RESUMO
The cause of ureteral ectopia in a single nonduplicated system is probably an abnormally high origin of the ureteral bud on the mesonephric duct. In the male patient with vague and unexplained lower urinary tract symptoms, extravesical ureteral ectopia must be considered, especially in prepubertal males with epididymitis and a solitary kidney. Physical examination, seminal vesiculography with delayed films, and voiding cystourethrogram should provide a diagnosis.
Assuntos
Glândulas Seminais/anormalidades , Ureter/anormalidades , Adolescente , Adulto , Criança , Epididimite/complicações , Humanos , Rim/anormalidades , Masculino , Radiografia , Glândulas Seminais/diagnóstico por imagem , Glândulas Seminais/embriologia , Glândulas Seminais/patologia , Ureter/diagnóstico por imagem , Ureter/embriologiaRESUMO
OBJECTIVES: Traumatic loss of significant lengths of ureter all too often results in nephrectomy when vascularized pedicles of bowel or bladder fail or are not available for substitution. Historically, alloplastic replacement of ureters has failed due to obstruction, bioincompatibility, or graft migration. This study was undertaken to test the performance of ringed expanded polytetrafluoroethylene (PTFE) tube grafts as ureteral replacements in a canine model. METHODS: Eight female dogs underwent partial ureteral replacement with ringed PTFE tube grafts. An involuting anastomosis was used to anchor the graft to the bladder. The dogs were followed with intravenous urograms and Whitaker infusion pressure tests for up to 12 months. RESULTS: Six of 8 animals (75%) had preservation of excellent renal function with normal intravenous urograms and low Whitaker infusion pressures. One animal had mild hydronephrosis with an elevated infusion pressure. One animal died of spontaneous renal rupture secondary to obstruction at the ureteral-graft anastomosis. All other grafts were patent by histologic examination without encrustation or infection. CONCLUSIONS: Although not suggested as first-line therapy after ureteral loss, expanded PTFE may have a use as a prosthetic ureteral replacement in situations where conventional surgical therapies are unsuccessful. This material appears to be biocompatible, and the technique of bladder anastomosis described here prevented migration of the prosthesis.
Assuntos
Politetrafluoretileno , Próteses e Implantes , Ureter/cirurgia , Animais , Cães , Estudos de Avaliação como Assunto , FemininoRESUMO
Renal axis variations occurring in age-grouped populations are described. We discovered a significant difference in renal axis deviations between young and old population groups with a tendency for a more vertical axis as age increases. Possible reasons for these changes are proposed. We suggest that not all renal axis deviations in the elderly population require extensive evaluation.
Assuntos
Rim/diagnóstico por imagem , Adolescente , Adulto , Fatores Etários , Idoso , Feminino , Humanos , Masculino , RadiografiaRESUMO
Complications found in 47 individuals who underwent radical retroperitoneal node dissection were retrospectively analyzed. Our results indicate no mortality and an over-all complication rate of 29.7 per cent. An increased number of complications was noted in those patients who underwent elective appendectomy and in those node dissection above the renal vessels.
Assuntos
Neoplasias dos Genitais Masculinos/cirurgia , Excisão de Linfonodo/efeitos adversos , Complicações Pós-Operatórias , Rabdomiossarcoma/cirurgia , Cordão Espermático/cirurgia , Neoplasias Testiculares/cirurgia , Adolescente , Adulto , Apendicectomia , Humanos , Masculino , Pessoa de Meia-Idade , Espaço Retroperitoneal , Estudos RetrospectivosRESUMO
The preoperative staging procedures used in 45 patients with surgical Stage I and Stage II nonseminomatous germ cell tumors of the testis were analyzed retrospectively. Our results indicate that gallium-67-citrate scan and supraclavicular lymph node biopsy add little information in the routine preoperative evaluation of these patients. Bipedal lymphangiography, in our experience, was no more accurate than excretory urograms in selecting patients with retroperitoneal disease and in addition provides no information regarding the status of the upper urinary tract. Thus, we suggest that physical examination, excretory urography, chest x-ray film, whole lung tomography, serum tumor markers, and liver scan provide sufficient information to proceed with surgical treatment when appropriate.
Assuntos
Neoplasias Embrionárias de Células Germinativas/patologia , Neoplasias Testiculares/patologia , Humanos , Linfonodos/patologia , Linfografia , Masculino , Estadiamento de Neoplasias , Neoplasias Embrionárias de Células Germinativas/diagnóstico , Estudos Retrospectivos , Neoplasias Testiculares/diagnóstico , UrografiaAssuntos
Neoplasias dos Genitais Masculinos/terapia , Rabdomiossarcoma/terapia , Cordão Espermático , Adolescente , Adulto , Castração , Ciclofosfamida/administração & dosagem , Dactinomicina/administração & dosagem , Quimioterapia Combinada , Humanos , Masculino , Dosagem Radioterapêutica , Vincristina/administração & dosagemRESUMO
Primate research has associated vasectomy with accelerated rates of atherogenesis. We have evaluated the effect of vasectomy on serum lipoprotein profiles in healthy men. There was a decrease in high density lipoprotein levels, which was greatest in men with a family history of atherosclerotic disease. With the great number of variables known to affect high density lipoprotein levels further studies are needed to determine if this change can be attributed to the vasectomy.
