ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1954.tb04729.x

出版商:Blackwell Publishing Ltd    

年代:1954

数据来源: WILEY

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1954.tb04730.x

出版商:Blackwell Publishing Ltd    

年代:1954

数据来源: WILEY

摘要:

SUMMARY1Severe biochemical imbalances have been found in patients suffering from chronic prostatic obstruction.2Severe dilutions of the plasma electrolytes have been observed in two patients.3Relief of prostatic obstruction has resulted in further biochemical abnormalities due to severe tubular dysfunction.4The treatment of these biochemical abnormalities is outlined.

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1954.tb04731.x

出版商:Blackwell Publishing Ltd    

年代:1954

数据来源: WILEY

摘要:

SUMMARY1The incidence of recurrence following operative treatment of upper urinary tract stone has been investigated in 216 out of 345 patients subjected to operation during the years 1915 to 1950. These patients all attended for interview followed by X‐ray and urine examination. No case is included in which operation took place less than two years ago.2Possible ætiological factors are detailed, as well as the side, sex, and age incidence for the entire series of 345 cases. There is evidence of an earlier onset of lithiasis in males.3Recurrence has been graded as “mild” and “severe,” depending on whether or not secondary operation has been necessary. “False” recurrences,i.e., stones overlooked at operation, are included, but their incidence is not accurately known. Recurrence figures for the various types of operation are:–Pyelolithotomy (100 cases): Mild recurrence, 20 per cent.; severe recurrence, 27 per cent.Nephrolithotomy (forty cases): Mild recurrence, 25 per cent.; severe recurrence, 37.5 per cent.Ureterolithotomy (forty‐nine cases): Mild recurrence, 29 per cent.; severe recurrence, 8 per cent.Ureteric meatotomy (six cases): Mild recurrence, 17 per cent.Nephrectomy (forty‐five cases): Contralateral recurrence, 11.1 per cent.The total recurrence following 240 operations of all types (including nephrectomy) is 40 per cent. Following 195 conservative operations the recurrence rate is 46.7 per cent.4Less than half the recurrences actively sought advice for relief of symptoms and would have been missed by questionnaire follow‐up.5Reasons are presented for the high recurrence rate, the principal factor being the strict standards observed in the investigation.6Comparison of recurrence in the decades 1930 to 1940 and 1940 to 1950 shows a reduction of 11 per cent. in the latter, from 47 to 36 per cent.7Recurrence is twice as common in males (54.3 per cent.) as in females (21.8 per cent.).8Contralateral recurrence is almost as common after nephrectomy (11.1 per cent.) as after conservative operations (12.3 per cent.).9Of the eighty‐nine recurrent cases twenty‐five (28 per cent.) were detected within two years, fifty‐two (58.4 per cent.) within five years, and seventy‐eight (87.6 per cent.) within ten years of operation.10Whether the stones were single or multiple seems to bear no constant relationship to the incidence of recurrence.11Urinary infection and recurrence are closely related. Of those patients with sterile urine before operation only 13 per cent. had a recurrence compared with 64.5 per cent, of those with infected urine. In this seriesB. coliwas the commonest organism, and the urea‐splitting organisms did not appear to be as important as usual.12The incidence of hyperparathyroidism is low (2.7 per cent.).13The management of recurrent cases is discussed and measures are suggested for avoiding recurrence. Conservatism in this field appears to be completely justified and an increasingly important place has been found for partial nephrectomy.14Regular follow‐up of these cases is essential.15The various operations for upper urinary tract stone treat the effect not the cause. Recurrence may be lessened by the various measures mentioned but will continue until more i

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1954.tb04732.x

出版商:Blackwell Publishing Ltd    

年代:1954

数据来源: WILEY

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1954.tb04733.x

出版商:Blackwell Publishing Ltd    

年代:1954

数据来源: WILEY

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1954.tb04734.x

出版商:Blackwell Publishing Ltd    

年代:1954

数据来源: WILEY

摘要:

SUMMARYDeep perineal drainage straight out of the bladder and prostatic cavity, and down through the left ischiorectal fossa, is advocated in certain cases of prostatic adenomectomy done by the upper route, whether transvesically or prevesically, in conjunction with primary closure or with non‐opening of the bladder.The indications are a small urethra, a strictured urethra, or an intolerant urethra. The author describes his own technique for transvesical prostatic adenomectomy, and for the establishment of this special type of drainag

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1954.tb04735.x

出版商:Blackwell Publishing Ltd    

年代:1954

数据来源: WILEY

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1954.tb04736.x

出版商:Blackwell Publishing Ltd    

年代:1954

数据来源: WILEY

摘要:

SUMMARYA case is reported of a ureterocele, containing a calculus, prolapsing through the urethra and presenting at the vulva in a female aged 63 years. The calculus was extracted, following meatotomy, while the ureterocele was still prolapsed. The ureterocele was reduced into the bladder and later resected transurethrally. The observation is made that compression of a prolapsed ureterocele causes pain in the loin on the same side.

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1954.tb04737.x

出版商:Blackwell Publishing Ltd    

年代:1954

数据来源: WILEY

摘要:

SUMMARYThree cases have been described of extraperitoneal retrovesical tumours. They were respectively a retrovesical adenoma of the prostate, a retrovesical fibroma, and a large, recurrent retrotrigonal adenoma of the prostate in a patient who had had the prostate enucleated ten years previously. The diagnosis, pathology, and operative treatment are described and discussed.

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1954.tb04738.x

出版商:Blackwell Publishing Ltd    

年代:1954

数据来源: WILEY