[Ureteral risk during prostatectomies].
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Biomedical subjects
Publications and source records attributed to I Rovinescu.
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Appendico vesical fistula is an uncommon clinical entity which concerns not only the general and urological surgeons but also the general practitioner. It develops as a complication of untreated appendicitis and may go unrecognized for many years. The chief clinical feature is recurrent episodes of acute cystitis. It may occur at any age but usually in the younger group. The frequent absence of pneumaturia and fecaluria helps to distinguish it from other variants of entero-vesical fistula. Appendectomy and excision of the fistula are usually followed by complete recovery.
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The patient with more than one primary malignant neoplasm has ceased to be a pathologic curiosity and has instead become a practical problem. It is possible for a patient to have two simultaneous developping independant cancers, but is also possible for a second primary cancer to develop in a cancer prone individual after the initial malignant lesion has been removed by radical surgical procedures. The generally improved survival rate after treatment of cancer has permitted more patients to live long enough for a second or even a third primary lesion to develop and it probably also reflects the more thorough pathological studies in both surgical and autopsy cases. It may be hoped that factors of genetic predisposition, ethiology and pathogenesis that are obscure in the patient with single lesions may be brought out in patients with multiple cancers. We present the case of a 83 years old patient with three different primary malignancies. His first tumour was a clear cell carcinoma of the left kidney at the age of 71, followed by a transitional cell carcinoma gr. II/IV of the bladder seven years later, and followed by a third one two and a half years latter which was a distinct adeno carcinoma of the prostate.
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The polyp of the ureter is a tumour which originates in the connective tissue and is covered by normal urothelium. Radical surgery is justified in some of these urothelial tumours but one should also consider a more conservative attitude when one deals with a benign fibro-epithelial polyp of the ureter especially when they are located in the lower or upper third of the ureter. We present two cases, one which represents the eleventh case of benign fibro-epithelial polyp described in children in the literature.