Biomedical subjects
P W Boer
Publications and source records attributed to P W Boer.
The treatment of ejaculation disorders after retroperitoneal lymph node dissection.
In 14 patients by bilateral retroperitoneal lymph node dissection for nonseminoma tumors of the testes, several sexual functions before and after node dissection were compared. All patients had normal sexual function before the operation. After the operation, antegrade ejaculation was found to have disappeared completely in 12 patients, retrograde ejaculation was demonstrable in ten of these patients. In ten patients, antegrade ejaculation was restored after treatment with 25 mg imipramine twice daily by mouth. In the two patients who still showed antegrade ejaculation, albeit diminished, imipramine medication led to an increased number of spermatoza. During imipramine medication, the partners of five patients became pregnant. The preliminary conclusion from these findings is that ejaculation disorders, which most males develop after bilateral retroperitoneal lymph node dissection, can be successfully treated with daily oral doses of 25-50 mg imipramine in the majority of patients who still desire children.
Intermittent self-catheterisation: a new instrument.
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Sutureless repair of ruptured urethra.
Two cases of complete traumatic rupture of the posterior urethra are described. The ends of the urethra were united without suture by pulling them together with a transurethral balloon catheter. The results were excellent; the patients healed without sticture and remained continent. These observations suggest the applicability of the method to similar injuries.
[Analgesics and kidney disorders].
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Penile cancer.
A retrospective study was made of the case histories of 91 patients with a penile tumor. The tumor histology of 56 patients could be re-evaluated, confirming the diagnosis: epidermoid cancer. Fifty three of these 56 patients were treated more than five years before the retrospective evaluation. Penile carcinoma has not increased in frequency during the last few decades. No correlation could be found between venereal diseases and penile carcinoma, nor between the duration of symptoms before treatment and the development of metastases. Amputation is the treatment of choice. Lymph node dissection must be performed when metastatic disease is suspected. When patients die of tumor, this is caused by metastatic disease, but in about 50 percent of cases the patients can be saved by dissection of positive nodes, preventing a further extension. More than 70 percent of 53 patients have survived for at least five years without evidence of recurrence or metastatic disease including six (out of 11) patients in whom the dissected inguinal lymph nodes showed involvement. In this series of patients cytostatic therapy was not used. Bleomycin is known to have a definite action on these tumors, but only the far future can show if better results are to be expected with a combination of the described therapy with cytostatic drugs.
A case of embryonal sarcoma (rhabdomyosarcoma) of the prostate treated with combined surgical and cytostatic therapy.
The case history of a 22-months old boy with a malignant embryonal tumor of the prostate is given. Five years after initiation and three years after termination of a combined therapy with cytostatic drugs (actinomycin D, vincristine sulfate and cyclophosphamide) and surgery he is in good health without any signs of recurrence or metastatic disease. On this moment it is still impossible to be certain whether this therapy is the key for treatment of these tumors, but the successes published and the result till now in this case can be an indication that we are going in the right direction. Perhaps we may even hope that in the future we will have cytostatic drugs and combinations of therapy which will enable us to avoid mutilating operations.
[Angiography of the small pelvis in bladder tumors].
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