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Objective To investigate the cause and treatment experience for traumatic renal subcapsular hematoma.MethodsThe data of eleven cases with traumatic renal subcapsular hematoma were reviewed.four cases were caused by external injury,and seven cases were iatrogenic,including four cases of postESWL patients,two cases of post-ureteroscopic lithotripsy patients and one case after percutaneous renal biopsy.The patients were treated with conservative treatment,percutaneous drainage of the hematoma and surgical exploration,respectively.Results Four cases received conservative treatment,six cases received percutaneous drainage of the hematoma,and one case received surgical exploration.Seven of the ten cases who received conservative treatment or percutaneous drainage of the hematoma were continuously followed up for 1 to 3 years.They recovered well without complications such as renal hypertension,renal function impairment,hydronephrosis and renocortical pyogenic infection.One case was performed nephrectomy due to severe trauma and hemorrhage during the surgical exploration.ConclusionTraumatic renal subcapsular hematoma usually occurs after flank abdomen injury,iatrogenic injury such as ESWL,ureteroscopic lithotripsy and percutaneous renal biopsy.CT and ultrasound examination are the major means to diagnose traumatic renal subcapsular hematoma and determine the severity.Optimistic prognosis can be obtained after conservative treatment and percutaneous drainage of the hematoma.Surgical exploration should be avoided as far as possible.
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Objective To explore the effect on radical surgery of kidney cancer by post-pyelic retrograde free control of renal pedicle. Methods The patients with pre-T3a stage kidney cancer were divided into two groups, 50 patients in traditional surgical group (traditional group) and 52 patients in post-pyelic retrograde free control of renal pedicle group(research group). The surgical duration, hemarrhage volume, local tumor recurrence in one year after operation, and distal metastasis rate had been compared between the two groups. Results One hundred and two patients underwent successful operations and had one year of follow-up as scheduled after being discharged from hospital. The traditional group took (130± 37) min for surgical duration, and had (400 ± 306) ml of hemarrhage volume; and the research group took (99 ± 28) min for surgical duration, and had (280 ± 225) ml of hemarrhage volume,there were significant difference between the two groups (P < 0.05). After one year of follow-up, 2% (1/50) of local recurrence rate and 6%(3/50) of distal metastasis rate occurred in the traditional group,and only 2% (1/52) of local recurrence rate and 4% (2/52) of distal metastasis rate happened in the research group. There were no obvious difference between the two groups. Conclusion The radical surgery of kidney cancer by post-pyelic retrograde free control of renal pedicle has such features as easy performance, short surgical duration, less hemarrhage, and can lower the surgical risk, achieve satisfactory efficacy and deserve popularization.
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Objective To discuss the experiences of management of female duplicated kidney with urinary incontinence. Methods The clinical data of 25 cases with duplicated kidney with urinary incontinence were retrospectively analyzed. They were all female, age ranged from 2 to 12 years old, averaging 7. Fifteen cases were with right side lesions, 10 with left side. The main complaint was urinary incontinence and itching of pudendum. The diagnosis was set up by physical examinations and imaging methods. Results Twenty-five cases reported continent after operation. For the patients taken ureteral replant, the upper kidney function kept or recovered during follow-up. Conclusions Sonography, IVU, and MRU play an important part in the diagnosis of duplicated kidney with urinary incontinence. Operation is the key treatment for this disease.
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Objective To probe the most effective method for the diagnosis of early renal pelvic cancer. Methods Ultrasound, introvenus urogram (IVU), retrograde pyelography, CT, magnetic resonance urography and transurethral ureteropeyloscopy were performed, and the accuracy rate was evaluated. Results The accuracy rate of IVU, retrograde pyelography, CT, transurethral ureteropeyloscopy, MRU and ultrasound were 89%, 94%, 80%, 50%, 40% and 22% respectively. Conclusions IVU and retrograde pyelography are the common and necessary diagnostic methods for early renal pelvic cancer. Transurethral ureteropeyloscopy is an invasive method and used as a final method when other methods fail to identify the disease.
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Objective To evaluate the short ferm effect of transurethral urethrotomy with the contact Nd:YNG laser for urethral stricture and obliteration. Methods 26 patients with urethral stricture or obliteration were treated with transurethral urehrotomy from August 1993 to October 1999.All patients underwent transurethral urethrotomy with the contact Nd:YNG laser delivered with the 600?m bare fiber at 30 to 50W.The urethrotomy was guided only by a metal sound introduced through the suprapubic tract. Results Satisfactory voiding was achieved after catheter removal in all patients.26 patients were followed up for 6～24 months.Normal micturation was observed in 24 patients(92.3%).Recurrent stricture occurred in 2 patients (7.7%).Of the 2 patients one needed periodical urethral dilatation and the other required repeat internal urethrotomy.The only complication was epididymitis in 2 patients.Urethroscopy was performed in 18 patients 4～12 weeks after catheter removal.Urethrotomy revealed a widely patent uretha with complete epithelialization at the site of the previous urethrotomy. Conclusions Transurethral urethrotomy with the contact Nd:YNG laser is a safe and effective treatment for urethral stricture and obliteration.The rate of stricture recurrence is relatively low.Complications not frequeutly seen and satisfectory short-term effect can be obtained.