The Journal of urology
-
The Journal of urology · Nov 1983
Ultrasonography for the diagnosis and staging of blunt scrotal trauma.
Of 19 patients with blunt testicular trauma diagnosed and staged correctly by physical examination and ultrasonography 10 were explored surgically and 9 were managed nonoperatively (treatment was supported by ultrasonography). Fractured testicles occurred in 5 of the 10 explored patients and were repaired surgically, and in 2 of the 9 conservatively managed patients. These 2 patients refused an operation. ⋯ Ultrasonography used in conjunction with a thorough physical examination is highly accurate, readily available, noninvasive and gives minimal discomfort. This modality can be used to follow nonoperative scrotal injury to resolution. With the availability of high resolution real-time ultrasonography more rapid and reliable screening of the scrotum is possible.
-
The Journal of urology · Oct 1983
Intervention in patients with renovascular hypertension and renal insufficiency.
We report on 21 severely hypertensive patients with renal artery stenosis and renal insufficiency in whom percutaneous transluminal angioplasty and/or renal artery surgery was done in an effort to lower blood pressure and to preserve renal function. Of 12 patients who underwent angioplasty renal function and blood pressure improved in 3. ⋯ Two patients died postoperatively but 10 improved, with followup in 6 exceeding 3 years. This retrospective experience suggests that percutaneous transluminal angioplasty is not likely to supplant an operation in the treatment of patients with atherosclerotic renovascular hypertension and renal insufficiency.
-
The Journal of urology · May 1983
Extended cadaver renal preservation with combined simple cold storage and hypothermic pulsatile perfusion.
Although simple cold storage and hypothermic pulsatile perfusion are each accepted methods of cadaver kidney preservation the efficacy of combining these techniques for extended renal preservation is unclear. In 18 patients cadaver allografts were used that had been preserved with combined simple cold storage (range 6 to 20 hours) and hypothermic pulsatile perfusion (range 9 to 38 hours). The total interval of preservation for these kidneys ranged from 25 to 48 hours. ⋯ In 14 patients (78 per cent) grafts continued to function at intervals of 3 to 38 months after transplantation. Of the remaining 4 patients 3 lost the grafts to rejection, while 1 died 7 months after transplantation with a well functioning graft. These data suggest that the combination of simple cold storage and hypothermic pulsatile perfusion provides a safe and effective method for extended renal preservation.
-
The stoma is the weak link of external urinary diversion. Improper stomal position or configuration produces the unnecessary burden of leakage for the patient with diversion. Stomal bleeding, incrustation and peristomal dermatitis cause inconvenience and expense. ⋯ The significant complication has been parastomal hernia. Minor modifications of the technique have lowered the incidence of hernia. Loop stomas are our principal form of stomal construction.
-
The Journal of urology · Mar 1983
Case ReportsCystic partially differentiated nephroblastoma and polycystic Wilms tumor: a spectrum of related clinical and pathologic entities.
Cystic partially differentiated nephroblastoma is a rare neoplasm occurring in young children and demonstrating features of classic nephroblastoma (Wilms tumor) and multilocular cysts. Cystic partially differentiated nephroblastoma actually represents a spectrum of cystic renal tumors in which varying amounts of blastema, stroma and epithelial structures are present. ⋯ The clinical and pathologic findings, and management of 2 infants with cystic partially differentiated nephroblastoma are presented. The controversy over the histogenesis of these lesions and whether they should be considered benign or potentially malignant is discussed.