A case of bilateral testicular rupture after blunt trauma is presented. It is unusual in that the patient presented with a unilateral retractile testis with pain. The contralateral testis was asymptomatic but was found to be ruptured at exploration. The objectives of preservation of testicular function and prevention of misdiagnosis and undiagnosed cases are reiterated. Early exploration of all blunt trauma to the scrotum and testis is advocated. The surgical management of the ruptured testis is reviewed with regard to orchiectomy, primary closure, closure with portion of tunica vaginalis and decompression of the contused testis.
Pancreatic adenocarcinoma can present initially as urologic disease. The 15 reported cases in the literature are analyzed and 5 cases, featuring ureteral obstruction, renal artery compression, abdominal bruit, positive urinary cytology, varicocele, renal mass and hematuria as the initial presentation of this disease, are added. The diagnosis and management are reviewed.
The value of bone marrow acid phosphatase in the staging of prostatic cancer has been a controversial issue. A number of investigators have concluded that the enzymatic determinations of bone marrow acid phosphatase are inaccurate because of lack of specificity. The introduction of the immune methods for measuring acid phosphatase has revived interest in the role of immune bone marrow acid phosphatase in pre-treatment staging. Fifty-five patients underwent determination of simultaneous immune bone marrow and serum acid phosphatase before any treatment. While positive values did predict a risk for initial and subsequent metastasis they could not be used to dictate against definitive therapy. Positive bone marrow values were paralleled by positive serum values and provided no additional staging information.
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