RESUMEN
We report our experience on 24 UPJ obstruction, that underwent endopyelotomy. The follow-up on these patients range from 12 to 72 months. The success rate, based on patient symptomatology as well as urographical and scintigraphical parameters, was 83.3%. An adequate selection of cases, with grade of hydronephrosis and crossing vessels pre-operatorial detection, would possibly show a further improvement of success rate. The antegrade transpelvic endopyelotomy adopted in the most recent cases, allows the identification of crossing vessels and the performance of a safer endopyelotomy. The average operating time was very short, while morbidity was limited to 3 cases (2 of gross haematuria and 1 urosepsis). All this shows that endopyelotomy is the first choice treatment of UPJ obstruction.
Asunto(s)
Endoscopía , Pelvis Renal/cirugía , Obstrucción Ureteral/cirugía , Adulto , Anciano , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Factores de TiempoRESUMEN
We report our experience on PVC detection in 250 consecutive urodynamic evaluations in female patients. We emphasize the absence of evident correlations between the post-voiding contractions (PVCs) and their amplitude and the urodynamic features. We suggest a possible relation between the PVCs and two clinical features: enuresis (80% of cases associated with PVC) and mixed urinary incontinence (61.5%). Defining PVC as an improper form of detrusor instability, probably generated by a reduction of pelvic muscle tone, we underline the role performed by an urodynamic investigation defining urethral sphincter as well pelvic floor activity, this procedure being justified by the notorious interdependence between perineal and detrusorial activity.