Comparison of extravesical versus internal ureteroneocystostomy in renal transplants.
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Biomedical subjects
Publications and source records attributed to A Hashmi.
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J.J stents provide free drainage from the kidney to the bladder, reduce or eliminate urine leakage and provide stenting of the ureter. They were used in a total of 200 cases. In 158 to prevent ureteric obstruction before extracorporeal shock wave lithotripsy (ESWL), in 25 to bypass obstruction and in 12 as an adjunct to complicated upper urinary tract surgery. Majority (97%) of the stents were placed endoscopically under local anaesthesia (71.5%). In all the cases stents were successful to provide free drainage. No mortality was attributable to the use of stents but certain complications were encountered. Encrustation of the stents occurred in 21 (10.5%) and migration in 11 (5.5%) cases. Stents were removed easily under local anaesthesia by cystoscope. "J" stents thus provide an effective means to reduce complications and enhance effectiveness specially of ESWL therapy.
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Controversy exists surrounding the appropriate indications for intravenous pyelography (IVP) in assessing blunt renal injuries in children. Forty-one consecutive cases of suspected blunt renal injuries, who had an IVP performed between January 1988 and December 1990 at The Children's Hospital of Eastern Ontario, were examined by a retrospective chart review. Eighty percent of the IVPs were normal. Of the eight abnormal IVPs, four were contusions, two lacerations, and two nontraumatic abnormalities. There was no hemodynamic compromise, no requirement for surgical intervention, and no deaths in the study population. In the absence of significant hematuria (> or = 100 rbc/hpf), the probability of detecting a traumatic abnormality on IVP is low (4%). There was no correlation between the mechanism of injury and the IVP findings. We conclude that intravenous pyelography has a low yield in the absence of significant hematuria (> or = 100 rbc/hpf).
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