Andrew Sporer

Effects of Bethanechol Chloride on the External Urethral Sphincter in Spinal Cord Injury Patients

The neuropharmacodynamics of bethanechol chloride on the external urethral sphincter in male spinal cord injury patients with chronic lesions have been investigated. There were 90 cystosphincterometric and sphincteroperineal electromyographic studies conducted on 45 subjects in 4 different positions, showing varying urodynamic patterns. A gross postural cystophincteric discordant reflex was noted in the majority of patients with recent complete upper motor neuron bladders (less than 2 years in duration). The external sphincter tends to be coordinated in late cases of quadriplegics and in all paraplegics. With the administration of bethanechol chloride there was an increase in the striated sphincter pressure profile when the patient was in the sitting position, resulting in detrusor sphincter dyssnergia. This phenomenon seems to be dose-related. When the dose of bethanechol chloride is adjusted according to the types of vesicourethral dysfunctions or in combination with dantrolene sodium the most beneficial non-surgical rehabilitation of the urinary tract can be obtained in this particular group of patients.

Kaposi sarcoma limited to glans penis

Two cases of Kaposi sarcoma are presented. In each case the lesion had a bluish discoloration and was painless. Excision of lesions with wider margins was adequate therapy.

Comparative evaluation of intravenous urogram and ultrasound in prostatism.

The combination of renal ultrasound, abdominal scout film, and urine analysis detected all significant renal pathology in 53 patients before surgery for prostatism. It is suggested that these combined examinations in conjunction with a blood urea nitrogen determination can replace urography in the preoperative screening of these patients.

Study of renal blood supply and its implication in renal pelvic surgery

Studies of the blood supply and healing potential of the renal pelvis were correlated. Angiographic studies of anatomic dissection of the blood supply, performed following an injection technique, proved that branches from the renal, lumbar, capsular, and ureteral arteries result in an abundant capillary supply. Comparison of healing after longitudinal and trnsverse incisions showed no significant difference.

Carcinoma of kidney Benign-appearing calcified cyst

Abstract A case of a calcified, simple cyst of the kidney with an unusual lining epithelium is presented. A possible etiologic basis is suggested.

The importance of continuous pump suction in TUR hydraulic hemostasis.

An intravesicoprostatic hydrostatic pressure below 10 mm Hg maintains normal anatomy and physiology of the muscular and vascular prostatic structures by continuous pump suction. An increase of the hydrostatic intravesicoprostatic pressure above 10 mm Hg produces a distortion in the musculature of the prostate, especially at the true capsule, opening the cut vessels, making possible the absorption of the irrigant free of electrolytes (TUR syndrome). A low hydrostatic intravesicoprostatic pressure permits the compression of cut vessels by the inflow hydraulic pressure of 90 cm H2O achieving hydraulic hemostasis during TURP reducing the bleeding and operative time by more than 50% and making hemostasis easier. In our last 400 TURs, blood transfusions have been unnecessary. Less electrocoagulation is required, resulting in a more rapid recovery.