CT and angiographic correlates: surgical image of renal mass lesions.

Twenty-three consecutive patients with surgically proved renal mass lesions were examined preoperatively by means of computerized tomography (CT) and renal angiography. Histopathology of the 23 renal masses included the following: hypernephroma (17), transitional cell carcinoma (3), oncocytoma (2), benign cyst (1). Computed tomography was correct in the preoperative diagnosis of 21 of 23 masses (91 per cent); angiographic diagnosis was correct in 18 of 23 consecutive masses (78 per cent). Correlation of the findings on CT and angiography resulted in correct diagnosis in 22 of the 23 lesions (96 per cent). Independently, CT and angiography each contribute essential information for diagnosis and preoperative planning. CT discloses anatomic detail, tissue consistency, organ system relationships, and relatively precise estimates of tumor bulk. Angiography remains a necessary complement providing a surgical image of tumor vascularity and vessel origins.

Enterovesical fistulas in Crohn disease.

Fistulous communication between the intestinal tract and the bladder is uncommon in Crohn disease. Only 2% of patients afflicted with this disease present with bladder symptoms. Five patients with a mean age of thirty years presented with a prolonged history of bowel disease but a short history of urinary symptoms. Only three patients presented with pneumaturia and fecaluria. None of the fistulas could be demonstrated radiographically. Cystoscopy disclosed the fistulous site as well as acute and chronic inflammation of the bladder. Small-bowel resection with excision of the fistula, partial bladder resection, and diverting ileostomy were performed as a first stage. Ileostomy closure was done two to four weeks later.

Complete duplication of male urethra in children.

Urethral duplication is a rare congenital anomaly. It may be complete or partial, and each form has its distinctive anatomy, symptom complex, and surgical therapy. Surgical management, utilizing a penile retropubic-transvesical approach, is described.

Diagnosis of fetal hydronephrosis in utero using ultrasound.

Detection of fetal hydronephrosis in utero, subsequent investigation, and surgical treatment is described. With the increasing use of ultrasound for obstetrical problems and greater experience with fetal sonography, more urologic abnormalities will be diagnosed prenatally.

Ureteroceles in siblings.

We report on 2 siblings with simple ureteroceles. A simple ureterocele associated with a single ureter is encountered less frequently than an ectopic ureterocele in children. The severity of associated ureterectasis and hydronephrosis is generally greater than in adults.

Fibroepithelial polyp of the verumontanum: a case report and review of the literature.

A fibrous polyp of the verumontanum in a 10-year-old boy is described. The diagnosis, treatment and histology are discussed and the literature is reviewed. Perhaps this lesion will be noted more frequently with the availability of improved radiographic and cystoscopic techniques. The treatment has been greatly simplified with the advent of the pediatric resectoscope.

Renal carcinoma in adolescents.

Renal adenocarcinoma is an infrequent tumor in children. The clinical and radiographic findings in 4 adolescents with such tumors are described. The surgical therapies of these patients and the possible role of adjunctive chemotherapy and radiotherapy are discussed.

Correlation of cytology and cystoscopy.

A total of 152 patients had cytology and cystoscopy performed for either initial or recurrent bladder tumors and postoperative control examinations. Positive cytology was found in 97 per cent of patients with pathologically proved bladder tumors. However, 23 per cent of the patients with negative cytology had positive cystoscopic and pathologically proved findings. Without cystoscopic examination a significant number of recurrent tumors may be missed because of a negative cytology.

Benign ureteral lesions: rare causes of hydronephrosis in children.

Three unusual cases of hydronephrosis in children secondary to ureteral lesions, (1) congenital abnormality and (2) due to benign tumor, are presented. The radiographic findings and management are discussed. Conservative surgical management is suitable for these lesions.