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Outcome of antenatally diagnosed pelviureteric junction obstruction
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Subsequently, strong collaterals developed. Definitive scrotal transfer was performed 6 weeks later via inguinal incision. Thirty months later, the testes had recovered very well. Their volume had increased markedly and further development was normal.Thomas A. Angerpointner Horizontal Testis With a Varicocele: A New Physical Sign. R.A. Whee1erandJ.D. AtweZl. Br J Surg 78:225, (February), 1991.
Twelve boys between the ages of 5 and 17 presenting with a varicocele were examined to determine the lie of their testis. In each patient the associated testis lay in the horizontal axis while the unaffected testis lay in the vertical axis. In three patients the affected testis was smaller than the contralateral testis. It is suggested that the abnormal lie of the testis is due to the gravitational weight of the distended veins at the superior pole which displace the inferior pole posteriorly. Another possibility is that the horizontal lie is a primary phenomenon due to the venous drainage emerging from the testis in a varicocele.-John D. Orr
INTERNATIONAL
ABSTRACTS
life. The median time interval for URT changes to develop between birth and first assessment showing abnormal findings was 33 months and between the last normal URT assessment and the development of URT changes was 16 months. Six patients with URT changes were treated conservatively and 36 required intervention. Twenty-eight of 42 patients showed initial improvement of URT changes but 25 subsequently deteriorated with renal failure in one and renal impairment in two. In group 2, 24 patients who had URT changes present at birth were also studied for a mean follow-up of 115 months. The URT changes in 8 patients deteriorated after the initial assessment over a median time of 15 months. Twelve patients’ URT changes improved spontaneously without active intervention over a median time interval of 16 months, but 5 subsequently deteriorated. Overall, the prognosis of children with URT changes at birth did not seem to be any worse than of children developing changes later in life. Lesions of sacral and thoracolumbar regions of the spine were most commonly associated with URT changes. Frequent assessment at regular intervals and long term follow-up is required for patients with spina bifida.-Thomas A. Angerpointner
The Detection of Reflux Nephropathy in Infants by Technetium Dimercaptosuccinic Acid Studies. R.H. Farnsworth, MA. Rossleigh, D.M. Leighton, et al. J Urol145:542-546, (March), 1991.
Dimercaptosuccinic acid (DMSA) studies were performed in 113 infants, aged less than 1 year, who were at risk for renal scarring. Of these patients 86 presented with urinary tract infection; 27 were asymptomatic. A voiding cystourethrogram was performed in all cases, and excretory urography (IVP) was done in 99. More abnormalities were detected by DMSA study when compared to scars on IVP. When both studies were abnormal, there was an excellent correlation on a site by site basis. Fever or systemic disorder was not a reliable sign to determine whether there was upper tract involvement with infection. The incidence of DMSA abnormalities in infants increased with high-grade vesicoureteral reflux and decreased with low-grade reflux. There was no significant difference in the incidence of abnormal kidneys between the infected and noninfected groups, suggesting that renal scarring may occur with sterile reflux.-Geotge Hokomb, Jr. Outcome of Antenatally Diagnosed Pelviureteric Junction Obstruction. A.S. Najmaldin, D.M. Burge and J.D. Atwell. Br J
Urol67:96-99, (January), 1991. Forty-five of 107 consecutive patients diagnosed antenatally had pelviureteric junction (PUJ) hydronephrosis (66 units). Of these, 24 units had obstructive and 42 nonobstructive bydronephrosis. Significant compromise of renal function was found only in the obstructive group, and they required early pyeloplasty. In the nonobstructive group, 2 units deteriorated, 13 improved, and 27 were unchanged. The authors emphasize the need for long-term follow-up in antenatally diagnosed PUJ hydronephrosis without obstruction in order to determine the natural history of the condition.-A. Azmy Follow-Up of Spina Bifida Children With and Without Upper Renal Tract Changes at Birth. J.D. Greig, D.G. Young, and A.F. Azmy. Eur J Pediatr Surg 15-9, (February), 1991.
