SUMMARY
Two further cases of urachal carcinoma are added to the 76 already reported in the English literature. An important factor contributing to the poor prognosis appears to be inadequate excision of the tumour at the time of partial cystectomy. No tumour at the apex of the bladder should be treated endoscopically without a tissue diagnosis; if biopsy reveals adenocarcinoma the urachus is the most likely site of origin. Treatment entails en bloc excision of the transversalis fascia, the fatty tissue in the cave of Retzius and an adequate margin of bladder wall together with the overlying peritoneum. Radiotherapy has little to offer for the early case but may be a useful adjunct to surgery in the presence of advanced disease.
A simple, portable urinary flowmeter is described. In an attempt to assess its practical significance, the urinary flow rates of 200 male subjects were recorded. In the absence of symptomatic urethral obstruction the flow rate varies with the age of the subject and the voided volume; the latter should exceed 200 ml if the maximum rate is to be determined. The majority of patients with obstructive prostatic disease or urethral stricture will void with rates below 5 ml/sec, the range of normal being 15 to 45 ml per second.
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