ABSTRACT
From 1974 to 1993, the authors admitted 212 patients with renal trauma to their department. A large proportion of these cases were due to skiing accidents. Based on a retrospective study of 78 patients admitted to the Grenoble urology department, the authors describe the features of this trauma. 91% of patients were males with a mean age of 27.5 years, with 9% of type III trauma. Treatment was surgical in 55% of cases. Total nephrectomy was performed in 21% of patients. Partial nephrectomy was performed in 25.5% of cases, with a morbidity of 45%, predominantly consisting of fistulas.
Subject(s)
Kidney/injuries , Skiing/injuries , Adolescent , Adult , Athletic Injuries/classification , Athletic Injuries/epidemiology , Athletic Injuries/surgery , Child , Contusions/epidemiology , Female , Follow-Up Studies , France/epidemiology , Hematoma/epidemiology , Humans , Ischemia/epidemiology , Kidney/blood supply , Kidney/surgery , Kidney Diseases/etiology , Male , Nephrectomy/adverse effects , Nephrectomy/classification , Nephrectomy/statistics & numerical data , Retrospective Studies , Rupture , Survival Rate , Urinary Fistula/etiologyABSTRACT
Surgical complications of renal transplantation, rejection and infectious diseases are factors contributing to poor renal graft survival. Factors directly concerning the donor can be involved in graft failure: age, medical history, causes of donor brain death. Urologic or arterial anatomic variations are often the source of difficult surgical conditions during renal transplantation. Technical errors during graft procurement must be avoided such as excess of traction or coagulation. Failure in perfusion preservation. As few renal grafts are available, it is thus essential to obtain optimal conditions to avoid failure in cadaver donor graft linked to technical errors during organ procurement.
Subject(s)
Kidney Transplantation/adverse effects , Kidney/surgery , Urologic Diseases/etiology , Vascular Diseases/etiology , Adolescent , Adult , Child , Child, Preschool , Humans , Methods , Middle Aged , Risk Factors , Tissue Donors , Tissue and Organ Procurement , Urologic Diseases/prevention & control , Vascular Diseases/prevention & controlABSTRACT
The emergency treatment of Fournier's and perineal gangrene is now well defined and is based on excision of the necrotic tissues and broad spectrum antibiotics combined with hyperbarid oxygen therapy and symptomatic resuscitation measures. However, several procedures have been described for the reconstruction of the excised zones. In the light of one case of Fournier's gangrene, the authors evaluate reconstruction of the penile skin by means of a helical split-skin graft. With a follow-up of one year, the morphological and functional result was excellent. The patient has normal erection and the suture line does not contain any retractile adhesions. The authors therefore consider that this simple, but little known procedure should be part of the urologist's therapeutic arsenal for reconstruction of the penile skin.
