ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1992.tb15479.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

SummaryInterpretation of the diuresis renogram is dependent on a full understanding of the factors that contribute to the washout curve, a major determinant being the urinary flow rate induced by the diuretic. Frusemide‐induced flow rates were measured in 86 patients over a 30‐min period and related to creatinine clearance in 39,99mTc‐DTPA clearance (glomerular filtration rate (GFR)) in 27, and123l‐Hippuran clearance (effective renal plasma flow) in 20. The flow rates 3 to 6 min and 15 to 18 min after administration of the diuretic received specific attention because of their importance to F + 20 and F ‐ 15 diuresis renography respectively. The mean urinary flow rate 15 to 18 min after frusemide was 3.5 ml/min greater than at 3 to 6 min (P<0.001), explaining the value of the F ‐ 15 renogram in further evaluating equivocal F + 20 curves. Linear relationships were observed between each parameter of function and the 3 to 6 min and 15 to 18 min periods as follows: creatinine clearancer=0.66,r=0.77;99mTc‐DTPA clearancer=0.66,r=0.77;123l‐Hippuran clearancer=0.59,r=0.71. From regression analysis of the data presented it is possible, with knowledge of total and split function, to predict single‐kidney flow rates. It is demonstrated that these may commonly exceed flow rates used for perfusion studies if function is normal, but a single‐kidney flow rate of 10 ml/min is unlikely to be attained if the single‐kidney GFR i

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1992.tb15480.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

SummaryThe results are presented of the first long‐term follow‐up study of patients with suspected obstruction of the upper urinary tract investigated by a modified form of diuresis renography (F‐15 renography). The incidence of equivocal results from diuresis renography is significantly reduced by the use of the F‐15 renogram.F‐15 renography provides a reliable assessment of the upper urinary tract in patients with suspected obstruction and is recommended in the investigation of equivocal upper urinary tract d

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1992.tb15481.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

SummaryHypothermia is a well recognised complication of open surgery. We had observed hypothermia, occasionally followed by rebound hyperthermia in the early post‐operative period, in patients undergoing percutaneous nephrolithotomy, and therefore decided to monitor patients undergoing this procedure more closely. During a 12‐month period, 32 patients were monitored during 38 percutaneous nephrolithotomies; 12 procedures were performed using irrigation fluid at room temperature (22°C) and 26 with fluid warmed to 37°C. Although no statistically significant differences between temperature changes were seen, the most profound temperature falls occurred in patients who received fluid at room temperature. The recovery ward staff observed improved post‐operative recovery in patients who had received warmed fluid. Three of the 5 patients who underwent more than 1 percutaneous procedure received fluid at 22°C and fluid at 37°C on separate occasions. In each patient a more profound temperature fall occurred when the cold fluid was used. Only 1 patient, who received cold fluid, developed rebound hyperthermia in the early post‐operative period. Warming of irrigation fluid and close monitoring of core temperature may prevent unnecessary morbidity in patients undergoing percutaneous neph

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1992.tb15482.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

SummaryThe urethral and bladder pressure increments registered during a cough were investigated in 30 woman with genuine stress incontinence (GSI) and compared with those from 30 previously investigated healthy women. The pressures were measured by means of a double microtip transducer catheter with the bladder sensor uncovered and the urethral sensor covered with a water‐filled rubber cylinder and placed at the bladder neck, midurethrally, or distally in the urethra. In GSI women the pressure increment preceding the pressure spike produced by coughing was significantly higher in the bladder compared with the urethra, and the pressure increment seemed to be initiated in the bladder and all along the urethra simultaneously. In healthy women the pressure increment preceding a pressure spike was significantly higher in the midurethra compared with the bladder and it seemed to be initiated in the midurethra. These findings seem to reflect a defective active closure mechanism in GSI which may be a contributing factor in its pathogenesi

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1992.tb15483.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

