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The cellular deoxyribonucleic acid content of formalin-fixed, paraffin-embedded tissue from nine renal oncocytomas was determined using an Epics-C flow cytometer. The tissues were all from surgical specimens, and all neoplasms met stringent light and electron microscopic criteria for the diagnosis of oncocytoma. Thirteen samples of pure tumor, 5 of tumor and normal kidney, and 3 of normal kidney alone were analyzed. All oncocytomas had single, sharp G1 peaks with no evidence of aneuploidy, and this peak was similar to that of normal renal parenchyma. This was true even for three oncocytomas that had multiple major chromosomal anomalies on karyotyping. These data support the concept that renal oncocytomas are euploid neoplasms, consistent with their benign biologic behavior. The apparent discrepancy between the results of flow cytometry and karyotyping is discussed.

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Fibroepithelial polyps are one of the less common obstructive lesions of the female urethra. The authors describe two cases of giant fibroepithelial polyps in paraplegic women. Both patients had a history of long-term indwelling catheterization to manage neurogenic bladder. The chronic irritation caused by the catheters was thought to be responsible for the development of the polyps. Resection is required in these cases to relieve the urethral obstruction and eliminate the possibility of malignant disease.

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Between 1984 and 1986 at the Wellesley Hospital in Toronto, 210 percutaneous renal nephrostomies were performed for drainage and 140 were done to provide access for nephrolithotomy. Less than 2% of the patients experienced complications requiring intervention and less than 0.5% required an open surgical approach for the management of procedure-related problems. Complications that were managed conservatively included splenic puncture, false aneurysm, laceration of the renal artery, arteriovenous fistula, hemorrhage requiring transfusion, pneumothorax-empyema, urinoma, septic shock and the hemolysis-hyponatremia-renal shutdown syndrome.

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Unusual tubular calcification occurred in the nephrostomy tract of a 30-year-old male, 6 months after percutaneous nephrostolithotomy. To our knowledge, this phenomena has not been previously reported. The main radiologic differential diagnoses are focal dystrophic calcification and vascular calcification. The etiology is unknown but may have been related to the patients' tendency to form renal calculi. The temporal sequence of events and the location of the nephrostomy catheter which correlated with the calcification suggests the correct diagnosis.

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We herein describe a new technique for the assessment of the clinically significant obstructed renal unit. The diuretic ultrasound utilizes the noninvasive, high resolution ultrasound unit in combination with diuresis induction with furosemide to assess renal collecting system obstruction.

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Salpingitis and vesicular fistulas are rare complications of Crohn's disease. In this report the authors describe a case of oophorovesicular-colonic fistula secondary to Crohn's disease. The patient presented with bleeding from the bladder during menstruation, fecaluria and pneumaturia. A single-stage left salpingo-oophorectomy, sigmoid resection and repair of the fistula were carried out, with complete resolution of symptoms and preservation of fertility potential.

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The authors report a case of right ureteropelvic junction obstruction in an otherwise healthy 31-year-old man. Because of previous surgical manipulation of the right testicle, the diagnosis was obscured, delaying therapeutic intervention. Renal pain often refers to the testicle and groin, and testicular pain to the flank. Therefore evaluation of organs in the primary referral distribution must be considered in cases of obscure intractable pain in this area.

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The principal morbidity of retroperitoneal lymphadenectomy is the potential loss of ejaculation and, therefore, fertility owing to damage of the retroperitoneal sympathetic nerves that form the superior hypogastric plexus. We describe the results of our retroperitoneal lymphadenectomy when individual nerves from the sympathetic ganglia are identified and preserved while still performing a thorough bilateral retroperitoneal lymphadenectomy. The nerve-sparing procedure was technically feasible in 20 of 30 consecutive patients and it was only impractical with extensive gross disease. Of the 20 patients 18 (90 per cent) ejaculate, including 8 with bulky (5 cm. or more) residual retroperitoneal disease who underwent a successful nerve-sparing operation. All 12 patients (100 per cent) with nonbulky disease ejaculate. With short followup, no retroperitoneal recurrences have been detected. This technique is an alternative to limited dissection designed to spare nerves using boundaries based on the patterns of metastatic involvement.

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This study evaluates the ability of DNA histograms obtained by flow cytometry to detect and quantify reversible alterations in spermatogenesis induced by cyclophosphamide, a known inhibitor of spermatogenesis. Evaluation of per cent of cells in each of the haploid (lc), diploid (2c), and tetraploid peaks (4c) as determined by flow cytometry in treated and control Balb/C mice over a six-week period, and comparison with routine histologic evaluation have led us to conclude that DNA histogram evaluation is a rapid and accurate means of identifying testicular damage and recovery. This technique may be useful in sequential monitoring of the effects of malignancy and/or treatments applied on spermatogenesis in young men.

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