Adrenal masses are very heterogeneous and comprise benign or malignant tumors, unilateral or bilateral masses and variable endocrine activity. Because of these attributes adrenal gland masses are a clinical challenge. This article gives a summary of diagnostic steps and indications for adrenal surgery including perioperative management.

The aim of this study was to investigate the patterns of renal function recovery during partial nephrectomy (PN) on an experimental solitary kidney rabbit model and establish the upper tolerable time limits of applied ischemia. Forty-eight New Zealand rabbits underwent an open right nephrectomy and after 30 days, the animals were clustered into five groups (A, B, C, D, E). The first four groups received an open left PN, under different types of ischemia. Groups A ( n = 8) and B ( n = 10) were subjected to 90 and 60 min of warm ischemia (WI), respectively, while groups C ( n = 10) and D ( n = 10) received 90 and 120 min of cold ischemia (CI) with ice-slush cooling. Group E ( n = 10) served as sham group. Serum determinations of creatinine (SCr) and BUN were recorded preoperatively and on postoperative days (POD) 1, 3, 6 and 15. The animals were euthanized and the remaining kidneys were harvested and evaluated microscopically. The type and duration of ischemia were statistically significant parameters ( P < 0.001). Groups B, C and D exhibited a similar pattern of recovery from trial initiation to the 15th POD ( P = 0.788 and P = 0.068, respectively). Group A was extremely differentiated, with 100% mortality caused by uremia. The microscopic findings were consistent to the serum biochemistry. In our solitary kidney rabbit model, the upper limits of tolerable WI seem to be set on 60 min. CI can safely preserve the model’s renal function—even up to 120 min.

Various techniques of the ileal neobladder have been proposed during the last 15 years. In this article, we present our 10-year experience of a personal modification of the ileal S-pouch, using a short, small bowel segment.

OBJECTIVE To evaluate the use of Goretex pubovaginal sling and compare the results with a typical indigenous material graft made of rectal fascia. METHODS We have prospectively evaluated 48 consecutive patients in a randomized fashion in whom a sling procedure was performed to treat their type III incontinence. Sixteen women had a vesicourethral suspension (VUS) by a Goretex sling and another group of 32 patients, comparable in age range and medium age with the previous group, had a similar VUS by a sling from the rectus abdominis fascia. Both groups were evaluated urodynamically 6 and 30 months later. RESULTS In the first group, cure of incontinence was observed in 87.5% and in the remaining patients it was significantly improved. In 2 patients there was an erosion of the urethra and the Goretex sling had to be removed 3.5 years later. Three other women remained dry but complained of occasional irritative symptoms. In the remaining 11 there was no erosion and the excellent postoperative result was maintained. In the group with fascial slings there was no erosion observed and in general they had less irritative symptoms. Cure or improvement of incontinence was comparable with the first group when studied 6 months after surgery, but there was a significant difference in the 30 months postoperative evaluation. CONCLUSIONS Use of a Goretex sling provides better long-term results even though it is associated with somewhat increased morbidity.