Bilharzial anuria

ABSTRACT

In a series of 451 patients affected with bilharzial ureteric strictures, anuria developed in 24 cases [5.3%]. All patients were males with a mean age of 35 years. Five of the cases had preious unilateral nephrectomy. Two had middle third ureteric strictures, while all others had lower third strictures. On admission all patients appeared ill and had their blood urea and serum creatinine around 300mg/100 ml and 12.5 mg/100 ml respectively. Nephrostomy was performed in all cases. Following this, one patient died, 3 had complications and 8 out of 19 cases who had bilateral nephrostomy were discovered to have a unilateral functioning kidney. After an average period of two weeks, their general condition was improved and all 23 patients were operated on to rectify their ureteric strictures. Following this, 3 cases developed wound infection and there was no mortality. When they were discharged, all patients had improvement in their renal function. Within one month 2 cases had normal levels of their blood urea and serum creatinine, which remained so over two years follow up. While in all other patients, after an initial improvement in their blood urea and serum creatinine, continuation of these tests showed above normal levels during the period of follow up. It was observed that preliminary percutaneous nephrostomy in anuric bilharzial patients improves renal function significantly. Surgery should always be attempted and long term results depend on the quality of preserved renal tissues