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PubMed1979

[Cystoscopy and its importance in urology].

From the enumeration of modern endoscopic methods for diagnosis and treatment of urological disease, the characteristics of their value and their importance for modern urology becomes evident that by means of these methods, the basis of which was created 100 years ago with the introduction of the cystoscopy, examination and treatment became possible in all regions of the urinary tracts. Based on cystoscopy a subspeciality in urology developed, which might be called endoscopic surgery in urology. The endoscopic treatment methods are relatively atraumatic and loaded with a more insignificant complication rate than the open operative interventions. However, they demand an exact knowledge of the indications and contraindications. By the great possibilities which nowadays open the modern methods of endoscopic diagnostics and therapy we are indebted to their inventors still 100 years after the detection of the cystoscope, among the inventors German researchers and masters play an important role.

Color↗

PubMed1978

Short stay surgery in pediatric urology.

Short stay surgery represents an innovation in the delivery and cost of medical care. The short stay surgical unit at the Children's Hospital of Michigan has provided urologic care for 311 children during the most recent 12 months of its operation. Eighteen patients (5.7 per cent) required postoperative hospitalization. No children have required rehospitalization after discharge from the short stay unit. Short stay surgery in pediatric urology has resulted in more economic and efficient use of hospital facilities and has decreased cost per procedure. Morbidity has not increased. Short stay surgery is well accepted by the child, parent and referring physician, and has not posed problems for the operating surgeons. Short stay urologic surgery is safe and applicable to many diagnostic and therapeutic urologic surgical procedures.

Adolescent↗

PubMed1978

[The current state of spinal anesthesia in urologic interventions].

It is reported on the experiences of several years in 9,400 spinal anaesthesias in the urology in patients at an advanced age. Still at present the spinal anaesthesia has a dominating position in the urological intervention. Despite modern and differenciated anaesthetic methods the importance of the spinal anaesthesia is by no means reduced for most urological interventions, particularly for the transurethral operation technique, but it rather increased during the last years by the new local anaesthetics, by the development of thinnest spinal needles, but also the increased knowledge of the dangers of general anaesthesia. In urological diagnostics and therapy the spinal anaesthesia has still its full right and is less toxic for the patient and has less severe complications than the general anaesthesia. However, prerequisites for its use are: a) mastery of technique b) full assent of the patient c) psychic guidance of the patient during the whole duration of the intervention and d) balanced pre-, intra- and postoperative substitution of the volume e) overcoming of the established opinion that the spinal anaesthesia has a particular depressing effect on circulation and frequently causes post-spinal headache.

Aged↗

PubMed1978

The carcinoembryonic antigen test in urologic cancer.

The diagnostic value of the CEA test was evaluated in 2,029 blood and urine samples from 308 patients with urologic cancer, 13 with nonurologic cancer, 20 urologic patients with nonmalignant disease, and in 30 controls. The blood CEA test was positive in 50% of the patients with active urologic cancer and in 35% of those with inactive cancer. The urine CEA test was elevated only in patients with active bladder cancer, but most of these had concurrently infected urines. At the present time, the CEA test does not reflect the accuracy necessary for an acceptable diagnostic test for the detection of urologic cancer.

Carcinoembryonic Antigen↗

PubMed1976

[Possibilities of vascular surgery in urology and nephrology].

The vascular surgical procedures most frequently applied in urology and nephrology are described. The urological aspects of the various methods are stressed and cases suitable for joint urological and vascular surgery are presented. With respect to the occlusion of the renal artery the difference between the recanalization of this vessel and of the peripheral vessels is pointed out and the importance of preserving the kidney is emphasised. The hope is expressed that by the increasing use of vascular surgical methods a more effective therapeutical possibility will be available to increasing numbers of urological-nephrological patients.

Arteriovenous Shunt, Surgical↗

PubMed1976

The incidence and treatment of intestinal and urological complications after combined radiotherapy for uterine carcinomas.