The aim of this study was to assess two groups of children with spina bifida, one with and the other without upper renal tract (URT) changes at birth, and to evaluate the outcome of their management. In group 1, there were 148 patients who had normal URT at birth. They were studied for a mean follow-up of 131 months. Twenty-eight percent developed URT changes in later
Congenital Renal Arteriovenous Malformations in Infancy. R.I. Macpherson, D. F#e, and A. Aaronson. Pediatr Radio1 21:108-
110, (January), 1991. The authors report two cases of congenital renal arteriovenous fistulas diagnosed in infancy. Both patients had significant systemic hypertension which subsided following nephrectomy. The sonographic, computed tomographic, and angiographic features of these arteriovenous malformations are described in detail.-J’rem Pun’ NEOPLASMS Wilms’ and Associated Renal Tumours of Childhood. K.S. White and H. Frossman. Pediatr Radio1 21:81-88, (January), 1991.
The authors discuss the important role of imaging modalities in the diagnosis, staging, and follow-up of patients with Wilms’ and other renal tumors of childhood. They recommend that in the initial evaluation of renal tumors an abdominal radiograph and ultrasound should be done. If Wilms’ tumor is suspected, computed tomography (CT) of the abdomen and chest should be performed. Magnetic resonance imaging may be helpful in cases in which the-origin of the tumor is not clear. Evaluation-of the inferior vena cava can be obtained by ultrasound and CT. Definition of the inferior vena cava with ultrasound and CT is sometimes difficult, and in these cases inferior venacavography should be used. After tumor resection, the authors recommend that an abdominal CT limited to the operative bed be performed as a baseline. Follow-up evaluation of the tumor bed and contralateral kidney in patients with stage I to III disease should be performed with CT at 6, 12, and 24 months postoperatively. CT is the most sensitive modality for detecting small pulmonary nodules and pleural disease. Patients with stage IV disease need more frequent followup.-Prem Pun’ Wilms’ Tumours: Pre- and Post-Chemotherapy CT Appearances. YY. Ng, A. Hall, C. Craggs, et al. Clin Radio1 43:255-259,
(April), 1991. The authors describe computed tomographic (CT) appearances of chemotherapy-induced changes in Wilms’ tumors in 18 children. Clinical response to chemotherapy resulted in reduction in tumor size of at least 50%. Cystic changes in the tumors were commonly seen. CT did not reliably differentiate between lymph node
Subsequently, strong collaterals developed. Definitive scrotal transfer was performed 6 weeks later via inguinal incision. Thirty months later, the testes had recovered very well. Their volume had increased markedly and further development was normal.Thomas A. Angerpointner Horizontal Testis With a Varicocele: A New Physical Sign. R.A. Whee1erandJ.D. AtweZl. Br J Surg 78:225, (February), 1991.
Twelve boys between the ages of 5 and 17 presenting with a varicocele were examined to determine the lie of their testis. In each patient the associated testis lay in the horizontal axis while the unaffected testis lay in the vertical axis. In three patients the affected testis was smaller than the contralateral testis. It is suggested that the abnormal lie of the testis is due to the gravitational weight of the distended veins at the superior pole which displace the inferior pole posteriorly. Another possibility is that the horizontal lie is a primary phenomenon due to the venous drainage emerging from the testis in a varicocele.-John D. Orr
INTERNATIONAL
ABSTRACTS
life. The median time interval for URT changes to develop between birth and first assessment showing abnormal findings was 33 months and between the last normal URT assessment and the development of URT changes was 16 months. Six patients with URT changes were treated conservatively and 36 required intervention. Twenty-eight of 42 patients showed initial improvement of URT changes but 25 subsequently deteriorated with renal failure in one and renal impairment in two. In group 2, 24 patients who had URT changes present at birth were also studied for a mean follow-up of 115 months. The URT changes in 8 patients deteriorated after the initial assessment over a median time of 15 months. Twelve patients’ URT changes improved spontaneously without active intervention over a median time interval of 16 months, but 5 subsequently deteriorated. Overall, the prognosis of children with URT changes at birth did not seem to be any worse than of children developing changes later in life. Lesions of sacral and thoracolumbar regions of the spine were most commonly associated with URT changes. Frequent assessment at regular intervals and long term follow-up is required for patients with spina bifida.-Thomas A. Angerpointner
The Detection of Reflux Nephropathy in Infants by Technetium Dimercaptosuccinic Acid Studies. R.H. Farnsworth, MA. Rossleigh, D.M. Leighton, et al. J Urol145:542-546, (March), 1991.
