The value of sigmoid myotomy in reducing bowel pressure and thus averting renal damage following ureterocolic anastomosis

The value of sigmoid myotomy in reducing bowel pressure and thus averting renal damage following ureterocolic anastomosis

INTERNATIONAL ABSTRACTS OF PEDIATRIC SURGERY consistent unreliability of the quantitative measurement of pyuria in centrifuged specimens. It is pointe...

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INTERNATIONAL ABSTRACTS OF PEDIATRIC SURGERY consistent unreliability of the quantitative measurement of pyuria in centrifuged specimens. It is pointed out that while the most common cause for pyuria is a urinary tract infection, the presence of pyuria does not necessarily mean that renal disease is present, not that significant bacteriuria must be present. Also, the absence of pyuria cannot be taken as evidence of absence of baeteriuria either. The corollary on these points is that bacteriuria may be present in the absence of significant pyuria and that the absence of pyuria in any single specimen should not be misconstrued as evidence of the lack of

bacteriuria.--Robert J. Izant, Jr. RIGHT RETROCAVAL URETER AND ITS OPERATIVE CORRECTION IN AN ELEVEN YEAR

OLD Boy, E. Stoll and J. Ruza. Helvet. Paediat. Acta 20:456, 1965. This malformation is rare. Until 1949 only 26 cases had been reported in the literature. Recently, however, more than 100 such cases have been published. The cause lies primarily in a malformation of the veins and not of the urinary duct systenl. The patient was admitted to the hospital for evaluation of enuresis. The results of the examination revealed a right-sided hydronephrosis with a proximal hydroureter. The operative correction with sectioning of the kidney pelvis and end-to-end reanastomoses in front of the vena cava was successful.--V. Grob-Vontobel. URINARY DIVERSION AND URETERAL REIMPLANTATION. D. J. Logan, L. B. King and K. E. Barber. J. Urol. 94:665, 1965. Reimplantation of the severely damaged, dilated ureter may require temporary decompression which has been usually accomplished by either preliminary nephrostomy or by a splinting catheter from below. The authors report the use of temporary Ttube ureterostomy in the lower ureter just above the site of reimplantation. They believe this has been as effective as temporary nephrostomy and that this method has tlm advantage of not requiring a separate operation. The T-tube can be utilized to measure pressures at which the ureter will drain into the bladder postoperatively; this pressure

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should be less than 15 cm. of water before diversion is discontinued. No stricture or fistula has resulted from use of this method in 4 cases.---W. Hardy Hendren THE TREATMENT OF NEUROGENIC URINARY INCONTINENCE USING THE COLONIC CONDUIT. R. A. Mogg. Brit. J. Urol. 37:681, 1965. Children with neurogenic urinary incontinence resulting from spina bifida were treated by urinary diversion to the skin surface using the isolated pelvic colon as a conduit. The ureterocolonic anastomoses were splinted with polythene tubes. Co]on has several advantages over ileum as a urinary conduit; there is always adequate redundant colon, the thicker musculature of the colon allows a safer anastomosis and there is less intraperitoneal manipulation so that there is less tendency to postoperative ileus.--J. H. Johnston THE VALUE OF SIGMOID MYOTOMY IN REDUCING BOWEL PRESSURE AND THUS AVERTING RENAL DAMAGE FOLLOWING URETEROCOLIC ANASTOMOSIS. O. Dan~l and R. S. Ram. Brit. J. Urol. 37:654, 1965. A method of measuring intracolonic pressure is described. The pressure in 81 individuals showed marked variation; in one third of them it exceeded 30 cm. of water. Such high pressm'es predispose to renal failure following ureterocolic anastomosis. The operation of sigmoid-myotomy, which consists of incising the colonic musculature longitudinally through one of the taenia over a distance of 30 to 35 cm. is effective in reducing intracolonic pressure. The procedure is recommended as an ancillary to ureterocolie anastomosis.--/. H. Johnston. NATURE OF PERISTALSIS IN URETERS ANASTOMOSED TO SKIN. P. K. Maloney, It. J. Urol. 94:536, 1965. The author demonstrates ureteral peristaltic pressure studies obtained by catheterizing ureters which have been anastomosed to the skin. Patients with smoothly functioning cutaneous ureterostomies and stable excretory urograms had resting pressures of less than 10 mm. of Hg and contraction