[Scintigraphic localization of colonic bleeding].

Background: Endoscopy and, occasionally, X-ray studies are used to discover the focus of a gastrointestinal bleeding.

Material And Methods: We describe a case of severe gastrointestinal bleeding where these methods failed. Scintigraphy after labelling of erythrocytes with 99m technetium was performed in a continuous manner for 60 minutes.

Transurethral ureterocystostomy.

Management of distal ureteric obstruction because of impacted stone, malignancy or scarred orifice using conventional methods may be cumbersome or may fail. Transurethral ureterocystostomy, performed by direct vision using resectoscope and Colling's knife in combination with fluoroscopic X-ray control, has solved the problem in seven patients with stones, two with prostatic cancer and one with scarred orifice. Thus, temporary or permanent transurethral ureterocystostomy can be recommended in selected cases of obstruction of the distal ureter by stone, malignancy or scar.

[Circumcision by the method of Lucas].

Circumcision a.m. Lucas is described and the results are given in 85 boys with a median age of four years (range, 2-14 years).

[Follow-up of patients after splenectomy at a local hospital].

We have studied the records of 79 patients splenectomised between 1965-1995 and questioned the 39 patients still alive regarding pneumococcal immunisation and measures against infections. Fifty percent of patients operated before 1978 had still not been immunised. Twenty-four percent of the patients operated after 1978 were neither immunised at the hospital nor recommended this, and 10% had still not been immunised in 1995.

Percutaneous sclerotherapy of hydronephrosis in a non-functioning kidney.

A 27-year-old woman was admitted with an abdominal mass in the right hypochondrium. Ultrasound, intravenous urography and scintigraphy revealed a giant non-functioning hydronephrosis. Because she refused surgery, a percutaneous aspiration with instillation of doxycycline was performed.

Conventional or Li vasectomy: a questionnaire study.

Objective: To compare pain, discomfort, complications and convalescence during and after vasectomy performed conventionally or using the Li 'no-scalpel' method.

Patients And Methods: Between March 1993 and May 1995, 256 men were vasectomized at two city hospitals in Copenhagen; half of the patients underwent the conventional technique at one hospital and the remaining half the Li method at the other. The two groups were matched for the time at which they underwent surgery and therefore for the duration of follow-up.

[Blood loss during transurethral resection of the prostate].

Measurement of the perioperative blood loss during transurethral resection of the prostate was performed using the modern HemoCue photometer in 100 men. The measurement lasts only 5-10 minutes. The median weight of the removed prostate was 28 grams and the operating time 60 minutes.

[Results of radiotherapy of ureteral obstruction in invasive bladder cancer].

Retrospective evaluation of the records of 574 patients with muscle-invasive bladder cancer revealed 90 patients (16%) with ureteric obstruction; the obstruction was bilateral in 24%. The effect of radiotherapy was assessed in 55 patients with 68 obstructed kidneys. Six patients with eight obstructed kidneys required percutaneous nephrostomy or ureteric catheters in addition to radiotherapy.

[Semirigid and flexible uretero-nephroscopy].

Thirty-seven ureteronephroscopies with the modern ureteroscope were attempted in 30 patients (median age of 60 years) because of radiographic filling defects, tumours, stenoses, stones, broken double "J" stent, unilateral haematuria and surveillance. Only one ureteronephroscopy (3%) could not be performed. The radiographic filling defects represented tumour (ten), stones (three) and a torn-off papilla (one).

Expression and characterization of preproVIP derived peptides in the human male urogenital tract.

Expression of the gene sequence encoding vasoactive intestinal polypeptide (VIP) leads to the synthesis of a 170 amino acid precursor molecule which can be processed to five fragments: preproVIP 22-79, peptide histidine methionine (PHM), or peptide histidine valine (PHV), preproVIP 111-122, VIP and preproVIP 156-170. Using region specific radioimmunoassays and antisera against the functional domains of the VIP precursor in combination with immunocytochemistry and chromatography, the localization, distribution and identity of the preproVIP derived peptides within the human male urogenital tract were investigated. Postmortem as well as fresh tissue specimens were used.

Results of radiotherapy on ureteric obstruction in muscle-invasive bladder cancer.

Objective: To evaluate the effect of radiotherapy on ureteric obstruction due to muscle-invasive bladder cancer.

Patients And Methods: Retrospective evaluation of the records of 574 patients with muscle-invasive bladder cancer revealed 90 patients (16%) with ureteric obstruction; the obstruction was bilateral in 24%. The effect of radiotherapy was assessed in 55 patients with 68 obstructed kidneys.

