Diverticulum of the urethra is to be suspected in women with unexplained lower urinary tract symptoms. We recommend a collaboration of the two specialties: Gynaecology and Urology.
Forty-eight consecutive arteriovenous fistulae of the upper arm constructed in 44 patients between 1983 and 1987 were reviewed. The median observation time was 8.5 months (range 1 day-65 months). The overall patency rate for fistulae used for haemodialysis (early failures excluded) was 50% after one year and 38% after two years. However, only six (18.7%) of the used fistulae stopped because of thrombosis. The total number of thromboses was nine (19.6%). The main cause of discontinuance of fistulae was a high number of deaths (n = 22), presumably a result of a high median age of 62 years. Early failure rate was seven of 46 (15.2%); in three cases (6.5%) this was caused by thrombosis. The results are compared to other alternatives for radiocephalic fistulae and the difficulties of comparisons are discussed. It is concluded that the upper arm arteriovenous fistula can serve as a second choice, when a radio-cephalic fistula fails.
Treatment of cystine stones in the urinary tract can be difficult because of a high frequency of recurrence, resistance to Extracorporeal Shock Wave Lithotripsy (ESWL), difficulty in localization and access to peripheral stones during Percutaneous Nephrolithotripsy (PCNL), and the insufficient effect of oral chemolysis. We present two cases of urinary cystine calculi treated with a combination of pyelolithotomy, PCNL, ESWL and percutaneous irrigation chemolysis, using N-acetylcysteine and Tromethamine-E.
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