No abstract

Radiation-induced hemorrhagic cystitis continues to cause frustration for patients and urologists alike. Virtually all present modes of treatment tend to yield short-term benefits and entail potentially devastating risk by virtue of the tissue destructive nature. We report our 10-year experience in the treatment of hemorrhagic radiation cystitis with hyperbaric oxygen therapy, a tissue-reparative method, in followup of our prior reports. A total of 13 patients who previously underwent radiation therapy for various pelvic malignancies had endoscopically or biopsy proved hemorrhagic cystitis. All but 1 patient experienced durable cessation of hematuria with minimal side effects following hyperbaric oxygen therapy. These results suggest hyperbaric oxygen therapy to be a significant weapon in the armamentarium for treatment of hematuria secondary to radiation-induced injury to the bladder.

Bacterial adherence to anion exchange resin has recently been reported to provide a useful, rapid, in vitro screening assay for identifying putative antiadherence agents. The studies presented in this report provide additional evidence that adherence to anion exchange resin is similar to urinary bladder mucosa adherence. Results are as follows. 1) Heparin inhibits the adherence of Escherichia coli, Klebsiella ozaenae, Proteus mirabilis, Streptococcus fecalis and Pseudomonas aeruginosa to both the mucin deficient bladder and anion exchange resin. 2) Drugs which inhibit E. coli adherence to the bladder also inhibit E. coli adherence to the resin and conversely, drugs which do not effect E. coli adherence to the resin do not affect attachment to the bladder. 3) Extracts from mammalian urinary bladder mucosa prevent E. coli adherence to both the bladder and resin. 4) The ability of heparin to displace preattached bacteria from anion exchange resin is inversely proportional to the time the bacteria are in contact with resin. Similar results were obtained for the ability of heparin to displace bacteria from the bladder. These studies indicate that bacterial adherence to anion exchange resin responds to heparin and other chemical agents in a manner similar to the mucin deficient rabbit urinary bladder. Because of the ease and rapid nature of this in vitro assay, it serves as a useful screen for potential bacterial antiadherence agents and could be used to help elucidate mechanisms of bacterial attachment.

We report a case of idiopathic priapism that was only identified as high-flow or arterial priapism after drainage of the corpora cavernosa. Following failure of conservative and surgical treatment attempts, two consecutive embolizations of a unilateral penile artery were performed with gelgoam particles.