ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1988.tb09152.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

Summary—Since the installation of an extracorporeal shock wave lithotriptor (ESWL) unit 12 months ago, 2000 lithotripsy procedures have been performed. Overall, 68.4% of patients were stone‐free by the end of the first month. Residual lithiasis (fragments0.5 cm) was observed in 10.1%. Complications were obstruction, infection, headache due to the epidural anaesthesia, anuria, renal failure, perirenal haematoma and cardiac arrest. A number of patients required additional operative treatment; this was always endoscopic and no open procedures were performed. Hospitalisation averaged 1

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1988.tb09153.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

Summary—Minute‐by‐minute urinary flow rates before and after the intravenous injection of 40 mg frusemide were investigated in 29 well hydrated adult patients with varying creatinine clearances. Total urinary flow rates 3 to 6 min after frusemide ranged from 1 to 42 ml/min (mean 19). At 15 to 18 min after the diuretic, flow rates ranged from 8 to 46 ml/min (mean 23). Flow rates were proportional to creatinine clearance (r = 0.73; r = 0.8) and decreased with falling clearance, although significant diuresis (4 ml/min/kidney) was achieved down to single kidney clearances of 10 ml/min. Where single kidney clearances were less than 31 ml/min, single kidney flow rates of 10 ml/min or more were not guaranteed. Below this clearance, diuresis renography remains completely reliable and unequivocal in the majority of cases. However, perfusion pressure flow studies will not necessarily be urodynamically comparable and it should not be expected that the results of the two tests will agree in individual cases of upper tract dilatation. Recommended timing for frusemide administration should be 20 min into the test, or 15 min before radiopharmaceutical inje

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1988.tb09154.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

Summary—A study has been carried out on the actions of the prostaglandins E2and F2αand their synthesis inhibitors, indomethacin and diclofenac sodium, upon isolated human ureteric smooth muscle, using the technique of microsuperfusion designed to ensure good tissue viability.Indomethacin and diclofenac sodium were shown to abolish almost completely the contractile response of ureteric muscle to electrical field stimulation. Contractile activity, in the presence of the inhibitors, could be restored by prostaglandin E2or F2αor by increasing the external potassium concentration, [K+]o, of the superfusate.Prostaglandin E2or F2αalone were shown to increase dramatically both the phasic and tonic component of the electrically stimulated contractions, on occasions inducing spontaneous activity.A possible mechanism of action was elucidated with an electrophysiological technique using intracellular microelectrodes. The mean membrane potential recorded was 54.7 mV (SD ± 10 mV, n=15). The depolarising action of raising [K+]owas demonstrated and prostaglandin F2α(3 times 10‐6M) was shown to produce a small depolarisation of the ureteric muscle cell

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1988.tb09155.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

Summary—The effects of three methods of acute ureteric dilatation (by graded Teflon dilators, low and high pressure balloon dilators) were evaluated radiologically, renographically and histologically in minipigs. The minipig ureter was dilated from its normal calibre of 4 F to 10 F.All three methods caused upper urinary tract dilatation and an obstructive nephropathy which had not resolved 96 h after dilatation. Histology at 24 h showed destruction of the transitional epithelium, with inflammation throughout the ureteric wall. Four weeks after dilatation the ureter was still dilated and urothelial nests were seen in the lamina propria and in the muscle coats. There was no evidence of ischaemic necrosis or ureteric stricture formation. The implications of these findings for clinical practice are discusse

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1988.tb09156.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

Summary—Detrusor bladder neck dyssynergia (DBND) is a well recognised cause of bladder outflow obstruction, especially in the younger man. The cause is unknown, and the aim of this study was to determine if any neurological dysfunction is associated with this condition.Twenty‐five males with proven DBND had sacral reflex latency studies performed. The conduction latencies indicate that the underlying cause is unrelated to any demonstrable neuropathy. Sacral reflex latencies are not helpful in the investigation of D

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1988.tb09157.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

Summary—Bladder outlet obstruction in women is rare. The characteristics and aetiology of the condition in 163 females are discussed and their relation to treatment evaluate

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1988.tb09158.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

Summary—Eighteen patients who underwent urinary diversion in childhood were undiverted. There were three main groups: the neurologically intact bladder, the neuropathic bladder and the “occult” neuropathic bladder. The simplest procedure of anastomosing the proximal ureters to the distal ureters was preferred. The neuropathic group required excision of the bladder remnant and substitution with detubularised bowel.In four patients the renal function was progressively deteriorating pre‐operatively and two have required transplants. Renal failure in one of these patients was accelerated by a post‐operative anastomotic stenosis and infection, although his early post‐operative course was

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1988.tb09159.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

Summary—Embolisation of the internal iliac artery was performed under local anaesthesia in eight patients with severe bladder haemorrhage and in two with severe bleeding from the prostatic bed after prostatectomy.Good and effective control of the bleeding was achieved in six of the patients with bladder haemorrhage, with a partial response in the other two. Both patients with post‐prostatectomy bleeding responded well to embolisation, with prompt cessation of the bleeding.This technique is recommended for the control of severe bleeding from the bladder or prostate in the seriously ill pati

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1988.tb09160.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

Summary—Pedicled preputial patch urethroplasty has been used in 48 patients for the treatment of urethral strictures that have not responded to endoscopic surgery. The procedure is simple to perform and almost universally applicable. It avoids the problems associated with the use of scrotal skin. Its wider use is recommende

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1988.tb09161.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY