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Late complications after ureterosigmoidostomy in patients with exstrophy of the bladder
1060
cases are Bliichlinger
ABSTRACTS
quite
exceptional.-- T.
Wyss-
Megacystis. E. Balzar, G. Wei~enbacher, and E. Melzer. P~diatr P~diolog 10:480-484, 1975. This is a case report of a 489 boy who presented with a cystic tumor of the lower abdomen. On cystography, a huge prevesical ureteric diverticulum was found. This was removed surgically and nephrectomy was performed, since there was no renal function on the affected side. The diverticulum showed a tiny opening to the bladder and the ureter entered the diverticulum very close to this opening without direct communication to the bladder.--G. Brandesky Reimplantation of the Ureter, P. Clark and R. U. Hosmane. Br J Urol 48:31-37 (February), 1976.
A modification of the Politano-Leadbetter technique of ureteric reimplantation for the cure of reflux is described. It has been used with 91 ureters in 56 patients. Persistent reflux after surgery occurred in only one ureter. Two ureters were obstructed and needed reoperation. The point is made that it is unnecessary and inadvisable to excise the extremity of the ureter.--J. 11. Johnston The Elastic Component of Normal and Dilated Ureters in Children: Chemical and Histochemical Characterization. F. Pagano, G. Passerini, R. Cortivo, D. Daga-Gordinl, and G. Abatangelo. Br J Urol 48:13-17 (February), 1976.
The authors, from Padova, Italy, compared normal and dilated ureters in children with regard to their elastic tissue content. They estimated that the elastin content of dilated ureters represents 39/oo-5~ of the organic material as compared with less than 1~ in normal ureters.--J. H. Johnston Late Complications After Ureterosigmoidostomy in Patients With Exstrophy of the Bladder. J. Sikora, M. Lehner, and P. P. Rickham. Heir Chir Acta 42:745-748 (December), 1975.
Thirty-three patients with exstrophic bladder had an ureterosigmoidostomy according to Mathisen between 1953 and 1969; two of them died postoperatively. Twenty-six o f these patients were checked 6-22 yr after the first surgery: 18 were fully continent; 23 intravenous pyelographies were performed; only 8 patients had a normal
pyelography; 5 had 1 damaged and 1 normal kidney; and 10 had 2 damaged kidneys. The complications were: 11 ectasias of the kidney, 10 hydronephrosis, and 4 hypotrophic kidneys.--C. Jaussi-Bovet Ring Ureterostomy. D. I. Williams and W. J. Cromie. Br J Urol 47:789-792 (January), 1976 The authors point out the requirements for a satisfactory ureterostomy. It must provide: (1) effective drainage; (2) no indwelling tubes; (3) no interference with ureteric blood supply; (4) some urine flow into the bladder in order to avoid complete defunctionalization with its potential for bladder contracture; and (5) easily reversible by a closure not interrupting ureteric continuity or interfering with subsequent ureteral reimplantation into the bladder. A ring ureterostomy fulfills these requirements. The technique requires a large and tortuous ureter, whose highest loop is mobilized, protecting its blood supply. A singlelayer side-to-side anastomosis is made between the two limbs of the loop at the base. The ring thus created is supported by a muscle bridge and opened and sutured to the skin. Later, closure is accomplished by excising each limb of the ring down to the site of side-to-side anastomosis, leaving the ureter in continuity. The authors have experience with ten ring ureterostomies in seven male infants, four with posterior urethral valves and three with the prune belly syndrome. All cases achieved satisfactory upper tract drainage. Closure has been accomplished in four of the cases.--Howard M. Snyder Ultrasound Assessment of Residual Urine in Children. N. W. Harrison, C. Parks, and T. Sherwood. Br J Urol 47:805-14 (January), 1976.
Residual urine predisposes to infection, may be evidence of a neuropathic bladder, and can be a significant factor in producing incontinence and upper tract dilatation. A simple, accurate, noninvasive, harmless means of measuring residual urine is needed, A brief description of ultrasound principles is given. A series of 17 children mostly with neuropathic bladders were studied with B-mode scans done in sagittal and transverse planes. The authors found it was easy to distinguish empty from full bladders. Increments of filling were more easily detected in the sagittal plane than in the transverse plane. The correlation of ultrasound and bladder volume is a straight line for in-
cases are Bliichlinger
ABSTRACTS
quite
exceptional.-- T.