OPNE HUNDRED AND SIXTY-FOUR PATIENTS WITH GYNECOLOGICAL CARCINOMAS (104 ca colli uteri, 60 cacorporis uteri) were examined retrospectively two to seven years after combined internal-external radiotherapy. Thirty-seven per cent of the patients displayed mild intestinal symptoms during the therapy. The frequency of symptoms remained unchanged after the termination of therapy, though they tended to become more severe. Twenty-five per cent of the patients had urological symptoms during the therapy. Their rate remained the same during the arly follow-up, but increased subsequently, because the frequencies of infections and hematuria had increased. Fourteen patients developed a complication requiring operative treatment five to fifty-seven months after the discontinuation of therapy. Three of them had both intestinal and urological complications, while six had only urological complications. The intestinal complications were repaired with smallgut resections and colostomies, while the urological complications (ureteral strictures) were repaired with different diversion operations with good operative results. Thirteen of the patients with serious complications are alive. One patient had died of profuse rectovaginal bleeding. The mean radiation doses employed were not different in the group with serious complications. Evleven of the patients with complications suffered from different concurrent diseases, which may have diminished their radiation tolerance. The radiotherapy of gynecological malignancies ought to be preformed individually noticing the intestinal reactions during the therapy and the concurrent disease. The value of renography in early detection of urinary tract complications is stressed.

Female↗

PubMed1976

[Urology -- yesterday and today (author's transl)].

The developments in urology over the past 10 years both in regard to diagnosis and therapy are reviewed. The value of diagnostic procedures such as intravenous urography, angiography, isotope rhenogram and scintigram in tumours of the kidney and the significance of lymphangiography in the decision concerning the operability of tumours of the bladder, the prostate and the testicle are discussed. The importance of cytological examinations in the early diagnosis of cancer of the bladder and the prostate, as well as in the postoperative follow up of cases of bladder carcinoma is emphasized. Metabolic diseases such as renal calculus formation and renal hypertension are of great importance in regard to social aspects of medicine owing to their increasing occurrence. New urological equipment, as well as established instruments such as fibre optics and "Urat-I" for the treatment of bladder calculi, as well as cryotherapy of prostatic tumours is demonstrated. Coagulum pyelotomy is recommended for the treatment of friable stones in the renal pelvis and the calyces. This review of the current stand of development in the field of urology is coupled with proposals of a suitable training programme for future urologists.

History, 19th Century↗

PubMed1975

Urologic complications after operations for anorectal cancer, with an evaluation of preoperative intravenous pyelography.

Urologic complications arose in 23.7 per cent of 569 patients who underwent abdominoperineal or low anterior resection for anorectal cancer. No radomization of the two operations was attempted, low anterior resection being performed whenever resection 5 cm below the tumor was possible. Complications were more frequent after abdominoperineal resection and in men. Preoperative intravenous pyelography was performed in the cases of 541 of the patients, including 60 who underwent palliative colostomy. The pyelograms of 30 per cent of these patients were abnormal. The abnormalities were anatomic variations of the urinary tract in 25 per cent and urologic diseases in 75 per cent. None of the postoperative urologic complications was related to an abnormal preoperative pyelogram. No relation was found between the radicality of abdominoperineal and low anterior resection and the pyelographic signs of tumor involvement.

Anus Neoplasms↗

PubMed2026

Comparison of quality of life in children with posterior urethral valves, isolated hydronephrosis and minor urologic conditions.

OBJECTIVE: To compare the quality of life (QoL) and family impact scores of children with posterior urethral valves (PUV), isolated hydronephrosis (HN), and those with minor urologic conditions, referred to here as minor urologic controls (MUC). METHODS: From December 2022 to April 2025, the PedsQL Inventory and Family Impact Module (FIM) questionnaires were distributed to patients in dedicated PUV, HN, and community-based urology clinics. Higher scores indicate better QoL. Children ≥8 years self-completed the questionnaires, while parents served as proxies for younger children. PUV patients were compared to HN patients and MUC. RESULTS: A total of 331 patients were included (124 PUV, 101 HN, and 106 MUC). The median age differed across groups, with HN patients being the youngest (median: 7 months), followed by MUC patients (median: 36 months) and PUV patients (median: 79.5 months). Overall, PUV patients scored similarly to HN patients and MUC in QoL and FIM scores. When stratified by age, however, PUV patients <2 years old had lower median scores in total QoL, psychosocial, and family functioning domains compared to other groups. CONCLUSION: Overall, PUV was not associated with lower QoL or family impact scores compared to comparator groups in this tertiary-care cohort; however, lower scores were observed among younger children with PUV, likely reflecting parent-perceived burden early in the disease course. This highlights the importance of age-tailored support and close monitoring, particularly for younger children and families navigating early post-diagnosis care.

