ABSTRACT
In order to improve the selection of patients for surgical treatment functional roentgenoradiological diagnostic methods: "diuretic" renography (RRG) and excretory urography (EU) were employed in a group of 126 patients with hydronephrosis, Stages I, II and III, after V. S. Karpenko's classification (1980). Computer-assisted qualitative and quantitative assessment of the results obtained was performed with their further comparison with the results of routine RRG and EU. Regular changes in RRG and EU indices in the presence of diuretic load were shown for each stage of disease, and significant differences were revealed. The authors discussed morphofunctional changes and pathophysiological mechanisms laying the basis of reactions of the cavitary kidney system (CKS) to forced urination and reflected in indices of "diuretic" RRG and EU. A high differential-diagnostic value of the above methods in hydronephrosis was confirmed. Their use made it possible to specify indications for reconstructive operations, especially in controversial cases of the functional obstruction of the ureteropelvic segment. After diuretic RRG and EU one could refrain from surgery in 28% of the patients with obligatory follow-up.
Subject(s)
Hydronephrosis/diagnosis , Adolescent , Adult , Humans , Hydronephrosis/diagnostic imaging , Iodohippuric Acid , Radiography , Radioisotope RenographySubject(s)
Kidney Diseases/physiopathology , Postoperative Complications/physiopathology , Radioisotope Renography , Adolescent , Adult , Aged , Glomerular Filtration Rate , Humans , Iodohippuric Acid , Kidney Diseases/complications , Kidney Diseases/diagnosis , Kidney Failure, Chronic/diagnosis , Kidney Failure, Chronic/physiopathology , Middle Aged , Pentetic Acid , Postoperative Complications/diagnosis , Renal CirculationSubject(s)
Kidney/physiopathology , Prostatic Diseases/physiopathology , Urodynamics , Adult , Aged , Humans , Male , Middle Aged , SclerosisSubject(s)
Adrenal Gland Neoplasms/diagnosis , Paraganglioma/diagnosis , Adrenal Cortex Hormones/metabolism , Adrenal Gland Neoplasms/metabolism , Adrenal Glands/diagnostic imaging , Adult , Aldosterone/metabolism , Diagnosis, Differential , Female , Humans , Male , Methods , Middle Aged , Pheochromocytoma/diagnosis , Radiography , Radionuclide ImagingABSTRACT
A study was made of 137 patients with prostatic sclerosis ranging in age from 14 to 79. Basing on the results of clinical, x-ray and radionuclide examination of patients with prostatic sclerosis 3 degrees of disturbed urodynamics of the lower urinary tract have been singled out for this disease entity: compensated, subcompensated and decompensated. In accordance with the above degrees of the disturbed urodynamics groups of patients have been analysed before and after surgery (partial and subtotal resection of the prostate and prostatectomy). Prostatic sclerosis has been shown to cause changes in the urine output rate, the time of urination and residual urine. The UFM index is lowered as compared to the normal one more than 6 times. Residual urine (RU) reached 234.0 +/- 62.2 ml, the time of urination is extended by more than 2.4 times. It has been established that disturbed permeability of the posterior urethra results in the disturbance of the urodynamics of the upper urinary tract, separate and summary renal function. Radionuclide investigation helped to study the long-term results of operation efficacy by the reparation of the urodynamics in 91 patients with prostatic sclerosis. In most of the patients, the urodynamic indices returned to normal or improved: in 78.2% of the patients with prostatic sclerosis, the time of urination returned to normal, in 21.2% the time reduced. The UFM index returned to normal in 36.2% of the patients, in 40.6% it was moderately reduced, and in 23.0%, it remained sharply reduced. RU over 100 ml was determined in 6.5% of the patients only. After reparation of the permeability of the posterior urethra renal function either returned to normal or greatly improved in 37.9% of the patients. In 52.5% of the patients, renal function did not reach normal however, gradually improving it got stable at a certain level which was sufficient for the improved conditions of a patient and his future life.
