Expansion of bladder capacity by the use of intact sigmoid. An experimental study and two case reports.

To enlarge bladder capacity after extensive segmental bladder resection, the authors sutered bladder margins to the serosal aspect of intact sigmoid (Heeg's method). Experimental data and two clinical cases have proved this technique to be of practical value.

Original transvesical prostatectomy.

Starting out from a series of theoretical considerations, and checked clinically, the authors describe an original technique for prostatic adenomectomy, being more efficient in limitation of surgical haemorrhage, urinary infection and postoperative hypogastric fistulae. The operative technique and its results in comparison with classic techniques are presented.

The place of echography in percutaneous nephrostomy and nephrostolithotomy.

The advantages and limits of echography in the performance of percutaneous nephrostomy and nephrostolithotomy are described, based on our own cases.

Anterograde urethrotomy, a new method for internal urethrotomy.

The authors elaborated a new device permitting to perform internal urethrotomy for urethral stricture in an anterograde way, even in cases where optical retrograde urethrotomy could not be applied. The new device is similar to a bladder biopsy forceps with a diameter of Ch 5. Its cutting knife is movable. It can be used with Sachse's urethrotome, inserting it in its guide channel with closed knife and passing it through the stricture. By opening the knife, anterograde urethrotomy can be performed. Out of 145 urethrotomies, this method was utilized in only 3 cases.

[Malignant liver hemangiopericytoma ruptured after an abdominal traumatism]. / Hemangiopericitom hepatic malign rupt dupa un traumatism abdominal.

This paper reports a case of malignant liver hemangiopericytoma broken after an abdominal traumatism which revealed that the patient has this disease. This case is interesting because the abdominal traumatism gave us the opportunity of making a precocious diagnosis. The clinical and paraclinical signs of acute abdomen fastened surgery. The paper reviews the medical literature linked to these rare tumors. The paper also describes morphological features typical for these vascular tumors, whose evolution is unpredictable.

[The use of Plastex-type synthetic mesh in the surgery of abdominal wall defects]. / Utilizarea plasei sintetice tip "Plastex" în chirurgia deficitelor parietale abdominale.

The study analyzes a statistical series of 45 patients suffering from large abdominal wall defects and who were managed by plastic surgery with "Plastex" type synthetic mesh, in the period 1 Jan. 1995-1 Apr. 1998. One of the treatment's basic principles is the preserving of the peritoneal pouch from the hernia sac, which must be fixed on the internal side of the synthetic material that replaces the musculoaponeurotic defect. The authors emphasize the low incidence of complications and the absence of recurrences when they used the "Plastex" type synthetic mesh, very well tolerated by the surrounding tissues. For all these reasons, the authors warmly recommend it for plastic surgery in all incisional hernias, because their coming out shows the poor quality of the local musculoaponeurotic material.

[Technic of transvesical suprapubic adenomectomy for the control of hemorrhage and urinary infection]. / Technik der transvesikalen suprapubischen Adenomektomie zur Beherrschung der Blutung und Harninfektion

The advantages of our method: 1. By omission of the urethral catheter the infection is nearly completely avoided. 2. It guarantees a good haemostasis. 3. It reduces the intraoperative and later complications of adenectomy (infection and anaemia). 4. It facilitates the postoperative treatment. 5. One avoids urethritis and strictures caused by the urethral catheter. 6. It shortens the postoperative period of rest. 7. One economises medicaments (antibiotically, antianaemically). 8. The possible break of the catgut thread at its removal is of no danger, as it is resorbed.

Improved suprapubic vesical drainage in transvesical prostatectomy.

An improved drainage is used in transvesical prostatectomy in order to avoid urinary retention after removal of the Novak-type suprapubic drainage with bladder neck cerclage haemostasis (described by some authors in 1975). The causes of urinary retention are analysed, the drainage technique as well as the mechanisms eliminating the above-mentioned complications are described.

Emergency percutaneous nephrostomy in the septic kidney.

From 250 upper tract obstructive uropathy cases we have studied 64 patients hospitalized with toxico-septic shock. The constant symptom was arterial hypotension. Other 3 patients with long-standing urinary infection due to lithiasis developed this dreaded complication after PNL (staghorn stones-2, pyelic stone-1). In complicated obstructive uropathy cases associated with toxico-septic shock, percutaneous nephrostomy for high urinary derivation in emergency is usually made under local anaesthesia. Its aim is rapid and efficient clearance of kidney obstruction, with minimal damage for the patient; then it is followed by strong antibiotherapy associated with other reanimation and intensive care measures. There were 11 deaths. The stone generating obstructive uropathy was removed subsequently, after the improvement of biological constants and general state of the patient, under the protection of percutaneous nephrostomy.