Regarding the absence of tumor recurrences in our retrospective analysis and the favorable toxicity profile with no episodes of long-term toxicity, we suggest that two adjuvant courses of single-agent carboplatin for clinical stage I seminoma patients might be equivalent to radiotherapy.
A series of 32 patients underwent direct vision urethrotomy. The technique is simple and the stay in hospital short. Intra- and postoperative complications are rare. Postoperatively, a silicon catheter is left for approximately 7 days, then hydraulic self-dilatation is performed by the patient for 6 months. 25 patients in this series (83%) voided satisfactorily after the procedure and needed no further treatment. Unsatisfactory results were obtained in patients with long strictures, in traumatic strictures with large scarred areas and in patients who failed to carry out regular hydraulic self-dilatation. We advise direct-vision urethrotomy as a treatment of choice for urethral strictures which do not exceed a length of 3 cm.
Submucosal injections of bovine collagen (Zyplast) were administered to 67 children and 7 adults with 115 refluxing ureters. Reflux was grade I in 14 ureters, grade II in 54, grade III in 38 and grade IV in 9. All patients had a history of recurrent urinary infection. One year after treatment 70 ureters showed no reflux, 20 were grade I and 25 showed a complete recurrence. The cure rate was 81% if grade I recurrence is included. In all, 68 ureters were followed up for 2 to 4 years. In 19 ureters a second injection was given, 47 showed no reflux, 19 had grade I reflux and 2 had a recurrence. In 5 ureters reflux grade I disappeared without a second injection. The cure rate was 97%. Renal scarring was seen in 4 kidneys. Collagen injections are an adequate method of treatment for reflux grades I-III.
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