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R Talbot-Wright

Publications and source records attributed to R Talbot-Wright.

34 records · Page 2Linked to original sources
PubMed1990

[Entero-urinary fistula. A study of 22 cases].

We performed a retrospective study on 22 patients with entero-urinary fistulas that had been diagnosed and treated at the Hospital Clinico i Provincial in Barcelona during the period spanning 1981-1988. Fistulas were classified according to the organs or parts with which they communicated. Among the important etiogenic conditions were diverticular disease of colon. Crohn's disease, actinic lesions, trauma and xanthogranulomatous pyelonephritis. The clinical manifestations were principally urological in the form of recurrent urinary infection and terminal pneumaturia. The most useful diagnostic techniques were cystoscopy; serial voiding cystourethrography (SVCU), retrograde urethrography and pyelography. Treatment was by surgery in all cases. Diversion procedures or surgical excision of the fistulous tract were performed as warranted by each case. The etiopathogenic, morphological and therapeutical aspects of vesico-enteric fistulas are discussed.

Adolescent↗
PubMed1989

Orthotopic renal transplant and results in 139 consecutive cases.

Although a commonly performed technique, heterotopic renal transplantation may be a cause of late graft failure owing to ureteral stenosis, urinary fistula and vesicoureteral reflux secondary to the immune response. The new retroperitoneal lumbar approach to the splenic vessels has allowed the orthotopic technique to be developed using the splenic artery or aorta, the renal vein and a pyelo-pyelic anastomosis. In this manner the renal graft is located in an anatomical position that is well protected, and with the recipient urinary tract the normal physiology is preserved with comparatively low complication and mortality rates. A third transplant attempt also is simplified. This method is the only alternative in some cases. Transplant ureter pathology symptoms are not observed. The results of 139 consecutive cases are presented.

Adult↗
PubMed1989

Prolonged anuria after failed percutaneous transluminal angioplasty in a kidney transplant patient solved by surgery.

We present the case of a 21-year-old transplanted female patient who presented with anuria due to a renal artery stenosis secondary to a failed percutaneous transluminal angioplasty. The interest is that, to our knowledge, it is the longest case (220 days) reported in the literature of anuria in these conditions solved by surgery with an immediate urine output recovery. We report the underlying pathophysiology.

Adult↗
PubMed1988

Ileal conduit and orthotopic renal transplantation. An alternative in pathology of the nonviable lower urinary tract.

The technique of orthotopic renal transplantation with urinary shunt, using the ileal conduit as an alternative in cases of pathologically nonviable lower urinary tract, is described. Various techniques for heterotopic renal transplantation using the ileal conduit have been used. We feel that orthotopic renal transplantation accompanied by the ileal conduit results in a more anatomical and physiological unit than the previously proposed alternatives.

Adult↗
PubMedDate not supplied

Usefulness of urinary nuclear matrix protein 22 (NMP22) as a marker for transitional cell carcinoma of the bladder.

OBJECTIVES: The purpose of this study was to evaluate an immunoassay for urinary nuclear matrix protein, NMP22, as a novel marker for urothelial cancer. PATIENTS AND METHODS: NMP22 values were determined for 71 patients and 21 healthy volunteers. Each subject provided a single (3 voids) urine sample for analysis at the time of entry into the study. Each sample was assayed for levels of NMP22. RESULTS: When the cut-off value was set at 10 U/ml, the positive rate for urinary NMP22 in bladder cancer was 37.8% (17 out of 45), whereas that in post-treatment cases and benign diseases was 30.8% (8 out of 26) compared to 14.3% (3 out of 21) for healthy volunteers. This cut-off value provided a sensitivity of 37.8% and a specificity of 80.9%. In the bladder cancer group, NMP22 levels were related to tumor size, shape, grade and stage. CONCLUSIONS: Despite the many reports that suggest NMP22 as a promising urinary marker for monitoring transitional cell carcinoma, this study does not support its usefulness as a substitute tool for urinary cytology in the control of bladder tumors.

Adult↗
PubMedDate not supplied

[Kidney transplantation].

In a consecutive series of 639 Renal Transplants (RT) performed between January 1st 1978 and December 31st 1988, 75 Renal Transplanctectomies (RTX) were carried out. Of those, fifty-seven (76%) were due to immunological causes, 10 (13.3%) to vascular complications, 7 (9.3%) to urological problems and 1 (1.3%) to deep infection. The time elapsed between RTX and RT was as follows: 25 were performed earlier than 6 weeks, 17 between 6 weeks to 6 months, and 33 after 6 months. The higher number of complications did not happened, as it is frequently described, in the first group; on the contrary, it fell in the group that had been transplanted longer. There were 13 immunologically caused renal rhexis, 5 of which were RTX, another 5 were operated on and diagnosed at perioperation, and immediately received the appropriate treatment so they were able to keep their kidney, and finally, 3 patients were diagnosed a rejection with renal rhexis, ecographically confirmed. These patients were given only medical treatment, which was enough to allow jugulation of the picture. RTX techniques used were: extracapsular in 28 cases and intracapsular in 47. Surgical approach, except for 2 cases of simultaneous kidney and pancreas transplantation, was extraperitoneal.

