Making of a stoma

responses, and this will be neither the first nor the last. In October, 1976, I removed a pure seminoma from an eighty-two-year-old white male with urinary retention. A physical examination in a 1972 hospital admission described the external genitalia “negative.” a poor historian, The patient, Ascribed the mass as present for “about three months.” I doubt that this will be any record, but again reaffirm Dr. Wasserman’s statement that all testicular masses should come under suspicion regardless of the patient’s age. Louis J. Marchetti, M.D. Moore Memorial Hospital Pinehurst, North Carolina 28374 PARAURETHRAL

LEIOMYOMA

To the Editor: In the December, 1976, issue (vol. 8, page 605) of UROLOGY, Eugene V. Cattolica, M.D., Robert Klein, M.D., and William Knigge, M.D., reported two cases of paraurethral leiomyoma in two middle-aged females. In I973 I presented an identical case report at the Kimbrough Urological Seminar. At the time of the discussion of this paper, Dr. Ian Thompson noted several similar cases with which he had had experience. Shortly thereafter, as a result of a news article reporting my case in the OB-GYN News, a gynecologist in Texas telephoned me that he had seen several such cases in his practice. Dr. Frederick L. Howell sent me case summaries of two similar patients whom he had treated in his urologic practice in Alexandria, Virginia, several months before. In view of the apparent epidemic of these lesions at that time, I decided not to submit my case report to any other publication other than the Proceedings of the Kimbrough Urological Seminar. It appears that this type of lesion is not as uncommon as previously thought.

heroin. Both proved to be particularly troublesome problems relative to wound healing, control of infection, and preservation of renal function in these self-imposed compromised hosts, especially when prednisone therapy was necessary for the treatment of chronic active hepatitis. I believe urologists will increasingly encounter these additional renal complications of drug addiction. Robert P. Nelson, M.D. Medical University of South Carolina Charleston. South Carolina 29401 MAKING OF A STOMA To the Editor: We wish to compliment Dr. Roy Witherington, Dr. Jack Amie, and Dr. Arnold P. Mulkey on “Making of a Stoma” which appeared in the January issue (vol. 9, page 69) of UROLOGY. In our experience, a minor modification of the bud construction as illustrated has eliminated peristomal

H. Alan Bigley, Jr., M.D. 405 South Sycamore Street Petersburg, Virginia 23803

DRUG ADDICTION COMPLICATIONS

AND RENAL

To the Editor: I would like to amplify the fine article by J. Olivero, M.D., et al., “Renal Complications of Drug Addiction,” which appeared in the December issue (vol. 8, page 526) of UROLOGY, by noting two other complications of addiction. Recently I have encountered a renal carbuncle and a perinephric abscess in two patients addicted to

610

radial scars due to skin sutures. The bud is constructed with everting, absorbable sutures incorporating in order subcutaneous tissue, dermis, terminal conduit full-thickness, and conduit seromuscular layers. Tying this suture everts the stoma and buries the knot. John M. Barry, M.D. Clarence Hodges, M.D. University of Oregon Medical School Hospital Portland, Oregon 97201

UROLOGY

/ MAY 1977 / VOLUME

IX, NUMBER5