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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Six months to 5 years after nephrectomy in renal donors, creatinine clearances and PSP tests of 34 cases had recovered to 81.8% and 68.2% respectively of prenephrectomy performance. Blood urea nitrogen, creatinine and uric acid levels had increased to 24.9%, 36.7% and 24.3% respectively of prenephrectomy values. There was compensatory hypertrophy of the remaining kidney. The mean increase in size of the remaining kidney was 12.0% x 17.8%. There were early complications in 11 (32%) of the donors, in the form of pneumothorax in six cases, wound infection in two cases, hepatitis in two cases and urinary tract infection in one case. There was one late complication of neuralgic pain in the scar region.
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PMID:Renal function after nephrectomy in renal donors. 717 20

The pediatric patient with acute scrotal pain and swelling can pose a difficult diagnostic problem. The therapeutic approach to these patients, however, need not be difficult. Despite the advent of Doppler ultrasonic equipment and technetium pertechnetate scanning to differentiate torsion of the testes from other causes of acute scrotal pain and swelling, the policy of emergency scrotal exploration in nearly all such pediatric patients seems to be most appropriate. The exception to this rule might be the rare child with frank pyuria and/or urinary tract infection in whom the diagnosis of epididymo-orchitis is suggested by all parameters.
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PMID:Acute scrotal pain and swelling in children: a surgical emergency. 745 98

A case is presented of an ectopic ureter opening into the seminal vesicle associated with hypodysplastic kidney in an infant. We reviewed 135 cases (139 ureteral units) of male ectopic ureter from the Japanese literature and, of the 139 ectopic ureters, 109 were single-system ectopic ureters, and 26 ureters were associated with the ureteral duplication. Sixty-three and 73 ureters opened into the urinary tract and seminal tract, respectively. In patients 15 years or older, 65 cases of ectopic ureter opened into the seminal tract and 33 cases opened into the urinary tract, whereas in children under 15 years, the ectopic orifice was located more often in the urinary tract (26 cases) than in the seminal tract (8 cases). Presenting symptoms differed according to the location of the ectopic orifice. Ectopic ureters opening into the urinary tract most often presented with urinary tract infection and abdominal or lumbar pain. On the other hand, voiding and ejaculatory symptoms as well as perineal or genital pain were characteristic in ectopic ureters opening into the seminal tract. Of the 83 associated renal segments that were surgically removed, dysplasia, hypoplasia and aplasia were found in 22, 24, 14 cases, respectively. It was noteworthy that 48 of the 53 single ectopic ureters opening into the seminal vesicle were associated with ipsilateral renal dysgenesis.
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PMID:Ectopic ureter opening into the seminal vesicle in an infant: a case report and review of the Japanese literature. 755 86

As part of a prospective cohort study of 388 men undergoing transurethral resection of the prostate (TURP) for benign prostatic hypertrophy, pre-operative factors and the outcome of surgery during the first post-operative year were compared between patients in whom their surgeon felt the principal reason for operating was chronic retention (37%), acute retention (with no chronic retention) (28%), or symptomatic prostatism (with no history of chronic or acute retention) (35%). Although in many respects the patients in the 3 diagnostic categories were similar, patients with chronic retention were more likely to be younger, of higher social class and to have worse general health. Patients with acute retention were more likely to present with a urinary tract infection and to have electrocardiographic abnormalities, and symptomatic patients presented with more severe urinary symptoms. Minor differences between the categories with regard to post-operative morbidity and mortality were not statistically significant at the 5% level. However, some significant differences did exist. Patients with acute retention were more likely to experience urinary and non-urinary infections and impotence after surgery, while symptomatic patients reported less improvement in their health status as regards pain and social isolation. These results suggest that the method of categorisation is clinically valid and a necessary distinction to make when auditing TURP.
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PMID:Differences in outcome of transurethral resection of the prostate for benign prostatic hypertrophy between three diagnostic categories. 769 94

