Three patients with amyloidosis of the lower genitourinary tract are described. In the cases of primary localized amyloidosis of the urethra and primary systemic amyloidosis involving the prostate the clinical presentation mimicked cancer of the respective sites. In the case of secondary localized amyloidosis of the seminal vesicles chronic perineal pain suggested seminal vesiculitis.
Herein we describe 2 patients in whom a bifid renal pelvis was associated with peristaltic dysfunction and pyelopelvic reflux, causing pyelocaliectasis and flank pain. The patients were improved with pyelopyelostomy. Previous explanations for the yo-yo phenomenon have indicated that there is functional obstruction because of a higher resting pressure in the common stem. The asynchronous peristaltic waves a coincident with a relatively low pressure in the oal fold that acted as a baffle to direct the flow of urine from the lower segment of the bifid pelvis down the ureter. This baffle favored reflux into the upper segment.
Emphysematous pyelonephritis is an uncommon infection of the renal parenchyma found most often in diabetic patients. The fortieth case of emphysematous pyelonephritis is reported and a plan for management is proposed based on differentiating this condition from gas-forming infections of the perinephric space and the renal collecting system.
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