ABSTRACT
From 1984 to 1989 35 patients presented with uncharacteristic flank pain or recurrent urinary tract infections and small nonobstructing caliceal calculi. Thirty patients were treated; 13 with percutaneous stone extraction, 8 with extracorporeal shock wave lithotripsy, 3 with ureteroscopic stone manipulation and 2 by open surgery. Stone removal was successful in 39 patients and they were all relieved of their symptoms (86%). Stone size was decreased in 2 patients who felt a marked alleviation. Where the stone remained unaffected the symptoms persisted unabated. These observations suggest that small caliceal stones can cause pain. The results of treatment are such that it is justifiable to treat a small caliceal stone in patient suffering from flank pain of no other known cause.
Subject(s)
Kidney Calculi/therapy , Kidney Calices , Adult , Aged , Endoscopy , Female , Follow-Up Studies , Humans , Kidney Calculi/diagnostic imaging , Lithotripsy , Male , Middle Aged , Nephrostomy, Percutaneous , Pain Measurement , UrographyABSTRACT
Since 1979 we have used human umbilical vein graft as the ultimate vascular access for hemodialysis in patients with chronic renal failure. In 24 patients 33 graft fistulas were performed. Several complications were encountered. Among these infection was the most serious, occurring in seven grafts. All these grafts were removed and never used for hemodialysis. Thrombosis occurred 25 times, and five grafts were lost because of this, whereas 20 grafts had successful thrombectomy and continued to function. Aneurysm formation occurred four times, two grafts were lost. Stenosis was seen in three cases, one graft was lost. In the material 26 grafts were used for hemodialysis and a median function time of 8.5 months was obtained. At the end of the observation period 10 grafts were open, eight were used for hemodialysis, two were not used because of successful transplantation. The umbilical vein graft is an acceptable alternative as vascular access where conventional methods of fistula formation have been exhausted.
Subject(s)
Arteriovenous Shunt, Surgical , Kidney Failure, Chronic/therapy , Renal Dialysis , Umbilical Veins/transplantation , Adolescent , Adult , Aged , Female , Graft Occlusion, Vascular/etiology , Humans , Kidney Failure, Chronic/surgery , Male , Middle Aged , Postoperative Complications , Thrombosis/etiologyABSTRACT
110 adult patients with benign and malignant conditions subjected to an ileal conduit urinary diversion were followed from 1 to 8 years after the operation. 62 patients (59 with a malignant disease) died in the follow-up period. The patients were divided into 3 groups according to their primary diseases: (1) benign, (2) malignant without irradiation, and (3) malignant with irradiation. Early complication rates were 22% in group 1, 33% in group 2, and 29% in group 3. In addition, the complications were more serious in the group with malignant diseases. Late complication rates were 70% in group 1, 80% in group 2, and 54% in group 3, possibly due to a shorter time of observation in group 3. Renal function deteriorated in 18% of the patients but only 3% became uremic. When urinary diversion is inevitable we find this method acceptable, at least until the long-term results of newer methods are known.
