Evaluation of the effects of premoistening of polyamide 6 nylon suture material on its overall characteristics.

A clinical evaluation in 59 ptients showed that the premoistened form of polyamide 6 nylon suture material (Ethilon; Ethicon) is significantly better for the closing of clean surgical skin incisions than the unmoistened form. The moistening agent presumably did not adversely affect wound healing.

Urological management of the patient with spinal cord injury.

A total of 515 patients with spinal cord injuries were admitted to the Conradie Hospital's Spinal Cord Injuries Centre during a 3-year period from September 1974 to September 1977. Intermittent catheterization was used for urinary drainage in all patients with incomplete lesions as initially assessed neurologically, and indwelling catheterization in those with complete lesions. Transcutaneous suprapubic Bonnano (stab) continuous catheter drainage was used in a random group of 24 male patients with complete neurological lesions. The majority of the patients were admitted within 24 hours of injury. The follow-up period varied from 1 to 4 years. At 3 months more than 50% of patients had a balanced neurogenic bladder and were catheter-free. At 12 months 19% of patients were still catheter-dependent for reasons explained. Bladder outlet operations were more frequent among patients with thoracic lesions and were indicated 3 times more often in patients with complete neurological lesions. Bladder outlet operations were performed on 8.6% of patients. Only 5 patients (1%) required permanent urinary diversion. A urodynamic work-up is no longer regarded as merely a research tool in the investigation of patients with neurogenic bladder dysfunction. Both urodynamic and videoradiological techniques are a prerequisite to proper management of the neurogenic urinary tract.

Diagnosis and treatment of abdominal aortic aneurysm. A report of 82 cases.

Resection for abdominal aortic aneurysm (AAA) is being performed with decreasing mortality and morbidity. A retrospective study on 82 consecutive patients with AAAs admitted during the period 1974-1977 shoowed that 66 had a non-ruptured aneurysm and 16 a ruptured aneurysm. The mean age of the patients was 66,7 years. Concomitant disease was frequent. Operative mortality aneurysms and 37% in the group with ruptured aneurysms.

Migration of a kirschner wire in the body. A case report.

Foreign bodies may enter the body by various ways, yet migration in the body seldom occurs. A case is described where a Kirschner wire, which had been inserted in the shoulder joint, migrated through the pleural cavity and the diaphragm, apparently by force of gravity. It was subsequently easily removed by laparotomy.

Fertility in undescended testes.

Since 1956 many children with undescended testes have been treated at the Red Cross War Memorial Children's Hospital in Cape Town, and in this article the conesequent degree of fertility achieved by orchidopexy, the method of treatment, is appraised. In 567 children the condition was unilateral, and in 202 it was bilateral. Assessment of potential fertility in 76 unilateral and in 29 bilateral cases was mainly by semen analysis; the average age of the youths at the time of the examination was 19 years, and parenthood was therefore regarded as an unsuitable criterion for assessment. Four hundred and ninety-two youths had their condition reviewed, and the condition of 587 testes was assessed. The anatomical state of the testes was ascertained to help in the assessment, but also, and of greater importance, to obtain evidence of the usefulness of orchidopexy for cosmetic or psychological benefit. Biopsy of the affected testes, carried out in some, proved to be nor more informative than the anatomical appraisal, with regard to spermatogenesis. Two useful facts emerged from the study. About 10% of bilateral undescended testes are capable of normal spermatogenesis after orchidopexy, and 65% are sterile, while the fertility of persons with unilateral undescended testis is impaired, 28% having little hope of paternity, and 4% no hope at all.

Familial vesico-ureteral reflux.

Four families of which 2 or more members were affected with primary vesico-ureteral reflux are reported. A multifactorial inheritance pattern subject to environmental factors is likely. Early examination and detection of the disorder in relatives at risk provide an opportunity to avoid the serious sequelae of vesico-ureteral reflux.

Management of urethral valve obstruction in male neonates.

Over the past 6 years, 18 neonates with a posterior urethral valve obstruction have been treated. The mortality has been markedly reduced by meticulous investigation, better medical management of renal failure, greater use of catheter drainage and simpler methods of valve ablation and reduction in the use of nephrostomy and ureterostomy. Mortality was 33%, but ther has been no mortality in the last 7 patients.