Partial nephrectomy for tumour.

Thirty-three cases of malignant renal tumour removed by partial nephrectomy are discussed. The indications of this conservative therapy as well as the surgical technique, the results obtained, especially survivals beyond 10 years, as well as the period of time after which the neoplastic disease can be considered as cured are presented.

Urinary infection.

For further cytomicrobiological analysis correct urine collection is required because, in women, there is the possibility of contaminating the urine sample at micturition by the saprophyte flora of the vagina. In men, preputial hypertrophy and the germs growing on the prepuce, especially in the smegma, can cause false analytical results which may lead to misdiagnoses and inadequate treatment. To avoid this in women, the urine sample must be taken by urethral catheterization and in men by micturition but exposing the glans to avoid urine contamination by the balanopreputial flora.

[Comments on the surgical treatment of hydronephrosis]. / Comentario a los tratamientos quirúrgicos de la hidronefrósis.

The author first recalls that the first operation to correct hydronephrosis due to ureter stenosis was performed by Trendelenburg. He then defines the causal lesion of hydronephrosis and describes its etiology. He stresses that the only procedure for correcting hydronephrosis caused by stenosis of the juxtapyelic ureter is the removal of this portion, the lesion of which it is impossible to repair or correct. He criticizes the numerous operations proposed by different authors and even the partial removal of the renal pelvis. He points out that most of the operation procedures described as new, have already been published. He finally stresses that the best operation is the removal of the stenosed ureter followed by direct pyelo-ureter anastomosis and kidney draining by means of a tutor probe placed from the pelvis to the bladder during the operation and kept in place for a few days.

Partial nephrectomy for renal tumour: 21 cases.

Partial nephrectomy has been performed in 21 cases of kidney tumours. It can be used for well-limited parenchymatous tumours and obligatory in patients with a solitary kidney, but is not advisable for tumours originating in the urothelium. These results are compared with the parallel experience with radical surgery and followed during 46 years in the same centre, they give a greater value to this study and encourage the reasoned practice of partial nephrectomy for tumours especially in the solitary kidney.

[Surgical considerations in congenital hydronephrosis]. / Considérations chirurgicales dans l'hydronéphrose congénitale.

The anatomo-operative characteristics of the ischemic stenosis of the juxtapyelic part of the ureter, its embryogenic fundamentals, clinical semiology and urography, emphasizing the signs of the latter for the differential diagnosis of hydronephrosis are presented. The most adequate surgical technique, that is the extirpation of the scleroatrophic part of the ureter, followed by uretero-pyelostomy, with special care in preserving the arteries of the ureter, is summarized and the technique for the postoperative drainage of the kidney is pointed out. The poor effectiveness of other procedures are commented.

Caliceal urodynamics.

In this study the author emphasizes the existence of a muscular element that had not been described until now. This muscular element is situated around Malpighi's pyramid and its fibres are followed by the caliceal muscle and the elements that form Henle's peripapillar ring. The systolic and diastolic function of this peripyramidal muscle can be observed in the urographies, during the evacuation of the collector tubules of Bellini, and its synchronization with the next caliceal and pyelic musculature.