ABSTRACT
Our results in 18 cases with the Gil-Vernet technique of surgical correction of vesicoureteral reflux are presented. The ureteral orifices are advanced across the trigone by means of a single submucosal mattress suture in order to increase the intramural length of each distal ureter. The new procedure offers some advantages to the more widely applied techniques. It is rapid and simple to perform and the intrinsic and extrinsic musculature of the terminal ureters is preserved. This technique can be used indiscriminately in cases of primary unilateral or bilateral reflux, including grades II to IV.
Subject(s)
Vesico-Ureteral Reflux/surgery , Adolescent , Adult , Child , Child, Preschool , Female , Follow-Up Studies , Humans , Male , Postoperative Complications/etiology , Suture Techniques , Ureter/surgery , Urinary Bladder/surgeryABSTRACT
Late complications involving the bladder and ureter occasionally occur following irradiation to the minor pelvis. Intermittent light bleeding from the bladder can be contained by nonspecific installation therapy. With life-threatening hemorrhage, silver nitrate or formalin instillation is effective. The treatment of irradiation ulcers, irradiation contracted bladder, vesicovaginal fistulae, and late irradiation reactions of the ureter are discussed in incurable bladder contractions and vesicovaginal fistulae, a supravesicle urinary diversion is necessary.
Subject(s)
Pelvic Neoplasms/radiotherapy , Radiation Injuries/surgery , Ureter/radiation effects , Urinary Bladder/radiation effects , Adult , Aged , Female , Humans , Middle Aged , Ureteral Diseases/surgery , Urinary Bladder Diseases/surgery , Urinary DiversionABSTRACT
Because of the retroperitoneal situation of the kidneys, dorsoanterior echography suggests itself. The rapid B-picture process is particularly suitable for urology because the movements of the kidney due to respiration can be followed. "Silent kidney" can be explained. Space-occupying processes can be differentiated. Pararenal processes can be recognised through sonography. Further indications are postoperative monitoring after plastic operations on the efferent urinary passages. The kidney can be visualized without radiation load in allergy to contrast media or in pregnancy. Cyst puncture under echographic observation can contribute to differential diagnosis. Percutaneous nephrostomy under ultrasonic observation can avoid operative intervention.
Subject(s)
Kidney Diseases/diagnosis , Kidney Neoplasms/diagnosis , Ultrasonography , Adult , Aged , Child , Humans , Hydronephrosis/therapy , Kidney Diseases, Cystic/diagnosis , Kidney Diseases, Cystic/therapy , Nephrosclerosis/diagnosis , Punctures , Subphrenic Abscess/diagnosis , Urinary Calculi/diagnosisABSTRACT
Transureteroureterostomy creates an artificial ureter bifidus. In the common branch, the resting pressure is a little bit higher than in its bifurcation and the peristalsis of the bifurcation is never synchronous. That is why an ureteroureteral reflux may be produced by the anastomosis. The ureteroureteral reflux created by a ureteral dyskinesia, however, causes an infection in the recipient kidney only if there is a predisposition to infection or a vesicoureteral reflux in the recipient ureter. A transureteroureterostomy was performed on five female patients suffering from unilateral distal damage of the ureter, four of them after gynecologic operations. One patient had a single kidney right. The damaged ureter was anastomized with the left ureteral stump of the nephrectomied side. In one case, an abscessing retroperioneal urinoma with a serious diffuse peritonitis developed as a direct complication of the operation because of an insufficient suture. On revision, the transplanted ureter had to be drained into the skin. Despite this serious complication, the recipient ureter remained uninjured and the recipient kidney was not damaged. The four other patients had no complications.
Subject(s)
Ureter/surgery , Adolescent , Adult , Child , Female , Humans , Methods , Middle Aged , Ureter/injuries , Ureteral Diseases/surgeryABSTRACT
Over a 10-year period 321 children underwent 490 antireflux operations. 21 duplicated vesicoureteric reflux was observed in 18 patients. The follow-up and the comparison with other authors results in 334 patients indicate that the submucosal inlay of the duplicated ureters is a particularly suitable operation. The Politano-Leadbetter and the Lich-Grégoir techniques yield good results.
Subject(s)
Ureter/abnormalities , Vesico-Ureteral Reflux/surgery , Adolescent , Child , Child, Preschool , Female , Humans , Infant , Male , MethodsABSTRACT
In an analysis of 75 children with stenosis of the ureter opening, our results are compared to those in the literature (see in particular Tables 1 and 2). Abdominal pain stands out as the major symptom in more than half of the children. In our cases, intramural disturbances predominate in ca, 2/3 of cases, in the literature in about half of cases. The occurrence of extramural disturbances (accessory vessels, adhesions, higher opening of the ureter) occurs with equal frequency. The determining diagnostic procedure for stenosis of the ureter opening is an excretion urogram. Indications for a retrograde pyelogram and the performance of a micturation cystoureterogram are discussed. The operation of choice for stenosis of the ureter opening is the plastic operation of the renal pelvis of Anderson-Hynes, which has a success rate of at least 80%. Amoung our group of patients, primary nephrectomies were only seldom necessary.
