Percutaneous transrenal ureteroneocystostomy.

Advanced cancer of the prostate causes mechanical obstruction of the ureteral orifice in 10% of patients. In our patient with advanced prostate carcinoma, after the usual method of placement of a ureteral stent had failed, antegrade percutaneous ureteroneocystostomy with placement of a double-J performed by means of the Lawson retrograde nephrostomy set. After removal of the stent 8 months later, the anastomosis functioned without a decrease in caliber until the patient died 2 years later. Our technique represents another new option for the treatment of such patients.

Results in the treatment of renal tumours.

151 Patients having renal tumours were treated in our Urologic Department between 1975 and 1992; 86.1% of them were operated. Application of a new surgical method introduced in 1983, resulted achieving the level of international standards given in the literature: the survival of patients with tumours in stage of T1-T2 increased to 90%. Further progress is not expected from the perfection of surgical techniques, but from the use of new markers, and new methods of tumour-immunology.

[Immunotherapy of superficial bladder tumors in a hospital department]. / Felületes hólyagtumorok immunoterápiája osztályunkon.

Since 1988 27 patients with bladder cancer - in the T1, G1, G2 stage - have been treated by intra-cavitally applied BCG (Pasteur). The follow-up period was 12-62 months. There was no relapse in 18 cases (66%) in 4 cases (16%) increase the average relapse rate, in 5 cases the treatment was unsuccessful. These results suggest that the treatment is effective, affordable and occur few complications.

Procedures increasing the effectivity of percutaneous nephrolithotomy.

The advantages of percutaneous nephrolithotomy are reviewed and the difficulties are pointed out. During more than 100 successful nephrolithotomies it was found that stones or their fragments often drift away during manipulation into lateral or upper calices which cannot be visualized by a rigid nephroscope. Thus, removal of calculi was possible only by an auxiliary manipulation and so it took more time. To prevent this, an occlusive catheter was introduced, simultaneously with the ureteral catheter, into the renal cavital system and by blocking the balloon, the orifice of the calices was closed. In the case of multiple stones, two calices were simultaneously punctured and the two nephroscopes introduced were alternately applied during ultrasonic crushing of the stone, depending on which of the two instruments was closer. The modifications introduced by the author have significantly reduced the time of the operation and increased the effectivity of the procedure.

Postoperative epididymitis after bladder surgery without vasectomy.

In 362 cases bladder operations were performed without previous vasectomy. The incidence of postoperative epididymitis was 15.4 per cent after transvesical prostatectomy, 3.5 per cent after suprapubic section, and 1.6 per cent after transurethral prostatectomy. The incidence was twice as high in case of diabetes and previous bilateral epididymitis, as in the other cases. The incidence of postoperative epididymitis was slightly increased in patients who 1. had not been catheterized before hospitalization; 2. had residual urines over 90 ml; 3. had been free from pyuria before surgery. The prevalent pathogens in case of epididymitis included coagulase-negative staphylococci, Ps. aeruginosa and Enterobacter. Involvement of E. coli, Proteus and Pseudomonas was confined to highly resistant strains.

Retroperitoneal lymphadenectomy in the treatment of malignant testis tumours.

Experience gained in the treatment of 38 malignant testicular tumour patients is reported. The results of castration + chemotherapy (all these patients died within one year) are compared to those of retroperitoneal lymphadenectomy in 15 patients. To preserve the ability of ejaculation the lymph glands accompanying the iliac artery were spared on the contralateral side. Experience has shown that chemotherapy is considered necessary even when the histological finding of the lymph node is completely negative.

[Endometriosis of the kidney (author's transl)]. / Endometriose der Niere.

Endometriosis of the left kidney complicated by urolithiasis is described. This represents the tenth case in the world literature of kidney endometriosis. The most common symptom is low back pain. Macroscopic hematuria was only present in half the cases. The preoperative radiological findings have been interpreted as tumor in four cases, contracted, pyelonephritic kidney in two cases and congenital abnormalities in two cases.

[Papillary tumors of the renal pelvis: 25-year-old clinical material]. / Uber die papillären Tumoren des Nierenhohlsystems--25jähriges klinisches Material.

A total of 83 patients with papillary tumour in the renal pelvis have been observed in 25 years. The peak incidence was in the age group between 51 and 70 years. The first symptom was almost always haematuria without any other symptom. The therapy is surgical, complemented with radiotherapy and/or chemotherapy. The problem of the involvement of the bladder is discussed.

[Incidence of pyelectases and their surgical correction]. / Uber die Häufigkeit der Nierenbeckenerweiterungen und deren operative Lösung.

Among 1611 urological patients 90 (5.4%) displayed pyelectasis. In almost one-third of the cases dilatation was caused by the presence of a calculus In 33 cases plastic surgery mainly of the Anderson-type was applied. 78% of the operations was successful. The incidence of nephrectomy was higher in the group in which complaints were of more than two years standing (10 out of 33) than in the group where treatment was started less than two years after the appearance of complaints (7 out of 41). In 26 cases dilatation was caused by occlusion by a calculus; in one half of these cases, nephrectomy was the only operation which could be performed.