Dimercaptosuccinic acid (DMSA) studies were performed in 113 infants, aged less than 1 year, who were at risk for renal scarring. Of these patients 86 presented with urinary tract infection; 27 were asymptomatic. A voiding cystourethrogram was performed in all cases, and excretory urography (IVP) was done in 99. More abnormalities were detected by DMSA study when compared to scars on IVP. When both studies were abnormal, there was an excellent correlation on a site by site basis. Fever or systemic disorder was not a reliable sign to determine whether there was upper tract involvement with infection. The incidence of DMSA abnormalities in infants increased with high-grade vesicoureteral reflux and decreased with low-grade reflux. There was no significant difference in the incidence of abnormal kidneys between the infected and noninfected groups, suggesting that renal scarring may occur with sterile reflux.-Geotge Hokomb, Jr. Outcome of Antenatally Diagnosed Pelviureteric Junction Obstruction. A.S. Najmaldin, D.M. Burge and J.D. Atwell. Br J
Urol67:96-99, (January), 1991. Forty-five of 107 consecutive patients diagnosed antenatally had pelviureteric junction (PUJ) hydronephrosis (66 units). Of these, 24 units had obstructive and 42 nonobstructive bydronephrosis. Significant compromise of renal function was found only in the obstructive group, and they required early pyeloplasty. In the nonobstructive group, 2 units deteriorated, 13 improved, and 27 were unchanged. The authors emphasize the need for long-term follow-up in antenatally diagnosed PUJ hydronephrosis without obstruction in order to determine the natural history of the condition.-A. Azmy Follow-Up of Spina Bifida Children With and Without Upper Renal Tract Changes at Birth. J.D. Greig, D.G. Young, and A.F. Azmy. Eur J Pediatr Surg 15-9, (February), 1991.
The aim of this study was to assess two groups of children with spina bifida, one with and the other without upper renal tract (URT) changes at birth, and to evaluate the outcome of their management. In group 1, there were 148 patients who had normal URT at birth. They were studied for a mean follow-up of 131 months. Twenty-eight percent developed URT changes in later
Congenital Renal Arteriovenous Malformations in Infancy. R.I. Macpherson, D. F#e, and A. Aaronson. Pediatr Radio1 21:108-
110, (January), 1991. The authors report two cases of congenital renal arteriovenous fistulas diagnosed in infancy. Both patients had significant systemic hypertension which subsided following nephrectomy. The sonographic, computed tomographic, and angiographic features of these arteriovenous malformations are described in detail.-J’rem Pun’ NEOPLASMS Wilms’ and Associated Renal Tumours of Childhood. K.S. White and H. Frossman. Pediatr Radio1 21:81-88, (January), 1991.
The authors discuss the important role of imaging modalities in the diagnosis, staging, and follow-up of patients with Wilms’ and other renal tumors of childhood. They recommend that in the initial evaluation of renal tumors an abdominal radiograph and ultrasound should be done. If Wilms’ tumor is suspected, computed tomography (CT) of the abdomen and chest should be performed. Magnetic resonance imaging may be helpful in cases in which the-origin of the tumor is not clear. Evaluation-of the inferior vena cava can be obtained by ultrasound and CT. Definition of the inferior vena cava with ultrasound and CT is sometimes difficult, and in these cases inferior venacavography should be used. After tumor resection, the authors recommend that an abdominal CT limited to the operative bed be performed as a baseline. Follow-up evaluation of the tumor bed and contralateral kidney in patients with stage I to III disease should be performed with CT at 6, 12, and 24 months postoperatively. CT is the most sensitive modality for detecting small pulmonary nodules and pleural disease. Patients with stage IV disease need more frequent followup.-Prem Pun’ Wilms’ Tumours: Pre- and Post-Chemotherapy CT Appearances. YY. Ng, A. Hall, C. Craggs, et al. Clin Radio1 43:255-259,
(April), 1991. The authors describe computed tomographic (CT) appearances of chemotherapy-induced changes in Wilms’ tumors in 18 children. Clinical response to chemotherapy resulted in reduction in tumor size of at least 50%. Cystic changes in the tumors were commonly seen. CT did not reliably differentiate between lymph node