Joseph E. Montie

Construction Of Male Genitalia In The Transsexual, Using A Tubed Groin Flap For The Penis And A Hydraulic Inflation Device

A technique for construction of external male genitalia in a transsexual patient is presented in detail. The McGregor groin flap is used for penile construction, and the Scott inflatable prosthesis is used to produce an erection. The shape of the penis is improved by secondary local excisions, and the clitoris is bivalved and inserted at the base of the penis to allow sexual sensation. The appearance and the function of the constructed genitalia have been deemed quite satisfactory by this transsexual patient.

Results of Non-Operative Management of Blunt Renal Trauma

A study of 84 patients with blunt renal trauma has revealed that expectant, non-operative management of the clinically stable patient with either minor or more severe injuries (excluding vascular pedicle trauma) gives satisfactory results and entails few subsequent complications. The nephrectomy rate with expectant management is markedly lower than that reported after an immediate operation. The salvage of functioning renal tissue appears to be commensurate with angiographic delineation of devascularized tissue and would seem to be comparable to that of patients afforded immediate surgical intervention, without the threat of loss of the renal unit that appears to be entailed by early operation.

Free Flap Phalloplasty

AbstractBecause of dissatisfaction with the length of time and number of operative procedures necessary for our previously reported phalloplasty procedure we have attempted a free flap approach in 3 patients. This procedure was successful in 2 patients, while in 1 a staged construction was necessary after failure of the free flap. The operative technique is described and the procedure is recommended cautiously to medical centers with microsurgical capabilities that are engaged in phalloplasty.

An Analysis of Factors Affecting Survival in 150 Patients with Renal Carcinoma

A review of 150 patients with renal carcinoma revealed that 45 per cent were hospitalized with distant metastases or tumors that were unresectable. Although the behavior of the neoplasm in the 55 per cent who were theoretically curable was generally unpredictable, longevity and survival were markedly increased in patients with tumors less than 8 cm. in size and concomitantly with other acknowledged features of low stages of the disease. Since patients can survive with tumor for long periods and metastases may occur many years after the operation prognosis must be guarded and long followup is needed to assess the results of therapy at any stage of the disease.

Ultrasound as a New Method of Male Contraception

Twenty male cats were treated once or twice with 1 watt/sq cm of ultrasound for 10 minutes. Each of 24 male dogs received one to three treatments with 1 watt/sq cm for 10 minutes. Another six dogs were treated with 2 watts/sq cm for 15 minutes. Four Cebus apella monkeys were treated with the same dosage as that used for the cats and dogs. A dosage of 1 watt/sq cm for 10 minutes was also applied to four human patients without the use of anesthetics, and no pain or side effects were noted. In all treated animals as well as in human patients the results indicate that ultrasound significantly suppresses spermatogenesis according to the dosage and frequency of treatment, without any effect on Leydig cells or blood testosterone levels.

Problems associated with Gibbons ureteral catheter.

Two recent cases of bilateral ureteral obstruction secondary to benign retroperitoneal fibrosis were treated initially with Gibbons indwelling ureteral catheters. Inadequate catheter length, calyceal stone formation, catheter encrustation, and distal migration form the basis for this report.

Our experience with the adrenogenital syndrome: a review of 16 cases.

An analysis of 16 children with the adrenogenital syndrome illustrates the diversity of the clinical and laboratory features of the disorder. The need for critical periodic evaluation of individual assessment of each child and the dosage of corticosteroids being used is emphasized.

Hypospadias Results of surgical treatment and perspectives in management

An institutional experience with the repair of hypospadias over a fifteen-year period is reviewed. The 119 patients treated surigcally serve as the substance of this report. Recommendations concerning options in surgical treatment are predicated on this experience and the contemporary literature.