Wyss-
Megacystis. E. Balzar, G. Wei~enbacher, and E. Melzer. P~diatr P~diolog 10:480-484, 1975. This is a case report of a 489 boy who presented with a cystic tumor of the lower abdomen. On cystography, a huge prevesical ureteric diverticulum was found. This was removed surgically and nephrectomy was performed, since there was no renal function on the affected side. The diverticulum showed a tiny opening to the bladder and the ureter entered the diverticulum very close to this opening without direct communication to the bladder.--G. Brandesky Reimplantation of the Ureter, P. Clark and R. U. Hosmane. Br J Urol 48:31-37 (February), 1976.
A modification of the Politano-Leadbetter technique of ureteric reimplantation for the cure of reflux is described. It has been used with 91 ureters in 56 patients. Persistent reflux after surgery occurred in only one ureter. Two ureters were obstructed and needed reoperation. The point is made that it is unnecessary and inadvisable to excise the extremity of the ureter.--J. 11. Johnston The Elastic Component of Normal and Dilated Ureters in Children: Chemical and Histochemical Characterization. F. Pagano, G. Passerini, R. Cortivo, D. Daga-Gordinl, and G. Abatangelo. Br J Urol 48:13-17 (February), 1976.
The authors, from Padova, Italy, compared normal and dilated ureters in children with regard to their elastic tissue content. They estimated that the elastin content of dilated ureters represents 39/oo-5~ of the organic material as compared with less than 1~ in normal ureters.--J. H. Johnston Late Complications After Ureterosigmoidostomy in Patients With Exstrophy of the Bladder. J. Sikora, M. Lehner, and P. P. Rickham. Heir Chir Acta 42:745-748 (December), 1975.
Thirty-three patients with exstrophic bladder had an ureterosigmoidostomy according to Mathisen between 1953 and 1969; two of them died postoperatively. Twenty-six o f these patients were checked 6-22 yr after the first surgery: 18 were fully continent; 23 intravenous pyelographies were performed; only 8 patients had a normal
pyelography; 5 had 1 damaged and 1 normal kidney; and 10 had 2 damaged kidneys. The complications were: 11 ectasias of the kidney, 10 hydronephrosis, and 4 hypotrophic kidneys.--C. Jaussi-Bovet Ring Ureterostomy. D. I. Williams and W. J. Cromie. Br J Urol 47:789-792 (January), 1976 The authors point out the requirements for a satisfactory ureterostomy. It must provide: (1) effective drainage; (2) no indwelling tubes; (3) no interference with ureteric blood supply; (4) some urine flow into the bladder in order to avoid complete defunctionalization with its potential for bladder contracture; and (5) easily reversible by a closure not interrupting ureteric continuity or interfering with subsequent ureteral reimplantation into the bladder. A ring ureterostomy fulfills these requirements. The technique requires a large and tortuous ureter, whose highest loop is mobilized, protecting its blood supply. A singlelayer side-to-side anastomosis is made between the two limbs of the loop at the base. The ring thus created is supported by a muscle bridge and opened and sutured to the skin. Later, closure is accomplished by excising each limb of the ring down to the site of side-to-side anastomosis, leaving the ureter in continuity. The authors have experience with ten ring ureterostomies in seven male infants, four with posterior urethral valves and three with the prune belly syndrome. All cases achieved satisfactory upper tract drainage. Closure has been accomplished in four of the cases.--Howard M. Snyder Ultrasound Assessment of Residual Urine in Children. N. W. Harrison, C. Parks, and T. Sherwood. Br J Urol 47:805-14 (January), 1976.
Residual urine predisposes to infection, may be evidence of a neuropathic bladder, and can be a significant factor in producing incontinence and upper tract dilatation. A simple, accurate, noninvasive, harmless means of measuring residual urine is needed, A brief description of ultrasound principles is given. A series of 17 children mostly with neuropathic bladders were studied with B-mode scans done in sagittal and transverse planes. The authors found it was easy to distinguish empty from full bladders. Increments of filling were more easily detected in the sagittal plane than in the transverse plane. The correlation of ultrasound and bladder volume is a straight line for in-