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According to the newly established method of micro-explosion lithotripsy, a cystolithotriptor with an explosive catheter, the tip of which was charged with 5mg. lead azide explosives, was developed. In 3 clinical cases bladder stones from 32 to 65mm. in diameter were crushed successfully into several fragments by 1 to 8 explosions using the cystolithotriptor. The fragments then were smashed into grains with Young’s cystoscope and washed out by aspiration. This success may prove the usefulness of micro-explosion lithotripsy, which also may be introduced for the treatment of calculi in other organs in the future.

The ability to detect prostatic cancer by transrectal ultrasonography was evaluated in a prospective blind study of 216 men. The sensitivity of transrectal ultrasonography was 86 per cent but the specificity was only 41 per cent. Tumors less than 1cm. in diameter were most difficult to detect by transrectal ultrasonography. The positive and negative predictive values of transrectal ultrasonography were 36 and 89 per cent, respectively. Abnormal scans that strongly suggested carcinoma were present in 10 per cent of the men who had a normal digital examination but no biopsy was performed.

Ultrasound estimated bladder weight was compared before and after surgery for benign prostatic hyperplasia (BPH) to reveal a possible reversible change in bladder hypertrophy.

New equipment for transrectal ultrasonotomography has been developed. With this equipment an excellent cross-section picture of various intrapelvic organs is easily obtained. Diagnostic application of the technique is particularly significant for abnormalities of the prostate because the shape of the prostate cannot be revealed by x-ray.

The effect of the section or stimulation of various nerves on prostatic contraction and fluid excretion was investigated dynamically in the dog using an apparatus devised in our laboratory.

We treated 105 consecutive patients with bladder calculi by microexplosion lithotripsy, with a success rate of 100per cent. The weight of the removed calculi averaged 18gm., with a range of 2 to 305gm. For the procedure spinal anesthesia was used in 78 patients, while general anesthesia was used in 24. Minor extraperitoneal bladder perforation occurred only once and it resolved spontaneously several days later. Presently, we consider microexplosion lithotripsy to be the treatment of first choice for bladder calculi.

The volume, maximum horizontal area, maximum length, maximum width and depth of the seminal vesicles were measured by transrectal ultrasonography in 76 subjects without seminal vesicle disorders, divided into 7 groups at 10-year intervals. The average of each parameter in each group was presented. The volume and maximum horizontal area began to decrease after the age of 60 years. No statistically significant difference among subject ages was observed for the other 3 parameters. A correlation was observed between the volume and maximum horizontal area of the seminal vesicles. Our study confirmed that maximum horizontal area of the seminal vesicles may be substituted for the volume.

A special chair-type apparatus for transrectal ultrasonotomography was developed in our labor-tory 3 years ago. We did a mass screening program for prostatic disease, using this equipment as the primary study in the system. The 132 apparently normal men evaluated ranged in age from 40 to 76 years (mean 55.0). The 48 patients suspected of having prostatic disease underwent secondary studies, consisting of the usual urological examinations. Prostatic disease was detected in 24 cases, including 18 cases of benign prostatic hyperplasia. Thus, the model program revealed an extraordinarily high prevalence of latent prostatic disease among apparently normal older men.

We describe a new method for percutaneous stone removal from the upper urinary tract. A flexible fiberoptic bronchoscope is introduced directly into the renal pelvis through a trocar under ultrasonic real-time guidance. The fiberscope is introduced into the ureter from the ureteropelvic junction. The stone situated in the upper portion of the ureter is trapped by the stone basket and extracted under endoscopic control. This direct percutaneous method without pre-establishing a nephrostomy provides a noninvasive operation using a small skin incision for urinary stones.