Re: retroperitoneal seminoma.
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Biomedical subjects
Publications and source records attributed to J E Gottesman.
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Clinical differentiation of the various pathological conditions which affect the scrotal contents can be difficult. The value of gray scale ultrasonography was assessed prospectively in 55 patients (110 testes) with specific clinical presentations and was compared to the reported results of other noninvasive imaging procedures. The homogeneous texture of the testes and the coarser pattern of the epididymal region were normally more clearly separable with gray scale signal processing. In this series, a clear differentiation of the origin of an abnormality was possible in 80% of the cases. A negative sonogram was highly reliable. However, the benefits of scrotal ultrasonography can only be evaluated after consideration of the clinical setting and alternative noninvasive diagnostic modalities.
Evaluation of 27 patients with scrotal masses was done with gray scale ultrasound. Given the clinical diagnosis ultrasound proved reliable in almost all cases.
Small-Carrion penile prostheses were implanted in 61 patients who have been followed for 3 to 21 months. Of these 61 patients 55 have achieved satisfactory results, with a return of normal sexual function. The importance of preoperative evaluation and preparation is stressed.
Due to increasing number of radical surgeries for malignant tumors of the pelvis the incidence of iatrogenically caused erectile impotence rises. Available surgical management comprises implantation of rigid penile prothesis or inflatable device. The authors prefer a rigid implant (Small-Carrion penile prothesis) on account of its simplicity and have been impressed with the results.
Five cases of granulomatous disease of the male genitalia are presented. Of these, 3 cases involved foreign-body reactions in which some form of hydrocarbon was the causative agent. In the other 2 cases, idiopathic granulomatous processes were found, and this condition may be secondary to endogenous lipoid degenerative processes.
Exploration of an unusual case of a painful, recurrent, perineal mass revealed partial priapism of the right corpora cavernosa. Etiology is speculative and no definitive therapy is offered.
A quick, simple, safe, and efficient means of hydrocelectomy is presented. The technique consists of extruding and fixing the testicle into a scrotal pouch. Twenty hydroceles were repaired without complication or recurrence.
The insertion of two silicone rods into the penile corpora cavernosa (Small-Carrion penile prosthesis) is a considerable procedure for operative management of erectile impotence. Of 61 treated patients, 55 had a satisfactory anatomical and functional result, most of them regained the same sexual activity as prior to onset of impotence. Their partners were satisfied, too. Preoperative evaluation of causes of impotence is particularly important. Type and number of complications in this operative procedure are reported in detail.
Two patients with severe bladder disease have undergone temporary urinary diversion with a sigmoid conduit as part of planned reconstruction of the lower urinary tract. Their lower urinary tracts have been reconstituted successfully by means of sigmoid cystoplasties. Experimental data further support use of the sigmoid conduit vis-a-vis use of the traditional ileal conduit for long-term diversion and reconstruction. A main advantage of the sigmoid segment is the ability to create an antirefluxing ureterointestinal anastomosis. We have demonstrated that ureteral reflux from ileal conduits produces histologic evidence of pyelonephritis. Colonic conduits, by preventing reflux, reduce the frequency of pyelonephritis and function in an equivalent manner to ileal segments when used either for cutaneous diversion or ureteral substitution in reconstruction.
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