Hernan M. Carrion

Small-Carrion penile prosthesis

A normal state of erection can be achieved by bilateral, intracorporal implantation of the Small-Carrion penile prosthesis. This prosthesis gives adequate length and, more importantly for normal intercourse, normal width to the penis. Although the prosthesis is firm, it is flexible enough to keep the phallus inconspicuous under various types of undershorts, either in the normal position or against the abdominal wall. The fact that the patient will have a permanent erection has not been a deterrent. Furthermore, there have been no complaints about this postoperatively. Raz and Kaufman, Goodwin, Melman, Nellens et al., and others have reported excellent results with the use of the Small-Carrion prosthesis.

Ureteropelvic Junction Obstruction Resulting from Percutaneous Cyst Puncture and Intracystic Isophendylate Injection: An Unusual Complication

AbstractA case is reported of an iatrogenic ureteropelvic junction obstruction caused by percutaneous renal cyst decompression and an attempt at sclerosis with the intracystic sclerosing agent isophendylate.

Renal angiomyolipoma; polycystic kidney, and renal cell carcinoma in patient with tuberous sclerosis.

A patient with tuberous sclerosis presented with renal failure secondary to bilateral angiomyolipoma. The angiomyolipoma was associated with polycystic disease and a foci of renal cell carcinoma. This unusual combination has not been reported previously, although each entity has been described separately in tuberous sclerosis.

Evaluation and Treatment of Priapism

We herein review the last 29 patients with priapism treated at our hospitals with respect to the physiology and pathophysiology of erection and priapism, respectively, and present a rational approach to the management of priapism. Emphasis is given to the corpus cavernosum to corpus spongiosum shunt with a vascular anastomosis technique.

Significance of asymptomatic bacterium in neurogenic bladder disease

Whether or not to treat bacteriuria (greater than or equal to 100,000 col/cc) in the asymptomatic patient has long been controversial. Fifty-two patients with uncomplicated neurogenic bladder disease secondary to spinal cord injury and bacteriuria were followed throughout their hospitalization. Antibiotics were reserved only for symptomatic patients. Our results indicate the value of no treatment for chronic bacteriuria as an alternative to chronic suppressive therapy.

Vesicoureteral reflux and end stage renal disease.

Thirty per cent of 50 consecutive patients with end stage renal disease were found to have vesicoureteral reflux. This finding is at variance with the usually published etiologies of end stage renal disease. Forty per cent of the patients with reflux had no history to suggest the presence of this entity. The clinical importance of reflux in the post-transplant period as well as its possible etiologic role in end stage renal disease is discussed.

Erectile impotence: Complication of external sphincterotomy

Abstract At the Jackson Memorial and the Miami Veterans Administration Hospitals, external sphincterotomy is the preferred surgical procedure for treating unsatisfactory voiding or vesicoureteral reflux among cord-injured patients. Eight of 25 patients returning questionnaires relating external sphincterotomy and penile erections admitted to severe impotence postoperatively. A review of the literature failed to uncover a precedent for this finding. Local factors secondary to use of the cutting loop and electrocoagulation appeared to be the most likely causative factors.

Retrocaval ureter: Report of 8 cases and the surgical management

We present 8 cases of retrocaval ureter, one of which concerns a unique periureteral venous ring formed by the persistence of the right posterior cardinal vein along with a normal vena cava. Current radiographic concepts are reviewed and the importance of inferior venacavography in the preoperative evaluation for correction of the retrocaval ureter is emphasized.

Urachal Carcinoma: Diagnosis by Computerized Axial Tomography

A case of mucin-producing adenocarcinoma of the urachus is reported. Preoperative diagnosis was established by computerized axial tomography. The embryology, histogenesis, signs, symptoms, diagnostic criteria and treatment are discussed.

Double-ended pigtail ureteral stent: useful modification to single end ureteral stent

A newly created ureteral stenting catheter of double-ended pigtail design is introduced. The pigtail design at both ends maintains the catheter in place by serving as a solid anchoring device, both intravesically and within the renal pelvis; upward or downward migration of the stent is thus prevented. It is designed also to minimize trigonal irritation. The catheter can be introduced easily either cystoendoscopically or through a percutaneous antegrade route, or by a combination of both methods. It offers the additional advantage of being readily available from an inexpensive stock source; it may be quickly and easily custom made and shaped for any ureter by the physician immediately prior to its insertion. It thus avoids having to have premanufactured, more expensive ureteral stents of different lengths. Open surgery for upper urinary tract decompression can thus be avoided.