Operative Urology II

Renovascular Surgery.- A. Renovascular Hypertension.- I. Diagnostic Tests.- 1. Radioactive Renogram.- 2. Renal Scanning.- 3. Intravenous Urography.- 4. Renal Arteriogram.- 5. Individual Kidney Function Tests.- 6. Assay of Renal Vein Plasma for Pressor Substances.- 7. Pressure Gradient and Renal Blood Flow Determinations.- 8. Renal Biopsy.- II. Surgical Treatment.- 1. Nephrectomy.- 2. Partial Nephrectomy.- 3. Nephropexy.- 4. Surgical Approaches to the Renal Vessels.- a) Endartereetomy.- b) Segmental Resection and End-to-End Anastomosis of the Renal Artery.- c) Aortorenal Bypass Grafts.- d) Splenorenal Anastomosis.- e) Reimplantation (Renal-Aortic).- f) Arteriotomy and Patch-plasty.- g) Autotransplantation.- 5. Bilateral Renal Artery Stenosis.- 6. Medical Versus Surgical Treatment.- B. Surgery of Renal Artery Aneurysms.- C. Renal Artery Embolism.- I. Technique of Embolectomy.- D. Renal Vein Thrombosis.- Conclusion.- References.- Renal Transplantation.- I. Renal Transplantation.- Historical Background.- II. Evaluation of Patients.- A. Evaluation of the Recipient.- 1. Age.- 2. Diagnosis.- 3. Urinary Tract Status.- 4. Circulating Antibodies.- 5. Timing of the Transplant.- 6. Psychological Factors.- B. Evaluation of the Donor.- 1. Living Donors.- 2. Cadaveric Donors.- III. Technique of Donor Nephrectomy.- A. Living Donor.- 1. Preparation.- 2. Surgery.- 3. After Surgery.- B. Cadaveric Donor.- 1. General Considerations.- 2. Technique.- 3. Evaluation of Cadaver Kidney.- 4. Utilization of both Kidneys.- IV. Technique of Recipient Implantation.- A. Adults.- 1. Approach.- 2. Dissection.- 3. Venous Anastomosis.- 4. Arterial Anastomosis.- 5. Hemostasis.- 6. Ureteral Anastomosis.- B. Infants.- C. Nephrectomy in the Recipient.- 1. Indications.- 2. Techniques.- V. Postoperative Care.- A. Following Immediate Function of the Graft.- 1. Nursing.- 2. Fluid Balance.- 3. Immunosuppressive Agents.- 4. Antibiotics.- B. Following Delayed Function from the Graft.- C. Subsequent Hospital Care.- 1. Nursing.- 2. Urethral Catheter.- 3. Wound Drains.- 4. Renal Function - Graft Rejection.- 5. Laboratory Studies.- 6. Radiographic Studies.- 7. Pharmacology.- a) Immunosuppressive Drugs.- b) Antihypertensives.- c) Antacid.- D. Post Hospitalization Care.- VI. Urological Complications and Urinary Infections.- A. Urological Complications.- 1. Obstruction.- 2. Fistulae.- a) Ureterocutaneous Fistulae.- b) Ureteroureteral Fistulae.- c) Pyelopelvic Fistulae.- d) Vesicocutaneous Fistulae.- B. Urinary Infections.- VII. Other Complications Following Transplantation.- A. Surgical Complications.- 1. Peptic Ulceration.- 2. Pancreatitis.- 3. Aseptic Necrosis of the Femoral Head.- 4. Hyperparathyroidism.- B. Medical Complications.- 1. Hypercorticoid State (Iatrogenic Cushing's Syndrome).- 2. Hepatitis.- 3. Arthritis, Neuritis.- VIII. Infections.- A. Introduction.- 1. Surgical Wound Infections.- 2. Other Pyogenic Infections.- 3. Urinary Infections.- B. Opportunistic Infections.- 1. Introduction.- 2. Fungi.- 3. Viruses.- 4. Protozoan.- 5. Autoimmune Pneumonitis.- C. Specific Infections.- Tuberculosis.- IX. Pathology.- A. Unmodified Host.- 1. Anatomy.- 2. Physiology.- B. Modified Host.