The incidence of urinary tract infection in patients without bacteriuria who underwent extracorporeal shock wave lithotripsy.

The incidence and severity of urinary tract infections in 145 patients with renal calculi undergoing extracorporeal shock wave lithotripsy (ESWL*) who were catheterized for a short period without evidence of bacteriuria and/or infected stones evaluated. The patients were followed clinically and bacteriologically 1 and 14 days after the procedure. Bacteriuria was observed in 7 of the 145 patients (4.8%): in 5 patients 24 hours after ESWL and in 2 patients 2 weeks later. Of these patients 2 were symptomatic but only 1 had fever. No patient was hospitalized. We found no correlation between bacteriuria and the number or size of the stones. We conclude that the incidence of bacteriuria in catheterized patients who underwent ESWL without urinary tract infection is low and the use of antibiotics in these patients is probably not indicated.

Intubated ureterotomy for ureteral obstruction following radiotherapy and radical hysterectomy. Case report.

A woman suffering from carcinoma of the cervix went through radical hysterectomy and radiotherapy. The treatment was complicated by obstruction of the lower left ureter which was dealt with by transureteroureterostomy. Eighteen months later she was admitted with severe stricture of the common pelvic ureter and massive retroperitoneal fibrosis. The afflicted ureteral segment was successfully reformed by intubated ureterotomy.

Clinical evaluation of aztreonam for serious gram-negative bacterial infections.

In an open study aztreonam was evaluated for efficacy and safety in 20 hospital in-patients presenting with presumptive or confirmed hospital acquired aerobic gram-negative infections. The overall clinical cure rate was 100% (19/19) with a corresponding microbiological cure rate of 100% in those patients in whom an organism was isolated initially (17/17). Reinfection with enterococcus occurred in 2 patients with UTI within a week of stopping aztreonam and one patient developed superinfection during treatment, but none were given any additional therapy. No evidence of drug-associated toxicity was found on any of the laboratory evaluations. One patient developed diarrhea 3 days after starting therapy, was withdrawn from the study and subsequently excluded from the analysis. One other patient remained febrile despite evidence of clinical and microbiological cure. Both these incidents were thought to be possibility drug-related. This study confirms aztreonam as a safe and effective way to treat patients with serious gram-negative infections.

Biopsy of ureteral tumor in patient with ileal conduit.

A patient with ileal conduit and recent dilation of the left upper collecting system had flexible fiberoptic endoscopy of the ileal loop. The entire lumen of the intestinal conduit and the ureteroileal anastomosis were visualized. In addition retrograde pyelography and direct vision biopsy of a tumor in the ureter were performed.

The radionuclide scintigraphic appearance in a rare case of epidermoid cyst of the testis.

A rare case of epidermoid cyst of the testis, represented scintigraphically by an area of avascularity in the affected testicle, is described. The differential diagnosis from epididymitis and torsion of testis, and the diagnostic value fo the scintigraphic method to rule out malignant (vascular) testicular tumors, is emphasized.

External bladder--amniotic fluid shunt for fetal urinary tract obstruction.

Ultrasound diagnosis of bilateral hydronephrosis, hydroureters, and megacystis together with oligohydramnios secondary to urethral stenosis was made in a male fetus at 29 weeks' gestation. In utero decompression of the obstructed urinary tract and expansion of the amniotic fluid was achieved by placing an external bladder-amniotic fluid shunt using two catheters, one inserted into the fetal bladder and the other placed in the amniotic sac. The infant was delivered by cesarean section at 35 weeks' gestation and had a favorable outcome.

Unilateral renal agenesis associated with multiple skeletal abnormalities.

Two cases are presented in which an association between unilateral renal agenesis and multiple skeletal abnormalities is found. The pathologic agents responsible for the URA act similarily on other organ systems, including the skeleton. The skeletal abnormality can be diagnosed easily and promptly and may be an indicator for anomalies in other systems as well, especially the urogenital system.

Subcutaneous intraperitoneal prosthesis for maintenance peritoneal dialysis.

A subcutaneous intraperitoneal proslysis has been successfully implanted in three chronic uraemic patients. Fifty peritoneal dialyses have been done during 6-3 patient-months, without complications. During this short experience, peritonitis was not seen at all. The patients' acceptance of the prosthesis was good. Lack of abdominal tubes or bags is a remarkable technical improvement of this device.