- Email: [email protected]
Congenital solitary kidney: A review of 74 cases
160 The m o s t c o m m o n cause of obstruction was posterior urethral valve. P r o m p t adequate drainage of the urinary system is the most important part of successful m a n a g e m e n t . S. Kim Congenital Solitary Kidney: A Review of 74 Cases. B. Emanuel, R. Nachman, N. Aronson, and H. Weiss. J. Urol. 111:394-397 (/Harch) 1974. Seventy-four cases of solitary kidney are reviewed. Forty-seven patients were lacking the left kidney and 27 the right. Thirty-one of seventy-four cases were diagnosed in the first year of life and 56 of 74 by 5 yr of age. Of the 39 cases discovered in the newborn, 16 of 39 had imperforate anus, anal stricture, or choanal deformity, and 14 of 39 had cardiac anomalies. Twenty-two of seventy-four had hydronephrosis and 11 of 22 had reflux. In the children more than 6 m o of age, a solitary kidney was discovered during evaluation for recurrent urinary tract infection, investigation of malformation syndromes, or the angiographic study of congenital heart disease. O f the group, seven are dead and only 33 of the 74 are asymptomatic. The others have recurrent urinary tract infections, hydronephrosis, and 19 have required corrective operation for infection. Two patients have undergone renal transplantation, eight patients are uremic, and six have renal stones. O f the 19 undergoing corrective surgery, five had ureteral reimplantation, seven YV plastys, four nephrostomies, two ureterostomies, and one pyeloplasty. The authors emphasize the relationship of a solitary kidney to syndromes involving the vertebrae, GI tract, cardiovascular system, and urogenital system. There appears to be a higher incidence of problems associated with solitary kidney. Early aggressive treatment is recommended. S. Kim The Definition and Diagnosis of Antenatal Renal Vein Thrombosis. E. S. Tank, P. L. Bessette, and K. P. Heidelberger. J. Urol. 111:242-244 (February) 1974.
This is a single case report of a newborn born with an abdominal mass and a normal kidney on the other side. The specimen showed old t h r o m b u s present in the renal veins with calcification and recanalization supporting an antenatal catastrophe. Nephrectomy was considered the treatment of choice. S. Kim Intrarenal Reflux and the Scarred Kidney. G. L. Rolleston, T. M. J. /Haling, and C. J. Hodson. Arch. Dis. Child. 49:531-539 (July) 1974.
ABSTRACTS
This is a 10-yr retrospective study of micturating cystourethrography in 386 patients with no obstruction but with vesicoureteric reflux. The main indication for the examination was bacteriuria. The age range was 3 days to 48 yr; 144 were less than 1 yr, 97 were 1 to 4 yr of age, and 42 patients were 13 yr or older. In 16 patients (four bilateral ) intrarenal reflux was detected and these 16 are the basis of the report. At the initial examination ten patients were less than 1 yr and six were 1 to 4 yr, i.e., intrarenal reflux was found in 6.7~o of those patients under 5 yr of age. O f the 20 kidneys showing intrarenal reflux, nine showed parenchymal d a m a g e on intravenous pyelography. The site of the damage was related to the site of the reflux in eight of the nine. Seven of the nine d a m a g e d kidneys were subsequently reviewed and in two the damage had progressed while the remaining five had not shown any further damage. All of the latter five had successful antireflux operations. Of the remaining 11 kidneys which were normal at the initial examination, four subsequently showed damage, i.e., 13 of the 20 kidneys which had intrarenal reflux showed parenchymal damage (65~o). Only one of eight kidneys with intrarenal reflux initially still had this reflux when reexamined. In patients under 5 yr of age, there were 365 refluxing ureters with 58 kidneys damaged, and of these, 13 (24~o) showed intrarenal reflux. The authors suggest that intrarenal reflux is the cause of scarring seen in "chronic atrophic pyelonephritis." - - D . G. Young Familial Incidence of Bifid and Double Ureters. J. D. Atwell, P. L. Cook, C. J. Howell, I. Hyde, and B. C. Parker. Arch. Dis. Child. 49:390-393 (April) 1974.
