- Email: [email protected]
Textbook of Genitourinary Surgery, 2nd ed.
BOOK REVIEW
free bladder mucosal graft can be used regardless of the individual anatomy or proximity to the ureteral orifices, because it can easily be tailored. This technique represents an important repair of difficult, recurrent, or multiple vesicovaginal fistulae. Editorial Comment: With this technique the graft is harvested from the lateral bladder wall and the donor site defect is allowed to heal by re-epithelialization. Fistula repair is performed transvesically. Bladder epithelium is removed around the margins of the fistula, and the graft is sutured into place. The procedure was successful in all patients. Fistulas were complex in some cases, and radiation for cervical carcinoma was the cause in 1. This technique appears to be simple and afforded excellent results. It surprised me that bladder epithelial grafts provided sufficient thickness. Also surprising is graft survival because, according to this report, no attempt is made to approximate the bladder wall or close the vaginal defect. More experience is needed with this technique. Jack W. McAninch, M.D. Oral Stanozolol in Lichen Sclerosus et Atrophicus D. PARSAD
AND
R. SAINI, Himalayan Institute of Medical Sciences, Jolly Grant, Dehradun, U.P., India
J. Amer. Acad. Dermatol., 38: 278 –279, 1998 No Abstract Editorial Comment: Lichen sclerosus et atrophicus of the penis, or balanitis xerotica obliterans, can be extremely debilitating because of pain, ulceration, inflammation and induration, and extremely difficult to control. For 3 months 5 patients received orally 2 mg. stanozolol, a potent anabolic steroid, twice daily. Lesions were classified on a scale of 0 to 4 according to severity. Before treatment the mean score was 3.6 and at the end of therapy it was 1. Painful erections and soreness were relieved. The authors provide no information on symptoms of balanitis xerotica obliterans after completion of therapy. Stanozolol is a potent fibrinolytic agent, and it is this property that is presumed to produce the desired results. Liver function must be monitored closely in these patients. Jack W. McAninch, M.D.
BOOK REVIEW Textbook of Genitourinary Surgery, 2nd ed. H. N. WHITFIELD, W. F. HENDRY, R. S. KIRBY AND J. W. DUCKETT, Oxford: Blackwell Science Ltd., 1,516 pages, 1998 This book is the second edition of a text that was first published in 1985. The editors have brought together a group of multidisciplinary, international contributors with diverse areas of expertise. Of the 184 authors 105 are from Europe or Scandinavia, 47 from the United States, and the remainder from Canada, the Middle East, the Far East and Australia. Thus, this text has a truly international flavor. Rather than the traditional organization by organ systems commonly found in comprehensive textbooks of this type, it is organized by disease entities. Compared to other comprehensive textbooks, there is less emphasis given to the basic sciences except as to how those areas pertain to a specific disease entity. For example, while there is only an 11-page chapter devoted to renal blood flow, there are entire chapters on management of hypertension, renovascular disease, the loin pain-hematuria syndrome, and exercise induced and incidental hematuria. This organization makes for a handy reference when reviewing a specific disease entity. However, it is probably not the best textbook for the beginning urologist who does not yet understand normal genitourinary physiology. This textbook is beautifully illustrated with abundant color drawings and photographs, and radiographic images. Most radiographic images and intraoperative photographs are accompanied by line drawing legends for interpretation of these images. The images in this text make it a pleasure to read. The artwork is purposefully designed to convey the conceptual basis of a procedure, while eliminating the precise anatomical detail found in many medical drawings. It conveys the concept of a procedure, not anatomy, which is a strength of the text and not a weakness. The international flavor and organization by disease entities have advantages and disadvantages. Each chapter represents the opinion of an expert in the area of discussion and is not necessarily a comprehensive review of the subject. Many of the chapters on genitourinary malignancies describe a European approach to the evaluation and treatment of tumors. For example, the chapter on testicular carcinoma describes at
2243
2244
BOOK REVIEW
length the use of radiation therapy for clinical stages I and II nonseminomatous testis cancer, while devoting relatively little discussion to retroperitoneal lymph node dissection and chemotherapy. While these chapters are well written and informative, they require a somewhat greater level of sophistication on the part of the reader to recognize that a given approach is regional and not necessarily comprehensive. This book would make an excellent addition to the library of the average urologist. Michael O. Koch, M. D. Indiana University Medical Center Indianapolis, Indiana
