Alfred S. Buck

Stage A prostatic carcinoma and repeat transurethral resection: a reappraisal 5 years later.

The treatment of patients with stage A prostatic carcinoma demands precise pathological review. In an attempt to evaluate these patients thoroughly earlier reports from our institution recommended repeat transurethral biopsy. Recent studies have reaffirmed the benign nature of stage A1 disease. To examine the efficacy of this procedure a referee pathologist reviewed 8 years of experience with patients with stage A prostatic carcinoma from our institution. Clinical followup was more than 5 years in most cases. Of the 40 patients who underwent repeat transurethral biopsy the tumor in 38 remained stage A1 pathologically. While 1 patient died of the tumor the the remainder are without clinical disease. This low incidence of upstaging does not support the routine use of repeat resections.

Primary Psoas Abscess: Case Report and Review of Literature

AbstractWe report a case of a primary non-tuberculous psoas abscess and review the literature. Most psoas abscesses are secondary to extension of inflammatory processes from adjacent structures. Primary psoas abscess is a relatively rare condition and is usually staphylococcal in nature. The pathophysiology, clinical presentation and treatment are discussed. Accepted for publication September 12, 1980. The opinions or assertions contained herein are the private views of the authors and are not to be construed as official or as reflecting the views of the Department of the Army or the Department of Defense.

Benign Testis Tumors

Benign testis tumors are reported to be extraordinarily rare. Recent clinical experience has shown a high prevalence (7 of 12 patients) of these tumors, which, although small, is much higher than other reports. We herein present 4 illustrative cases and a practical categorization of the varied pathologic events causing these tumors.

Torulopsis Pyelonephritis Associated with Papillary Necrosis: A Case Report

A case of Torulopsis glabrata pyelonephritis associated with papillary necrosis is presented. Torulopsis glabrata is a potential pathogen in the urinary tract capable of producing renal damage, sepsis and death. In this case the involved kidney sustained progressive damage, necessitating nephrectomy for cure. Examination of the kidney showed fungal involvement of the parenchyma and collecting system.

Hemangioendothelioma of the testis: second reported case.

AbstractThe second case of hemangioendothelioma of the testis is reported and the pertinent pathologic findings are discussed.

Renal carbuncle: Comparison between surgical open drainage and closed percutaneous drainage

This article represents a retrospective study of 12 patients with renal carbuncle treated at the combined urological services of The Mason Clinic in Seattle, Washington, and Madigan Army Medical Center in Tacoma, Washington. All patients were initially treated with antibiotics. Two recovered without further treatment. Of the 10 patients who failed to respond, 2 underwent nephrectomy for nonfunctioning kidneys, 4 underwent closed percutaneous drainage, and 4 underwent surgical open drainage. All patients treated with open surgical drainage recovered and retained functioning kidneys. Of the 4 patients who underwent closed percutaneous drainage, 2 failed to respond and required subsequent emergency nephrectomy because of sepsis. The authors believe that renal exploration and open drainage should be the initial definitive mode of surgical treatment of renal carbuncle in those patients who fail antibiotic therapy alone.

Recommended technique for repair of incisional flank hernia

Abstract Described herein is a technique that has proved successful in repairing a flank fascial defect with a synthetic monofilament mesh (Marlex).

Urinary Ascites Resulting from Umbilical Artery Catheterization

AbstractA case is reported of neonatal urinary ascites resulting from traumatic umbilical artery catheterization.

Unilateral ureteral obstruction secondary to sarcoidosis

An episode of unilateral ureteral obstruction secondary to sarcoidosis is described. Corticosteroid treatment resulted in prompt and complete resolution of the obstruction and associated lymphadenopathy. We believe this represents the first reported case of ureteral obstruction secondary to sarcoidosis.

Evaluation and treatment of dyssynergic bladder neck obstruction Is synchronous pressure-flow cystourethrography necessary?

Eighteen male patients underwent unilateral bladder neck incision for relief of bladder neck obstruction. The presence of obstruction was determined by clinical symptoms, residual urine, and uroflowmetry only. The decision to perform bladder neck incision was based on the typical endoscopic appearance of the prostatic urethra and bladder neck. Sixteen of 18 patients (89 per cent) had normal postoperative uroflowmetry. Subjectively, all patients judged themselves improved by the procedure. In those patients who are judged to be obstructed by clinical symptoms and uroflowmetry, dyssynergic bladder neck obstruction may be diagnosed by classic endoscopic findings rather than the routine use of synchronous pressure-flow cystourethrography.