Surgical treatment of ureterocele in the adult

A ureterocele is a congenital cystic ballooning of the terminal submucosal ureter. Simple orthotopic ureterocele represents about 30% of all ureteroceles and occurs primarily in adult males. Ectopic ureterocele represents about 70% of all ureteroceles, occuring mainly in female children with a left predominance. Ten per cent are bilateral. From 1970 to 1991 we observed 15 patients (11 females, 4 males) with ureteroceles. We preferred the surgical approach for treating ureteroceles in all patients. Only 1 patient treated in this manner had a subsequent reflux.

Ectopic ureter: Case report

An ectopic ureter is one which opens anywhere other than on the posterolateral extremity of the trigone and is an uncommon urological anomaly with a female predominance. The aim of this study is to consider an unusual case of ectopic ureter with a large distal diverticula simulating a bladder duplicity.

Aztreonam in the treatment of urinary tract infections: a multicenter trial

A multicenter trial involving several urologic units in Italy provided pooled data on 1,427 patients with urinary tract infections to evaluate the efficacy and safety of aztreonam, a new monobactam antibiotic. Microbiologic and clinical data were collected methodically in all cases. A majority of the patients (79.9%) were hospitalized during the study period, an associated pathology was noted in 29.1%, and 16.7% were receiving additional therapy. Aztreonam was administered by different routes and in different dosages according to the severity of the pathology. At the end of treatment, 93.6% of the patients showed a positive microbiologic response. Eradication percentages of the 6 main pathogens determined from cultures taken within the seventh day after the end of treatment were as follows: 93.9% for Escherichia coli (n = 415), 86.3% for Pseudomonas sp. (n = 207), 91.6% for Proteus sp. (n = 192), 89.8% for Providencia sp. (n = 59), 96.2% for Klebsiella sp. (n = 56), and 98.1% for Serratia sp. (n = 56). Aztreonam was well tolerated. Of the 1,427 patients evaluated for safety, only 54 (3.8%) reported 55 adverse reactions, necessitating the withdrawal of therapy in 5 (0.2%) instances.

Acetohydroxamic acid therapy in infected renal stones

The use of acetohydroxamic acid at different dosages is recommended in the treatment of renal lithiasis secondary to urease-producing bacteria. The effects of this drug are directed to urinary ammonium and urinary pH reduction and to potentiation of antibiotic therapy.

Urease inhibitor therapy in infected renal stones

The strict dependence of struvite and carbonate apatite renal stones on the urease-producing germs confirm the need to combine bacterial urease inhibitor drugs with antibiotic treatment. Of the two antiurease drugs used the better results were obtained with acetohydroxamic acid, both for its minimum side effects and its more powerful urease-inhibitor capacity. Thus stone recurrence was avoided even in patients with urinary infection not responding to specific antibiotic treatment.