- 1. Interstitium.- 2. Tubules.- 3. Glomeruli.- 4. Vessels.- 5. Ureter and Pelvis.- C. Circulating Antibodies.- D. Glomerulonephritis.- 1. Identical Twins.- 2. Non Twins.- X. Antigen Identification and "Matching".- A. Introduction.- B. Red Blood Cell Antigens.- C. Leucocyte Antigens.- 1. Lymphocyte Cytotoxicity.- 2. Other Tests of Leucocyte Antigens.- D. Direct Cross-Match of Recipient Serum and Donor Leucocytes.- Summary.- XI. Thymectomy and Splenectomy.- A. Thymectomy.- 1. Introduction.- 2. Clinical Renal Transplantation.- B. Splenectomy.- 1. Introduction.- 2. Laboratory Data.- 3. Clinical Data.- XII. Renal Preservation.- A. Introduction.- B. Short-Term Storage.- C. Long-Term Preservation.- D. Permanent Preservation.- E. Tests of Renal Injury.- F. Biochemical Methods of Enhancing Organ Tolerance to Ischemia.- XIII. Unusual Cases.- A. Introduction.- B. Erythremia.- C. Renovascular Hypertension.- D. Pregnancy.- E. Transplantation of Disease.- 1. Carcinomas.- 2. Infections Diseases.- F. Hyperparathyroidism.- XIV. Results of Clinical Renal Transplantation.- A. Introduction.- B. Monozygotic Twins.- C. Dizygotic Twins.- D. Related Donors.- 1. Sibling Donors.- 2. Parent Donors.- 3. Other Blood Relative Donors.- E. Cadaveric Donors.- F. Living Unrelated Donors.- Summary.- References.- Open Surgery of the Prostate.- A. Introduction.- B. Indications and Choice of Operation.- I. Benign Prostatic Hypertrophy.- II. Chronic Prostatitis and Prostatic Calculi.- III. Prostatic Abscess.- IV. Malignancy of the Prostate.- C. Preoperative Preparation.- I. Evaluation of Renal Function.- II. Preoperative Infection.- III. Coagulation Defects.- IV. Cardiopulmonary Reserve.- V. Cystoscopy.- VI. Miscellaneous Factors.- D. Techniques of Open Prostatic Surgery.- I. Transvesical Suprapubic Prostatectomy.- 1. Indications and Contraindications.- 2. Technique.- II. Retropubic Prostatectomy.- 1. Indications.- 2. Technique.- III. Combined or Transvesico-Capsular Prostatectomy.- 1. Indications.- 2. Technique.- IV. Radical Retropubic Prostatectomy.- 1. Indications.- 2. Technique.- V. Perineal Prostatectomy.- 1. Simple Perineal Prostatectomy.- a) Indications.- b) Technique.- 2. Radical Perineal Prostatectomy.- a) Indications.- b) Technique.- VI. Other Techniques.- E. Postoperative Management.- I. Antibiotics.- II. Fluids and Diet.- III. Catheters and Drains.- F. Postoperative Complications.- I. Bladder Spasms.- II. Bleeding.- III. Infection.- IV. Incontinence.- V. Operations for Male Incontinence.- VI. Recto-urethral Fistula.- References.- The Neurogenic Bladder in Spinal Cord Injury.- A. The Architectonics of the Musculature of the Urinary Bladder, Terminal Ureters, Trigone and Urethra.- I. Architectonics of the Urinary Bladder Musculature.- 1. The Bladder Wall.- 2. The Bladder Neck.- II. Architectonics of the Musculature of the Terminal Ureters and Trigone.- III. Architectonics of the Urethral Musculature.- B.Innervation of the Urinary Bladder and Sphincters.- I. Central Innervation.- 1. Cortical Centers.- 2. Subcortical Centers.- 3. Mesencephalic Centers.- 4. Hypothalamic Centers and Preoptical Area.- 5. The Pons Centers.- 6. The Cerebellum Centers.- 7. Medulla Oblongata Centers.