Graft Rejection↗
PubMedDate not supplied

Splenorenal arterial shunt in the treatment of renovascular hypertension. Approach by a lumbar-retroperitoneal incision.

In a period of 16 years, 29 consecutive patients were operated on for a splenorenal arterial shunt through a lumbotomy incision and a retroperitoneal approach. There were 18 males and 11 females with a medium age of 42 years. All cases had uncontrollable and severe hypertension for an average medium time of 48 months, 11 patients had variable degrees of renal insufficiency. The diagnosis was made utilizing standard methods including in all cases angiography of the abdominal aorta, celiac axis and renal arteries. One patient died after the operation due to intestinal infarction, the remaining have been followed for a medium time of 50 months. All patients improved or cured their renal insufficiency. The hypertension was cured in 23, improved in 4 and failed in 1, this latter patient was successfully autotransplanted. A precise exposition of the surgical technique is presented with comments about their advantages and indications. A review of the literature in surgical experience with the technique of splenorenal arterial anastomosis has been done.

Adolescent↗
PubMedDate not supplied

[Vascular complications of kidney transplant. Stenosis of the renal artery].

The present paper analyzes the incidence of vascular complications and their treatment, in a series of 500 consecutive Heterotopical Kidney Transplants (KT), performed in our Service between January 1978 and December 1988. There was a total of 14 (2.8%) complications of which 8 (1.6%) correspond to renal artery stenosis. Of the 8 cases with renal artery stenosis, in 2 of them primary surgical treatment was indicated. The first one was a transplantectomy (TRX) and the second one reconstructive direct surgery. In the 6 remaining patients a Percutaneous Transluminal Angioplasty (PTA) was indicated. In three of these patients the stenosis resolved although one of them needed a second dilatation. In the last three there was: a thrombosis requiring TRX, a post dilatation anuria added to failure in the treatment of HT and which, finally, had to undergo surgery, and a third failure that could not be resolved by surgery and had to be subjected to graft nephrectomy. One of the patients in the surgical group died.

Adolescent↗
PubMedDate not supplied

[Xanthogranulomatous pyelonephritis. Our experience in the last 10 years].

A retrospective study of 34 xanthogranulomatous pyelonephritis (XGP) cases operated on in our Service was performed. An analysis is made of the clinical signs, laboratory data, imaging diagnostic techniques and the value of cytology in the assessment of this entity. A very characteristic clinical and biological picture, although somewhat nonspecific of XGP, was encountered. The high sensitivity of simple abdominal X-ray films and I.V.U., as well as the high specificity of cytologic studies in the diagnosis of the disease, was shown.

Adult↗
PubMedDate not supplied

[Congenital obstructive disease of the ureter].

Congenital diseases of the ureter form a broad sub-section of urology, where nomenclature is not clear and much less their etiopathogeny. In attempt to clear this up, we present the morphological study of ureteral development throughout the whole embryonic period, in both human and rat embryos, by means of the use of optical and electronic microscopy. After the description of ureteral obstruction phenomena (at the ureterovesical union and in the ureter itself), we discuss their physiopathological implications in embryonic development and we put forward a common etiopathogenic theory for obstructive diseases of the ureter with a congenital origin.

Animals↗
PubMedDate not supplied

[Renopancreatic transplant. Urologic complications].

OBJECTIVE: Retrospective study of urological complications in our series of reno-pancreatic transplants. MATERIAL AND METHODS: Between February 1983 and May 1994 our group has conducted 93 RPT, 80 of which, mean age 36 +/- 6 years (24-54 years), are studied in this paper: 57 male and 23 female with an average time in dialysis of 20 +/- 15 months (0-84 months) and diabetes evolution of 21 +/- 5 years (11-37 years). RESULTS: Actuarial annual survival of patient, renal graft and pancreatic graft has been 85%, 79% and 74% respectively. Haematuria: 25% incidence, with graft pancreatitis etiology in 16 cases, rejection in 8 and urinary fistula in 6. Urinary infection: 85% incidence, symptomatic in 23 patients (29%) and asymptomatic in the remaining cases. Dysuria, urethritis and urethral stenosis: 14 patients, all male, most with both conditions associated. Reconversion of pancreatic exocrine secretion by intestinal route was performed in 7 patients. Urinary fistula: secondary to surgery in 9 cases and rejection in 4. Etiology of one case remained unknown. In 4 cases it was resolved with conservative treatment, and with surgical correction in 8. One patient required pancreatic transplantectomy and one patient died of AMI. CONCLUSIONS: Urological complication in RPT account for a significant morbidity, urinary fistula being the one with greater repercussion on the patient and pancreatic graft survival.

Adult↗