ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1990.tb14986.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Summary—Family screening was offered to the relatives of 57 patients with duplex renal systems and this resulted in the detection of another 37 cases. A further 5 first degree relatives had abnormal intravenous urography, so that 25% of the screened relatives had significant renal abnormalities. It is suggested that there may be a place for screening the whole family if renal tract duplex is detecte

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1990.tb14987.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Dilatation in the upper limb of a duplex ureter is usually secondary to obstruction and may be associated with a ureterocele. By contrast, vesicoureteric reflux is the usual cause of a dilated lower moiety ureter. We report 3 cases in which unusual or complex causes of dilatation of 1 limb of a duplex ureter were demonstrated.

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1990.tb14988.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Summary—A single (100 mg/kg) intraperitoneal dose of 2‐bromoethanamine hydrobromide induced renal papillary necrosis (RPN) acutely in rodents and caused a transient crystalluria between 4 and 8 h after dosing. These crystals comprised struvite or magnesium ammonium phosphate (MAP) as assessed by shape, solubility, infra‐red spectrum and X‐ray microprobe analysis. Acid‐soluble, bi‐refringent crystals were also present within the renal medullary matrix during the same time period as the crystalluria. The presence of the MAP was associated with loss of the anionic renal medullary mucopolysaccharides staining. A total of 5/64 rats with a 2‐bromoethanamine‐induced renal papillary necrosis and monitored for up to 160 days had bladder calculi that were predominantly MAP. These data suggest that medullary mucopolysaccharide matrix disruption associated with RPN leads to a release of previously bound cations, super‐saturation and the nucleation of crystalline MAP. These processes could also be implicated in the formation of MA

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1990.tb14989.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Summary—Among the causes of constricted ureter is benign or malignant encasement. The diagnosis of ureteric encasement is frequently overlooked, even by well informed clinicians and radiologists. The most common benign cause is retroperitoneal fibrosis and the most frequent malignant causes are extension from an adjacent primary tumour, true metastases to the ureter and lymphoma. Lack of recognition of the process may lead to mistaken diagnosis of an inflammatory stricture or infiltrating transitional cell tumour, with resultant inappropriate management. A sign which appears to be almost specific for encasement, the bullet and bodkin configuration, is described here. Newer imaging modalities such as computed tomography and ultrasound, while helpful, are probably less sensitive and less specific than the retrograde ureterogram because a detectable mass is not always presen

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1990.tb14990.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Summary—A group of 21 mentally retarded patients with severe, long‐standing urinary symptoms underwent urodynamical investigation. The most common abnormalities were detrusor areflexia and detrusor hyper‐reflexia. Of 11 patients treated surgically, 10 derived marked benefit. Drugs were successful in reducing micturition problems in 3/6 patients. Severely retarded patients with spastic quadriplegia are difficult to investigate and if this is associated with detrusor hyper‐reflexia it is impossible to treat them in any way. Severely retarded patients with detrusor areflexia and infrequent voiding can benefit from bladder outlet surgery. Patients with moderate (especially mild) retardation can be investigated and treated in the same way as non‐retard

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1990.tb14991.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Summary—Oxybutynin hydrochloride (3 mg) was compared with placebo by randomised, double‐blind crossover trial in 53 females with idiopathic detrusor instability. Symptoms were cured or markedly improved in 60% of patients on oxybutynin and 2.3% on placebo. During the first treatment period, oxybutynin reduced the frequency of voiding by 35%, compared with 9% for placebo. Oxybutynin gave a significantly greater improvement than placebo in volume at the first desire to void (70 ml increase versus 7.7 ml), maximum filling‐phase detrusor pressure (17 cm H2O reduction versus no benefit) and cystometric capacity (104 ml increase versus 7.0 ml). A marked oxybutynin carry‐over effect was seen during the second treatment period. Side effects from the 3 mg dose of oxybutynin caused 7.5% of subjects to discontinue

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1990.tb14992.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Summary—A total of 53 females who entered a double‐blind crossover trial of oxybutynin and placebo for idiopathic detrusor instability were questioned about life events and associated medical disorders and were given a psychometric test. Their response to treatment was studied in relation to these factors.It was found that 11% of patients had nocturnal enuresis beyond age 8 and 25% had irritable bowel syndrome: their response to treatment was generally poor. Life events were not consistently related to treatment response. The mean psychoneurotic score of “poor responders” (43.7) was similar to that of female psychoneurotic out‐patients (47.7), although one‐third of poor responders were normal. Patients who responded well to simple anticholinergic treatment had a mean score (30.7), which was similar to that of normal urban females (33.5).Most good responders and one‐third of poor responders showed little evidence of psychoneuroticism: a further search for neurophysiological abnormality in idiopathic detrusor instabil

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1990.tb14993.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Summary—Detrusor instability occurs in approximately 10% of the adult population, producing troublesome symptoms. The pharmacotherapy currently available is usually only partially effective and cannot be adequately evaluated except under “blind” conditions because of the significant component attributable to placebo effects. The results of the present study revealed no advantage resulting from treatment with flavoxate, as assessed both subjectively and objectively. We suggest that this therapy does not appear to be beneficial in the medical management of detrusor instab

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1990.tb14994.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Summary—Sixteen males with stress incontinence due to sphincter damage were investigated with videourodynamic studies after implantation of a perineal artificial urinary sphincter. Twelve patients were rendered dry; 4 remained incontinent, all of whom were shown by cystometry to have incontinence from detrusor instability. Of these, 2 also had stress incontinence proven by videourography.Detrusor instability was present in 9 patients before implantation; the instability worsened considerably in 2 patients and new instability was shown in another 2 patients.The limitations of the artificial urinary sphincter and the implications of detrusor instability in patients with an artificial sphincter are discussed.The artificial urinary sphincter is an extremely successful device for the treatment of acquired stress incontinenc

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1990.tb14995.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY