Epididymo-orchitis: a retrospective study of 121 patients.

One hundred twenty-one patients with acute epididymitis or epididymo-orchitis were evaluated retrospectively according to their clinical symptoms, duration of symptoms, physical examination, and laboratory studies. The patients younger than 30 years of age usually showed less severity of symptoms than the patients older than 50 years of age. The latter often demonstrated evidence of outflow obstruction. Eighty-two percent of patients with demonstrated urographic abnormalities had lower tract abnormalities, mainly secondary to outflow obstruction. All of these patients were older than 50 years of age. An intravenous pyelogram is indicated only in patients over 50 years of age and in young adults with positive bacteriologic urine culture.

Incidental extraction of double pigtail catheter during nephrostomy removal.

An unusual complication of nephrostomy removal is presented. A double pigtail catheter was trapped by the nephrostomy tube and accidentally extracted. Suggestions for preventing this complication are presented.

Method for securing a single-lumen urethral catheter in the female.

When a single-lumen urethral catheter (catheter coudé) is applied for bladder catheterization in the female, secure fixation of such a catheter may present a problem. A simple method for fixation of a single-lumen urethral catheter in the female is described.

Nephrogenic adenoma: benign proliferative lesion of urothelium.

Three new cases of a rare benign proliferative lesion of the urothelium (nephrogenic adenoma) are hereby added to the existent 58 reported cases. All 3 lesions occurred in the bladder. Two of the 3 cases presented with a history of surgical interventions on the bladder, and the third patient had a history of chronic cystitis and pyelonephritis, and was on chronic dialysis. Diagnosis was made on histologic examination of cystoscopic biopsy of the lesions. Transurethral resection and/or fulguration was the treatment of choice. There was no recurrence of the lesions on follow-up cystoscopic examination.

Urologic complications after surgery on lumbosacral spine.

Forty-five of 74 patients (60%) postsurgery for disk disease showed findings of neurogenic bladders. Sixty-nine of these patients had no complaints before surgery and presented with complaints only after surgery. We believe this is a high surgical morbidity, and all patients should have a presurgical urodynamic diagnostic evaluation to aid in selection of patients in whom surgery will be most helpful and to establish a presurgical baseline for further postsurgical urodynamic comparison.

Conservative approach in treating acute renal carbuncle.

During the years 1980-82 seven patients with renal carbuncles successfully underwent conservative treatment with antibiotics alone. Early diagnosis was made using excretory urography and nephrotomography, ultrasound and computerized tomography scan. Follow-up studies showed a normal kidney in six of the seven patients. One patient had a clinical remission, but ultrasound follow-up showed a small area in the right kidney with a few low-level echoes, representing focal scarring.

Relationship between subjective complaints and urinary flow.

Two hundred six patients were examined with urine flowmetry and residual urine measurements to determine if a relationship exists between pathologic urine flowmetry determinations and specific subjective patient complaints. A statistical correlation exists in men with the complaint of frequency and in women with the complaint of frequency and incontinence. Possible explanation for these findings is discussed.

Oxybutynin Chloride (Ditrophan)--clinical uses and limitations.

Eighteen patients treated with oxybutynin chloride are presented. The effect of the drug on the hyperactive detrusor is shown and discussed. Side effects and limitations are described and related to treatment.

HLA-A and HLA-B antigens in transitional cell carcinoma of the bladder.

A possible association between HLA-A and HLA-B loci alleles and bladder carcinoma has been investigated in 44 patients with biopsy proved transitional cell carcinoma of the bladder. The patients were compared to 400 healthy controls and matched for ethnic origin. Typing was done by the standard National Institutes of Health microlymphocytotoxicity technique. Comparison between the HLA-A and HLA-B series of the patients and the controls, and the different stages of disease did not yield any significant difference.

Bilateral chronic ureteritis associated with Serratia marcescens.

To our knowledge this is the first case of bilateral obstructive uropathy caused by nonspecific chronic ureteritis to be reported. Prior to operation the bilateral involvement was throught to be due to a tuberculous infection or retroperitoneal fibrosis. The diagnostic difficulties were similar to those previously reported in the unilateral involvement. The focus of the infective organism found was Serratia marcescens which originated in the right kindey.

Fungal infections after renal transplantation.

Fungal infections occurred in 3 of 22 renal transplants (13.6%). Two patients developed rhinocerebral phycomycosis, and Rhizopus arrhizus was isolated from cultures of the nasal conchae. Both patients were treated with systemic amphotericin B. Three-and-a-half months after transplantation the third patient developed an acute ureteral obstruction secondary to infection with Aspergillus nidulans; this necessitated removal of the graft. There was no immediate mortality associated with these fungal infections but there was immediate loss of the grafts in the two patients.

The management of urologic complications after kidney transplantation.

Urologic complications occurred in four (20%) of 20 kidney transplants performed in 18 patients. The complications encountered were acute hemorrhage from the distal end of the ureter, a calyceal fistula, a ureteral stricture with associated fungus infection, and obstructive uropathy. In two of the four cases it was necessary to sacrifice the transplant.