Joseph J. Seebode

New Iglesias Resectoscope with Continuous Irrigation, Simultaneous Suction and Low Intravesical Pressure

The new Iglesias resectoscope that allows simultaneous suction, continuous irrigation and low intravesical pressure is described. Advantages of this instrument include no interruption, better endoscopic vision by a continuous clear inflow of more than 600 ml. per minute, a low intravesical pressure less than 10 mm. Hg during the transurethral resection, shorter operating time, less bleeding, easier teaching and no more wet floor and wet surgeon. Since the entire amount of irrigating fluid is collected blood loss can be calculated and the amount of absorption can be determined.

Plasmacytoma of the Testis

We report a case of plasmacytoma of the testis without evidence of bone or immunoglobulin abnormalities. The presentation, evaluation and management of this extremely unusual tumor are reviewed.

Candicidin: Physiologic effect on prostate

In a double-blind study, candicidin therapy resulted in over-all clinical improvement of benign prostatic hypertrophy symptoms in 78.1 per cent of treated patients compared with 10 per cent for patients given a placebo. Histologic review of prostates of candicidin-treated patients showed more stroma relative to the epithelium. The epithelium was less active with more cuboidal than columnar cells. There were fewer papillary infoldings, and the epithelium contained more true cysts than did the prostates of patients given a placebo. Urinary testosterone, 17-ketosteroids, 17-hydroxycorticosteroids, and serum androgen, follicle-stimulating hormones, and corticosteroid levels ramained within normal values with candicidin therapy.

Plasma androgens and estrogens in paraplegic men.

The plasma testosterone, estrone (E1), and estradiol (E2) levels were measured in paraplegic men and age-matched controls. Sephadex LH-20 columns and the celite technique were used to extract the sex steroids and a radioimmunoassay was used to measure them. Leydig cell stimulation was achieved with human chorionic gonadotropin administration.

FAMILIAL OCCURRENCE OF TESTICULAR NEOPLASMS (IN COUSINS)

Testicular malignancies in closely related family members rarely occur. Only 18 cases have been reported in the literature. Our cases concern two families with testicular tumors occurring in cousins. This is the first such incidence reported. The need for a thorough checkup of other family members is reiterated.

Hydraulic hemostasis in transurethral resection of the prostate using the Iglesias continuous suction resectoscope.

An intravesicoprostatic hydrostatic pressure less than 10 mm. Hg maintains normal anatomy and physiology of the muscular and vascular prostatic structures. An increase in hydrostatic intravesicoprostatic pressure to more than 10mm. Hg produces a distortion in the musculature of the prostate, especially at the true capsule, opening the cut vessels and making possible the absorption of the irrigant free of electrolytes (transurethral resection syndrome). A low hydrostatic intravesicoprostatic pressure permits the compression of cut vessels by the inflow hydraulic pressure of 90 cm. water, achieving hydraulic hemostasis during transurethral resection of the prostate. Less electrocoagulation is necessary, resulting in more rapid patient recovery.

Giant prostatic calculi

Abstract An unusual case of giant prostatic calculus associated with urinary incontinence is presented. The calculus was removed suprapubically and the postoperative course was uneventful except for continuing incontinence. An incontinence procedure was performed with satisfactory results.

Serratia marcescens and the urologist.

Serratia marcescens, long considered a non-pathogen, is now found to be responsible for outbreaks of nosocomial infections. An outbreak of Serratia infection at 2 institutions is reported, in which 253 cultures of Serratia were grown and 115 patients were involved. The 3 most important conditions that preceded isolation of Serratia were the use of indwelling urethral catheters, antibiotic therapy and operation. All infections were acquired in the hospital. An epidemiological survey showed that the organism is present in the environment, even in the absence of active infection.

Obstructed Solitary Pelvic Kidney and Urinary Ascites

We report on a patient with a congenital pelvic kidney who presented with anuria and urinary ascites. Extensive pelvic endometriosis involving the ureteropelvic junction was the cause of severe obstruction. We discuss successful management of this condition and review the literature.

Iglesias Articulated Endoscopy Teaching Attachment

A new articulated teaching attachment with a single joint is described. The attachment allows a 360-degree rotation in 3 planes (sagittal, horizontal and frontal) by the 3 rotary unions at the single joint with only 2 tubes. Simultaneous observation by 2 persons and the operator is achieved by combining 2 of these optical units. The attachment may be sterilized by soaking. It can be dismantled for cleaning and for replacement of any damaged parts. Finally, it facilitates taking still photographs, movies and television endoscopy without interference to the operator.