Thirty patients (11 male) found to have a duplex urinary tract are the index patients of this study. The sibs and parents have been studied by limited pyelography. The results show that of the 45 sibs, eight had a bifid pelvicalyceal system and seven had double a n d / o r bifid ureters. Of the 27 mothers, the corresponding figures were five and three; of the 29 fathers, eight and one. The 101 relatives had 21 with bifid pelvicalyceal systems and 11 with double a n d / o r bifid ureters. The authors consider this a n o m a l y to be due to an autosomal d o m i n a n t gene of variable penetrance. D.G. Young High-dose Delayed Urogram in the Detection of the Occult I:ctopic Ureter. I. M. Hutton and N. A. Green. Br. J. Urol. 46:289-294 (June) 1974.
Four cases of ectopic ureter are described,
This is a single case report of a newborn born with an abdominal mass and a normal kidney on the other side. The specimen showed old t h r o m b u s present in the renal veins with calcification and recanalization supporting an antenatal catastrophe. Nephrectomy was considered the treatment of choice. S. Kim Intrarenal Reflux and the Scarred Kidney. G. L. Rolleston, T. M. J. /Haling, and C. J. Hodson. Arch. Dis. Child. 49:531-539 (July) 1974.
ABSTRACTS
This is a 10-yr retrospective study of micturating cystourethrography in 386 patients with no obstruction but with vesicoureteric reflux. The main indication for the examination was bacteriuria. The age range was 3 days to 48 yr; 144 were less than 1 yr, 97 were 1 to 4 yr of age, and 42 patients were 13 yr or older. In 16 patients (four bilateral ) intrarenal reflux was detected and these 16 are the basis of the report. At the initial examination ten patients were less than 1 yr and six were 1 to 4 yr, i.e., intrarenal reflux was found in 6.7~o of those patients under 5 yr of age. O f the 20 kidneys showing intrarenal reflux, nine showed parenchymal d a m a g e on intravenous pyelography. The site of the damage was related to the site of the reflux in eight of the nine. Seven of the nine d a m a g e d kidneys were subsequently reviewed and in two the damage had progressed while the remaining five had not shown any further damage. All of the latter five had successful antireflux operations. Of the remaining 11 kidneys which were normal at the initial examination, four subsequently showed damage, i.e., 13 of the 20 kidneys which had intrarenal reflux showed parenchymal damage (65~o). Only one of eight kidneys with intrarenal reflux initially still had this reflux when reexamined. In patients under 5 yr of age, there were 365 refluxing ureters with 58 kidneys damaged, and of these, 13 (24~o) showed intrarenal reflux. The authors suggest that intrarenal reflux is the cause of scarring seen in "chronic atrophic pyelonephritis." - - D . G. Young Familial Incidence of Bifid and Double Ureters. J. D. Atwell, P. L. Cook, C. J. Howell, I. Hyde, and B. C. Parker. Arch. Dis. Child. 49:390-393 (April) 1974.
Thirty patients (11 male) found to have a duplex urinary tract are the index patients of this study. The sibs and parents have been studied by limited pyelography. The results show that of the 45 sibs, eight had a bifid pelvicalyceal system and seven had double a n d / o r bifid ureters. Of the 27 mothers, the corresponding figures were five and three; of the 29 fathers, eight and one. The 101 relatives had 21 with bifid pelvicalyceal systems and 11 with double a n d / o r bifid ureters. The authors consider this a n o m a l y to be due to an autosomal d o m i n a n t gene of variable penetrance. D.G. Young High-dose Delayed Urogram in the Detection of the Occult I:ctopic Ureter. I. M. Hutton and N. A. Green. Br. J. Urol. 46:289-294 (June) 1974.
Four cases of ectopic ureter are described,