Uroenteric fistulae

Seven cases in which a fistulous tract communicating the urinary system with the intestinal tract are presented. One case was a vesico colonic fistula following a full thickness resection of a bilharzial bladder ulcer in association with diverticulitis of the pelvic colon. A second case was a uaretero colonic fistula in association with colonic diverticulitis following ureterolithotomy The other five cases were urethro-rectal fistulae four following direct penetrating trauma and one after prostatectomy. The clinical course, etiology, pathogenesis and operative modalities of correction are discussed

management of Pyonephrosis

Sixty cases of pyonephrosis were treated in an 8-year period between 1977 and 1987. All patients were treated surgically. The operation consisted of primary nephrectomy. In contrast, nephrostomy as initial treatment was performed in some cases, There were many major complications [i.e. leading to death or substantial prolongation of hospitalization]. This experience suggests that nephrostomy is indicated when the patient is severely ill or the kidney is expected to recover function. Where dialysis is available, it may be applied to improve the patient's condition for a definitive radical operation instead of nephrostomy. It was prefered by us to apply percutaneous drainage where function appeared to be limited and there is still some function of the kidney by isotopic screening