No abstract

We analyzed four personal cases and 51 reported cases of dissecting aneurysms of the arteries of the head and neck. Subintimal dissection more commonly affects the intracranial vessels before age 40. In contrast, medial dissection tends to affect extracranial vessels after age 30. Vertebrobasilar dissection more variably affects either arterial plane. The reasons for these differing patterns of dissection are still not clear. In young subjects, the subintimal layer appears to be more susceptible; in contrast, the media becomes increasingly vulnerable with age, particularly in the presence of acquired medial disease.

From April 1978 to September 1993, the Department of Urology of Giessen Medical School used laser urethrotomy as standard endoscopic treatment in benign urethral strictures. In this period, 900 urethrotomies were performed in 450 patients. The majority of strictures treated were iatrogenic (65%), located in the posterior urethra (62.8%) and classified as short ( < 1 cm) (71%). Argon laser urethrotomy was carried out in the 12° position according to the technique of internal optical urethrotomy. An indwelling transurethral catheter was left for 48 h after urethrotomy. Uroflowmetry after argon laser urethrotomy revealed the efficacy of the method. A retrospective analysis of the operations was performed. Analysis showed that recurrence appeared on average after 15.2 months (range 1–39) in up to 70.1%. Nearly 50% of recurrence was evident within 1 year following surgery. Recurrence was independent of location, length and etiology of the stricture. We conclude according to our data that argon laser urethrotomy is technically feasible. Due to the high recurrence rate the method offers no advantage over conventional internal optical urethrotomy.

Metastases to the penis due to a primary carcinoma ofthe prostate are rare. In approximately half of the patients, malignant priapism is the main symptom. This study reports on a case of malignant priapism, caused by a direct and metastatic infiltration of the corpora cavernosa by a prostatic adenocarcinoma. Sonography gave hints, the magnetic resonance imaging verified the infiltration and aspiration cytology verified the carcinoma. Hemodynamics, evaluated by Doppler sonography, and intracavemosal blood gas analysis demonstrated a mixed high-low priapism without need of therapy.

We report a case of pheochromocytoma of the prostate. The clinical presentation, diagnostic evaluation, therapy and pathological findings are discussed.