Biomedical subjects
Publications and source records attributed to J Eldrup.
Two cases of inguinal scrotal bladder herniation are reported. Both patients were operated upon with repositioning of the bladder and fascial repair. Herniation of the urinary bladder should be suspected in men aged over 50 years with scrotal herniation and symptoms of bladder outlet obstruction.
The case records of all patients admitted to one of the hospitals in the County of Frederiksborg with radiologically demonstrated first episodes of urinary calculi during a period of one year in 1983/1984 and 1988/1989 respectively were reviewed retrospectively. Uniform frequencies of calculus incidence and sex distribution were encountered mutually and as compared with the remainder of Denmark during the two periods. In 30% of the cases the calculi were localized to the kidneys and in 58% to the ureter. In approximately 65% of the patients, the greatest diameter of the stones was 100 mm or less. Spontaneous passage of the stones occurred in approximately 40%. Development in the treatment of urinary tract stones has followed the development in the county as a whole. The number of operative interventions during the five year period was reduced by 30% and extracorporeal shock wave treatment was employed in 22% during the second period.
During a period of nine months, 50 men aged 21-75 years were investigated on account of erective dysfunction by means of a simple outpatient programme of investigation. Five patients could be discharged after the primary contact with history-taking and information about further investigation and treatment. Forty-five patients were submitted to the programme of investigation which consisted of measurement of penile blood pressure, Doppler investigation of the penile arteries and the papaverine test. After this, ten patients (20%) could be referred for sexological advice while five were discharged as they did not desire further treatment. Sixteen patients (32%) were taught self injection. Out of the six patients (12%) in whom arterial insufficiency was demonstrated, penile prostheses were introduced operatively in four. Venous leakage from the corpus cavernosum was demonstrated in seven patients (14%) by means of cavernosometry and cavernosography. Venous ligature was performed in five with good effect in two. Thus, specific treatment could be offered to 35 men (70%) with satisfactory therapeutic results in 22 (44%).
A case of prostatic-type polyp in the wall of the urinary bladder in a 73-year-old male is presented. The literature concerning ectopic prostatic tissue in the urinary tract is reviewed and it is concluded that the lesion is benign. However, recurrence has been reported in two cases. The etiology and pathogenesis is unknown.
Spontaneous rupture of the urinary bladder is extremely rare. A case of spontaneous intraperitoneal rupture of the urinary bladder 18 years after radiation therapy for testis cancer is reported.
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The results and complications of 100 consecutive ureteroscopy studies are reported. Introduction through the orifice or the intramural ureter failed in 11 per cent of the patients and in 14 per cent the ureteroscope could not be advanced up to the level of the lesion. Ureteroscopy was successful in 75 per cent of the patients and stone extraction was successful in 69 per cent. Complications occurred in 9 patients: 4 had an uncomplicated urinary tract infection, 4 had a ureteral perforation and 1 presented with ureteral stenosis at the site of the extracted stone a few weeks later. At followup 1 to 3 months after ureteroscopy clinical examination, excretory urography and/or renography revealed no further late sequelae.
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The association between acute epididymitis and development of antisperm antibodies was investigated by the gelatin agglutination technique in prospectively collected serum samples from 27 patients. Agglutinating antisperm antibodies, mainly of the IgG class, were detected in seven men (27 per cent), a significantly increased frequency compared to prevalences previously found among blood donors and men from infertile couples. The antibodies developed de novo in four patients (15 per cent). The increased incidence of positive sera and the kinetics of the antibody responses strongly indicate a causal link between acute epididymitis and autoimmunization against spermatozoa. In the majority of the patients the antibody titers were low, being of only theoretical importance in respect to later fertility.
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The distribution of 133Xe from the bladder was investigated in sliced mice at autoradiography and quantitatively by counting tissue samples from the abdomen and thoracic cavity. Xenon is a highly diffusible inert gas that passes the bladder urothelium. In living mice activity could be seen in the intra-abdominal fat, liver and kidneys; the activity in the kidneys depended on reflux through the ureters. The xenon gas was found in the highest concentration in the lungs where it is expired. The study confirms the assumption that instillation of xenon in the bladder can be used as an indicator for permeability and flow in the wall of the urinary bladder.
Testicular biopsy specimens from 4 (8%) of 50 men previously treated for maldescended testes had a carcinoma-in-situ pattern. 2 of these men had adjacent invasive carcinoma (seminoma and embryonal carcinoma). The patient with embryonal carcinoma had an enlarged testis but the 3 other patients with neoplasia had no clinical signs or symptoms of malignancy. Routine follow-up including testicular biopsy in young men with maldescended testes is essential because of the increased risk of malignancy and may detect testicular neoplasia at a stage when orchidectomy alone is curative.
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