Transactions of the American Association of Genito-Urinary Surgeons最新文献

The calcium content and calcium kinetics of the fatty tissue complex comprising the renal sinus organ of the rat kidney are reported. A comparison is made to control brown and white fat in the same animal. The calcium content of the renal sinus tissue is significantly greater than controls. Calcium localization in the mitochondria of the sinus tissue complex is demonstrated. Radioactive iostope studies (45Ca, 85Sr and 99mTc) indicate a dynamic exchange of calcium between the systemic pool and the sinus organ. Active accumulation appears to be operative. Supporting evidence for the existence of a portal vascular system joining the renal sinus complex and the renal parenchyma is presented. The significance of a calcium sink in the renal sinus tissue of the rat kidney is discussed.

During the last 15 years excretory urography has been a routine preoperative diagnostic procedure for patients with bladder outlet obstruction in our department and, perhaps, for many more years in other urological centers. There are 2 reasons that this investigation should be done: 1) to detect abnormalities of the upper urinary tract that can be important indicators to operate or for the postoperative course and 2) to detect abnormalities in the bladder that should be corrected simultaneously with the prostatectomy or that can interfere with the procedure.

A retrospective study is presented of our experience from 1962 to 1976 with the splenorenal bypass procedure in the treatment of 32 patients with renovascular hypertension. The over-all results were 53 per cent of the patients cured, 28 per cent improved and 19 per cent failures. Improved results were noted when the splenorenal bypass was performed in relation to specific operative indications. The results were somewhat better in men than in women and poor results were obtained in children. Intraoperative and early postoperative complications were minimal. There were 2 postoperative deaths, for a hospital mortality rate of 6.3 per cent. Late complications were limited to splenic artery graft stenoses, which developed in 3 patients (9.4 per cent). When performed in relation to specific clinical and operative indications the splenorenal bypass is believed to represent an excellent means to achieve safe and effective renal revascularization.

Voiding abnormalities are encountered frequently in pediatric patients. Symptoms of daytime incontinence, frequency and nocturnal enuresis in any combination may indicate underlying neurophysiologic detrusor imbalance. Incomplete evaluation of these symptoms can result in inappropriate medical therapy or even ineffective operations. Within the preceding 7 months 34 children with hard-core voiding abnormalities were evaluated with urodynamic techniques. Several categories of abnormal voiding patterns were identified, including the hyperactive external sphincter, uninhibited pediatric neurogenic bladder, detrusor hyperreflexia secondary to chronic cystitis, hyperactive external sphincter with hypotonic bladder and the hyperactive external sphincter with detrusor irritability. All patients received specific pharmacotherapy based on presenting signs and symptoms, and voiding pattern abnormality. Of the 24 patients who have been treated in this manner and were evaluated 83.5 per cent have had complete remission of symptoms while on therapy, the remainder being improved but still having occasional symptoms. The technique and data demonstrate that children with hard-core voiding abnormalities can achieve rehabilitation with urodynamic assessment.

Our increasingly inefficient, cumbersome, often ineffective and time-consuming manual mental cataloguing and retrieving system indicated to us that there must be a better technique available. However, our search of existing systems failed to reveal any matching our needs. Therefore, we developed a 4-category system for cataloguing and retrieving urologic materials. Our program is divided into 3 sections: 1) index, 2) catalogued data and 3) computer programs. We have used this system for more than a year and believe that it has satisfied our original requirements. It is easily adaptable to changes of information, allows for identification of unlimited types of material, offers thorough and accurate data retrieval techniques and is economical now that the expense of organizing the system is behind.

A simplified method to drain the corpora cavernosa into the spongiosum in cases of priapism is discussed and the advantages are listed.