Sidney R. Weinberg

Chronic ileitis with concomitant ureteritis: Case report

A CAREFUL search reveals that whiIe over a thousand cases of regional, nonspecific enteritis have been reported from all over the worId, no cases of uroIogic compIications have been previousIy cited. In the decade since the disease was described by Crohn and his co-workers, no definite etioIogica1 agent has been found. According to present knowIedge from a study of the diseased tissues, the underIying disturbance is an infectious process that gives rise to a nonspecific, granuIomatous reaction. The area affected is usuaIIy the termina1 iIeum but other parts of the iIeum and jejunum have been described as being similarly invoIved. As the disease progresses, there is a characteristic formation of feca1 fistuIas. These are caused by a Iytic change induced by inflammatory processes and the fistuIas most frequently seen are peri-ana1, perirecta1, rectovaginal, or burrowing into a previous Iaparotomy scar. It is of interest to urologists to note that no fistuIas have been reported draining into the Iumbar area. Another characteristic change is the formation of Iarge, inffamed gIands draining the infected area. It is possible that in this case report about to be presented of a concomitant ureteritis with a regiona iIeitis, the infecting agent spread to the ureter via the Iymphatics of the lower ureter which drain into the hypogastric pIexus and from there an anastomosis with the inferior mesenteric gIands is possible. The infrequency of uretera compIications with ileitis suggests the fact that this lymphatic anastomosis between the intestines and the ureter is either a rarity, NEW YORK

Hydrodynamics of Micturition

This text of more than 400 pages records the symposium proceedings on the urodynamics of the lower urinary tract held in November 1968. The discussions covered the clinical, experimental, and the hydraulic engineering aspects of the act of voiding in both normal and abnormal states. The material presented in the clinical and experimental sections has major significance for understanding modern theories of function of the normal lower urinary tract and the treatment of the obstructed organs. The book is recommended reading to all concerned with the care of this type of patient and those investigators who are studying these problems. The sections on the relationship of the act of voiding to hydraulic engineering is, of course, complex and probably will be understood only by those with special training. The books should be read and discussed by residents and practicing urologists, especially in conference and study groups, for the results and

Subcutaneous inguinal vasectomy in conjunction with abdominal prostatectomy.

The procedure described obviates the complications of scrotal surgery (vasitis hematoma abscess formation etc.) and allows prophylactic bilateral vasectomy to be incidental to prostatectomy. 93 successful performances were carried out from 1965-1967. Usually a suprapubic transverse incision was used. The vasectomy was carried out after exposure of the rectus fascia and prior to prostatic enucleation to avoid retrograde infection. The fibrous sheath of the vas was incised. Then the vas was delivered from its envelope clamped and cut with a Bovie knife or a scalpel. The 2 ends were ligated (chromic catgut) or fulgurated. Postoperative urinary antiseptics were administered to 89 of the men. No postoperative epididymitis occurred. Advantages of the operation include: 1) performance of vasectomy through same incision as prostatectomy 2) avoidance of manipulation of scrotum and 3) saving of operative time.