RESUMO
A prospective study of our first 81 cases of ureteroscopy using extended length rigid endoscopes was performed. Of 55 stone manipulations attempted in 51 patients by 6 endoscopists 38 (69 per cent) were successful. Analyzed sequentially, removal was successful in 12 of 23 attempts (52 per cent) among the initial 40 patients and in 26 of 32 (81 per cent) among the subsequent 41 patients. Of 11 calculi larger than 1 cm. and of 23 positioned above the iliac vessels 7 (64 per cent) and 11 (48 per cent), respectively, were removed successfully. Disimpaction by ureteroscopic manipulation combined with extracorporeal shock wave lithotripsy was successful in 4 cases of upper ureteral calculi not treatable by extracorporeal shock wave lithotripsy alone. Diagnostic and therapeutic uses of the ureteroscope in addition to treatment of ureteral calculi have included the delineation of ureteral filling defects (9 patients), fulguration of known low grade tumors (4) and dilation of ureteral strictures (5). In 10 patients information was obtained endoscopically that was not possible by standard diagnostic techniques. The direct visual approach to the ureter has distinct advantages over blind ureteral instrumentation.
Assuntos
Endoscopia , Cálculos Ureterais/terapia , Doenças Ureterais/diagnóstico , Adulto , Idoso , Dilatação/métodos , Endoscópios , Feminino , Humanos , Litotripsia/métodos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Neoplasias Ureterais/diagnóstico , Obstrução Ureteral/terapiaAssuntos
Adenocarcinoma/diagnóstico por imagem , Angiomatose/diagnóstico por imagem , Neoplasias Oculares/complicações , Neoplasias Renais/diagnóstico por imagem , Artéria Renal/diagnóstico por imagem , Doença de von Hippel-Lindau/diagnóstico por imagem , Adenocarcinoma/complicações , Adulto , Humanos , Neoplasias Renais/complicações , Masculino , Pessoa de Meia-Idade , Ampliação Radiográfica , Doenças Retinianas/complicações , Doença de von Hippel-Lindau/complicaçõesRESUMO
Ileum was used as a ureteral replacement in 12 patients, 7 of whom had solitary kidneys. The conditions that necessitated an operation included renal pelvic and ureteral complications of calculi, a variety of traumatic ureteral injuries, retroperitoneal fibrosis and ureteral neoplasms. Renal function has been well preserved and electrolyte imbalance has been minimal.
Assuntos
Íleo/transplante , Doenças Ureterais/cirurgia , Neoplasias Ureterais/cirurgia , Adulto , Feminino , Humanos , Íleo/cirurgia , Masculino , Pessoa de Meia-Idade , Transplante Autólogo , Derivação Urinária/métodosRESUMO
Experience with the electrohydraulic lithotrite in treating 14 cases of bladder calculi is reported. This revolutionary lithotrite is applicable to most bladder stones and is associated with few complications.
Assuntos
Cálculos da Bexiga Urinária/terapia , Urologia/instrumentação , Adolescente , Adulto , Idoso , Eletricidade , Humanos , Métodos , Pessoa de Meia-Idade , Irrigação TerapêuticaRESUMO
Sex cord-stromal (gonadal stromal) tumors of the testis account for less than 4 per cent of the testicular tumors. The Leydig cell tumor in a child may produce isosexual virilization (case 3). In the adult it may have no endocrine manifestation (case 1) or gynecomastia and decrease in libidio may result from production of estrogens (case 2). Sertoli cell tumors (case 4) and granulosa cell tumors (case5) are rare.
Assuntos
Tumor de Células de Leydig , Neoplasias Testiculares , Hiperplasia Suprarrenal Congênita/complicações , Adulto , Idoso , Pré-Escolar , Diagnóstico Diferencial , Tumor de Células da Granulosa/patologia , Humanos , Tumor de Células de Leydig/diagnóstico , Tumor de Células de Leydig/patologia , Malacoplasia/diagnóstico , Masculino , Pessoa de Meia-Idade , Tumor de Células de Sertoli/patologia , Neoplasias Testiculares/complicações , Neoplasias Testiculares/diagnóstico , Neoplasias Testiculares/patologiaRESUMO
Angiographic methods were applied to control bleeding in 2 patients following genitourinary tract operations. In 1 patient hemorrhage into the prostatic bed after needle biopsy of the prostate was controlled with embolic occlusion of branches of the hypogastric arteries. In the second patient bleeding from the ileum following ileal loop cutaneous diversion was controlled with the infusion of vasopressin into the superior mesenteric artery. Therefore, angiography offers an attractive alternative to an operation in the management of postoperative hemmorrhage from the genitourinary tract.