SummaryThe artificial urinary sphincter (AUS) is rarely indicated in the treatment of women with stress incontinence because most of these women have deficient urethral support rather than pure sphincter weakness and the AUS is a treatment specifically for pure sphincter weakness. The procedure is contraindicated after pelvic radiotherapy and after previous sling surgery because of the high incidence of cuff erosion. Otherwise the artificial sphincter gives excellent results comparable to those seen in men with post‐protatectomy incontinence and much better than in neuropathic bladder dysfunctio

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1992.tb15484.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

SummaryLittle is known about the significance of pyuria in patients with spinal cord injuries. The progress in hospital of 55 such patients was studied. They were divided into 2 groups according to the method of bladder drainage on admission. Group A comprised 43 patients with indwelling catheters. Group B comprised 12 patients who were able to void with tapping, with/without compression and on intermittent catheterisation.The results showed that group A had a mean pyuria level of 185 WBC/HPF on admission. The incidence of urinary tract infection was 4 per patient during hospitalisation and the mean duration of bladder training was 82 days. Group B had a mean pyuria level of 32 WBC/HPF on admission. The incidence of urinary tract infection was 1 per patient during hospitalisation and the mean duration of bladder training was 40 days. The difference between groups A and B for all 3 parameters was statistically significant.These results suggest that patients with spinal cord injuries and indwelling catheters have a higher pyuria level and an increased risk of significant morbidity secondary to urinary tract infection, especially at the pyuria level of 100 WBC/HPF. A low pyuria level of 30 WBC/HPF was associated with a nil or low incidence of bacteriuria and urinary tract infection in our patients.

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1992.tb15485.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

SummaryA total of 21 patients received intravesical BCG for the prevention of recurrence of superficial transitional cell carcinoma of the bladder. Twelve patients received the Glaxo strain and 9 the Pasteur strain of the bacillus. Although thought to have different anti‐tumour activities owing to a difference in antigenicity, these 2 strains produced similar tumour‐free rates at 5 years' mean follow‐up with an overall tumour‐free rate

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1992.tb15486.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

SummaryThere has been increasing interest in the role of chemotherapy as primary treatments for patients with urothelial cancer and because of the poor prognosis of locally advanced tumours with conventional treatment, trials have been initiated comparing radiotherapy with chemotherapy as primary therapies. In this context it is important to assess the relationship between the responses to chemotherapy and radiotherapy, and this we have examined in 64 patients treated with MVMJ (methotrexate, vinblastine, mitozantrone and carboplatin).Either a complete or a partial response was found in 29 of the 64 patients, 15 had stable disease and 13 had progression of disease. Seven patients died within the first treatment month. The survival of the responding patients ranged from 114 to 1184 days.Six of 15 patients who had had pelvic irradiation prior to chemotherapy responded to MVMJ, the maximum duration of response being more than 3 years.Twenty‐two patients had radiotherapy following their chemotherapy. One of 13 patients not responding to MVMJ had a transient response to radical radiotherapy. Only 1 of 9 patients responding to chemotherapy and then relapsing responded to subsequent radical radiotherapy.Patients with metastatic disease or with recurrent disease after radiotherapy have a worthwhile chance of responding to chemotherapy and achieve durable remissions. In contrast, radiotherapy appears relatively ineffective in patients whose disease progresses or relapses after chemotherapy given as primary treatment with curative inten

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1992.tb15487.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

SummaryThe seemingly high complication and re‐operation rates associated with continent urinary diversion have led some to criticise its morbidity and question its role in reconstructive urological surgery. We therefore reviewed our experience with all patients undergoing either continent or standard urinary diversion performed by 3 urological surgeons during a specified 3‐year period. In 73 consecutive patients (22 continent urinary diversion, 51 standard urinary diversion), no significant difference was demonstrated with respect to the number of post‐operative in‐hospital days, complication rate, re‐operation rate and operative mortality rate between the 2 groups. While those undergoing continent diversion were on average younger and healthier than their counterparts receiving standard diversion, stratification of patients in each group according to age and a pre‐operative “fitness” score showed no significant difference in operative mortality or major morbidity between comparable patients in each group. The mean post‐operative length of hospital stay was, however, 3 days shorter for the youngest and fittest patients receiving standard versus continent

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1992.tb15488.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY