The Journal of urology
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The Journal of urology · Dec 1989
Technique of pudendal nerve localization for block or stimulation.
A diagnostic technique is described for study of the pudendal nerve via a dorsal rather than perineal approach. The method offers unique advantages for the urodynamic study of sphincteric function. The patient is placed in the prone position with slight flexion of the hips. ⋯ Local anesthesia and electrical stimulation then are used to position a needle tip adjacent to the pudendal nerve. This approach allows for specific localization of the nerve for accurate temporary or permanent nerve block. It also permits continuous urodynamic monitoring of pelvic floor behavior with stimulation of the pudendal nerve to assess functional integrity of the nerve and the pelvic floor striated muscles.
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The Journal of urology · Nov 1989
Has ultrasound influenced the therapy concept of blunt scrotal trauma?
We present the ultrasonic diagnoses and treatment of 44 patients with blunt scrotal trauma (rupture of the testis, hematocele, intratesticular hematoma and hematoma of the scrotal layers). Purely intratesticular hematoma without any other accompanying injury also can be detected sonographically. When massive scrotal swelling is present ultrasound is valuable to determine the status of the underlying testis even if discrete fracture planes of the tunica cannot always be detected. To achieve best long-term results early surgical intervention should be performed in cases of rupture of the testicle and hematocele, while hematoma of the scrotal layers and purely intratesticular hematoma can be treated conservatively.
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We reviewed the incidence and management of intraoperative rectal injuries in patients who underwent radical cystectomy from January 1980 through July 1988 to assess the role of primary repair without diverting colostomy as definitive therapy. During this interval 163 radical cystectomies were performed and 125 charts were available for review. The incidence of rectal injuries was 9.6% (12 of 125 patients). ⋯ The remainder were treated with an initial colostomy. Only 1 patient who had not received prior radiation required a colostomy after initial treatment with primary closure. The 8 successful primary rectal closures were done in 2 patients who underwent definitive pelvic radiation, 2 who had received 2,000 rad preoperatively and 4 who had not been irradiated.
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Purple urine drainage bags were found in 7 of 71 chronically catheterized elderly women. The purple staining of the bags is due to a violet discoloration (indirubin) of the plastic of the catheter bag and fine blue crystals of indigo in the urine. ⋯ Organisms identified were Providencia or Klebsiella species. Indican excretion was higher in patients with purple urinary catheter bags than in controls.
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The Journal of urology · May 1989
Case ReportsMeconium hydrocele: an unusual etiology of a scrotal mass in the newborn.
The in utero leakage of meconium from the gastrointestinal tract into the peritoneal cavity results in the clinical entity known as meconium peritonitis. A patent processus vaginalis in the male fetus may lead to the migration of meconium into the scrotum, and these infants can present with soft meconium-filled hydroceles at birth. Local tissue reaction during the first several weeks of life results in calcification of these hydroceles into hard tumor-like lesions that may mimic testicular neoplasia. We report an atypical case of meconium hydrocele in a newborn.