Renal ptosis is the caudal acquired displacement of one or both of the kidneys, with different degree and etiology, considered as a urological pathology because of its urodynamic changes and, in the last years, almost completely neglected. The aim of the work is to research a parenchymal involvement, through a close examination of our outpatient record of cases, compared with data from the literature about renal ptosis. The literature reports the largest incidence in females; in our record of cases, instead, the incidence is nearly the same. Second degree ptosis is the most frequent, but, in females, bilateral ptosis is prevalent (77%). We agree with the literature about urinary symptoms; actually, the most of the patients shows urinary colics or lumbar pain. We also noticed UTI (62%), urinary lithiasis (26%) and pyelocalyceal ectasia (46%). A lot of patients suffer from microscopic haematuria (77%) and, in 12%, we noticed gross haematuria. Hypertension affects about half of the patients (46%) and proteinuria too (42%). Echography highlights a reduced cortex (12%), cysts (14%) and other changes (8%). GFR is decreased in 30% of cases, to a different degree. The patients show different changes, according to their age. In conclusion, considering that the incidence and the anatomic and functional changes are remarkable, we think it opportune to take renal ptosis into account as a cause of chronic renal damage, also because it is included among the causes of obstructive nephrophaty, which according to some researches, can cause severe glomerular and tubular-intestinal changes, triggered off by a short urinary stasis and evident in the controlateral kidney too.
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PMID:[Renal ptosis: nephrologic consequences of an organ malposition]. 770 5

This prospective study was to assess the safety and acceptability to patients of early discharge after major gynaecological surgery. Selective patients who fulfilled certain criteria were offered early discharge after their operations. Forty patients were discharged within 72 hours. Fourteen of them had undergone abdominal hysterectomy, 5 with a mid-line incision; 13 had vaginal hysterectomy; 9 laparoscopy and laparotomy for ectopic pregnancy; 3 laparotomy for ovarian surgery and 1 a Manchester repair. The patients were discharged home on average 2.4 days after their operations. All were satisfied with their pain relief at home. There were 4 postdischarge complications. Two had superficial drip-site phlebitis, 1 a possible urinary tract infection and 1 a wound abscess. There was only 1 readmission 2 weeks post discharge for constipation. Thirty-one out of 40 (77.5%) of the patients had expressed that the home environment was more conducive to speedy recovery and 92.5% of the patients would choose early discharge again if given the option.
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PMID:Early discharge following major gynaecological surgery. 784 45

The findings of a preliminary study of women undergoing second-trimester dilatation and evacuation for pregnancy termination suggest that hypan produces better cervical preparation than the more commonly used prostaglandin gemeprost. All 50 subjects were between 15-20 weeks' gestation. The 25 women who were randomly assigned to the gemeprost group had a 1 mg vaginal pessary inserted in the posterior fornix 4-6 hours before abortion; an additional 1 mg pessary was inserted 2-4 hours before the procedure in nulliparous women. The 25 women in the hypan group had either a 3 x 55 mm dilator (15-17 weeks' gestation) or a 4 x 65 mm dilator (18-20 weeks' gestation) inserted in the cervix 24 hours pre-operatively. The mean pre-dilatation cervical diameter was significantly greater (p 0.0001) in the hypan group (14.5 mm) than the gemeprost group (8.7 mm). Also significantly greater (p 0.01) was the mean post-dilatation cervical diameter: 19.3 mm for hypan compared to 17.1 for gemeprost. Dilatation was rated as easy by 21 women in the hypan group compared to only 10 in the gemeprost group. In the hypan group, 24 women reported no pre-operative pain and 23 experienced no post-operative pain; in the gemeprost group, these numbers were 15 and 14, respectively. There were 4 cases of pre-operative bleeding among gemeprost acceptors but none in the hypan group. Finally, at the 6-week follow-up, 1 patient in the gemeprost group reported she had required evacuation of retained products of conception and 1 woman in the hypan group had been treated with antibiotics for a urinary tract infection. Although hypan, unlike gemeprost, requires insertion by a trained physician or nurse, its substantially lower cost, better cervical preparation, and lack of side effects justify its more widespread use.
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PMID:Randomised trial of hypan versus gemeprost in cervical preparation prior to second trimester termination of pregnancy. 801 48

