先天性水腎症に対する手術成績

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SCongenital hydronephrosis has been one of the important subjects for many years and its etiology and operative results have been reported from many institutions. We investigated on the results of twelve operations for congenital hydronephrosis chiefly by evaluating the intravenous pyelograms taken pre- and post-operatively. The results were classified into 4 grades, from excellent to poor, according to the degree of cali ectasis and delay in ureteral visualization. Good results were obtatined in 7 of 12 cases (58.3%). In order to evaluate the results of the operations, ureteral visualization as well as the pyelogram and intrapelvic pressure study through nephrostomy tube must be considered. Whenever there is a relief of pelviureteric obstruction with good urinary passage, prompt visualization of the ureter and the intrapelvic pressure not exceeding 15 cm H 2O were noted. At this time nephrostomy tube might be removed. Our principle of pyeloplasty is based 01; the urodynamic theory. If there is a sufficient mechanical stimulation of urinary stream on the upper portion of the ureter, its peristalsis would be active enough for urinary transport downwards. It is important how to achieve the good transport of urine from the renal pelvis into the ureter. Whichever technique IS employed, dismembered or non-dismembered pyeloplasty, excessive redundant pelvic wall has to be excised and wide funneling of the pelviureteric junction has to be aimed.
泌尿器科紀要刊行会の論文

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長根裕
三愛病院泌尿器科

先天性水腎症に対する手術成績

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