Formation of heterotopic bone tissue following operation on the renal pelvis.
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Aged↗
Biomedical subjects
M D Melekos
Publications and source records attributed to M D Melekos.
Vesical diverticula: etiology, diagnosis, tumorigenesis, and treatment. Analysis of 74 cases.
A thirteen-year review of bladder diverticula was undertaken and 74 cases were identified. In 8 patients primary neoplasms arose in the diverticula, and their treatment included diverticulectomy or partial cystectomy with or without postoperative irradiation, irradiation only, and transurethral resection of the tumor combined with fulguration of the diverticular wall and postoperative bladder instillations with doxorubicin or thiotepa solutions. Early diagnosis with additional visualization of the interior of vesical diverticulum is mandatory, since carcinoma arising in it has a poor prognosis.
Aged↗
Epididymitis: aspects concerning etiology and treatment.
Extended microbiological studies were performed on 49 patients with acute or chronic epididymitis, including bacteriology of epididymal specimens in cases of scrotal surgery. In no patient had instrumentation or catheterization resulted in epididymitis. The microbiological data showed a prevalence of Chlamydia trachomatis epididymal infections in men less than 40 years old, whereas common urinary tract pathogens prevailed in older patients. Cultures of urethral swabs and midstream urine provided reliable information on the type of microorganism that caused epididymitis. Ofloxacin, an antibiotic of the new quinolone group, was proved to be highly effective in the treatment of acute and chronic bacterial as well as chlamydial epididymitis.
Adult↗
Complications from urinary condom catheters.
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Humans↗
Penile duplication.
We report on a case of penile duplication in an eight-year-old boy. While diphallia was incomplete, there was a common root of the penis which divided into two shafts of different size, doubling in frontal plane. Only one urethra left the bladder along the lower and smaller penile shaft and ended with a hypospadiac meatus. After surgical plastic repair, the patient had a good functional and cosmetic result. In addition, this patient had a horseshoe kidney.
Child↗
Clinical evaluation of temocillin in urinary tract infections.
A group of 27 female and 2 male urological patients, aged 19 to 80 years (mean 44 years), were treated with intravenous temocillin 500 mg twice daily for 5 to 7 days. The diagnoses were acute pyelonephritis (n = 20), acute cystitis (n = 6), and acute cystitis and pyelonephritis combined (3). The causative organisms were Escherichia coli (n = 20). Proteus species (n = 9). Klebsiella species (n = 4). Streptococcus faecalis (n = 2). Staphylococcus epidermidis (n = 1), and Providencia stuartii (n = 1). 27 of the 29 patients (93%) were clinically and bacteriologically cured; bacteriuria persisted in 2 patients with prolonged obstructive uropathy. In acute non-obstructive pyelonephritis, the urinary excretion of beta-2-microglobulin rapidly decreased, documenting a prompt renal tubular restitution during therapy. The drug was well tolerated and proved very safe with regard to haematological, hepatic and renal parameters. Also, Candida haemagglutination titres did not increase significantly during therapy. Temocillin therapy should preferably be commenced after the results of the urine culture are available.
Adult↗
Prophylaxis of superficial bladder cancer with a modified intravesical epirubicin treatment schedule.
A controlled prospective trial on 99 eligible patients evaluated the efficacy of intravesical epirubicin administration as prophylaxis against tumor recurrences after complete endoscopic resection of superficial bladder cancer. The treatment schedule consisting of an initial 6- or 8-week course of instillations, followed by single maintenance doses (to the responders) at follow-up examinations, was modified in those of the initial responders who were at high risk for recurrence and who received an additional separate 4-week course of therapy. Sixty percent of the epirubicin-treated patients and 41% of the controls (who underwent resection alone) remained free of recurrences for a mean follow-up of 32.1 months, but the difference was not significant. However, in terms of relative risk for recurrences (recurrence rate per 100 patient-months and disease-free interval), comparisons between the two groups of patients revealed a significant benefit of epirubicin, overall as well as for those with a history of previous tumor recurrences, multifocal disease, and stage Ta and grade 2 neoplasms. Drug-induced toxicity was acceptable.
Administration, Intravesical↗
Intravesical bacillus Calmette-Guérin versus epirubicin in the prophylaxis of recurrent and/or multiple superficial bladder tumours.
A prospective, randomized trial was conducted to evaluate and compare the effects of modified adjuvant intravesical bacillus Calmette-Guérin (BCG) and epirubicin regimens in patients with superficial bladder cancer. One hundred thirty-two individuals with recurrent and/or multiple neoplasms, i.e. at high risk for tumour recurrence and progression, were enrolled. After complete transurethral resection of their tumours, the patients received a 6-week course of BCG instillations or an early 4-week course of epirubicin instillations as their initial therapy. Those with stage Ta and grade 1 neoplasms who remained free of recurrences received maintenance therapy consisting of single quarterly instillations. However, for those with stage T1 cancer of any grade or stage Ta of grade 2 or 3 neoplasms who also remained free of recurrences, the treatment schedules were modified: they received, instead of single maintenance doses, 3 weekly instillations of epirubicin at months 3 and 6 of follow-up, or a 3-week course of BCG at month 6 of follow-up. The recurrence-free rates did not differ significantly between the two study groups (44% for epirubicin versus 55% for BCG), for an identical median follow-up of 43 months. However, in terms of relative risk of recurrences, disease-free intervals and recurrence rate per 100 patient-months, a significant benefit in favour of BCG when compared with epirubicin was demonstrated in patients who had stage T1 or grade 3 neoplasms.
Administration, Intravesical↗