Humans↗

PubMed1977

Keys to the diagnosis of occult urologic disease in children.

All physicians who care for children should be aware of the many indications for further urologic examination. A straightforward algorithmic approach to urologic diagnosis is not possible. The physician must individualize and carefully weight the indications for the often-times expensive and uncomfortable tests that are required for urologic diagnosis. The reward is ample when a significant correctable lesion is recognized early enough for salvage on the basis of seemingly unrelated signs or symptoms.

Age Factors↗

PubMed1979

Urological injuries associated with pelvic trauma.

We reviewed 100 consecutive cases of pelvic fractures at our hospital to establish the relationship between bone injuries and urological lesions. There were 11 major urological injuries found: 6 patients had bladder laceration, 4 had rupture of the membranous urethra and 1 had a ureteral injury. Emphasis is placed on the physiopathology of the urological injuries.

Adolescent↗

PubMed1979

Urological complications in 119 consecutive renal transplants.

One hundred and nine patients undergoing 119 transplants have been followed up from 8 months to 9 years. Urological complications occurred in 16 transplants, an incidence of 13.4%. Ureteroneocystostomy was performed primarily in all cases; in 98 by the conventional Politano-Leadbetter technique with 9 (9.2%) urological complications and in 32 by an extravesical technique with 7 (21.8%) urological complications. One patient died as a result of ureteric obstruction, without operation. In 3 patients with lower ureteric obstruction, transurethral ureteric meatotomy was successful in 2 cases and resulted in no change in renal function in the third. Two patients with urinary fistulae were managed successfully by continuous drainage with indwelling urethral catheters. The remaining 10 patients required 12 open surgical procedures for relief of ureteric obstruction, with improvement in function in 7 patients.

Follow-Up Studies↗

PubMed1979

[Clinical and urological after care in gynecologic neoplasms].

Patients after operative and/or radiological therapy for cervical cancer should have gynecological follow-up examinations every two months in the first year. In cases of urological complications after irradiation therapy, radionephrography, infusion urogram, blood count, cystoscopy, and cystometry should also be carried out after two months. Depending on the clinical picture, radionephrography, blood count and urinalysis are to be repeated in regular intervals. After lymphography with positive findings, x-ray controls are necessary after two and four months. In cases of increasing hydronephrosis and hydroureter due to fibrostenosis of the ureter plastic surgery is recommended. Most urological complications are to be expected after radical operation and postoperative irradiation. In patients with endometrial uterine cancer, metastases mostly occur paraurethrally and in the lungs. Chest x-ray is to be taken every six months. Suspicious paraurethral hardening is cytologically diagnosed by needle biopsy. In ovarian carcinoma stage III and IV repeated x-ray controls of the lungs during longterm polychemotherapy are advisable. Prior to second look operations after combined treatment a second look laparoscopy is particularly important. Urological complications are more frequent after therapy of cervical cancer while ovarian carcinoma is more likely to develop complications of the small bowel.

Adult↗

PubMedDate not supplied

[Urological treatments before and after kidney transplantations].

