John W. Draper

Vasovasostomy: Improved Microsurgical Technique

2 microsurgical tehniques were employed in dog vasovasostomies. In Group 1 (12) the vas was divided about 1 cm cranial to the convoluted part and anastomosed over a 32 stainless steel wir e splint with 6-8 sutures of 7-zero black silk. Only 2 dogs had anastomoses considered successes (normal vasograms). Failure usually resulted from obstruction (scarring) of the lumen of the vas at the exit site of the splint. 20 end-to-end vasovasostomies were performed in 14 dogs (Group 2) without the use of a splint. In 19 of 20 anastomoses patency with excellent morphological and functional repair was achieved (evidence from vasograms injection of saline solution into lumen of removed vas passage of sperm through anastomoses). More fibrosis and scar tissue was noted in dogs in which the first method was employed.

Lumbar approaches to kidney. Complications associated with procedure.

Abstract The lumbar approaches to the kidney were reviewed in 327 patients. Immediate complications were pleural injury and damage to the spleen. Delayed complications were incisional “root-like” pain, incisional weakness (bulge), draining wound sinuses, and lumbar hernias. There was no apparent correlation between type of incision and rib removed and either immediate or delayed complications. Special attention should be given in wound closure in which the kidney is infected or there had been a perinephric abscess. These precautions may lessen the incidence of sinuses or lumbar hernias.

Two-stage urethroplasty Improved method for treating bulbomembranous strictures

Twelve years experience with a two-stage urethroplasty for the surgical management of severe and complicated urethral strictures in 200 patients is summarized. The techniques used, including a modification of the Johanson urethroplasty for bulbomembranous urethral strictures and for multiple strictures without splitting the scrotum, are discussed. The most usual complications of these procedures are reported, as well as how to deal with them, and long-term final results are given. The principles of these procedures are surgically sound, considering the pathology of the strictures. At no time after urethroplasty were urethral dilatations necessary in these 200 patients.

Reconstruction of lower ureter and urethra, and closure of vesicovaginal fistula and other bladder defects Various uses of bladder flap

Abstract This report describes the various uses of a large bladder flap for the reconstruction of the lower ureter and female urethra. It also explains the method for closing a large vesicovaginal fistula and other bladder-wall defects with an advancement flap of bladder wall. Fifteen cases are presented in which these procedures were carried out.