Use of electrocoagulation in the treatment of vesicovaginal fistulas.

The role of electrocoagulation for the treatment of vesicovaginal fistulas has not been clearly defined. To determine the use of this therapeutic modality, 15 cases of fistulas treated with electrocoagulation were retrospectively reviewed. Fulguration represented the primary treatment in 12 patients and the secondary treatment in 3 after an initial attempt at open surgical closure failed.

Transmission of nonA/nonB hepatitis during coagulation pyelolithotomy.

The use of coagulum for renal stone surgery is an important yet less frequently used tool in the urological armamentarium. We report the first documented case of transmission of viral hepatitis during coagulum pyelolithotomy. We review the basic tenets of its use, with a brief discussion of the blood-borne transmission of viral particles and risk of hepatic injury with volatile anesthetic agents, and propose the continued safe use of coagulum by autologous donation of cryoprecipitate.

A comparison of endoscopic suspension of the vesical neck with suprapubic vesicourethropexy for treatment of stress urinary incontinence.

To compare the efficacy of the Stamey endoscopic vesical neck suspension with the Marshall-Marchetti-Krantz vesicourethropexy in the correction of stress urinary incontinence, we studied retrospectively 127 consecutive patients who underwent either procedure during a defined interval at our institution. Of 95 women for whom adequate data were available 41 (group 1) underwent the Stamey and 54 (group 2) underwent the Marshall-Marchetti-Krantz procedures. Characteristics of the 2 groups were similar.

Clear cell adenocarcinoma of the urethra.

We report the eighth case of clear cell adenocarcinoma of the female urethra. The histology and management are discussed.

Long-term survivor of prostatic carcinoma with lung metastases.

A patient with stage D2 carcinoma of the prostate is presented with biopsy-proved pulmonary metastases. Treatment consisted of hormonal therapy in the form of orchiectomy and ethinyl estradiol and he is alive 14 years later without evidence of disease. The pulmonary manifestations of prostatic carcinoma are discussed as well as the prognostic implications.

Review of experience with vesicovaginal fistula repair.

Experience with suprapubic closure of vesicovaginal fistulas in 42 patients considered candidates for this procedure is reviewed. Five patients required a second operation for cure and the reasons for failure are discussed. Wide exposure with tension-free closure of well vascularized flaps and the judicious interposition of pedicled omentum have produced the most encouraging results.

Review of experience with vesicovaginal fistula repair.

Experience with suprapubic closure of vesicovaginal fistulas in 42 patients considered candidates for this procedure is reviewed. Five patients required a second operation for cure and the reasons for failure are discussed. Wide exposure with tension-free closure of well vascularized flaps and the judicious interposition of pedicled omentum have produced the most encouraging results.

Transurethral external sphincterotomy and its effect on potency.

A series of 43 male patients who underwent external sphincterotomy because of vesicosphincteric dysfunction is reviewed. There were 6 patients who subsequently noticed absence or a marked decrease in erectile ability. Various factors are considered that might have affected potency, and the theoretical reasons for this occurrence and subsequent recovery are discussed.

Silent hydronephrosis, a hazard revisited.

Six patients with neurogenic bladder secondary to spinal cord injury were seen in our Centre for routine follow-up. All of these individuals had attained the catheter-free state by various means and were, by their standards, functioning very well. They had gone from 6 months to 2 1/2 years without genito-urinary re-evaluations.

Metastases to the eye from transitional cell carcinoma of the bladder.

Two patients with eye metastases from widely disseminated transitional cell carcinoma of the bladder are described. Factors relating to patient survival and the rate of metastases of transitional cell malignancies are discussed.

The use of tetrazolium to determine hydronephrotic damage in human kidneys.

A study detailing an assay for evaluating hydronephrotic damage is presented. We used nitroblue tetrazolium, which is reduced by intact renal tissue. When marked hydronephrotic damage has occurred little evidence of tetrazolium reducing activity is present.