Urinary calculi in pregnancy

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OF OYSFUNCTIOW I~ETASTASISEO CARCItkm

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THERAPYANO CNES%OARD VACCINATION

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mch k!ntel Cox

lil Ilrc E:rlifc/r: L1’e found the case profile on “.is\.“‘l’t(l”latic rheochromoc\,tonia of Retroperitoileum Prescntin,c as I,arge Hypovascl~lar Alass.*’ b\ Xlatsushita c,t (11. I)ublished in the Ma!. issue (\ 01. 19. l’agcs 5Fi3 %l) of UROLOGY extremely interestirq. \\‘t, reported’ on a similar case \\.here the patient ~xesented a confusing clinical picture simulating Inwpanc! -induced h!yertension. \x.hich. after cleli\.vrx-. masqueraded as intractable fe\w of unknon,n clri,qin. The thrust of our report was that pheochromoc!,tonla should be considered in the differential cliagnosis of plwrperal feyer. In our patient. coinpIted tomography xvas also an invaluable diagnostic tool, Hoz\,e\w. in another report. abdominal cornputed tomographs failed to diagnose the ttmlor. but gallilml scan confirmed abnormal uptake in this re
George J. Kleiwr. .\l.D. E:-ICOCZ \\‘ilma Irlarkris Grrston. hl’T(iZSCP) Iklmrtment

of Obstetric> and G! necolog~ hIontefiore Aledical Center-North Central Bronx IIospital Bronx. Se\\ York 10-187

tase levels and carcinoembr!.onic antigen:, and \verc able to demonstrate a remission of ostcomvtastases b!, scintigraphy (Hclv. C/lir. /lclrc -48. G3-3.58 (1982). Our method \t.as published in 11~1. \\‘elt. (:32:50G5:3. 1981). By combining both approaches it tna> lw possible to achie1.e e\‘en better results in thr> twat merit of metastatic prostate carcinoma.

LIRINARY BCG ADJUVAANT THERAPY PROST4TIC CARCINOhlA

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Ii) fhc Editor: \\‘v read the paper by P. (Zuinan c,f al. entitled “Bacilllls Calmette-Guerin (BCCG) ,4djtl\.ant Therapy in Stage D Prostate Canccbr.” (UiroI ()(;I 20: 101. 19%) vith great interest. As can bc seen in Figrlw 1. \\Y have been able to achieve the 5aiiit~ ~,lir\,i\.;ll-1”01”n8ation effect in casc5 of cl!.sfunctional rnetastatic prostate carcinoma hy means of .specific immune therapx~ with inactij ated carcinoma cells and ncuraminidase (C’rologicr Infcrtmtio~tr/li.\.Kargcr. Basel, in press). As \vith lmspecific immune stimulation with BCC. \ve noted no acl\ crw effwts xvhatsower. apart from 011~’ allergic reactiwl. In addition to the improvement of survival rate. \x cl ol)ser\x,d a significant. reproducible louverinq of radic~in~munolo~icall~~ determined phospha-

CALCULI

IN PREGIiAN(:j’

This most excellent re\.icw of J. R. 7h the Edifor: Drago. T. J. Rohner. and R. A. Chz of their esperience in “Management of Urinar! Calcllli in Pregnancy.” published in the December isslit, (\wl. 20. pages p578-81. 1982) of UROLOGY. ccrtainl~~ tnakes the point that over half of them cm bth sl~ccessfull!. treated conser\~ati\~el!; Hokvcver. it does not include obstructing ion.-ll.ing ureteral storw. \2:heii a large ‘calculus ii1 the lo\\ t’r iireter of a pregnant \voman is causing obstrl~ction and has to be rrmo\,ed. v’e found that a vaginal approach is not onl\. tcchnicall\easv. but high11 sllccessful: this is I! h\- \\ e recommend the we of an old and almost forgotten procedure - rqinal r~rrterostom\ - in lwv-lvin,q atones in pregnant \vonicn.