Biomedical subjects
Publications and source records attributed to A G Hutchinson.
A case is described in which a patient, who initially presented with five separate bladder calculi, was found to have had coalescence of three calculi to produce a large stone. This may be one mechanism in the development of a giant vesical calculus.
The bacteriological status of the pre-operative urine, removed calcium and the pelvic urine was studied in 63 consecutive patients undergoing removal of intrarenal calculi. The overall infection rates in the pre-operative urine, removed calculi and pelvic urine were 29%, 38% and 30% respectively. In patients with staghorn calculi, 58% of patients had an infected pre-operative M.S.S.U., and 82.5% of removed calculi demonstrated significant bacterial growth, with Proteus mirabilis being the predominant organism isolated. In patients with single or multiple oxalate calculi, 17% had an infected pre-operative M.S.S.U., and 22% of removed calculi demonstrated a significant bacterial growth. The findings would indicate that the presence of a positive M.S.S.U. in a patient with a renal calculus is an indication for surgical removal.
Over a 15-year period, 19 patients with hydronephrosis due to pelviureteric obstruction associated with lower polar vessels were treated by ureterolysis and transposition of the vessels. Only those patients who, at operation, showed rapid pelvic emptying was not observed, a pyeloplasty was performed in addition. Complete relief of symptoms occurred in 90% of the patients. Post-operative reduction in the degree of hydronephrosis was demonstrated by intravenous urography in 74% and renal pelvic drainage was judged excellent by diuresis renography in 80%. Diuresis renography allowed the demonstration of free and rapid pelvic drainage in the majority of those patients with persisting hydronephrosis shown by intravenous urography.