Acta urologica Belgica最新文献

The effectiveness of a vacuum erection device was evaluated in a 3-year prospective trial involving 110 men with erectile disorders. The patients ranged from 36 to 75 years of age (average: 61). Fifty-seven had chosen the vacuum device as a first treatment attempt; 27 were on intracavernous self-injections with a vasoactive agent but wanted another treatment; and several treatment modalities had failed in the remaining 26 patients. At the 3-month follow-up, the patients were mailed a questionnaire to evaluate the quality of sexual intercourse with the vacuum constriction device. Partner satisfaction was evaluated in parallel. Improvement in sexual parameters as well as difficulties and side effects induced by the device were investigated. Our results confirm the efficacy of the vacuum constriction device in the treatment of erectile dysfunction in selected patients.

The continent urinary diversion is the technique usually used to replace the urinary bladder after total cystectomy The formation of calculi in the pouch is a frequent late complication. We have treated successfully with extra corporeal wave shock lithotripsy (ESWL) two patients who have developed calculi in their pouch two years after realisation of an ileal urinary diversion (Indiana pouch). E.S.W.L. is a good and non invasive technique to cure those calculi with no danger for the continence of the pouch.

We present the first case of a patient with priapism after oral intake of the phenothiazine prothipendylhydrochloride.

A number of minor urological surgical procedures can be readily carried out in children in outpatient clinics with the availability of a good topical local anaesthetic. In boys, the separation of preputial adhesions, frenulotomy, meatoplasty, meatal dilatation following circumcision or meatal surgery, the removal of smegma and excision of penile skin lesions can be performed as outpatient treatment. In girls, hymenal abnormalities, meatal abnormalities and labial adhesions come into consideration for its use. Success is dependent on a good estimation of the mental capacity of the child to undergo a local surgical procedure and correct use of the anaesthetic.

The authors, after reviewing the literature concerning various instruments used for ligating the Santorini's plexus, have reported their experience to control the dorsal venous complex with a Deschamps' needle modified by themselves.

A 63-year old man presented with urinary frequency and urge. An IVU showed a tumour in the lower right ureter. Partial ureterectomy was done with a uretero-ureterostomy. Pathological investigation showed an inverted papilloma. Inverted papilloma of the ureter should always be considered in the differential diagnosis before major surgery is done. There is an association between inverted papilloma and urothelial carcinoma. Our patient developed an invasive bladder tumour 6 years after the operation on the inverted papilloma.

We describe a papillary transitional cell carcinoma with subcutaneous metastases in the cephalic region in a 74-year old male patient who had been suffering from recurrent low grade bladder tumors for 7 years. Subcutaneous metastases from bladder carcinoma occur infrequently, and cephalic localization is even more unusual. The presentation, diagnosis and hospital course is given.

Urinary incontinence following prostate surgery was evaluated in 489 consecutive patients: 216 patients underwent a transurethral resection, 98 patients a transvesical prostatectomy for benign prostatic hyperplasia and 175 patients a radical prostatectomy for localized prostate cancer. In the first group incontinence was present in 19% of the patients immediately after catheter withdrawal, 16% after 1 month, 8% after 3 months, 3% and 2% after 6 and 9 months, 1.5% after 1 year and 0.5% after 15 months. In the second group incontinence was present in 15% immediately after catheter withdrawal, 12% after 1 month, 5% after 3 months, 2% after 6 months and 1% after 9, 12 and 15 months. In the last group the incontinence rate was higher, 66% were incontinent immediately after catheter withdrawal, 53% after 1 month, 33% after 3 months, 12% after 6 months, 8% after 9 months. After 12 and 15 months still 2% had problems with persistent incontinence. These results compare favourably with the results from the literature. The fact that a rehabilitation program was introduced for the patients with post-operative incontinence, may have been a contributing factor.

The surgical treatment of hypospadias continues to inspire urologists to develop new techniques. Views on the physiopathology of hypospadias have changed a great deal over the last ten years. Treatment techniques have also changed over the last ten years. An analysis of current trends in the treatment of hypospadias therefore appears justified.

Sarcomatoid renal cell carcinoma (SRCC) is an uncommon tumor of the renal parenchyma, representing one to five percent of all primary kidney tumors. The major symptoms are the same as in the classic renal cell carcinoma: haematuria and flank pain. The tumor consists of a bimorph feature of clear cells with areas of spindle cells and giant cells, resembling a sarcoma. Immunohistochemistry and electronmicroscopy are often necessary to prove the epithelial origin of these spindle cells. Therapy is essentially surgical but in some cases there can be a benefit of chemotherapy.