free bladder mucosal graft can be used regardless of the individual anatomy or proximity to the ureteral orifices, because it can easily be tailored. This technique represents an important repair of difficult, recurrent, or multiple vesicovaginal fistulae. Editorial Comment: With this technique the graft is harvested from the lateral bladder wall and the donor site defect is allowed to heal by re-epithelialization. Fistula repair is performed transvesically. Bladder epithelium is removed around the margins of the fistula, and the graft is sutured into place. The procedure was successful in all patients. Fistulas were complex in some cases, and radiation for cervical carcinoma was the cause in 1. This technique appears to be simple and afforded excellent results. It surprised me that bladder epithelial grafts provided sufficient thickness. Also surprising is graft survival because, according to this report, no attempt is made to approximate the bladder wall or close the vaginal defect. More experience is needed with this technique. Jack W. McAninch, M.D. Oral Stanozolol in Lichen Sclerosus et Atrophicus D. PARSAD
AND
R. SAINI, Himalayan Institute of Medical Sciences, Jolly Grant, Dehradun, U.P., India
J. Amer. Acad. Dermatol., 38: 278 –279, 1998 No Abstract Editorial Comment: Lichen sclerosus et atrophicus of the penis, or balanitis xerotica obliterans, can be extremely debilitating because of pain, ulceration, inflammation and induration, and extremely difficult to control. For 3 months 5 patients received orally 2 mg. stanozolol, a potent anabolic steroid, twice daily. Lesions were classified on a scale of 0 to 4 according to severity. Before treatment the mean score was 3.6 and at the end of therapy it was 1. Painful erections and soreness were relieved. The authors provide no information on symptoms of balanitis xerotica obliterans after completion of therapy. Stanozolol is a potent fibrinolytic agent, and it is this property that is presumed to produce the desired results. Liver function must be monitored closely in these patients. Jack W. McAninch, M.D.
BOOK REVIEW Textbook of Genitourinary Surgery, 2nd ed. H. N. WHITFIELD, W. F. HENDRY, R. S. KIRBY AND J. W. DUCKETT, Oxford: Blackwell Science Ltd., 1,516 pages, 1998 This book is the second edition of a text that was first published in 1985. The editors have brought together a group of multidisciplinary, international contributors with diverse areas of expertise. Of the 184 authors 105 are from Europe or Scandinavia, 47 from the United States, and the remainder from Canada, the Middle East, the Far East and Australia. Thus, this text has a truly international flavor. Rather than the traditional organization by organ systems commonly found in comprehensive textbooks of this type, it is organized by disease entities. Compared to other comprehensive textbooks, there is less emphasis given to the basic sciences except as to how those areas pertain to a specific disease entity. For example, while there is only an 11-page chapter devoted to renal blood flow, there are entire chapters on management of hypertension, renovascular disease, the loin pain-hematuria syndrome, and exercise induced and incidental hematuria. This organization makes for a handy reference when reviewing a specific disease entity. However, it is probably not the best textbook for the beginning urologist who does not yet understand normal genitourinary physiology. This textbook is beautifully illustrated with abundant color drawings and photographs, and radiographic images. Most radiographic images and intraoperative photographs are accompanied by line drawing legends for interpretation of these images. The images in this text make it a pleasure to read. The artwork is purposefully designed to convey the conceptual basis of a procedure, while eliminating the precise anatomical detail found in many medical drawings. It conveys the concept of a procedure, not anatomy, which is a strength of the text and not a weakness. The international flavor and organization by disease entities have advantages and disadvantages. Each chapter represents the opinion of an expert in the area of discussion and is not necessarily a comprehensive review of the subject. Many of the chapters on genitourinary malignancies describe a European approach to the evaluation and treatment of tumors. For example, the chapter on testicular carcinoma describes at
2243
2244
BOOK REVIEW
length the use of radiation therapy for clinical stages I and II nonseminomatous testis cancer, while devoting relatively little discussion to retroperitoneal lymph node dissection and chemotherapy. While these chapters are well written and informative, they require a somewhat greater level of sophistication on the part of the reader to recognize that a given approach is regional and not necessarily comprehensive. This book would make an excellent addition to the library of the average urologist. Michael O. Koch, M. D. Indiana University Medical Center Indianapolis, Indiana