摘要:

Summary—Since March 1985, over 1000 patients have been treated on the lithotripter at St Thomas' Hospital. Since it is the only machine in the country offering treatment to National Health Service patients at no cost to the referring Health Authority, there has been a heavy demand for treatment and 97% of referrals have been accepted. Analysis of the first 1000 patients shows extracorporeal shockwave lithotripsy (ESWL) to be a safe procedure with a low morbidity rate and no mortality. The number of patients who were stone‐free 3 months after treatment was low (44.1%) compared with the numbers reported in other series. The most likely reasons for this are the poor follow‐up rate (48.9%), the stringent criteria for the diagnosis of “stone‐free” and a possible skewed referral and follow

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1986.tb05887.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

Summary—Extracorporeal shockwave lithotripsy has been shown to be a safe and effective method of treating most upper urinary tract stones. Major complications, although few, include haemorrhage, septicaemia, “Steinstrasse” formation and cardiac arrhythmias. The experience from 600 consecutive cases is reviewed and methods of prevention are disc

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1986.tb05888.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

Summary—Open surgery for large or complex renal calculi may be difficult, particularly in patients with recurrent stones, and may require special operative techniques to preserve renal function. With the advent of percutaneous nephrolithotripsy (PCNL) and extracorporeal shockwave lithotripsy (ESWL) new approaches are now available for the treatment of these difficult cases. A review of 67 patients who presented between November 1984 and May 1986 has shown that it was possible to clear large stones in 71% of patients using a combination of PCN L and ESWL. There was no mortality; the morbidity for both procedures was low and was less than when either procedure was used alone for the treatment of complex stone

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1986.tb05889.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

Summary—One hundred and eighty‐one patients with renal calculi were treated by percutaneous nephrolithotorny in 21/2 years. In 171 cases the calculi were removed successfully and the complication rate was low. Intrarenal manipulation and irrigation should be done for only a limited period of time. This procedure can be carried out safely, in many centres, with adequate experience and minimal facilit

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1986.tb05890.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

Summary—To determine factors that may influence kidney stone formation in spinal cord injury patients, the medical records of 893 patients who had been followed up by the Milwaukee Veterans Administration Medical Center from 1970 to 1984 were extensively reviewed. Urography showed that 12 patients had kidney stones. Twenty‐four non‐kidney stone patients with a similar age range, sex and duration of time since injury were selected as controls. Variables, such as level of spinal lesion, completeness of neurological dysfunction, presence of ureteric reflux etc, were compared and analysed statistically. The results showed that there was no difference between patients with and those without renal stone as far as the level of spinal injury and completeness of spinal cord lesion were concerned. There was no relationship between kidney stone formation and methods of urinary drainage or the presence of ureteric reflux. However, patients with good bladder control had no renal calculi. Serum creatinine, phosphorus, uric acid and calcium levels were similar in both groups of patients. There was a relationship between sepsis, positive urine culture and kidney stone formation. The absence of physical activity was not a risk factor for renal calculi and patients on a high fibre diet had the same incidence of stones as those on a regular

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1986.tb05891.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

Summary—The efficacy of rice‐bran therapy was studied in patients with hypercalciuria who were suffering from calcium stones. The frequency of stone episodes was reduced dramatically, especially in “active recurrent stone formers”. Urinary calcium excretion was considerably reduced, while urinary phosphate and oxalate were slightly increased. Urinary magnesium, uric acid, serum calcium, phosphate, magnesium and uric acid were not affected. There were no changes in serum iron, copper and zinc even when patients were treated for long periods. The treatment was tolerated well and there were no serious side effects. Rice‐bran therapy is particularly useful in patients with hyperabsorptive hypercalciuria and it is effective in the prevention of recurrent urinary ston

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1986.tb05892.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

Summary—Renographic studies under standardised conditions of maximal diuresis provoked by infusion of hypotonic saline and frusemide were made on 51 patients with 54 dilated upper urinary tract systems in order to distinguish obstructed from non‐obstructed systems.Of the 23 systems judged on clinical and radiological grounds to be obstructed only 12 were in fact obstructed following infusion of hypotonic saline and frusemide. In 10 of these systems (1 0 patients) an Anderson‐Hynes pyeloplasty was carried out. All systems showed improved renal function after operation and the renographic pattern became non‐obs

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1986.tb05893.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

Summary—One hundred and three children with primary vesicoureteric reflux treated by endoscopic injection of Polytef paste between March 1984 and February 1986 have been followed up for periods ranging from 3 to 23 months. Seventy‐five per cent of refluxing ureters showed absence of reflux after one injection of Polytef paste; 14% of ureters required two to four sub‐ureteric injections of Polytef paste for the correction of vesicoureteric reflux; 8% of ureters showed improvement in the grade of reflux after the initial injection of Polytef paste.Duplex systems were more difficult to correct and recurrence of reflux was much higher than in primary reflux. Follow‐up intravenous urograms showed no evidence of ureteric obstruction in the treated ureters.The procedure is safe, simple and effective in correcting all grades of vesicoureteric reflux. To obtain best results, attention should be paid to minute details of the technique and the injection made with pinpoint a

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1986.tb05894.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

Summary—Microproteinuria was assessed by the measurement of albumin, retinol binding protein (RBP) and creatinine concentrations in random midstream urine samples using a single enzyme linked immunoassay (ELISA) in 36 children with vesicoureteric reflux (VUR) and 36 control patients. Infection was excluded by culture and microscopy of the specimens of urine. No patient was hypertensive. Albumin excretion increased in patients with increasing severity of VUR and with renal scarring. Similar findings were observed with RBP excretion. The results show that glomerular and tubular handling of proteins is altered in VUR. The degree of microproteinuria correlates well with the severity of the VUR and is evidence of tubular dysfunction. The effects of medical management and anti‐reflux surgery on microproteinuria require further evaluat

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1986.tb05895.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

Summary—This report describes the design, availability, repair facilities and costs of rigid ureteroscopes. Clinical factors affecting design are detailed. A classification is given. A new test of flow dynamics is described. Short operating ureteroscoges with a stable or integral telescope system appear to be superior to other types, especially as they may be used for antegrade ureteroscop

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1986.tb05896.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY