No abstract

In a retrospective study of 51 cases of systemic North American blastomycosis 11 patients were found to have genitourinary tract involvement, the prostate and epididymis being most commonly affected. Diagnosis was made by culture of the fungus from urine, abscess or prostate secretions, morphologic identification of the characteristic organism in urine or secretions, or histologic examination of tissue specimens. Treatment with amphotericin B reduced the mortality rate of 90 per cent to as low as 10 per cent. Long-term followup is necessary because of a relapse rate of 10 to 15 per cent.

In a retrospective study we analyzed the high incidence of 75 urological complications after abdominoperineal resection in 52 patients. A prospective study was done also to anticipate as well as to minimize or eliminate these highly significant complications. Direct injury leading to obstruction and fistula formation was avoided. Obstructive uropathy in 10 of 25 male patients was found as a direct result of preoperative evaluation. Same day prostatectomies in 5 patients made no appreciable difference in the urological management, complication rate or end results. Neurogenic bladder dysfunction of various degrees was found in 50 per cent of all patients but represented a long-term problem in only 10 per cent.

A non-functional and permanently damaged lower urinary tract is no longer a contraindication to kidney transplantation. In patients with this disorder the ureter commonly is drained by an intestinal conduit. We have used terminal loop cutaneous ureterostomy as a method of urinary drainage in 3 patients with cadaver kidney transplants who have been followed for up to 8 years. The technique of terminal loop cutaneous ureterostomy and a report of these cases are presented.