two with recurrent abdominal pain. Only 16 had pyuria and bacteriuria on the initial visit. Fifty-one of 54 had radiographic evidence of urinary tract calculi, and in the other three spontaneous passage of the stone occurred before x-rays could be obtained. Forty children had a single stone, while 14 had two or more calculi. Four children had bilateral stones. Of the five with obstructive uropathy, four had ureteropelvic junction obstruction and one had severe urethral meatal stenosis. Of four with metabolic disease, one had predisposing calcinosis universalis, one cystinuria, one had renal tubular acidosis, and one had a parathyroid adenoma. Two children developed calculi after prolonged orthopedic immobilization. Of the remaining 43 children, 19 had a family history positive for calculi, but no other cause. Fourteen children passed the stones spontaneously. Of the remaining 27 with idiopathic stone disease, operation was refused in two, and one continued to pass multiple recurrent stones. Four of the five with obstructive uropathv had the anatomical defect corrected with simultaneous urolithotomy and a good result. Two with renal tubular defects underwent urolithotomy and on a strict controlled medical program have had no stone recurrence. The child with calcinosis universalis was untreated and the patient with parathyroid adenoma underwent a pyelolithotomy and parathyroid adenoma removal. The stone analysis on 41 calculi revealed 28 calcium oxalate stones, six cystine and the rest uric acid and calcium phosphate oxalate. In two children with bilateral calculi, stones of different composition were recovered from opposite kidneys. The authors emphasize removal of all calculi, control of infection, and correction of underlying metabolic and anatomic defects for the best resuits.--S. Kim Childhood Urolithiasir in Britain. S. Ghazoli,
patients are discussed briefly and were a heterogeneous group. Treatment was usually by pyelolithotomy, but nephroureterectomy was performed upon eight and partial nephrectomy in four patients. Calculi recurred in 13 of the 120 children. In nine of these, persistent Proteus infection appeared to be a significant predisposing cause.-D.G. Young Acute
Urinary Retention In Children
by Pyouroter. 6. Coolsoet and C. Cornil. J. Ural. 108:966-968
Cases of urinary retention in a 22-mo-old girl and a 3-yr-old boy are reported. An ectopic pyoureter leading to a nonfunctioning upper pole on the left side was the cause of urinary retention in the little girl, and a pyomegaureter and pyonephrotic kidney on the left side was the problem in the boy. In both cases there was complete occlusion of the bladder outlet by the pyoureter. Both patients did well after operation. The authors have not found a similar case prior to this.-.% Kim Urethral Valves. ~3.1. Williams, R.H. Whitaker, TM. Barr&t, and I.E. Keeton. 8r. J. Ural. 45:200210 (April), 1973.
A series of 172 cases of urethral valves is reviewed. One third of the patients presented under the age of 3 mo. A new technique is described for division of the anterior valvular commissure. This consists of withdrawal, under x-ray control, of an insulated diathermy hook which engages and ruptures the membrane. In the management of persistent ureteric dilatation, the merits of, and the indications for loop ureterostomy, terminal ureterostomy, and ureteral tailoring and reimplantation are discussed. Of the 172 boys, 28 (16.2%) have died. Twenty-five of the dead presented under the age of 1 yr. Of 54 boys presenting under 3 mo of age, 22 (40.6:/,) have died.-J. H. Johnston
T.M. Barrof, and D.I. Williams. Arch. Dis. Child. 48:291-295
This report is of a further 120 patients of Williams after his previous series of 112. One hundred and ten had upper . _ urinary tract calculi, and in ten patients the calculi were confined to the bladder. Seventy-five per cent of the patients were under 5 yr of age. Ninety-five children had infection on admission, the predominant organisms being the Profeus group. In 12 of the 67 in whom calcium excretion was estimated, hypercalciuria was found. These
The Effects of Early Experimental Cryptorchidism
Maturation of the Guinea Afkinron. 8r. J. Surg. 60:253-258
Pig Testicle. P.M. (April), 1973.
Two groups of normal Hartley strain guinea pigs were used. At the age of 7 days when the testes had not yet reached the scrotum, one group was made either unilaterally or bilaterally cryptorchid; the second group acted as controls. Orchiopexy was performed at different ages before and after puberty, and biopsies