal function, muscle hypertrophy and acute onset of obstruction. CONCLUSIONS: There is increased TGF-beta mRNA expression in the renal pelvis following clinical and experimental ureteropelvic junction obstruction. These data implicate TGF-beta in the adaptive molecular responses that increase muscle and collagen elaboration seen in hydronephrosis.

Hypospadias repair using laser welding of ventral skin flap in rabbits: comparison with sutured repair.

We tested the feasibility of laser welding in hypospadias repair. A total of 30 New Zealand white rabbits (2 groups of 15) underwent creation of distal hypospadias. In the control group ventrally placed skin flaps were created and sutured to the urethra. In the experimental group the ventrally placed skin flaps were welded to the urethra using a continuous wave diode laser (808 plus or minus 1 nm., 6.25 watts per cm.2). The welded anastomoses were strengthened by applying a solder of fibrinogen combined with a laser energy-absorbing dye. No stents were left indwelling. Operative time using laser welding was considerably less than that with sutured repair. No fistulas were seen in the welded urethras, and no significant foreign body reaction was identified in the laser welded repairs. Hypospadias repair in the rabbit using the laser welding technique seems to be a feasible alternative to suture repair. Topical energy-absorbing dyes that enhance thermosetting solders further increase weld strength while reducing collateral thermal damage to target tissues.