The Journal of urology
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The Journal of urology · Dec 1976
The incidence of intersexuality in patients with hypospadias and cryptorchidism.
The incidence of intersexuality was determined in 45 patients with cryptorchidism and hypospadias seen between 1952 and 1975. Including patients with ambiguous genitalia the incidence was 53 per cent. When patients with ambiguous genitalia were excluded, providing a group more representative of the patient population usually seen by the urologist, a diagnosis of intersexuality was made in 27 per cent. The concomitant occurrence of hypospadias and cryptorchidism should alert the urologist to evaluate the patient for the presence of intersexuality.
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There was a 20 per cent mortality rate of 193 patients with bladder injury and in 94 percent of all patients there were associated injuries that caused the deaths. Blunt external trauma was responsible for 95 per cent of the injuries. ⋯ The advantages and disadvantages of urethral catheter drainage are discussed. Early diagnosis and treatment of bladder rupture are important if the significant mortality is to be reduced.
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Emphysematous pyelonephritis is a rare complication of urinary tract infection and generally occurs in patients with diabetes mellitus or urinary tract obstruction. We recently treated an 81-year-old diabetic woman with Klebsiella pneumoniae urinary tract infection and septicemia whose abdominal roentgenogram demonstrated a striking left pneumonephrogram as well as intraureteral and perirenal gas. The patient died despite intensive therapeutic efforts. Unfortunately, the prognosis for this severe necrotizing infection process remains unfavorable.
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Three instances of life-threating adverse reations to intravenous contrast media and penicillin have been presented. Hypotension was the major presenting sign, and was prolonged and relieved only by copious dluid therapy. In 1 case the onset of hypotension was delayed for an hour. Urologists should be aware of the variety and proper treatment of drug reactions.
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The Journal of urology · Jan 1975
Comparative StudySuccinylcholine-induced ventricular fibrillation in the paralyzed urology patient.
A myelotomy patient with succinylcholine-induced hyperkalemia and ventricular fibrillation was succesfully resusciated. The urologist and anesthetist can prevent this problem by using non-depolarizing muscle relaxants in patients with denervated skeletal muscle.