ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1988.tb04414.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

Summary—This report analyses the changes in the classification of the genitourinary tumours introduced by the 1987 edition of the TNM system. Criticism and suggestions for improvement are given. These are based on the extensive experience of the EORTC GU Group with clinical trial work, particularly the identification of prognostic factors, on their success in reaching international consensus on tumour classification, and on information from the literature.Many of the changes introduced in the 1987 system are not considered to be strictly necessary. These include the introduction of the new additional descriptors, including “C” and “R”, the changes in the T classification of prostatic and renal cancer, and the introduction of uniform N categories for all tumours and other features. We regret the omission of minimal requirements, the omission of the V classification for macroscopic or microscopic vascular invasion, the changes in the T categories of carcinoma of the bladder and the introduction of stage groupings for all urological tumours. Some of these changes are considered unacceptable. The attitude of the EORTC GU Group toward the use of the new TNM classification is indicated

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1988.tb04415.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

Summary—Thirty‐seven patients treated by partial nephrectomy for calculus disease between 1971 and 1986 were reviewed retrospectively. Of the 25 patients available for analysis, 20% developed immediate surgical complications, 20% had residual post‐operative stone and 33% developed true ipsilateral stone recurrence during the period of follow‐up.Our results from partial nephrectomy for calculus disease are compared with the results of treatment by percutaneous nephrolithotomy and extracorporeal Shockwave lithotripsy. It was concluded that partial nephrectomy should be reserved for situations where stone disease is associated with anatomical abnormalities which cannot be treated by the newer modalities of stone man

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1988.tb04416.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

Summary—Opinions vary on the effects produced by urinary inhibitors of crystallisation. We describe a simple method for studying inhibitory effects in urine based on nephelometry and optical microscopy. It was concluded that the inhibitory effect of a given substance on calcium oxalate crystallisation depends on the particular sample of urine being examined and that the most effective inhibitor can be determined only by studying the urine of each patient individuall

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1988.tb04417.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

Summary—We report the first patient in Finland and Scandinavia with a deficiency of adenine phosphoribosyltransferase (APRT). About 30 clinically affected patients have been reported in the literature. APRT deficiency is an enzyme disorder which is inherited autosomally in a recessive manner. The use of adenine in purine metabolism is disturbed and it accumulates in the body, where it is oxidised to poorly insoluble 2, 8‐dihydroxyadenine by xanthine oxidase. The dihydroxyadenine forms stones which can be mistaken for uric acid stones.Our patient had had frequent episodes of urolithiasis and the diagnosis was finally made after pyelolithotomy and stone analysis. The total APRT deficiency was detected in the haemolysate of erythrocytes. Partial eficiency of APRT in the patient's relatives showed heterozygosity of the enzyme defect.The only clinical manifestation of the defect is the formation of urinary stones. This can be prevented by diet and allopuri

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1988.tb04418.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

Summary—Forty patients with lower ureteric calculi for which intervention was considered desirable have been treated byin situextracorporeal Shockwave lithotripsy (ESWL) on the Dornier HM3 Lithotripter using a modified technique. Stone localisation was satisfactory in all patients. Adequate disintegration was achieved in 90% of patients following one treatment; 34 patients have been followed up for at least 3 months and 27 of these are stone‐free (79%). Treatment failed in 4 patients and 2 of these had dense lower ureteric stonestreetsas a result of previous ESWL. The re‐treatment rate, post‐treatment auxiliary procedure rate and complication rate were minimal. It was concluded thatin situESWL is an effective and safe method for treating certain selected lower ureteric stones and should be considered as a feasible alternative to the more conventional methods of tr

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1988.tb04419.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

Summary—A total of 618 children with primary vesicoureteric reflux (VUR) were examined preoperatively and 6, 9 and 24 months after an antireflux ureterocystostomy of the vertex of the bladder (AUVB); 206 children were operated on bilaterally, so that 824 AUVBs were performed. Most patients had grade 3 or 4 reflux and only 5% had grade 2 reflux. Successful results were noted in 792 ureteric units; in 10 cases of post‐operative stenosis and 17 cases of recurrent VUR a second AUVB was performed. The following causes of operative failure were found: obstruction of the submucosal ureter after tailoring (5 cases), stricture of the new ureteric orifice (3), necrosis of the terminal part of the ureter (2), submucosal ureter too short or too wide (12) and fibrosis of the detrusor muscle over the submucosal ureter (5); a success rate of 84% was noted after the second proced

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1988.tb04420.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

Summary—The cost‐efficiency and time‐saving associated with out‐patient flexible cystoscopy have propagated its use nationwide. However, only minimal attention has been paid to the feelings of patients exposed to this physically and emotionally invasive technique. We studied 53 consecutive patients attending for check cystoscopy at the time of their first flexible cystoscopy. Acting as their own historical controls, their feelings about rigid cystoscopy under general anaesthesia and subsequent flexible cystoscopy under local anaesthesia were assessed: 6/53 (11%) preferred rigid cystoscopy under general anaesthesia. The only significant association with their dislike of flexible cystoscopy, was their desire to stay in hospital overnight. It was concluded that with careful counselling and attention to individual needs, the preference for flexible cystoscopy over rigid cystoscopy under general anaesthesia can approa

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1988.tb04421.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

Summary—Microscopic haematuria is a common finding in young men. Controversy exists as to its significance and how it is best investigated. A prospective study of 100 young men under the age of 40 with microscopic haematuria has been performed. A positive diagnosis was made in 32 patients. Cystourethroscopy was of diagnostic value in only 3 patients and of therapeutic value in a further 3.It was concluded that cystourethroscopy is of minimal diagnostic value in young men with microscopic haematuria. Its routine use is unnecessary and should be reserved for those patients in whom investigation suggests that a treatable cause may be found in the lower urinary trac

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1988.tb04422.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

Summary—Factors which predispose some men with benign prostatic hyperplasia to chronic urinary retention whilst others develop acute retention are not understood. In order to assess whether there is an occult neuropathy associated with chronic retention, neurophysiological measurements were used to test the integrity of the lower urinary tract nerve supply. A series of 22 male patients with chronic urinary retention secondary to prostatic hyperplasia underwent sacral reflex latency measurement; 73% demonstrated a sensory suprasacral abnormality with intact spinal reflex arcs. These results suggest that although the sacral reflex pathways are intact, there is a sensory/proprioceptive abnormality in the higher neurological centres which may be an adaptive mechanism to the presence of bladder outflow obstructio

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1988.tb04423.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY