Tuberculous epididymo-orchitis following intravesical BCG.
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Biomedical subjects
Publications and source records attributed to N A Green.
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We have investigated the effects of iron overload in vivo on the tocopherol levels and the extent of lipid peroxidation in rat liver microsomes and their response to subsequent oxidative stress in vitro. The results demonstrate a direct correlation between consumption of antioxidant defences and the induction and extent of malondialdehyde production in microsomes prepared from iron-loaded rats. The data are consistent with the requirement for iron (II)/iron (III) ratios in lipid peroxidation in control microsomes.
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An anatomical study of cadaver prostates has demonstrated that, in all cases, adenomatous tissue lies inferior to the verumontanum. The proportion of tissue distal to the verumontanum varies from less than 10 to 50%. In a series of 100 patients the post-operative urodynamic studies showed that in the tansurethral resection group the mean urethral length was longer, the flow rate lower and the residual urine higher than in the retropubic prostatectomy group. It is suggested that prostatectomy by the transurethral route is less complete due to residual sub-verumontanal prostatic tissue. However, it is likely that by restricting resection to supra-verumontanal tissue many patients are spared post-operative stress incontinence.
The patterns of venous drainage of the testis and scrotum have been evaluated in patients with varicocele by a variety of radiological procedures, including left renal venography, and at the time of operation by ascending venography and retrograde injection of contrast medium into prominent varicosities. These studies have allowed classification of the system of veins involved in the condition into several groups, including involvement of the internal spermatic vein alone, pure cremasteric varicocele, mixed internal spermatic and cremasteric varicosities in one or both systems with valvular incompetence or mere dilatation without apparent incompetence of valves. As a result, an anatomical approach to the surgical management of varicocele is suggested which attempts to place the operative treatment on a more rational basis appropriate to each case.
Cryosurgery of the prostate gland has been used on mainly unfit patients for ten years as an alternative to open and endoscopic surgery in over 250 patients. With the use of a simple "rule of thumb" technique, blind cryosurgery can be recommended as causing few complications. Furthermore, the patient's early discharge from hospital can be achieved. Long-term functional results are satisfactory. More complicated techniques have been described and are mentioned, but as a result of experience simplicity of technique is recommended.
This personal review of the use of cryosurgery in prostatic disorders aims to put in perspective the value of the technique, establishing its place in the urologist's armamentarium mainly in the unfit subject but pointing to other applications as well. "Blind" perurethral cryosurgery has been used and has been shown to be effective in relieving urethral outflow obstruction, particularly in the second series of 178 patients with benign prostatic disease in which a simple "rule of thumb" technique was used.
The information given by urodynamic investigations has been of practical value in clinical practice and we feel that the time and money spent has been worthwhile. The results are particularly useful in patients with neuropathic bladders, women and stress incontinence in whom detrusor instability is also suspected, young men with "obstructive" symptoms and in men with post-prostatectomy problems. Its value in te large group of women with frequency, urgency and nocturia is debatable given our present lack of satisfactory treatment for these patients.
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A case of horseshoe kidney complicated by hydronephrosis, renal calculi, urinary infection, and tumor of the renal pelvis is reported. The incidence and etiology of the complications are discussed and the frequency of tumors in horseshoe kidneys described.