Urology
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The optimal treatment of prostatic carcinoma limited to the gland remains controversial. Treatment has included implantation of Iodine-125 seeds via both a suprapubic approach and, more recently, a transperineal technique utilizing ultrasound guidance. ⋯ One of 5 patients undergoing transperineal implant was found to have seeds lodged in the lung. Complications surrounding the various treatments of localized prostate carcinoma are reviewed.
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Infected urachal cysts present with protean clinical manifestations. Diagnosis is frequently difficult in spite of the use of modern genitourinary radiologic imaging techniques. Patients with intra-abdominal or pelvic symptoms are frequently misdiagnosed. Surgical excision is the treatment of choice for infected urachal cysts.
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Traumatic dislocation of the testicle is characterized by an ectopically displaced testis as the result of closed injury. We report on 1 patient with subcutaneous inguinal dislocation of the testis that was successfully treated by immediate closed reduction. Forty-nine other cases (36 unilateral and 13 bilateral) have been previously cited. Diagnostic guidelines, our therapeutic approach, and the relevant literature are presented.
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Serious systemic reactions caused by currently used ionic and nonionic contrast material are the anaphylactoid (allergic-like) reaction and the vagal reaction. Each likely has more than one etiology, and certain patients are at higher risk for developing such a reaction. The urologist and radiologist must be able to differentiate between the clinical manifestations of the anaphylactoid (asthma-like) reaction and the vagal (bradycardia and hypotension) reaction. Specific treatment for the anaphylactoid reaction is low-dose epinephrine; specific treatment for the vagal reaction is intravenous fluid and high-dose atropine.