Complete duplication of the bladder and urethra.

We report a case of complete duplication of the bladder and urethra. The condition was asymptomatic and was associated with congenital dislocation of the right hip. Excision of the dorsal urethra and bladder, and correction of the chordee were done.

Urolithiasis in Jordanian children. A report of 52 cases.

Fifty-two children with urinary calculi seen between 1975 and 1986 were reviewed. Males dominated the series. The age distribution ranged from 10 months to 14 years (mean 7.2 years); 71% presented after school age. Most patients had upper tract stones. The main presenting symptoms were abdominal pain, infection and haematuria. The causative factors or co-factors were infection, malformations and urodynamic abnormalities. Metabolic disorders were rare. Calcium oxalate and uric acid stones were found most often. Surgical management was required in 88% of patients and only 3.8% had a recurrence. Presenting symptoms are variable and so a high index of suspicion is required for diagnosis.

Renal injuries.

The present paper reports on solitary and associated renal injuries. Conservative and surgical treatments are discussed and compared with literary data.

Idiopathic subcutaneous and laryngeal fibrosis.

A 40-year-old totally deaf male presented with submucosal masses in the subglottic space and multiple subcutaneous nodules in the eyelids, scrotum and thighs. Biopsies of these masses revealed dense fibrosis associated with non-specific chronic inflammation. Although the findings were clinically similar to those of neurofibromatosis, amyloidosis, multifocal fibrosclerosis with cutaneous nodules, and familial multicentric fibromatosis, they did not fit completely with any of the above-mentioned conditions. It is possible that this case represents a peculiar entity of its own.

Persistent cloaca in adult with satisfactory renal function.

A case of persistent and uncorrected cloaca in a twenty-five-year-old woman is presented. In spite of the anomaly not being corrected, no deterioration of her kidney function was noted. She is continent for both urine and stools. In addition to two uteri which were removed at different times, she has only one kidney on the right which is ectopic and malrotated, and an abnormal left thumb. The question of doing electromyographic studies of the pelvic muscles prior to the repair of the anomaly, together with the timing of the latter, is raised.

Bacteriology and composition of infected stones.

One hundred forty-two stones from 106 male and 36 female patients were investigated bacteriologically and chemically. Twenty (14%) of these stones were infected; 65 per cent were associated with infected urine. In 45 per cent of these infected stones an identical bacteria species was isolated from urine and stone of the same patient. Most of the infected stones were of the oxalate type (II), followed by uric acid/urate (5) and calcium phosphate (4) types. Only one stone grew a definite urea-splitting organism.

Congenital ureteric valves--a cause of urinary obstruction.

Congenital ureteric valves causing upper urinary tract obstruction was discovered after operation in 4 adults who had presented with different urological problems. The fifth patient, an infant, presented with failure to thrive and was suspected of having a congenital ureteric valve prior to operation. The infant had gross hydronephrosis and was treated by excision of the segment containing the valve and end-to-end anastomosis of the ureter and pyeloplasty because of a narrow pelviureteric junction. Three adults had severe kidney damage and underwent nephrectomy. The fourth adult, who had a horseshoe kidney with 4 small stones in the lowermost calix, underwent pyelolithotomy; in addition, the segment bearing the valve was excised and a ureteropyelostomy was carried out.