Hesitancy and poor stream in younger men without outflow tract obstruction--the anxious bladder

Sixteen younger men who presented with frequency, hesitancy and poor stream have been examined by clinical, urodynamic and endoscopic means. These urological symptoms have been found to be associated locally with a poor detrusor action and generally with a high incidence of dyspepsia and anxiety disorder. It is suggested that an initiating factor may be common to all 3 systems and hence a general rather than a local solution should be sought.

The long-term results of ileal conduit urinary diversion in children

Sixty-seven children undergoing urinary diversion by ileal conduit tolerated this procedure well. The initial results were most satisfying, but late complications occurred in 55 children (82%), and this is a cause for concern. Even when the surgical complications were avoided, it seemed important to consider carefully the psychological problems that these children with ileal loop diversion could develop as they advanced into adult life.

The management of vesicoureteric reflux in children

One hundred and seventy children with vesicoureteric reflux have been reviewed. Conservative therapy was the treatment of choice in Grade I reflux. Children with Grade II and Grade II reflux treated conservatively developed progressive upper tract dilation and scarring. Unilateral reflux sometimes became bilateral. In addition, the grade of reflux could worsen in the absence of symptoms or overt infection. Cystourethroscopy was an important investigation as an aid to management: the findings of abnormal ureteric orifices in the presence of Grade II and Grade III reflux indicated early surgical treatment. Surgery was also indicated in the presence of ureteric dilatation on excretion urography aand/or micturating cystourography. Vesicouretic reimplantation gave excellent results with few complications.

Seminal vesicle tumours

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The Bristol Pyelonephritis Registry: 10 years on

The reasons for the initiation and the basic structure of the Bristol Pyelonephritis Registry have been discussed. The detailed follow-up data on those patients clinically at "renal risk" has been noted, with a demonstrably low incidence of proven bacterial infection, no radiological progression and minimal interference with pregnancy. Satisfactory and reassuring information has thus accrued for the first time in a particular group of patients with often severe recurrent symptoms.

Vesico-intestinal fistulae

Vesico-intestinal fistulae carry a serious prognosis by the nature of the underlying pathology. The inflammatory lesions offer the best hope for surgery and the necessity for early radical surgery in this group is stressed. The clinical details of 74 cases of vesico-intestinal fistulae are given together with their investigations, treatment, and results. The improved results over the past 10 years appear to bear out the necessity for early treatment.