[Vasectomy using the Li method].

The no-scalpel vasectomy is described and evaluated. Nineteen out of 21 consecutive patients could be operated with this technique. The median operating time was 16 minutes, range 9-50 minutes.

Hormonal treatment of obstructed kidneys in patients with prostatic cancer.

A review of 1288 patients with previously untreated prostatic cancer revealed 209 patients (16%) with ureteric obstruction; the obstruction was bilateral in 36%. The effect of hormonal treatment was assessed in 88 patients with 120 obstructed kidneys: 77 patients had androgen deprivation or hormonal medication alone and 11 patients needed percutaneous nephrostomy or ureteric catheters in addition. Drainage improved in 58% of the kidneys.

[Treatment of superficial bladder tumors with intravesical BCG].

Thirty three patients with carcinoma in situ (CIS) or/and numerous recurrences of superficial bladder tumor were treated with intravesical BCG after transurethral resection. 63% of patients with CIS were free of recurrence after two years, two underwent cystectomy and one died because of progression. Patients with Ta and concomitant CIS responded well to BCG, while the patient with T1 tumor and CIS was free from recurrence for 15 months.

Topical anesthesia with eutetic mixture of local anesthetics cream in vasectomy: 2 randomized trials.

Two paired randomized trials testing topical anesthesia with a eutetic mixture of local anesthetics (EMLA cream*) in vasectomy were performed. In 1 trial EMLA cream was applied on 1 side of the scrotum, while infiltration anesthesia into the skin and subcutaneous tissue with mepivacaine was used on the contralateral side. All but 1 of the 13 patients (p less than 0.

Local anesthesia for extracorporeal shock wave lithotripsy: a study comparing eutetic mixture of local anesthetics cream and lidocaine infiltration.

A study of the anesthetic efficacy of a eutetic mixture of local anesthetics (EMLA cream) versus lidocaine infiltration in extracorporeal shock wave lithotripsy (ESWL) was done. A total of 46 patients had 30 gm. of EMLA cream applied to the skin over the kidney and 45 had subcutaneous infiltration anesthesia with 20 ml.

Ultrasonic diagnosis and transurethral incision of ureterocele with hydronephrosis.

In a 65-year-old woman with right-sided loin pain, ultrasonography revealed a grossly dilated and obstructed right pyelogram due to a 50-mm ureterocele. After transurethral lateral incision of the ureterocele, there was complete recovery without vesicoureteric reflux. Ultrasonography is advantageous in diagnosing acute urinary-tract obstruction, and transurethral incision is useful in the acute treatment of ureterocele.

Continuous intestinal dialysis for uraemia by intermittent oral intake of non-absorbable solutions. An experimental study.

A new approach to intestinal dialysis was investigated in a normal person and in a patient with chronic uraemia and a renal creatinine clearance of 10 ml/min. Both subjects drank 1-1.5 l non-absorbable solutions of polyethylene glycol or mannitol every fourth hour.

Long-term results of carbon dioxide laser treatment of meatal condylomata acuminata.

A group of 74 men who underwent carbon dioxide laser treatment of meatal condylomata were observed for an average of 18 months. The cure rate after 1 treatment of isolated meatal lesions was 78%; the presence of external lesions lowered the rate to 32% and additional external and urethral warts to 25%. Following multiple treatments all but 6 patients were cured; 83% of the recurrences developed within 3 months.

Tetracycline sclerotherapy of hydroceles and epididymal cysts. Long-term results.

Fourty patients with 32 hydroceles and 11 epididymal cysts were treated by aspiration and instillation of tetracycline. After a follow up period of 24-39 months the cure rate was 77%. Most of the early recurrences were the results of chemical inflammation and vanished spontaneously.

[Urethral stricture].

The incidence of urethral stricture has increased since the introduction of gonorrhoea to Europe in the 15th century. Nowadays, transurethral instrumentations and catheterisations are responsible for the majority of the urethral strictures. The mechanism is inflammatory or traumatic lesion of the urethral epithelium causing extravasation of urine and fibrosis.

[EMLA cream (lidocaine/prilocaine) versus infiltration analgesia with carbocaine (mepivacaine) in vasectomy].

The analgesic efficacy of EMLA cream was compared with infiltration with 1% carbocaine in 13 bilateral vasectomies. Twelve patients preferred infiltration analgesia. EMLA analgesia was only effective in the skin, and had to be supplemented as the incision reached subcutaneous tissue.