RESUMEN
We studied the role of urethrovesical reflux in the onset and maintenance of chronic inflammation in the urinary bladder in patients suffering from chronic cystitis combined with pseudopolyposis of the neck of the bladder and proximal part of the urethra. We modelled a simplified version of an urination fragment of a special computer graphic station. The original computer model theoretically proves the existance of urethrovesical reflux caused by pseudopolyposis in the zone of the urinary bladder cervix and/or proximal urethra. The data were confirmed by radionuclide investigation. Our studies proved the presence of urethrovesical reflux in patients with pseudopolyposis of the bladder cervix provoking retrograde infection of the lower urinary tract. We think it necessary to combine conventional conservative treatment of cystitis with endourethral surgical interventions aimed at reestablishment of normal urination.
Asunto(s)
Cistitis/diagnóstico , Cistitis/etiología , Reflujo Vesicoureteral/complicaciones , Enfermedad Crónica , Terapia Combinada , Simulación por Computador , Cistitis/terapia , Femenino , HumanosRESUMEN
In 18 of 487 patients (11 males, 7 females) operated for renal cancer, radical nephrectomy was made simultaneously with cholecystectomy (n = 14) and prosthetic repair of the abdominal aorta (n = 4). A transabdominal approach was used in all the cases. Duration of radical nephrectomies from the transabdominal approach varies from 95 to 180 min while simultaneous operations lasted from 130 to 228 min. Cholecystectomy increased duration of the operations by 25-55, aortic repair--by 60-90 min. Conduction of concomitant operations had no negative effect on the course of postoperative period or on the number of complications. 18 cases of simultaneous operations (radical nephrectomy and cholecystectomy or aortic repair) showed that there was neither increased number of complications nor duration of hospital stay. Cholecystectomy can be made from the same incision as radical nephrectomy whereas aortic repair demands the middle approach which is not convenient for performance of radical nephrectomy.
Asunto(s)
Aorta Abdominal/cirugía , Colelitiasis/cirugía , Neoplasias Renales/cirugía , Nefrectomía , Adulto , Anciano , Colecistectomía , Colelitiasis/complicaciones , Femenino , Humanos , Neoplasias Renales/complicaciones , Tiempo de Internación , Masculino , Persona de Mediana Edad , Periodo Posoperatorio , Estudios Retrospectivos , Factores de TiempoRESUMEN
Surgical treatment with application of the modified technique of high colpocleisis according to Latsko was performed in 174 patients aged 26-72 with postradiation vesicovaginal fistulas. The latter developed 6 months to 26 years after radiotherapy. The operation resulted in restoration of the urinary bladder capacity and spontaneous urination.
Asunto(s)
Colpotomía/métodos , Traumatismos por Radiación/cirugía , Vejiga Urinaria/cirugía , Vagina/cirugía , Fístula Vesicovaginal/cirugía , Adulto , Anciano , Femenino , Humanos , Persona de Mediana Edad , Neoplasias Pélvicas/radioterapia , Traumatismos por Radiación/complicaciones , Traumatismos por Radiación/fisiopatología , Procedimientos de Cirugía Plástica/métodos , Micción/fisiología , Fístula Vesicovaginal/etiología , Fístula Vesicovaginal/fisiopatologíaRESUMEN
One of the procedures used in surgical treatment of recurrent infections of the lower urinary tracts is transposition of the distal urethra. This procedure was used in 27 females. Persistent clinical recovery was achieved in 81.5% of cases. One patient withdrew. One patient (3.7%) did not respond, 11.1% required further conservative treatment. Transposition of distal urethra improves treatment outcomes in recurrent infections of the lower urinary tracts in cases when the disease is caused by vaginal ectopia or hypermotility of the external urethra.