- II. Peripheral Vesico-Sphincteral Innervation.- 1. The Spinal Parasympathetic Micturition Reflex Center (Cholinergic).- 2. Sympathetic or Sphinctero-Spinal Reflex Center (Adrenergic).- 3. Somatic Reflex Spinal Center of the Striate Sphincter.- III. Connection between the Micturition Centers in the Midbrain, Pons, Medulla Oblongata and Spinal Centers.- C. Physiology of the Urinary Bladder and Sphincters.- 1. Continence.- 2. Voiding of the Urinary Bladder.- D. Eleetrophysiology of the Urinary Bladder and Sphincters.- I. Electric Stimulation of the Pelvic Nerve.- 1. Determination of the Parameters of the Electric Stimulus.- a) Determination of the Optimal Duration of the Electric Stimulus.- b) Determination of the Optimal Frequency of the Electric Stimulus.- c) Determination of the Optimal Intensity of the Electric Stimulus.- d) Monolateral Electric Stimulation of Long Duration.- II. Bilateral Electric Stimulation of the Pelvic Nerves.- 1. Determination of the Optimal Parameters of the Electric Stimulus.- a) Determination of the Optimal Duration of the Electric Stimulus in Bilateral Stimulation of the Pelvic Nerves.- b) Determination of the Optimal Frequency of the Electric Stimulus in Bilateral Stimulation of the Pelvic Nerves.- c) Determination of the Optimal Intensity of the Electric Stimulus in Bilateral Stimulation of the Pelvic Nerves.- III. Fatigue Test of the Pelvic Nerves-Detrasor on Bilateral Electric Stimulation of the Pelvic Nerves.- 1. Fatigue Test on Prolonged Bilateral Electric Stimulation of the Pelvic Nerves with a Stimulus of Variable Frequency.- 2. Fatigue Test on Prolonged Bilateral Electric Stimulation of the Pelvic Nerves with a Stimulus of Variable Duration.- IV. Irradiation of the Electrical Stimulus.- Behaviour of the Urinary Bladder During Bilateral Electrical Stimulation of the Pelvic Nerves.- E. Electrical Stimulation of the Neurogenic Urinary Bladder.- I. The Difference Between Neuro- and Myostimulation of the Urinary Bladder.- II. The Site of Implantation of the Electrodes.- III. Pain in Electrical Stimulation of the Bladder.- IV. Erection During Electrical Stimulation.- V. Urethral Resistance During Electrical Stimulation of the Urinary Bladder.- VI. The Effect of Electric Stimulation on the Pelvic Nerves.- F. Clinical Application of Electrical Stimulation of the Neurogenic Bladder.- I. Electrical Neurostimulation of the Urinary Bladder.- a) The Parameters of the Electric Stimulus.- b) Stimulation of the Pelvic Nerves in Man by Electromagnetic Induction.- c) Clinical Cases.- d) Deinhibition of the Sacral Micturition Reflex Center by Electrical Stimulation.- II. Electrical Myostimulation of the Urinary Bladder.- a) The Parameters of the Electric Stimulus.- b) Resistance of the Bladder to Electrical Stimulation.- III. Electrical Stimulation of the Anterior Sacral Roots.- IV. Transrectal Electrical Stimulation of the Urinary Bladder.- V. Neuro- or Myo-Electrical Stimulation of the Urinary Bladder?.- VI. The Indications of Electrical Stimulation of the Urinary Bladder.- 1. Spinal Cord Injury.- 2. Neurologic Diseases of the Spinal Cord.- VII. The Results of Electrical Stimulation of the Urinary Bladder.- References.- Author Index.