Nonoperative management of iatrogenic prostatorectal fistula.

Iatrogenic prostatorectal fistula is a rarely seen urologic complication of transurethral resection of the prostate and stricture dilatation with sounds. In the past, such cases have been managed with colostomy diversion of the fecal stream and suprapubic cystostomy diversion of the urinary stream and in most cases operative closure of the fistula. This case illustrates that a more conservative nonoperative approach can lead to successful closure of such a fistula in selected cases.

Urethral urinary extravasation and complications.

Ten cases of urinary extravasation from the male urethra are reviewed. Parameters include etiology, symptoms, diagnosis, treatment, and complications. Prognosis may be predicted by extent of extravasation, associated disease states, and presence of shock.

Non-operative management of severe renal lacerations.

The management of severe renal lacerations produced by blunt trauma requires accurate diagnosis and close followup. All severe renal lacerations cannot be treated expectantly and non-operatively. However, in the stable patient with an accurately defined lesion and no other injury requiring surgical intervention a non-operative approach appears to be acceptable.

Ureteral colic secondary to blood clot in hemophiliac.

Cryoprecipitate therapy replaces necessary clotting factors in a patient with factor VIII deficient hemophilia. In such a patient with hematuria, cryoprecipitate therapy can initiate the formation of a massive blood clot in the urinary collecting system. A case is reported of a factor VIII-deficient hemophiliac in whom ureteral colic and poor function of the right kidney developed because of a blood clot formed shortly after cryoprecipitate therapy.

Posterior urethral valves: current concepts in diagnosis and treatment.

Since 1969 we have treated 10 pediatric cases of posterior urethral valves. Of these patients 5 underwent early upper tract diversion and 5 underwent valve resection and observation. There were no deaths and no patients with permanent urinary diversion.

Renal adenoma -- a misnomer.

Because it is difficult histologically to differentiate between a renal cell carcinoma and a renal adenoma, their differentiation has been based on size. Lesions less than 3 cm. have been called adenomas and those greater than 3 cm.

Self-emasculation: review of the literature, report of a case and outline of the objectives of management.

Self-emasculation is the end result of an unusual psychiatric disorder, which initially requires surgical treatment. Only 51 cases have been reported in the English literature since 1900. No previous attempt to preserve testicular androgen function by reimplantation or grafting has been reported.