[Experience with uretero-neocystostomy in 338 kidney transplantations]. / Erfahrungen mit der Uretero-Neo-Zystostomie bei 338 Nierentransplantationen.

In 338 consecutive human kidney transplants since 1972 uretero-neocystostomy was performed in a typical manner. The technique is a modification of Leadbetter's ureterosigmoid anastomosis and it is used for all cases of ureteral reimplantation at our institution. The rate of operative complications belonging to the urinary tract is 4.8%. In 29% out of 31 reexamined patients a vesico-ureteral reflux to the transplant appeared. We believe that the demonstrated method is useful for reconstruction of the urinary tract in renal transplants.

[Interventional sonography after kidney transplantation]. / Interventionelle Sonographie nach Nierentransplantation.

In cases of urinary fistulae as well as lymphoceles the only ultrasound-guided percutaneous nephrostomy has led to a good result. In cases of ureterostenosis and distal fistulae the renal function could be preserved by percutaneous nephrostomy. The anterograde pyelography was exact in demonstrating localization of the stenosis which led to a better operative procedure. The interventional ultrasound therefore represents an important option in the treatment of operative complications after kidney transplantation.

[Study of large cross sections of infiltrating renal cell carcinoma (pT3) and long-term observation (more than 4 years)]. / Untersuchung von Grossflächenschnitten infiltrierender Nierenzellkarzinome (pT3) und Langzeitbeobachtung (mehr als 4 Jahre).

In a series of 59 consecutive renal cell carcinomas (pT3) cross sections were performed and grading was reevaluated on a cytological basis as described by Thoenes. Follow-up was at least 4 years. Only 20.3% of all tumors revealed monoform grading (92 resp. 93), while 79.9% consisted of more than one grading (G1+G2, G2+G3: 45.8%; G1+G2+G3: 33.9%). Prognosis in this series depended highly significantly (p less than 0.002) on the percentage of G3-area of the vital tumor (NED greater than 4 ys.: 11.4%; DOD less than 2 ys.: 51.6%). It is concluded that measuring different G-areas in cross section of renal cell carcinomas raise considerably prognostic value of histopathology.

Multiple myeloma of the bladder and vagina.

A case is described of multiple myeloma with involvement of the urinary bladder and vagina. The patient was admitted with hematuria and postrenal obstruction. She was treated successfully with local radiotherapy and combination chemotherapy with vincristine, Adriamycin (doxorubicin), and dexamethasone (VAD).

[Accidental finding of a giant retroperitoneal lipoma in a traumatic rupture of the renal parenchyma]. / Zufallsbefund eines retroperitonealen Riesenlipoms bei traumatischer Nierenparenchymruptur.

With a rate of 0.1-3% of all tumour cases primary retroperitoneal neoplasms are very rare. Malignant tumours predominate. Preoperative radiological clarification as regards tumour status is very unsafe unless there are indications of infiltrating growth and metastases. In some cases, computed tomography can supply pointers to the kind of the tumour.

[Tuberculosis following kidney transplantation]. / Tuberkulose nach Nierentransplantation.

Morbidity of tuberculosis following kidney transplantation is about 1% (14/1719 kidney transplantations). All cases occurred within 1 year after transplantation; surprising was the relative high incidence in patients from outside Central Europe. Four patients with lack of clinical symptoms in whom the diagnosis was made by routine X-ray films of the chest survived after immediate therapy while five of ten patients with miliary tuberculosis died although proper treatment was performed. In cases of fever not caused by rejection or in pneumonia resistant to common antibiotics prophylactic antituberculous therapy should be considered even if microbiological evidence is not yet confirmed.

[Urologic findings in patients with kidney transplantations. Evaluation of a technic for uretero-cysto-neostomy]. / Urologische Befunde bei Nierentransplantatträgern.

74 consecutive human kidney transplants are reported. In 72 cases uretero-cysto-neostomies with an antireflux procedure were performed in a typical way. The technique, a modification of Leadbetter's uretero-sigmoido-neostomy, has been used by the author for years. The only urological complications were one proximal and one distal ureteral fistula. In 25% out of 20 reexamined patients a vesico-ureteral reflux was demonstrated by micturition cysto-urethrography. There was no correlation between urinary tract infections (25%) and vesico-ureteral reflux. The results are compared with the data given in literature.