The repair of pre-existing bladder sphincter lesions in patients excluded from kidney transplant programs, and the recovery of grafts threatened by ureteral complications, are favourable influences in establishing equilibrium between dialysis and transplantation. In a series of 74 kidney transplants, two patients were able to receive grafts: one after the reconstruction of an ileal tube and the other after bladder diverticulectomy and resection of the bladder neck. Two other grafts, complicated by ureteral necrosis, were able to be conserved following a uretero-ureterostomy in the first case, and a psoic bladder in the second. These repair operations are discussed from three points of view: incidence, procedures, and complications. Advances made in transplanting kidneys encourage its use in patients who were previously excluded from receiving transplants because of bladder sphincter lesions. These lesions can be the cause of a renal insufficiency, or those associated with the original kidney disease. This group of patients represents 3 to 5% of the population of patients on permanent dialysis who respond to the other criteria for inclusion in the lists of potential receivers of kidney transplants: some of them could benefit from the graft if their lesions were treated by the standard urological methods. Furthermore, 5 to 8% of those with kidney transplants could lose the grafted kidney, which is immunologically tolerated, because of urological complications. As with patients in the first category, they also could obtain benefit from repair procedures on the urinary tract. A total of 74 kidney grafts were performed in the Sheba medical Center between March 1971 and July 1977: two patients were able to benefit from preventive urological procedures before transplantation: two others with grafts developed ureteral complications and were benefited by therapeutic procedures rarely used in kidney transplantation cases.

Adult↗

PubMed1976

[Progress in the prevention and control of urologic complications of the cervix carcinoma. I. Urinary tract infections].

An investigation was made on patients with cervical carcinoma to test the efficiency of a general administration of antibiotics and chemotherapeutic drugs which are commonly used in urology. The study has been made to analyze the frequency of pathological findings in the urinary tract, in general, and, in particular, the pattern of bacteriological findings as well as antibiogramms at different times of carcinoma therapy. Additionally, consideration was given to the bacteriological situation before the onset of carcinoma therapy and to manifest urologic complications during and after carcinoma therapy. In cases of primary absence of bacteria in urine the therapy preferably used in this clinic was that with chloramphenicol and nifurantin administered up to the 4th week after operation and this was sufficient in two thirds of cases. Conversely, in patients with primary bacteriuria the results of treatment after 4 weeks were satisfactory in only one third of the cases. This poses the necessity of making a more subtle selection of drugs including broad spectrum penicillins. Moreover, therapy has to be continued mainly for women with a previous urological history and for women in whom infections of the urinary tract were observed on release from the hospital. In addition to prevention of chronic pyelonephritis improvement of postoperative wound healing as well as restriction of ureteral fibrosis, hydronephrosis and uremia, as a result of general control of infection are also of considerable importance.

Anti-Bacterial Agents↗

PubMed1977

Evaluation of research needs in nephrology in urology. Obstructive and neuromuscular disorders affecting the urinary system.

Obstructive and neuromuscular disorders are common problems of the urinary tract. They cause considerable morbidity and some mortality. In all problem areas research efforts have been and continue to be limited. The principal reason for the lack of research efforts in these areas is the lack of trained established investigators interested in the problems of the urinary tract. Unfortunately, most basic scientists with the research and investigative background to solve many of these problems see them as mundane and not worthy of investigation. In addition, these same basic scientists are out of touch with clinical urologic diseases and probably do not appreciate the magnitude of the problems. In our opinion the solution is 2-fold: to train qualified investigators in urology and nephrology, and to interest, educate and collaborate with the basic scientists about these clinical problems of the urinary tract.

Action Potentials↗

PubMed1978

Study of nonspecific lymphocyte transformation in urologic cancer patients.

Blast-cell transformation of lymphocytes in response to phytohaemagglutinin was examined in patients with urologic tumours and with nonmalignant urologic processes. A significant depression of immune reactivity was found in the malignant cases. The practical aspects of the findings are discussed.

Humans↗

PubMed1977

Ataralgesia in outpatient urology. Clinical evaluation.

The combination of fentanyl citrate (Sublimaze) and diazepam (Valium) was evaluated for efficacy of analgesia, sedation, and safety in 1,008 predominately outpatient urologic procedures. These procedures included prostate biopsies, basket extractions of ureteral calculi, internal urethrotomies, and cystourethroscopies. Ninety-two per cent were judged to be successful with regard to adequate tranquilization and relief of pain. No detrimental effects were seen with the recommmended method and dosage. This drug combination provides the clinician with an effective and safe alternative to local, general, or spinal anesthesia for many routine urologic procedures and allows them to becom true office procedures.

Adolescent↗