Colonic carcinoma at the site of ureterosigmoidostomy: what is the risk?

A case of colonic carcinoma arising 27 years after urinary diversion by ureterosigmoidostomy is reported. This late complication is now well recognized and increasing numbers of cases are being reported. The implications of this patient and the 31 previously reported cases are considered.

Treatment of urethral hemangioma by selective arterial embolization.

Control of significant hematuria by embolization of angiographically demonstrated vascular malformations of the prostatic and membranous urethra is reported in a patient with multiple diffuse superficial hemangiomas.

Ureteric obstruction of solitary kidneys by aneurysms of the iliac artery.

Two rare cases are reported, both known to have solitary kidneys, that had ureteric obstruction caused by iliac artery aneurysms. Iliac aneurysms have a high mortality and may present to the urologist as an uncommon cause of ureteric obstruction. When the ureter of a solitary kidney is obstructed it is recommended that both ureterolysis and a temporary proximal diversion be performed. A common iliac aneurysm should be excised and grafted where possible; an internal iliac aneurysm is best treated by simple ligation or partial excision only.

Penile injuries with particular reference to injury to the erectile tissue.

A retrospective study of 56 patients with penile injuries showed that 28 injuries were sustained during coitus and a further 12 in other sexual practices. Four different types of injury to the erectile mechanism are described and the management of each discussed. A modified phalloplasty technique is described for patients who have sustained a complete loss of the phallus.

Hepatic dysfunction in renal carcinoma.

In a retrospective review of 81 patients with renal carcinoma 34 (42%) had abnormalities of one or more liver function tests. Fifteen patients (18.5%) had abnormalities of 3 or more liver function tests but without evidence of hepatic metastases. There was a significant association between these patients and the presence of fever, anaemia, weight loss and a raised ESR (P less than 0.001) compared with those whose liver function was normal. Following nephrectomy, liver function returned to normal in 5 patients. Median survival in these patients was 35 months, whilst in those whose liver function remained abnormal the median survival was 8 months (P less than 0.01).

Transrectal biopsy of the prostate and bacteraemia.

Bacteraemia and urinary tract infection are well-recognized complications of urological procedures. This paper compares, for the first time, the incidence of bacteraemia after cystoscopy and transrectal biopsy of the prostate with that following cystoscopy alone. The incidence of bacteraemia in those undergoing biopsy was 73 per cent; following cystoscopy alone the incidence was 13 per cent. In view of this high incidence we recommend prophylactic antibiotic cover of transrectal prostatic biopsy.

Ultrasound examination of the scrotum.

The technique of real time ultrasound examination of the scrotum is described. The examination was performed on 120 patients and was found to be a helpful diagnostic aid in scrotal swelling and in the acute painful scrotum. It is recommended as a useful investigation for scrotal abnormalities.

Plasma cell balinitis of Zoon.

Superficial lesions of the glans penis can pose diagnostic difficulties. Plasma cell balanitis is such a condition and it may be confused clinically with erythroplasia of Queyrat. It is unresponsive to topical medication and curable only by circumcision.