Benign mesothelioma of the epididymis: case report.
A case of benign mesothelioma of the epididymis, successfully treated with local resection, is reported. Conservative surgery is allowed when malignancy is excluded by frozen section.
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A case of benign mesothelioma of the epididymis, successfully treated with local resection, is reported. Conservative surgery is allowed when malignancy is excluded by frozen section.
Nerve density in the lamina propria from endoscopic and open bladder biopsies is compared in normal and pathologic urinary bladders. A semiquantitative appreciation of nerve density is obtained by counting the fibers in a number of high power fields after S100 staining. Nerve density scoring on endoscopic biopsies is reliable and reproducible and can be applied in the assessment of neurogenic and nonneurogenic bladder disorders.
Recent opinions on the pathology, diagnostic methods and treatment of cystic nephroma are presented. This will be illustrated by a review of 10 patients with known cystic nephroma, operated and followed by our department. There is clear evidence that cystic nephroma is a benign lesion of the kidney, although the existence of two types of lesions has not definitely been excluded. Sonography and computerized tomography are effective methods for the identification of the lesions preoperatively. In doing so a conservative surgical approach is the treatment of choice.
Neuropathological examination of bladder biopsies was done on 14 patients with severe insulin-dependent adult-onset diabetes and compared with the acetylcholinesterase and S100 staining of 38 control specimens. A decrease in acetylcholinesterase activity, due to axonal degeneration was found in all cases. An increase in S100 positivity was found in the majority and is due to Schwann cell proliferation as a regeneration attempt after demyelination or axonal degeneration. When acetylcholinesterase activity decreases and an S100 density increase is found in a patient with diabetes, this combination is highly suggestive of thorough diabetic cystopathy amenable to early symptomatic treatment.
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The case is reported of a 75-year-old man with bullous pemphigoid that was resistant to conventional treatment with prednisone and azathioprine. A hypernephroma was discovered and surgically excised, whereafter the skin lesions healed completely without any other therapeutic measures being taken.
Cysts of the seminal vesicles are rare, and associated anomalies of the ipsilateral kidney are frequent. We report a case of a monolocular cystic mass in the seminal vesicle bed in a young male with recurrent epididymitis, with emphasis on the ultrasonographic and CT features. The embryological background is briefly mentioned.
Multi-resistant nosocomial urinary tract infections occurring in thirty patients with neurogenic bladder dysfunction were treated with ciprofloxacin 100 mg twice daily Early bacteriological eradication was obtained in 48.3%, persistence in 34.5% and superinfection in 17.2%. Recurrence, 30 days after initial eradication occurred in 50% while late eradication was maintained in 35% and reinfection with another germ was noted in 15%. Most recurring and reinfecting germs were still susceptible to ciprofloxacin. The drug was well tolerated. The overall outcome was mainly determined by the vesico-urethral dysfunction itself and by the presence of indwelling bladder catheters.
Ureterosciatic herniation is probably not as uncommon as a literature review would suggest. It rarely produces symptoms and is usually an incidental finding on urogram. The posterior position of the ureter passing beyond the medial wall of the bony pelvis is easily detected on intravenous urography with ipsilateral oblique films and can be confirmed tomographically. This ectopic course of the ureter can be depicted clearly on pelvic computed tomograms.
To investigate the feasibility and antitumoral effect of ketoconazole in the treatment of disseminated prostatic cancer, 22 patients with stage D2 disease were treated with 400 mg. ketoconazole orally every 8 hours. Of the 17 patients evaluable for antitumoral effect an initial tumor response of 88 per cent was observed (1 complete and 8 partial responses, and 6 with stable disease) with a mean duration of 15.8 months (range 5 to more than 30 months). Treatment-related side effects were encountered in 21 patients and consisted of asthenia, gastrointestinal complaints, skin reactions and cardiovascular complications. They were judged to be mild in 8 patients, moderate in 5 and severe in 8. Treatment had to be discontinued because of side effects in 7 patients (32 per cent). During treatment with ketoconazole serum testosterone levels decreased rapidly and attained nearly castrate levels at the end of week 3. However, after 1 month a steady increase was noted and the testosterone levels reached low normal ranges after 5 months. No hormonal or biochemical indications of adrenocortical insufficiency were noted. High dose ketoconazole is effective in the treatment of disseminated prostatic cancer. Its use is limited by the side effects and the inability to maintain castrate levels of testosterone.
The efficacy and the safety of bromocriptine 7.5 mg daily were investigated in a double-blind versus placebo trial in 32 patients with troublesome symptoms from benign prostatic hypertrophy. Differences between the treatments in respect of uroflowmetry, residual urine and safety parameters were not statistically significant. Differences in respect of nocturia, daytime frequency and overall efficacy were statistically significant in favour of bromocriptine. There could be a place for bromocriptine in the palliative treatment of the functional disability caused by benign prostatic hypertrophy when surgery is refused or contraindicated.
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Transureteroureterostomy in 12 consecutive cases is reviewed. Our technique of the operation (with retroperitoneal approach) is described. Stenosis of the recipient ureter or other complications did not develop in any of our cases. Based on our experience we continue to regard this procedure as an excellent means of urinary diversion for patients with unilateral lower ureteral lesions.
Twenty-eight patients with primary ureteral neoplasms of which 7 of a benign type were reviewed retrospectively. Sixteen of these patients underwent segmental resection, with a 2-year survival of 81% and with no ureteral recurrence. Eleven other patients underwent a complete nephroureterectomy with bladder cuff excision with a subsequent 2-year survival of 63.6%. We believe that segmental resection is indicated in all low-grade and low-stage lesions and with a small chance of recurrence.
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A total of 15 patients with proved chronic bacterial prostatitis underwent bilateral seminal vesiculography to determine the morphological appearance of the seminal vesicles and the ampulla ducti deferentis in this condition. A pathological condition, such as segmental stenosis or complete shriveling of the seminal vesicles, was obvious in 21 of 24 vesiculograms (87.5 per cent), while malformations of the ampulla were seen in 7 (29.1 per cent). The role of chronic bacterial prostatitis as an important pathogenetic factor in the history of epididymo-orchitis is discussed.