Simple renal cysts were treated by aspiration and injection of the sclerosing agent 3% polidocanol (Aetoxisclerol®) in 15 patients. All patients were followed up by ultrasound for 1–24 months. The age ranged from 35 to 81 years. There was 1 recurrence at 1 month. The efficacy of this treatment was 93%. Fourteen cysts completely disappeared, and no recurrence occurred after 1 year. Complications, such as microscopic hematuria, fever and infection, were not observed. The technique of polidocanol sclerotherapy was effective and safe.
Sixty patients with varicocele, complaining of infertility, underwent a corrective operation. Eighteen (30%) of the 60 patients impregnated their mates (impregnating group). Sperm concentration significantly increased after the operation in the impregnating group (p < .05), but not in the patients who failed to impregnate their mates (nonimpregnating group). Sperm motility was not altered after the operation in these two groups. Sperm velocity significantly increased postoperatively in the impregnating group (p < .05), while linearity was not altered in either group. Sperm swelling significantly increased postoperatively in the impregnating group (p < .05), but not in the nonimpregnating group. Preoperative sperm parameters were not different between the two groups. Varicocele may disturb sperm function including sperm motion besides spermatogenesis and may impair the fertility potential. However, a prospective large-scale controlled study is required to obtain a definitive conclusion.
Fifteen patients with hydroceles of the testis or spermatic cord were treated by aspiration and injection of the sclerosant solution polidocanol. The cure rate of hydroceles after one sclerotherapy session was 73%, and the overall cure rate using the procedure was 87%. No patient experienced pain during or after the procedure, which was conducted without anaesthesia. No complications were observed. It is concluded that sclerotherapy of hydroceles with polidocanol may be a useful alternative to open operation, due to its ease of administration, low frequency of complications, and high rate of effectiveness, and that this agent is preferable to certain other drugs in that it causes no pain during or after the injection.
The diagnostic significance of transrectal prostatic ultrasonography for chronic prostatitis and varicocele was evaluated in 380 male infertility patients. Of 20 patients with pyospermia, thought to be mainly caused by chronic prostatitis, 10.0 percent showed heterogeneous echo pattern of the prostate, while 25.0 percent showed capsular irregularity. Since 285 patients with non-infected semen showed similar sonographic findings, it is concluded that prostatic ultrasonography has little value in the diagnosis of chronic prostatitis in infertile patients. Enlarged periprostatic echo-free zone, thought to coincide with the dilatation of the Santrini's plexus, was found in 42.9 and 42.7 percent of patients with chronic prostatitis and varicocele, respectively, in contrast to 34.0 percent of patients without either diseases. Twelve percent of patients with varicocele showed highly enlarged echo-free zone, which was significantly more frequent compared to 5.0 percent in normal patients. Moreover, follow up of 4 patients with varicocele pre- and post-operatively found 2 of them to show a great improvement in the enlargement of the zone. These results suggest that varicocele may cause the dilation of the Santrini's plexus through a venous anastomosis in some patients and transrectal ultrasonography may be a useful tool in detecting small varicoceles in such patients.
A 60-year-old Japanese man was hospitalized because of urinary leakage from the anus on October 3, 1994. Retrograde urethrography detected a fistula between the bulbous urethra and the rectum. Urethrocystoscopy revealed a tumor on the urethrorectal fistula. Tumor biopsy showed a well differentiated adenocarcinoma. Cystourethrectomy with fistulectomy, and ileal conduit urinary diversion were performed. Pathological examination revealed primary adenocarcinoma in the fistula with invasion to the prostatic urethra and bladder wall. The patient showed no evidence of a recurrence as of August, 1996.
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