PIP: The short-term effect of vasectomy on human lipoprotein profiles, a known risk factor for atherosclerosis, was evaluated. The 28 subjects had a single profile measured before vasectomy and 3 months postoperatively. The mean change in high density lipoprotein levels was a decrease of 6.6 mg/dl, which was significant. The mean decrease in cholesterol levels of 22.5 mg/dl was also significant. The decrease in high density lipoprotein levels was noted in 26 of the 28 patients. The 13 patients with a family history of atherosclerotic disease had a mean change in high density lipoprotein levels of -9.3 mg/dl, compared with an average decrease of -4.6 mg/dl among the 15 patients with a negative family history. There was no significant difference in the change in cholesterol levels between the 2 groups. Smoking, obesity, hypertension, diabetes, age, or level of physical activity did not correlate with lipoprotein levels, and there was no association between the change in high density lipoprotein levels and cholesterol or triglyceride levels. Previous primate research has associated vasectomy with accelerated rates of atherogenesis. This is thought to be the 1st study to investigate the influence of vasectomy on lipoprotein profiles in humans. The modest decrease in lipoprotein levels in vasectomized men observed in this study, especially among men with a family history of atherosclerotic disease, raises questions about the longterm safety of vasectomy and calls for futher investigation.
Assuntos
Lipoproteínas HDL/sangue , Vasectomia/efeitos adversos , Arteriosclerose/etiologia , Arteriosclerose/genética , Colesterol/sangue , Humanos , Masculino , Período Pós-Operatório , Risco , Fatores de Tempo , Triglicerídeos/sangueRESUMO
Superficial transitional cell carcinoma of the bladder has a 50 to 70% recurrence rate. Recurrences may be related to tumor cell implantation during transurethral resection which disrupts the glycosaminoglycan layer of the bladder. This study demonstrated decreased tumor formation in murine bladders which were pre-treated with sucralfate, a synthetic glycosaminoglycan, prior to tumor cell instillation. These results suggest a possible role for sucralfate as a glycosaminoglycan supplement.
Assuntos
Carcinoma de Células de Transição/prevenção & controle , Sucralfato/farmacologia , Neoplasias da Bexiga Urinária/prevenção & controle , Animais , Carcinoma de Células de Transição/patologia , Feminino , Camundongos , Camundongos Endogâmicos C3H , Transplante de Neoplasias , Pré-Medicação , Bexiga Urinária/patologia , Neoplasias da Bexiga Urinária/patologiaRESUMO
We report 2 cases of sarcomatous transformation of mixed germ cell tumors of the testis. Both patients received cisplatin-based combination chemotherapy. Embryonal rhabdomyosarcoma, chondrosarcoma and spindle cell sarcoma were the dominant pathological patterns in the metastatic sites. Nongerm cell malignancies in mixed germ cell tumors following chemotherapy may be more common than previously described.
Assuntos
Condrossarcoma/patologia , Rabdomiossarcoma/patologia , Sarcoma/patologia , Teratoma/patologia , Neoplasias Testiculares/patologia , Adulto , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Cisplatino/administração & dosagem , Tecido Conjuntivo/patologia , Humanos , Metástase Linfática , Masculino , Neoplasias do Mediastino/patologia , Mediastino/patologia , Músculos/patologia , Metástase Neoplásica , Neoplasias Retroperitoneais/patologia , Espaço Retroperitoneal/patologia , Teratoma/tratamento farmacológico , Neoplasias Testiculares/tratamento farmacológicoRESUMO
Paratesticular mesotheliomas are uncommon tumors. We report 2 such cases and discuss their clinical and pathological findings.
Assuntos
Neoplasias dos Genitais Masculinos/diagnóstico , Mesotelioma/diagnóstico , Escroto , Adulto , Neoplasias dos Genitais Masculinos/ultraestrutura , Humanos , Masculino , Mesotelioma/ultraestrutura , Microscopia EletrônicaRESUMO
Iliac vein compression syndrome is the phenomenon of nonthrombotic iliac vein obstruction caused by compression of left iliac vein between the right iliac artery and fifth lumbar vertebra. Affected patients usually present with unilateral leg edema. The condition is most often seen in women, in whom it may also be a cause of vulvar varicosities. Presented here is a case of idiopathic iliac vein obstruction associated with an ipsilateral varicocele in a young man. This varicocele was caused by multiple collateral venous channels and was resistant to surgical high ligation. This case illustrates an unusual cause of varicocele formation and an anatomic reason for failure of standard surgical therapy.
Assuntos
Veia Ilíaca , Varicocele/diagnóstico , Doenças Vasculares/diagnóstico , Criança , Constrição Patológica , Diagnóstico Diferencial , Humanos , Masculino , Síndrome , Varicocele/etiologia , Doenças Vasculares/complicaçõesRESUMO
PURPOSE: Information was collected during the first 2 years of an ongoing, prospective, multi-institutional evaluation of the Dura-II penile prosthesis. Evaluation included data on clinical outcomes and a patient satisfaction survey, and will continue for 5 years after implantation for each patient. MATERIALS AND METHODS: To date 196 patients have been evaluated. Surgical data, adverse events and information from satisfaction surveys are reported. RESULTS: At a followup of 13.4 +/- 8.4 months postoperatively, adverse events occurred in 8.2% of the patients, resulting in reoperation in 5.1%. There have been no mechanical failures. Overall satisfaction rates were 85% at 3 months, 83% at 1 year and 91% at 2 years after implantation, and levels of sexual functioning were correspondingly high. A majority of patients assigned high scores to rigidity, concealability, ability to have intercourse and erection size, although satisfaction with erection size ranked lower than the other measures. CONCLUSIONS: The Dura-II penile prosthesis provides a satisfactory result and has an acceptable level of complications associated with its use. Further followup will assess temporal changes in satisfaction rates and sexual functioning for these patients.