Upper tract pressure flow studies in four clinically unobstructed ureters with double J stents in situ indicated that urinary flow occurred mainly around the stent and that there was significant vesicorenal pressure transmission. This study examined the dynamics of ureteric urinary flow and morphological effects consequent upon stenting a ureter in vivo. In a porcine model, ureteric intubation caused a rise in intrapelvic pressures, hydroureter, vesicorenal reflux and generalised thickening of the ureteric wall with characteristic histological changes in the urothelium. These findings suggest that double J stents may compromise urinary drainage when ureteric obstruction is not present, urging caution in their use in the damaged, unobstructed upper urinary tract.

This study was designed to compare different methods of treating renal calculi in order to establish which was the most cost effective and successful. Of 1052 patients with renal calculi, 350 underwent open surgery, 350 percutaneous nephrolithotomy, 328 extracorporeal shockwave lithotripsy (ESWL), and 24 both percutaneous nephrolithotomy and ESWL. Treatment was defined as successful if stones were eliminated or reduced to less than 2 mm after three months. Success was achieved in 273 (78%) patients after open surgery, 289 (83%) after percutaneous nephrolithotomy, 301 (92%) after ESWL, and 15 (62%) after percutaneous nephrolithotomy and ESWL. Comparative total costs to the NHS were estimated as £3500 for open surgery, £1861 for percutaneous nephrolithotomy, £1789 for ESWL, and £3210 for both ESWL and nephrolithotomy. ESWL caused no blood loss and little morbidity and is the cheapest and quickest way of returning patients to normal life.

Two hundred and fifty cases of percutaneous nephrolithotomy (PNL) are described. One hundred and fifty cases were treated in two stages, 100 in a single stage. The one-stage method has been shown to be as safe as the two-stage method but should be reserved for those with experience of the technique and who possess adequate instrumentation. PNL has proved to be a preferable option to open stone surgery and a useful alternative to extracorporeal shock wave lithotripsy (ESWL).

This document may differ from the final, published version of the research and has been made available online in accordance with publisher policies. To read and/or cite from the published version of the research, please visit the publisher's website (a subscription may be required.) TitleSurgical treatment for recurrent bulbar urethral stricture: A randomised open label superiority trial of open urethroplasty versus endoscopic urethrotomy (The OPEN Trial).

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Two hundred and fifty cases of percutaneous nephrolithotomy (PNL) are described. One hundred and fifty cases were treated in two stages, 100 in a single stage. The one-stage method has been shown to be as safe as the two-stage method but should be reserved for those with experience of the technique and who possess adequate instrumentation. PNL has proved to be a preferable option to open stone surgery and a useful alternative to extracorporeal shock wave lithotripsy (ESWL).

No abstract

A study was made of 20 patients fulfilling the criteria customarily used for the diagnosis of interstitial cystitis. A possible infective aetiology was sought by culture of bladder tissue, catheter and midstream specimens of urine, and urethral swabs by methods capable of detecting fastidious bacteria as well as aerobic pathogens. All bladder biopsies showed the histological appearances usually associated with interstitial cystitis, and bacteria were isolated from the catheter specimens and/or bladder biopsies of 12 patients. Eight of these isolates were fastidious bacteria, Gardnerella vaginalis (6) and Lactobacillus sp. (2). Fastidious bacteria were isolated from the midstream specimen of urine (MSU) and/or urethral swab of 6 other patients. The correlation of the histological and bacteriological findings supports the hypothesis of an infective aetiology and suggests that the so-called urethral syndrome and interstitial cystitis may be the earlier and later stages of the same disease process. The importance of early diagnosis of infection in these patients is emphasised.