Urology
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Randomized Controlled Trial Comparative Study Clinical Trial
BCG (RIVM) versus mitomycin intravesical therapy in superficial bladder cancer. First results of randomized prospective trial.
This study presents the preliminary results of a randomized prospective two-arm study in which bacillus Calmette-Guérin (BCG) RIVM, a Dutch BCG preparation, is compared with mitomycin C (MMC) in patients with primary or recurrent superficial bladder tumors, including carcinoma in situ (CIS). Therapeutic regimens were as follows: after complete transurethral resection of all visible tumors, BCG RIVM (1 x 10(9) bacilli in 50 mL saline) was instilled once a week for six consecutive weeks, and mitomycin C (30 mg in 50 mL saline) was administered once a week for one month (weeks 1 to 4) and thereafter once a month for a total of six months. Reported are the incidence of side effects in 165 patients and the recurrence rate of tumors in 308 patients after a follow-up period of twelve months. ⋯ In the BCG-treated group (N = 148), 44 (29.8%) had recurrent tumors, while in the MMC-treated group (N = 160), 40 (25.0%) had a recurrence. The recurrence rate for BCG-treated patients was 0.33; the recurrence rate for MMC-treated patients was 0.29 (P = 0.560, not significant). These preliminary data demonstrated no statistically significant difference between the two arms with regard to toxicity and recurrence of tumors.
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We report a case of suppurative vasitis that presented as an inguinal mass in a young man. Inflammation of the vas deferens may occur as a manifestation of genital tuberculosis or other genitourinary tract infection. ⋯ Suppuration is rare. We report a case that represents a rare cause of an inguinal mass.
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Genitourinary filariasis is a well-known entity in most tropical areas. However, filariasis cannot be eliminated from the differential diagnosis of testicular, epididymal, or spermatic cord masses in nontropical climes. We report a case of filariasis of the spermatic cord that manifested as an unexplained scrotal mass in a patient in Rochester, Minnesota.
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Use of bupivacaine as block to relieve postoperative pain in pediatric orchiopexy and hernia repair.
Bupivacaine was utilized for postoperative analgesia in patients undergoing orchiopexy and hernia repair. In a study of 75 pediatric patients, ranging in ages from twelve months to twelve years, who had undergone orchiopexy and hernia repair during a three-year period, 42 received bupivacaine hydrochloride as a local infiltration block anesthesia to relieve postoperative pain; 33 patients did not receive bupivacaine. Patients receiving bupivacaine had less postoperative pain and were more comfortable when leaving the hospital within a few hours after surgery.
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A forty-nine-year-old man had episodes of micturition syncope associated with an asymptomatic urinary tract infection. Treatment of the infection resolved the syncopal episodes. Micturition syncope occurs in the standing position; physical, electrocardiographic, and electroencephalographic studies usually have normal results. The case reported here is atypical in that micturition syncope was the only apparent symptom of urinary tract infection.