Ann Urol
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The authors report twenty two cases of obstructive anuria observed in children. Causes are diverse: 6 cases were observed during the course of tumors, 4 cases were secondary to bilateral renal stones (or unilateral in a single kidney), 3 cases were observed before surgical correction of latent or well tolerated congenital uropathy, and 9 cases in the immediate postoperative period (including 8 after antireflux surgery). In the emergency situation, treatment of obstructive anuria is based on urinary diversion ideally by percutaneous nephrostomy under ultrasonic control. But prevention is the best treatment of anuria: treatment of urinary tract infections resulting in renal stones, in case of tumor, ultrasonographic survey of chronic upper tract dilatation: rigorous atraumatic operative technique avoiding any oedema.
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The authors report their experience of calculus anuria in children. They based their study on a series of 12 cases. They point out, in particular, the diagnostic difficulties and prognostic risks which could be encountered. They also emphasize, the role of prompt renal drainage in the management of such an emergency and recommend percutaneous nephrostomy followed by cold nephrolithotripsy.
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Perineal nerve injury due to stretching is caused by excessive traction on the distal motor branches of the pudendal nerve that innervate the perineum and anus. These injuries can occur in a number of morbid conditions (prolapsus, anorectal dyschezia, pelvic surgery) and induce denervation of the pelvic floor that very probably modifies the resistance of the sphincters. ⋯ Diagnosis can be established by electrophysiologic studies of the perineum, particularly by measurements of distal pudendal nerve motor latencies. The authors report a series of sixty patients with stretch-induced neuropathy.