[Multiple adenomas of both kidneys--"renal adenomatosis?"].
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Biomedical subjects
Publications and source records attributed to P Porpáczy.
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In 50 patients with benign prostatic hyperplasia the preoperative diagnostical value of ultrasonography was compared with urography. The results show the sufficient efficacy of both methods in the case of bland history and normal urinary findings. In the estimation of adenoma weight the rectal ultrasonography is superior to other techniques.
Renal cyst puncture under ultrasonic guidance has proved an excellent and safe method in the differential diagnosis of cystic renal masses. The use of ultrasound in the follow-up of patients with renal cyst puncture is mandatory for evaluation of complications and results. The therapeutic success of renal cyst puncture is poor and estimated at about 25%. New percutaneous techniques with resection of the cystic wall lead us to expect much better results than with open surgical management.
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In 300 urological patients with long-term intake of phenacetin-containing compounds, renal (papillary necrosis, chronic interstitial nephritis) and extrarenal manifestations appeared after an average latency period of 20 years. Course and prognosis primarily depend on the successful cessation of analgesics and the elimination of the accompanying infection. In the last decade, an increase of transitional cell carcinoma induced by analgesics has been observed. 31 of our patients presented a tumor of the urothelium (i.e. 10.3%) 26 patients presented isolated carcinoma of the bladder, 2 persons were diagnosed as having cancer of the bladder and the renal pelvis, and 1 patient had cancer of the bladder and the ureter. Only 2 persons suffered from isolated carcinoma of the renal pelvis. A further increase of these specific cases if expected.
In the last two decades reports concerning analgesic nephropathies have been presented from most industrial countries. Today, there is no doubt concerning a causal association between long-term consumption of analgesics and renal failure. In a group of 274 urological patients, the reasons and consequences of long-term intake of phenacetin-containing compounds are herewith demonstrated. The reason for chronic consumption of analgesics is mainly headache, due to psychosomatic causes which had not been adequately treated. After an average latency period of 20 years, renal (papillary necrosis, chronic interstitial nephritis) and extrarenal manifestations appeared. Despite slow progression and low gradient symptoms, severe alterations could be determined at the first examination. Course and prognosis primarily depend on a successful cessation of analgesics and the elimination of the accompanying infection. In the last decade, an increase of transitional cell carcinoma induced by analgesics has been observed. 22 of our patients presented a tumor of the urothelium (i.e. 8%). A further increase of these specific cases is expected.
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70% of all patients who abuse phenacetin have headache. The nephrological aspects are reported of 240 patients who were phenacetin-dependent and in an average of 19 years had consumed an average of 6 kg - up to 25 compound powders daily. The degree of renal damage depends principally on the duration and regularity of ingestion of analgesics, and less on the total quantity. One fifth of the patients were already in a condition in which a fatal outcome was inevitable when they were admitted to hospital.
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