Robert A. Older

The Evaluation of Bladder Neck Dysfunction

Bladder neck dysfunction has been evaluated in 16 male patients. The efficacy of the traditional investigative methods for this entity is questionable and the value of video-urodynamics for definitive diagnosis is presented. The ability of the condition to masquerade as prostatis is apparent and treatment by unilateral bladder neck incision is proposed.

Contrast-Induced Renal Failure: A Radiological Problem and a Radiological Diagnosis

Renal failure induced by intravenous iodinated contrast media is a frequent medical problem. While such cases are generally reported first by the clinician, the phenomenon can be seen even earlier by the radiologist. An abnormally persistent nephrogram is a sign of abnormal clearance, which in turn should alert the physician to the likelihood of renal failure.

Value of subtracted bladder pressure measurement in routine urodynamics

A case is presented for the routine determination of detrusor pressure in the performance of urodynamic studies. Its particular value in the investigation of the patient with subtle bladder instability, urinary incontinence, and voiding dysfunction is described.

Ultrasonic, angiographic, and pathologic correlation of noncystic-appearing renal masses

The ultrasonic echo pattern of renal masses is retrospectively correlated with the angiographic vascular pattern in 36 cases where a noncystic-appearing mass was identified by either study. Pathologic or cytologic correlation was available in 31 of these masses. In carcinomas the echogenicity was usually found to correlate well with the degree of neovascularity.

Retrocaval ureter in turner syndrome

Turner syndrome is commonly associated with urinary tract anomalies. A second case is reported of its unusual association with retrocaval ureter and massive hydronephrosis.

Evaluation of women with chronic voiding discomfort

Many investigators have focused on the female urethral syndrome and its causes. The origin remains enigmatic, but the benign course of this condition is well established. We evaluated 105 patients with urethral syndrome and analyzed the necessity for a complex urologic workup. The lack of significant findings on these studies suggests that the cost effectiveness of radiographic and invasive studies cannot justify their continued use.

Importance of routine vascular nephrotomography in excretory urography

The rapid intravenous injection of a large bolus of contrast medium produces a vascular as well as a tubular nephrogram. They are additive but the vascular phase is early, intense, and brief whereas the tubular phase is less intense but more prolonged. The addition of tomography during either phase improves visualization of the renal parenchyma and its outline. A comparison study of tomography during the vascular phase (vascular nephrotomography) with that at five minutes demonstrated the superiority of the former. Our technique, data, and illustrative case abstracts are presented.

Renal cyst puncture and abscess formation.

Percutaneous needle puncture and aspiration of suspected cystic renal masses may provide accurate diagnosis in selected cases. However, renal cyst puncture is not a totally innocuous procedure and certain complications may be encountered. Report is made of 2 cases of renal cyst puncture followed by abscess formation, necessitating surgical intervention. An improved technique involving surgical preparation of the operative area and utilization of double-needle method of cyst puncture is advocated.

The Nonspecificity of Some Radiological Signs in Excretory Urography

Two radiological signs have recently been offered as being specific for an infected and obstructed urinary tract and renal infarction, respectively. The authors suggest that these signs suggest certain possibilities but do not indicate a specific diagnosis.

Computerized tomographic diagnosis of massive hydronephrosis of duplicated system in an adult

A case of massive hydronephrosis of the upper portion of a duplicated collecting system in a middle-aged male is presented. Computerized tomographic examination of the abdomen provided the most precise information and led to a correct preoperative diagnosis, whereas both urography and ultrasound did not.