Twenty-eight patients with lower urinary tract injuries were reviewed at Hôtel-Dieu de Montréal. Eighteen involved the urethra and ten involved the bladder. Pelvic rami fractures are the main cause of bladder rupture, including almost all cases of extraperitoneal bladder rupture. Pelvic fractures are also the main cause of posterior and bulbo-menbranous urethra rupture. Endoscopy and indwelling catheter insertions follow in importance. Rupture of the bladder can be either extraperitoneal (80%) or intraperitoneal (20%). Ruptures of the urethra involve mainly the posterior and bulbo-membranous segments of the urethra. Post-traumatic strictures nevertheless affect the anterior segment more commonly. In all suspected cases of injury involving the lower urinary tract, retrograde urethrography should be done first, followed by retrograde cystography if indicated. A good knowledge of the relationship of the anatomic compartments is essential to the assessment of communicating injury.

Female↗

PubMedDate not supplied

[Mammography].

Mammography is the most important method for the diagnosis and the screening of breast diseases. Sensitivity and accuracy of mammography are very high in the detection of breast cancer. The use of the stereotaxic localization and fine-needle aspiration of nonpalpable breast lesions improve its effectiveness. The American Breast Cancer Detection Demonstration Project (BCDDP) has demonstrated the benefits of breast screening for women over 40 years of age. Many American medical associations and societies have adopted the guidelines based on the BCDDP results, promoting breast cancer screening for these women. However, recently released results of some randomized breast screening studies demonstrated only a 5% reduction in mortality from breast cancer in women 40-49 years of age, and a 40% reduction for women aged over 50 years. There is no explanation for this dilemma at the present time. However, screening mammography should stay available for women over 40 years of age.

Adult↗