In 14 women with sympthomatic hydronephrosis due to pregnancy (calyx diameter 1-2,6 cm) an internal urinary drainage was carried out during the second half of pregnancy. Retrograde stenting was placed per cystoscopy in all cases. Follow-up examinations were taken weekly for the first two weeks and further on biweekly. Primary stenting was possible in 12 out of 14 cases, and in two patients dilatation of the ureteral orifice was necessary. 11 out of 14 patients suffered from complications such as severe dysuria (9), urinary tract infection (7), persisting lumbar pain plus catheter lumen obstruction (6 each) as well as catheter migration (3). Long-term follow-up showed that urinary tract obstruction was relieved by stenting in only 6 out of 14 patients. Sufficient urinary drainage by so called double-J ureteral stents was achieved in less than half of the cases. Moreover, there was a complication rate of more than 75%. Taking these results into consideration, internal drainage of complicated pregnancy hydronephrosis needs careful evaluation.
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PMID:[Internal drainage of urine in cases of complicated urinary stasis caused by pregnancy]. 827 64

A controlled, randomized trial with blind assessment of end points is described comparing ceftriaxone (1 g) given at induction of anesthesia with gentamicin (2 mg/kg) and metronidazole (500 mg) (GM), three times, every eight hours starting at induction, in preventing wound, chest, and urinary tract infections following bowel operations. Patients with inflammatory bowel disease received prophylaxis for five days. Two hundred sixty patients were randomized, and 196 were studied after exclusions. Ninety-four were given ceftriaxone, and 102 were given GM. Chest infection was defined as pyrexia plus clinical or radiologic signs of consolidation or the production of purulent sputum. Wound infection was diagnosed on the basis of purulent wound discharge or pyrexia plus swelling, redness, and pain around the wound, and urinary tract infection was diagnosed from microbiologic results. There was a significant reduction in wound infection (17 percent to 6 percent; P < 0.05) and in urinary tract infection (8 percent to 1 percent; P < 0.05) in the ceftriaxone group compared with the GM group. Chest infection occurred in 16 percent of the ceftriaxone group compared with 25 percent of the GM group, but this difference was not statistically significant. Infected patients were in the hospital more than four days longer than uninfected patients, a statistically significant difference (P < 0.01). It is concluded that ceftriaxone is superior to GM in reducing postoperative sepsis and that this effect is likely to be due to the sustained bactericidal blood levels achieved by ceftriaxone.
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PMID:Ceftriaxone is more effective than gentamicin/metronidazole prophylaxis in reducing wound and urinary tract infections after bowel operations. Results of a controlled, randomized, blind clinical trial. 837 23

Included in the study were 681 patients with stenosis and obstruction of the ureter (SOU), diagnosed at the Department of Urology, Clinical Center of Urology, University Aleksandrovska Hospital in Sofia for a period of 5 years. The diagnosis rested on clinical, laboratory, X-ray, radioisotopic, echographic, endoscopic and other investigations. Analysis of the clinical and laboratory data demonstrated an outstanding triad of clinical symptoms: pain (76.8 per cent), hematuria (74.0 per cent), dysuria (70.9 per cent). The laboratory data confirmed the standpoint of other authors that most common is the urinary tract infection, followed in incidence by microhematuria, leukocyturia and hemoglobin content lower than 10 mg %. The most common causative agents of infection were E. coli (29.8 per cent) and Proteus (26.28 per cent). The X-ray methods being used were excretory urography (76.8 per cent) and plain X-ray on kidney-ureter-bladder film (93.2 per cent of the patients). Excretory urography furnished information on the cause, degree and location of SOU and on the effect upon the kidney. It helped to determine the approach to treatment--conservative transureteral or operative.
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PMID:[The modern diagnosis of stenosis and obstruction of the ureter]. 841 76


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