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Extracorporeal shock wave lithotripsy with ultrasound-guided lithostar plus.

Abstract Since 1989, the Siemens lithostar plus, an upgrade of the lithostar with the ultrasonically guided overhead module, has been available for clinical use. This unit may be used for the treatment of either biliary or urinary calculi. We report on 75 patients with urinary calculi treated between March 1989 and June 1990 with the lithostar overhead module. Stone localization showed a rate of: caliceal stones 33.5%, pelvic stones 44%, upper ureteral stones 9.3% and lower ureter stones 13%. The overall disintegration rate was 86%, with a stone-free rate after 3 months of 78%.

Kontinente Harnableitung und Schwangerschaft

We report on our experience with 7 pregnancies in 6 women who previously underwent reconstruction of the urinary tract with a continent urinary diversion using an ileo caecal segment (Mainz-Pouch I), ureterosigmoidostomy or bladder augmentation. Urinary tract infection and upper tract dilatation were the only complications during pregnancy which required bilateral nephrostomies in one case. All other sequelae were handled conservatively. The continence mechanisms were not compromised during pregnancy or delivery. Deliveries were vaginal in two cases and by Caesarean section in five. All seven newborn were healthy. Pregnancy is not contraindicated after any type of urinary diversion includin…

Management of Renal Angiomyolipoma: A Report of 14 Cases and Review of the Literature

14 patients with renal angiomyolipoma are presented. Two of them had tuberous sclerosis (TS) with synchronous bilateral and multiple tumors. Two other patients without TS also had multiple tumors in 1 kidney. More than half the patients were symptomatic (n = 8), 2 of them with spontaneous rupture of the tumor. Misdiagnosis, spontaneous rupture and tumor growth can be prevented by utilizing conservative, organ-sparing techniques. In cases of solitary kidneys with large and/or hemorrhagic angiomyolipoma, superselective arterial embolization is indicated.

Whole-body potassium and bone mineral density up to 30 years after urinary diversion

Objectives  To evaluate the long-term effects of different types of urinary diversion on skeletal bone density and whole-body potassium content in patients with an early correction of base excess (<−2.5). Patients and methods  The early correction of base excess (<−2.5) is one of the principles of the treatment of patients undergoing urinary diversion at our institution. In 27 patients with urinary diversion, bone mineral density (assessed by dual-photon absorptiometry), whole-body potassium, electrolyte and creatinine levels were determined, and capillary blood gas analysed. The mean time since surgery was 16.8 years in 16 patients with a rectal reservoir, 20.5 years in six patients with a…

Die kombinierte operative und radiotherapeutische Behandlung (CORT) von Beckenwandrezidiven: Erfahrungsbericht nach 3 Jahren

CORT has been developed to treat recurrent gynaecological malignancies infiltrating the pelvic wall unilaterally. The surgical part consists of: (i) staging laparotomy/lymphadenectomy, (ii) maximum tumour resection at the pelvic wall and exenteration of infiltrated central pelvic organs, (iii) implantation of guiding tubes on the residual tumour/tumour bed on the pelvic wall, (iv) pelvic wall plasty with muscle, musculocutaneous and omentum flaps, (v) operative reconstruction of bowel, bladder and perineo-vulvo-vaginal functions. Radiation is performed as interstitial high dose rate brachytherapy through the implanted tubes. Patients without prior pelvic irradiation receive in addition, who…