Fowler's solution for treatment of recurrent intraurethral condyloma acuminata

LETTERS

TO THE EDITOR

FOWLER’S SOLUTION FOR TREATMENT OF RECURRENT IKTRAURETHRAL CONDYLOMA ACUMINATA

To the Editor: I would like to congratulate John Redman, M.D., Nabil K. Bissada, M.D., and J. Samir Sulieman, M.D., for their excellent article on “Condyloma Acuminatum of Male Urethra” in the April issue (vol. 3, page 499) of UROLOGY. I would, however, like to add another therapeutic modality, the prophylactic use of Fowler’s solution. Years ago in a residency at Jefferson Davis Hospital, Houston, Texas, a young Negro male patient died of the complications of intraurethral condyloma acuminata. His recalcitrant attitude and reluctance to permit anyone to do anything allowed his disease to progress from simple intraurethral condyloma acuminata to filling the entire bladder, obstructing both ureteral orifices. After an absence of several years he returned in a toxic condition. He did agree to nonsurgical treatment, and on admission he was found to be in extremis with severely compromised renal function. We were unable to place ureteral catheters, and he refused upper urinary diversion. As a result of this experience and before many of the more modern drugs mentioned in Dr. Redman’s bibliography were in use, on reviewing the literature we discovered the judicious use of Fowler’s solution, 3 to 4 drops taken orally four times a day, depending on the patient’s size and weight, would prevent the recurrence of intraurethral condyloma. Living in an area with many young men and having seen perhaps 25 cases of the intraurethral variety, averaging one or more per year, after initial resection, cauterization, and so on, I treat these men with Fowler’s solution, as mentioned, and thus f& never had a recurrence. I usuall!. continue this regimen for a minimum of three months, and if there are numerous lesions, up to one year with follow-up endoscopic examFor the pharmacologically oriented ination. urologist, Fowler’s solution is potassium arsenite and can be routinely prepared by any

UROLOGY

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IIrLY 1974

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pharmacist. (According to Dorland, it was named an English physician, after Thomas Fowler, 1736-1801.) Inadvertently, in Dr. Redman’s article, Fowler’s solution was not mentioned. I suspect that bismuth sodium triglycollamate (Bistrimate), gold, and other drugs used by our forefathers for lack of more modern drugs should not be forgotten in the legion of time. A wizened elderly otolaryngologist friend had me take bismuth sodium triglycollamate intermittently for several months to obviate and hopefully cure the irritative lymphoid follicular posterior pharyngitis I suffer with from time to tinle. R. H. Harrison, M.D. 2721 Oslrr Boulevard Bryan, Texas 77801

TUMORS OF FOLLOWING

SIGMOID COLON URETEROSIGMOIDOSTOMY

To the Editor: I enjoyed reading the article on “Adenacarcinoma of Colon at Ureterosigmoidostom; Site 14 Years After Conversion to Ileal by Stephen R. Shapiro, M.D., Attilo Locp,” Baez, M.D., Arnold H. Colodny, M.D., and Judah Folkman, M.D., in the February issue In this article, (vol. 3, page 229) of UROLOGY. the authors claimed that the case reported was the eleventh in the literature. May I refer them to the British literature, including one article by Whittaker, Pugh, and Dow’ and another by me?” W. Al. Lien, M.B., Ch.B., F.R.C.S. Consultant Surgeon Good Hope General Hospital Sutton Coldfield IVarwickshire, England References 1. PVHITTAKEH, R. H.,

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tnmours following nretcrosi~lnoitlostom). Hr. ,I. Ural. 43: 562 (1971). 2. LIEN, W. Xl.: Tumours of the sigmoid colon following ureterosian~oidostom~, Postgrad. hled. J. 49: 290 (1973). lank

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