Search

Experience had with radical prostatectomy in patients presenting localized prostate carcinoma is shared. A modified technique for new bladder-neck formation contributing to continence preservation is used in five patients, yielding very good postoperative results. In four cases a full recovery of continence is achieved within 3 months of the operation without resorting to drug therapy. In one case medical treatment with parasympaticolytics and agonists of voluntary sphincter is applied. The final outcome is stress incontinence only and passage of urine in the event of micturition postponed with 3-3.5 hours.

According to A. Someren (1989), R. Heicapell and R. Ackermann (1992), Ritchie A. W. S., de Kernion (1987) renal carcinoma is a condition clinically "imperceptible", lacking typical symptoms. The clinical characteristics presented by 509 patients, treated in the Department of Urology (Clinical Center of Urology at the Medical University--Sofia) over the period 1973--1994, are discussed. Symptoms typical of the urogenital system, and atypical ones as well, are separately classified. A catamnestic follow-up study of the complaints is also done. Pain is the most frequently noted (77.38 per cent), next ranking hematuria (59.92 per cent), tumor mass palpation (26.38 per cent), with the classical triad bing recorded in 11.50 per cent. Carcinoma of the kidney is considered as one of the major imitators, mimicking a diverse and atypical clinical picture.

As pointed out by J. R. McLaughlin et al. (1983), in the various countries worldwide there is considerable difference in incidence and mortality rates of renal carcinoma. In the period 1973 to 1994, a total of 509 patients with renal carcinoma are admitted to the Department of Urology (Clinical Center of Urology, Medical University--Sofia). They represent 0.82 per cent of the total number of admissions during the stated period, and 7.71 per cent of the patients with diseases of the urogenital system. According to data submitted by the National Center of Oncology, the incidence of renal carcinoma amounts to 1.53 per 100,000 of population. As shown by the results most of the patients come from Vratsa and Vidin districts. By incidence rate of the disease Bulgaria is assigned to the moderate morbidity type in Europe. Patients in active age amount to 66.46 per cent, and old age pensioners--to 31.74 per cent.

A patient has been observed with virilizing cancer of the adrenal cortex. Anesthesiologic-resuscitation and operative problems are discussed. The importance of corticosteroid substitutional treatment is emphasized. The operation was performed through transversal laparotomy under classical neuroleptanesthesia.