[Personal experience with percutaneous litholapaxy in nephrolithiasis].
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Biomedical subjects
Publications and source records attributed to V Skutil.
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There were 631 patients treated for proven urogenital tuberculosis in 1966-1985. Indications for nephrectomy were retrospectively analyzed in 137 (21.7%) patients operated. A badly damaged or functionless kidney was removed in 85 (62.0%) patients for the early control of persistent tuberculous cystitis; in 18 (13.1%) because of chronic, nonspecific urinary infection, dispersed calcifications with subsequent nephrolithiasis, pain or other discomfort; in 16 (11.7%) due to supposed nephrogenic hypertension, and in 3 (2.2%) because of extrarenal disease. In 15 (10.9%) patients the symptomless kidney was removed preventively. The management of renal tuberculosis by itself did not need nephrectomy.
Rifampicin (RMP, 600 mg), isoniazid (INH, 300 mg) and pyrazinamide (PZA, 1,000 mg) administered daily in the hospital for a duration of 2 months was followed at home by daily administration of 600 mg RMP and 300 mg INH for a duration of 4 months. 113 patients with previously untreated and bacteriologically proven urogenital tuberculosis were admitted to the study. Therapy was completed and evaluated in 106 (94%) patients. No failure of chemotherapy was observed during the treatment; one bacteriologically proven relapse occurred after completion of treatment within the 45- to 63-month follow-up. This 6-month chemotherapy seems as efficient as the standard treatment which lasted for 18-24 months.
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A case of extensive urogenitary tuberculosis treated by enterocystoplasty and two-stage urethroplasty is reported. 10 years after the last surgical procedure, the evacuation of the bladder enlarged by the sigmoid colon through the reconstructed urethra is satisfactory. The low micturating pressure and the mucus secretion do not cause disturbances in micturation.
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