Extracorporeal shockwave lithotripsy for kidney stone on surgical clip.

We report the successful use of extracorporeal shockwave lithotripsy for the destruction of a renal stone that had formed around a surgical clip. The SWL led to passage of both the stone and the clip.

Report of a multicenter clinical evaluation of the Dura-II penile prosthesis.

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.

Conservative management of rectocutaneous fistula following radical perineal prostatectomy.

Inadvertent rectal injury during radical perineal prostatectomy may sometimes lead to the development of a rectocutaneous fistula. This has traditionally been managed with diverting colostomy until closure of the fistula is assured. We report 3 cases of rectocutaneous fistula following radical perineal prostatectomy, which were managed in a more conservative fashion.

Renal cell carcinoma arising from the free wall of a renal cyst.

We report an unusual case of a 1 cm papillary renal cell carcinoma arising from the outer surface of the free wall of a radiographically simple renal cyst. Most malignancies arising from the wall of a renal cyst are present along the inner surface, usually adjacent to underlying renal parenchyma. While this is a rare occurrence, it does reinforce the need to explore even small solid renal masses.

Rectal injuries during radical perineal prostatectomy.

Objectives: To review a contemporary series of rectal injuries occurring during radical perineal prostatectomy.

Methods: Of 81 patients who underwent radical perineal prostatectomy, 9 (11%) sustained a full-thickness laceration of the anterior rectal wall. All 9 patients had a preoperative bowel preparation, although only 1 received a complete oral lavage regimen.

Transcatheter embolization of large idiopathic renal arteriovenous fistula.

Renal arteriovenous fistulas are unusual lesions with a variety of clinical manifestations. Congenital and acquired forms have been treated successfully with transcatheter embolization for 2 decades. In the case of large aneurysmal lesions the risk of inadvertent pulmonary embolism has traditionally precluded this approach and necessitated open surgery.

Laparoscopic management of incidentally noted omphalomesenteric duct remnant.

An adolescent undergoing laparoscopic varicocele ligation was incidentally found to have a persistent omphalomesenteric duct remnant. The fibrous band coursing between the umbilicus and terminal ileum was resected laparoscopically without difficulty. Remnants of the type presented herein should be removed to prevent subsequent complications.

The long-term risk of development of prostate cancer in patients with benign prostatic hyperplasia: correlation with stage A1 disease.

Although historical data generally attest to a relatively benign course for stage A1 prostate cancer, at least some recent studies suggest that with prolonged followup patients have a significant risk of disease progression. This study was done with the hypothesis that such disease progression is a function of patient age and close, prolonged followup, and not the mere presence of stage A1 disease. A total of 304 patients who underwent transurethral resection of the prostate for histologically confirmed benign prostatic hyperplasia was reviewed, with a minimum followup of 8 years.

Functional characteristics of enterocystoplasty after interruption of the mesenteric blood supply.

Previous studies have suggested that small (5 to 7 cm.) enteral patches used for bladder augmentation could remain viable following ligation of the mesenteric vascular pedicle. We performed subtotal cystectomy and ileocystoplasty in 5 female mongrel dogs using a 25 cm.