Yehoshua Ginesin

Lich-Gregoir anti-reflux operation: a surgical experience and 5-20 years of follow-up in 149 ureters

The surgical management of vesicoureteral reflux and the choice between the many good procedures available continue to be debated by urologists. The goal of each procedure is to achieve as normal a function of the urinary system as possible, to eliminate urinary tract infections, and thus to prevent further kidney damage. We present our experience in 149 antireflux repair operations with a technique first described by Lich and Gregoir in 1961. The follow-up in this study is 5-20 years, throughout which recurrent infections, reflux and other operative complications have carefully been considered. The success rate of this operation was 92.5%, with an additional 3.75% success in repair operations. Discussion and evaluation of other repair methods are reviewed but, in our opinion the Lich-Gregoir technique, because of its simplicity, should be the method of choice and should be used more by urologists.

An operation for incisional lumbar hernia.

To date, no standard technique for incisional lumbar hernia repair can be recommended since it depends on the size of the defect in the transversalis fascia. A new technique for this purpose, by using plication of the normal fascia, is described.

Obstructive jaundice caused by metastatic renal cell carcinoma.

We report the first instance of extrahepatic obstructive jaundice caused by renal cell carcinoma metastasis to ampulla of Vater

Effect of distilled water and bacillus Calmette-Guérin on exfoliated bladder tumor cells.

The effect of distilled water on exfoliated tumor cells from transitional bladder carcinoma was compared to the effect of bacillus Calmette-Guérin (BCG; a nonspecific immunotherapeutic agent) dissolved in either saline or distilled water. The experiment was controlled by comparison to the effect of saline on tumor cells under the same conditions. Distilled water proved as effective as BCG in distilled water (p less than 0.001) and much more destructive than BCG in saline within the 2-hour time limit of the experiment (p less than 0.001).

Idiopathic calcinosis of scrotum

A case of idiopathic calcinosis of the scrotum is presented. This term has been applied to an uncommon disorder characterized by solitary or multiple, firm painless papules or nodules of the scrotum that usually appear during childhood or early adult life. The lesions are skin colored to white-yellow, increase in size and number, may itch or drain a chalky white material. X-ray film reveals calcified shadows. Biopsy specimens of the lesions show masses of calcium deposits in the dermis without evidence of an epithelial lining.

Carcinosarcoma of the prostate.

Carcinosarcoma of the prostate is a very rare malignant tumor in men. Only 4 cases have been reported in the English literature. We give herein the 5th case report of carcinosarcoma of the prostate.

A Müllerian Prostatic Cyst Protruding into the Base of the Urinary Bladder

The unique appearance of a midline prostatic cyst is reported. The cyst presented as a round-shaped filling defect at the base of the urinary bladder during an intravenous pyelography study. Transabdominal sonography showed the mass to be a midline prostatic cyst. The sonographic features of the mass and its location are the hallmark of a müllerian duct prostatic cyst. Midline prostatic cysts are discussed and the features differentiating müllerian duct cysts from utricle cysts are emphasized.

Epidural morphine: a new approach to combined anesthesia and analgesia in urological patients

The effect of combined epidural anesthesia and epidural morphine injection is discussed. A group of 98 patients (group A), chosen at random, was operated on under such combined anesthesia and compared to a similar group of 98 patients (group B), equally chosen at random, operated on under either spinal or general anesthesia with no epidural morphine added. Over 87% of group A needed no narcotic drugs for postoperative pain. All patients in the group B needed 60-80 mg of morphine during the first 48 postoperative hours. The quantity of morphine required was the main parameter for comparison. The postoperative course in group A was considerably easier while the operative results were equal in both groups.

Incomplete quadruplication of urinary tract with contralateral agenesis of the kidney.

We describe here the first case of an exceptional anomaly consisting of an incomplete quadruplication of the urinary tract in a solitary left kidney. A review of the English literature failed to document such a case.

Metastatic Malignant Melanoma of the Kidney

A rare case of malignant melanoma metastasizing to the kidney is described. Five other cases were found in the English literature, this being the sixth. A review of the subject is brought up.