Ureterouterine fistula as a complication of cesarean section.

A rare case of ureterouterine fistula caused by a complication of cesarean section after a normal pregnancy is reported. The patient presented with a urinous seeping into the vagina, and the fistula was diagnosed preoperatively on urography and computerized tomography. Treatment consisted of a 2-stage surgical approach, including percutaneous nephrostomy and subsequent ureteral reimplantation.

[The "in situ" treatment of ureteral calculi with extracorporeal lithotripsy]. / Trattamento "in situ" della calcolosi ureterale con litotripsia extracorporea.

The authors report on 80 cases of ureteral calculi treated with in situ extracorporeal shock wave (ESWL), with no retrograde or antegrade maneuvers. Success rate was high (97.5%). Forty-two calculi were located in the proximal ureter above the sacroiliac joint; 10 were in the pre-sacral ureter, and 28 in the pelvic ureter, below the inferior border of the sacroiliac joint. After ESWL, double-J stents were positioned in 5 patients and nephrostomy was performed in 4 cases with positioning of 7-F pig-tail catheters; 8 patients (10%) underwent additional post-lithotripsy urologic and radiologic examinations. Lithotripsy having failed in 2 patients (2.5%), surgery with ureterolithotomy was performed. In situ ESWL of ureteral calculi emerges from this trial as the treatment of choice and not as an alternative to urologic maneuvers or open surgery with ureterolithotomy: the latter methods are necessary only after ESWL failure.

Ureterocalicostomy in the treatment of pyeloplasty failures.

Ureterocalicostomy was performed in 8 patients following failed pyeloplasty: 2 had undergone two previous pyeloplasties, while endourological management had been attempted in 3. With a mean follow-up of 58.7 months, radiographic studies demonstrated resolution of the obstruction in 6 cases (75%), while two kidneys lost their function. The definitive role of endourological techniques after pyeloplasty failure still waits the test of time although they deserve to be applied first, and ureterocalicostomy remains a reliable procedure in this particular setting.

Computed tomography of the ethmoid labyrinth and adjacent structures.

The architecture of ethmoid labyrinths as well as their relationships with adjacent structures are reviewed, giving special emphasis to the anatomic variants common in this area. The study was performed on six young normal subjects who were submitted to high resolution computed tomography. Approximately 25 axial scans, parallel to the floor of the anterior cranial fossa, were performed on each subject; four to five coronal CT scans were also added. Further data were supplemented by examinations of 62 patients affected by nonneoplastic disease of the paranasal sinuses. Microsurgery is replacing classic macrosurgery in the treatment of nonneoplastic disease of the paranasal sinuses. This new trend requires a perfect preoperative delineation of the anatomy. For this purpose, the present paper contains a list of 10 questions which can be answered exhaustively by computed tomography on the basis of the data illustrated. The answers cover most requirements of sinus microsurgery.