pyuria. and intrat,esical calculi following a MarshallI4archettLKrantz procedure are highly suggestive of inadvertent placement of permanent sutures into the lumen of the bladder. Cystoscopy will be diagnostic if the cause is the presence of intravesical sutures. These should bc resected transurethrally, for attempts at n-eating irritative bladder syrnptoms with antispasmedics tibiotics rvill be ineffectual until the fin-eign bodies arc removed. Some authors suggest that permanent sutures might be acceptable in a suspension when a transvesical or open-bladder approach is used, in which case, placernent of a suture through the bladder mucosa could be immediately recognized and corrected.. However, with permanent suture. one still risks potential morbidity from chrome osteitis pubis. \vhich is the most common major (complication occurring after bladder suspension 1, ith the ~~~~rs~~~lll-~~arc~~etti-~rant~ procedure. pcrriiancnt

suture

dots

not

make

a suspension

mot-e

permanent. The basis for the strength of the urethrovesk al suspension lies in the scarring and fixation of thr paraurethral l’ascia to the retropubis. Absorbable sutures

sinipl>

maintain

the vesical neck until

the

new

the patient’s

anatomic

position

own fibrous

of

tissue

forrnatio~~ U~Y LIVS and tahes over fLr the sutures.’ The conlplicatiorls folhnving the use of permanent SLI~UI-e for the Grshall-klarchetti-Krantz procedure fhl. out~~t+l~ an? potenrial advantages. Therefore. the use of rro~~~ll~sorb~~l~le suture cannot be justified. REFERENCES

1, Lapi&, J.: OperaGve techniyue fc)r stress urinary incominmce, Ilrologv 3: 657% 1974. 2. Marshall. V. F., Marchetti, A. A., and Krantz, K. E.: The correction of stress incontinence by simple vesicourethral stlspenGori, Surg. Gvnecol. ObsteL 88: 509, 1949.

Amylase-containing ovarian cystadenocarcinoma simulating a pancreatic pseudocyst

implicating liver as an ~-a~nylase-s~iitli(,si/iii~~ organ,’ this has been proved definitiveI! only ti)l the rat. In human subjects, Fallopian tubes have hecn shown to contain the enzyme and high serum amvlase lt~~ls arc sometimes associated with Fallopian tilhis p;~thology.2 It is not widely appreciated that humail ovaries also ma> contain amvlase. We recently encounferefl a patient with cystadenocar&oma of the oval-v otcd throughout the abdomen with a positive fluid wa\‘e. Pelvic examination show-ed a freely movable uterus with appat-entlv clear xincxal areas. The ovaries \vere not palpatecl. Initial laboratory finding; i&luded: whiith blood count, 11,600 per cubic millimeter; hemoglobin, 13.0 (inI. per 1Ofl ml.: hematocrit, 39. I per cent; blood urea niil-ogcn. 2.5 rng. per 100 ml.; fasting blood sugar, l 15 mg. pear. IO0 ml.; sodium, 141 mEq. per liter; potassium, 4.1 l~lE(l. per liter; calcium, 8.4 mg. per 100 ml.: phosphorus. .>.5 nag. per 100 ml.; serum glutamine pyruvic transamina5r. I.7 1 ‘, per milliiiter; lactic dehydrogenase, I60 U. per millilitc~ : bilirubin, 0.7 mg. per IO0 ml.: albumin, 4.4 Gm. per 100 ml.; globulins. 2.2 Gm. per IO0 ml.; prothrombin time. tOO p

Amylase-containing ovarian cystadenocarcinoma simulating a pancreatic pseudocyst.

pyuria. and intrat,esical calculi following a MarshallI4archettLKrantz procedure are highly suggestive of inadvertent placement of permanent sutures i...
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