Removal of UroLume endoprosthesis: experience of the North American Study Group for detrusor-sphincter dyssynergia application.

Purpose: We present the experience of the North American UroLume Multicenter Study Group with removal of the UroLume endoprosthesis.

Materials And Methods: A total of 160 neurologically impaired patients were enrolled in the North American UroLume Multicenter Study Group for detrusor external sphincter dyssynergia application. Analysis was performed in 2 groups of patients in which the device was removed during insertion and after implantation, respectively.

Long-term followup of the North American multicenter UroLume trial for the treatment of external detrusor-sphincter dyssynergia.

Purpose: We determine the long-term efficacy and safety of the UroLume stent as minimally invasive treatment for external detrusor-sphincter dyssynergia in spinal cord injured men.

Materials And Methods: A total of 160 spinal cord injured men with a mean age plus or minus standard deviation of 36.3 +/- 12.

Multicenter trial in North America of UroLume urinary sphincter prosthesis.

We investigated the effectiveness and associated complications of treatment with an endoluminal urethral sphincter prosthesis in 153 spinal cord injury men (mean age 36 years, range 16 to 74 years) with urodynamically diagnosed detrusor-external sphincter dyssynergia. These patients were prospectively treated with a urethral sphincter stent at 15 centers in North America. Followup ranged from 2 to 33 months.

Effect of bromocriptine in patients with apomorphine-responsive erectile impotence: an open study.

An open pilot study was undertaken to investigate the therapeutic effect of the dopaminergic agent, bromocriptine (BC), in impotent patients who developed an erectile response to the dopamine receptor agonist, apomorphine. Eight out of 17 patients reported improvement in ability to obtain an erection; five of these 8 subjects were able to achieve penetration. The optimum dose of BC was 2.

Complete response of lung metastases caused by prostatic cancer after chronic administration of a gonadotropin-releasing hormone analog, buserelin (HOE 766).

A stage D2 prostate cancer patient with biopsy-proven lung metastases and negative work-up for metastases is discussed. Treatment consisted of hormonal therapy in the form of chronic administration of an analog of gonadotropin-releasing hormone (GnRH-A), Buserelin, with follow-up for 24 months. The complete response of the patient to GnRH-A therapy provides an interesting and unusual case in the understanding of the biological behavior of prostate cancer.

Objective response and disease outcome in 59 patients with stage D2 prostatic cancer treated with either Buserelin or orchiectomy. Disease aggressivity and its association with response and outcome.

A comparative study was done in 59 recently diagnosed Stage D2 prostatic cancer patients treated with either long-term GnRH-A (Buserelin) (N = 42) or with orchiectomy (N = 17) and followed up for three years. The suppressed limits of plasma testosterone and estradiol levels after eight-week follow-up as well as the objective clinical response and disease outcome were found to be similar with either treatment. Hot flushes and loss of libido were noticed in both groups throughout the follow-up period; however, there were no other side effects.

Possible teratogenic effects of artificial insemination by donor.

Three trisomic offspring conceived by artificial insemination by donor (AID) were observed in a population in which a total of about 400 babies were so conceived. To test whether this excess represented a random fluctuation or a real effect of the AID procedure we surveyed, by questionnaire, a group of women who had born children conceived by AID. A significantly higher number of trisomic offspring were found than expected in a population with the observed age distribution.

Ultrasonic dilatation of the uterine cervix: morphologic evaluation of a new device in the sow.

The present study demonstrates that low-power ultrasonic activation of Hegar dilators reduces the mechanical force required for dilatation of the cervix. The acute and possible late effects of an ultrasonic dilator on the cervical mucosa in the sow were evaluated by histologic study and compared to the effects of similar mechanical dilatation. In both groups early effects were mild to moderate edema and vascular congestion of the cervical mucosa.

Changing profiles in vasectomy subjects in the past decade.

Two groups of vasectomy patients were reviewed: 376 men operated upon between 1968 and 1971 and 608 between 1974 and 1978. Average age, length of marriage, and number of living children prior to vasectomy were greater in the first group (P less than 0.01).

Experience with polytetrafluoroethylene grafts in patients on long-term hemodialysis.

Expanded polytetrafluoroethylene (PTFE) is a new material now being used to create subcutaneous arteriovenous anastomoses for vascular access in hemodialysis. The authors have been impressed with the versatility of grafts made from this material and, where failure occurs, the ease with which surgical revision can be carried out. Two cases are described to illustrate the adaptability of this material to reconstruction.

Polytetrafluorethylene (PTFE) grafts for hemodialysis. 18 months' experience.

18 months clinical experience with 6 mm polytetrafluorethylene forearm grafts for hemodialysis access has been described. 35 grafts were implanted, all in patients who had unsuitable vessels for construction of a regular Brescia-Cimino forearm fistula. The overall patency was 71% with mean duration of 10.

Vasectomy: benefits and risks.

Bilateral occlusion of the vas deferens, vasectomy, is progressively becoming the method of choice for couples seeking permanent contraception at a younger age, with smaller families. They are apparently well-informed and view the procedure as a natural step. Vasectomy is an inexpensively performed office procedure that causes minimal disruption of routine and has a high degree of community acceptance.

Canadian clinical trial of antilymphocyte globulin in human cadaver renal transplantation.

A multicentre, randomized clinical trial of antilymphocyte globulin (ALG) was conducted among patients who had undergone cadaver kidney transplantation; follow-up was continued for a minimum of 1 year. Of the 179 patients 92 were given conventional treatment only, while 87 were given in addition ALG (from a standardized, highly immunosuppressive, common pool of equine ALG), 20 mg/kg-d intravenously for 10 days after transplantation. The ALG-treated group had better accumulated graft survival, fewer nephrectomies, better graft function, less than half the number of acute rejection episodes and less prednisone use.

Bilateral nephrectomy for massive pulmonary hemorrhage in Goodpasture's syndrome.

A case of Goodpasture's syndrome is described in which bilateral nephrectomy was undertaken because of massive pulmonary hemorrhage. Similar cases recorded in the literature are reviewed. Various hypotheses to explain the beneficial effects of renal ablation on lung purpura are considered.

An artificial kidney system suitable for multiple simultaneous dialysis.

The standard twin-coil Kolff artificial kidney has been redesigned to a single-pass system employing cold dialysis, bath-heated and recirculated within the coil. With considerably reduced bath requirements, a comparable dialysis is achieved in spite of a lower bath-to-blood urea gradient. Coil pressure is monitored by a simplified high-and-low pressure control system linked to a specially designed roller blood pump.