Asunto(s)
Uretra/cirugía , Infecciones Urinarias/cirugía , Procedimientos Quirúrgicos Urológicos/métodos , Enfermedad Crónica , Femenino , Humanos , RecurrenciaRESUMEN
Diagnostic potential of urodynamic tests was studied in 279 females with combined and complicated enuresis. 90 healthy females and 21 cadavers served control. The statistical analysis covered the following urodynamic parameters: cystometric volume, detrusor pressure in cystometric volume, functional urethral length, maximal intraurethral pressure, fluctuations of maximal intraurethral pressure. Isolated measurements of cystometric volume, functional urethral length and maximal intraurethral pressure failed to provide sufficient diagnostic information in effort enuresis, whereas cystometry was most efficient in diagnosis of detrusor instability. Registration of urethral pressure fluctuations in the maximal point allows detection of urethral instability. Combined urodynamic examination can not be fully rejected in patients with complicated and combined enuresis.
Asunto(s)
Incontinencia Urinaria/diagnóstico , Urodinámica , Adulto , Cadáver , Femenino , Humanos , Métodos , Persona de Mediana Edad , Complicaciones Posoperatorias/diagnóstico , Complicaciones Posoperatorias/fisiopatología , Incontinencia Urinaria/fisiopatología , Incontinencia Urinaria de Esfuerzo/diagnóstico , Incontinencia Urinaria de Esfuerzo/fisiopatología , Esfínter Urinario ArtificialAsunto(s)
Lesión Renal Aguda/inducido químicamente , Ácido Aminocaproico/efectos adversos , Lesión Renal Aguda/diagnóstico por imagen , Lesión Renal Aguda/terapia , Adolescente , Ácido Aminocaproico/administración & dosificación , Terapia Combinada , Quimioterapia Combinada , Urgencias Médicas , Femenino , Humanos , Kanamicina/efectos adversos , Cuidados Posoperatorios/efectos adversos , RadiografíaAsunto(s)
Enfermedad Iatrogénica , Complicaciones Posoperatorias/cirugía , Derivación Urinaria/métodos , Fístula Vesicovaginal/cirugía , Adulto , Colon Sigmoide/cirugía , Terapia Combinada , Femenino , Humanos , Complicaciones Posoperatorias/etiología , Complicaciones Posoperatorias/fisiopatología , Quinuclidinas/uso terapéutico , Recurrencia , Reoperación , Urodinámica/efectos de los fármacos , Vagina , Fístula Vesicovaginal/etiología , Fístula Vesicovaginal/fisiopatologíaAsunto(s)
Uretra/fisiopatología , Enfermedades Uretrales/cirugía , Vejiga Urinaria/fisiopatología , Fístula Urinaria/cirugía , Fístula Vaginal/cirugía , Adolescente , Adulto , Femenino , Humanos , Persona de Mediana Edad , Complicaciones Posoperatorias/etiología , Enfermedades Uretrales/fisiopatología , Fístula Urinaria/fisiopatología , Incontinencia Urinaria de Esfuerzo/etiología , Fístula Vaginal/fisiopatologíaAsunto(s)
Fístula de la Vejiga Urinaria/fisiopatología , Vejiga Urinaria/fisiopatología , Enfermedades Uterinas/fisiopatología , Adulto , Femenino , Humanos , Periodo Posoperatorio , Factores de Tiempo , Vejiga Urinaria/cirugía , Fístula de la Vejiga Urinaria/cirugía , Urodinámica , Enfermedades Uterinas/cirugíaAsunto(s)
Uretritis/etiología , Adolescente , Adulto , Anciano , Femenino , Humanos , Persona de Mediana Edad , SíndromeRESUMEN
Stress incontinence of women is a widespread and sophisticated problem. Its incidence is between five and 20 per cent in medium and advanced age. In the last two years, 34 patients received treatment modified after the sling operation which had been inaugurated by Stoeckel and Kraatz. This surgical approach had been reserved for severe forms and recurrences of urinary incontinence. The surgical technique is described in this paper. Surgical action action had been preceded by complex gynaecological, neurological, and urological examinations. Sixteen patients have been without complaint for more than a year and six for more than half a year. The remaining twelve are continent, too, but require further observation. Postoperative urodynamic checks revealed proper function of the lower urinary tract.