Stephen N. Rous

Retrospective Study of 95 Patients with Staghorn Calculus Disease

Medical records were reviewed for 95 consecutive patients hospitalized with a diagnosis of staghorn calculus disease. Of those patients in whom a conservative, non-operative approach was taken 30 per cent ultimately died of renal failure and/or sepsis. It is concluded that surgical intervention is the treatment of choice for patients with staghorn calculus disease.

Is antibiotic prophylaxis worthwhile in patients with transurethral resection of prostate

Abstract A study was undertaken to determine whether or not prophylactic antibiotics were effective in preventing infectious complications in patients with post-transurethral resection of the prostate. One hundred consecutive patients with negative urine cultures were randomized preoperatively into an oral antibiotic group and a nonantibiotic group. There was no significant difference between the two groups in postoperative bacteriuria or morbidity.

Gross hematuria in 110 adult urologic hospital patients

Abstract An analysis of 110 consecutive adult urologic admissions with gross hematuria revealed that 23 per cent were found to have genitourinary carcinoma as the cause of the hematuria, The other leading causes of hematuria were infection and inflammation (29 per cent), benign prostatic hypertrophy (18 per cent), and stone disease (14 per cent). This series amply bears out the age old urologic maxim that gross hematuria must be evaluated thoroughly.

Squamous Cell Carcinoma of the Bladder

Medical records were reviewed for 17 consecutive patients hospitalized with a diagnosis of squamous cell carcinoma of the bladder. This number represented 6.5 per cent of all patients with bladder cancer seen during the study period. All 4 patients who underwent cystectomy and urinary diversion are well 3 1/2 to 6 1/2 years after treatment. All 13 patients treated with various other modalities are dead, with an average survival from diagnosis to death of 9 months. It is concluded that cystectomy is the treatment of choice for patients with squamous cell carcinoma of the bladder that is not already stage D.

Perinephric abscess: a review of 26 cases.

Herein we review 26 cases of perinephric abscess, analyzed according to incidence, etiology, laboratory findings, signs and symptoms, diagnosis, radiographic findings, operative procedures, mortality and associated diseases. Of the abscess cultures 67 per cent were gram-negative organisms, most commonly Proteus, and 76 per cent of the abscesses were directly attributable to renal causes, mainly nephrolithiasis. Diabetes mellitus occurred in only 3 of the 26 cases.

The treatment of urethral stricture disease by internal urethrotomy: a clinical review.

The results of internal urethrotomy with 6 weeks of postoperative catheter drainage and antimicrobial therapy in the treatment of urethral strictures in 28 patients are presented. Satisfactory results were obtained in 68 per cent of the patients. Because of the simplicity of this technique and the good results obtained we believe that internal urethrotomy often is the best initial approach to strictures that become difficult to manage by periodic dilation.

Automated Erythrocytopheresis for Relief of Priapism in Sickle Cell Hemoglobinopathies

Priapism, a complication of male patients with sickle hemoglobinopathies, has been managed by a variety of surgical and nonsurgical forms of therapy that often are unsuccessful. The application of automated erythrocytopheresis (red blood cell exchange) by continuous-flow and semicontinuous-flow procedures appears to offer distinct advantages in the treatment of complications resulting from sickle hemoglobinopathies. The successful application of erythrocytopheresis for the relief of priapism in a patient with hemoglobin SC disease is presented and probably represents the first case reported on the use of automated red blood cell exchange procedures in the treatment of this condition. Data and results of automated erythrocytopheresis in 4 additional patients are presented. The advantages and disadvantages of erythrocytopheresis in the treatment of priapism (and other complications of sickle hemoglobinopathies) are discussed and the method is compared to other modes of therapy.

Benign Lesions of the Tunica Albuginea

Although most testicular masses are malignant we present 7 cases to demonstrate that benign lesions of the tunica albuginea do occur and that these may be a source of diagnostic confusion. Consideration should be given to the possibility of a benign lesion of the tunica albuginea when the lesion is small, discrete, painless and projecting above the surface of the tunica albuginea. All of our patients were referred to us with a tentative diagnosis of testicular malignancy. We do not wish to decrease the importance of vigilance concerning testicular masses but the cases presented herein demonstrate that all masses of the testis are not malignant.

The Current Status of Undergraduate Urological Teaching

At the request of the Society of University Urologists a survey of urological teaching at 113 United States medical schools was done. The most distressing finding was that more than two-thirds (68 per cent) of the schools do not require any clinical exposure to urology before graduation. In view of the fact that urology is rarely, if ever, taught in any of the primary care disciplines after graduation, it is suggested that patient care may well suffer for this shortcoming in our medical education curriculum.

Gallium-67 scanning and conservative treatment in acute inflammatory lesions of the renal cortex

Three cases of suspected acute suppurative lesions of the renal cortex treated successfully with antimicrobial agents are presented. In support of other reports it appears that selected cases, particularly when diagnosed early, may be managed conservatively without surgical drainage. In those cases of severe sepsis, large intrarenal or perinephric abscesses, resistant organisms or those that are refractory to treatment, surgical intervention may be unavoidable. Gallium-67 nuclear scanning is a safe, non-invasive method of locating rapidly these areas of inflammation and has proved to be a useful tool in earlier diagnosis.