Ormond S. Culp

Radical prostatectomy in the treatment of prostatic cancer

The legitimate role of radical prostatectomy remains controversial. A prospective study was started at the Mayo Clinic in 1950 to evaluate therapeutic usefulness of the operation. Rigid criteria were established for selection of surgical candidates. From 1950 through 1972, 264 patients had radical prostatectomy for cancer at this clinic. Of 115 patients treated by radical perineal prostatectomy at least 10 years ago, 72% have lived from 10–21 years with 57% showing no clinical evidence of the disease. Of 74 patients operated on 15 or more years ago, 54% have survived for 15–21 years and 48% of these survivors appear to be cancer‐free. Size and grade of the adenocarcinoma influenced survival. Endocrine therapy, which was deferred until development of recurrence or metastasis, may have increased longevity in some instances. Radical prostatectomy for cancer has both curative and palliative potentialities in properly selected cases. It should be utilized more frequently, rationally, and effectively.

Hypernephroma in the solitary kidney: experience with 20 cases and review of the literature.

Twenty patients with renal cell carcinoma in anatomically or functionally solitary kidneys were treated and followed for up to 18 years. Factors pertinent to management and survival of these patients and 66 other well documented similar patients reported in the literature are analyzed. Most of the patients were unusually young and a significant number had had nephrectomy for contralateral renal cell carcinoma. Survival was closely related to the earlier presence of malignant disease in the other kidney, the duration of the interval between detection of the 2 neoplasms and the stage of the lesion in the solitary kidney. Partial nephrectomy has been the most successful treatment. The mean survival in the Mayo Clinic series has been 6 years for patients still alive and 2.4 years for those dead at the time of this analysis. Results in this and other series emphasize the importance of thorough long-term followup after nephrectomy for hypernephroma and of aggressive therapy when the remaining kidney becomes involved. It is foolhardy to abandon hope merely because there is a malignant tumor in a solitary kidney.

Complications of single and multistage operations for hypospadias: a comparative review.

From 1970 through 1975, 198 children with hypospadias were operated upon at our clinic. Three basic types of primary urethroplasty were used: 1) a modified 2-stage Cecil urethroplasty after separate straightening, 2) a modified 1-stage Denis Browne procedure after prior correction of chordee and 3) a 1-stage combined repair of hypospadias and chordee. A comparative review of early complications is presented.