Percutaneous Nephrostomy in Obstructive Uropathy

Since the original description by Goodwin in 1955, percutaneous nephrostomy (PNS) has assumed an important role in the management of obstructive uropathy. It was initially devised as an alternative to operative nephrostomy, but has now completely replaced the latter, for the following good reasons: 1. It can be done under local anesthesia. 2. It provides effective urinary drainage. 3. It carries an acceptable risk, with low morbidity and practically no mortality.

Percutaneous Nephropyelostomy and Endo-Urological Manipulations

After a long period of neglect (Goodwin et al. 1955), percutaneous nephropyelostomy (PNS) has gained general acceptance and replaced operative nephrostomy. In addition, the percutaneous approach has led to a number of new diagnostic and therapeutic procedures. The objective of this review is not to give a complete and detailed survey of PNS but rather to report on our technique and results with fine needle nephrostomy and various endo-urological manipulations.

First Aqueous Chemistry with Seaborgium (Element 106)

Internal Urinary Diversion by a Percutaneous Ureteric Splint

Transcatheter embolization of the kidney with butyl-2-cyanoacrylate: Experimental and clinical results

The technique and efficacy of therapeutic catheter embolization of the kidney with butyl-2-cyanoacrylate (Histoacryl) were studied in 80 rabbits (including control groups) and in 10 dogs. A mixture of butyl-2-cyanoacrylate, 50% glucose, and tantalum powder was used for the embolization. Complete and permanent vascular occlusion was found in nearly all cases. The main complication observed was a reflux of embolizing material into the lumbar arteries, which occurred in seven rabbits. Clinically, therapeutic embolization was performed in six patients with hypernephroma. The indication for embolization in these patients, as well as in two others with iatrogenic lesions, was pronounced hematuria…

Die perkutane Instrumentation bei Nierensteinen

Trotz vermehrter Kenntnisse uber die Steingenese und Erweiterung der konservativen Therapiemoglichkeiten, erreicht das Steinleiden einiger Patienten ein Stadium, in dem die Probleme der Therapie auf die Frage der Organerhaltung der steintragenden Niere reduziert sind. In derartigen Grenzfallen haben sich die perkutane Nephrostomie und die perkutane Steinextraktion bewahrt.

Percutaneous Stone Manipulation

Percutaneous stone manipulation by direct ultrasound disintegration, extraction or chemolysis was done on 34 patients. A total of 15 patients presented with an operatively established nephrostomy, while percutaneous nephrostomy and subsequent dilation of the nephrostomy channel were done in 19. The rate of complete stone clearance was 19 of 20 stones after percutaneous nephrostomy and 8 of 16 stones in the group with an operatively established nephrostomy. The primary goal, to remove obstructing pelvic stones, was achieved in all cases. There were no untoward side effects, such as back pressure damage owing to flushing of the collecting system during ultrasound disintegration, or persistent…

Selektive und superselektive Katheterembolisierung der Niere. Technik und Möglichkeiten einer Methode

Von der Vielzahl der in der Literatur angegebenen Embolisierungsmaterialien haben wir experimentell und klinisch Erfahrungen mit dem Gewebekleber Histoacryl gesammelt. Eine praktikable Handhabung der rasch polymerisierenden Substanzen wird ermoglicht durch: 1. Verdunnung mit Glucose 2. Mischung und Injektion im eisgekuhltem Zustand.

The impact of in-situ balloon occlusion of the renal artery and hypothermic perfusion on renal blood flow

Unilateral renal blood flow was evaluated in-situ in 13 dogs by cineangiodensitometry and microsphere distribution studies before and after intermittent balloon occlusion with and without hypothermic perfusion of one kidney. The contralateral kidney served as control. No significant difference in renal blood flow and vascular resistance was noted before, and 5, 30 and 60 minutes after unilateral intra-arterial manipulation. Compartmental flow distribution studies in 5 dogs revealed no evidence of alteration of intra-renal haemodynamics. In a clinical pilot study, unilateral renal blood flow measured by cineangiodensitometry showed no change of clinical significance 5 and 60 minutes after in…

31. Lokalisationsdiagnostik beim Hyperparathyreoidismus

Im Hinblick auf die hohe chirurgische Erfolgsrate beim Auffinden pathologischer Epithelkorperchen ist eine invasive Lokalisationsdiagnostik mit Angiographie und selektiver Blutentnahme zur PTH-Bestimmung vor Erstoperationen nicht indiziert. Nichtinvasive Masnahmen wie Sonographie und Computertomographie lassen sich auch vor Erstoperationen einsetzen. Dabei eignet sich die Sonographie nur fur den Cervicalbereich, die Computertomographie im wesentlichen fur den vorderen Mediastinalbereich.

Follow-up results of embolization therapy for palliation of incurable bladder carcinoma

Embolization therapy of the renal artery (N=10), hypogastric arteries (N=18) and ureter (N=24) was performed in 41 patients with incurable bladder carcinoma for palliation of gross hematuria and severe dysuria. Careful follow-up of the patients until death gave a mean survival time of 12.3 months after embolization; 6 patients are still alive. The results show that embolization therapy is justified for management of bleeding and dysuric complaints. Ureteral occlusion alone has almost no effect on hematuria. Combined embolization procedures yield better results than occlusion of the vessels or the ureter. Ureteral occlusion with a detachable balloon is superior to embolization with tissue ad…