Duplication of the primitive hindgut of the human being: an 8 year follow-up of a previous case report.

S 93 aorta and vena cava to those vessels of the recipient was performed. The ureters were sutured together distally and implanted into an ileal conduit using a modified Paquin anastomosis. There was rapid clearance of the elevated BUN and creatinine, indicating minimal impairment of glomerular function. There was immediate diuresis similar to that seen with transplantation of mature kidneys. The urine concentration ranged from 1.004 to 1.010 during the first 10 postoperative days. Electrolytes remained stable. Although there was theoretical concern about the functional capacity of the newborn kidney, no problems developed on this basis.Duniel T. Cloud. GIANT HYDRONEPHROSIS N CHILDREN. Aurelie C. U/son, Selwyn B. Levitt and John K. Lattimer. Pediatrics 44: 209-2 16, (August) 1969. Twenty children with giant hydronephrosis were seen at the Presbyterian and Babies Hospitals’ urological service in the period 1940 to 1967. Giant hydronephrosis was defined as hydronephrosis in which the renal pelvis contained fluid ranging from 40 per cent of the total body weight in the newborn to two per cent in those that were pubertal. The children were newborn to 14 years of age. In 13 of the 20 children, asymptomatic abdominal enlargement noted by the parents or the examining physician led to appropriate diagnostic studies. Involvement was bilateral in two children. Treatment was nephrectomy in 16, and urinary diversion by nephrostomy or pyelostomy in six of the 22 kidneys. Pyeloplasty was done later in three of these patients. In six children progressive contralateral hydronephrosis developed following nephrectomy. Fourteen children are well for periods of 14 months to 28 years. Tr,ree were lost to followup and three died within a year of diagnosis.--William K. Sieher. THE SINGLE ECTOPK URETER. J. H. John.don and T. J. Davenport. Brit. J. Ural. 41:428-433, (August) 1969. Five cases of single ectopic ureter are described. In three unilateral examples, the ureter opened into the vestibule, the vagina and the seminal vesicle. In the last named, the child presented with epididymitis. Cystourethrography showed reflux to a cystic seminal vesicle and thence to the ureter. Cystoscopy revealed an intravesical bulge. There was some degree of bladder outlet obstruction and contralateral upper tract dilatation. In two bilateral cases in girls. both ureters opened in the urethra, leading to continual urinary dribbling. With this type of ureteral ectopia the bladder is usually not demonstrable on intravenous urography. Reimplantation of the ureters into the bladder may fail to restore continence since the trigone, and therefore the vesical baseplate are lacking. The embryology of the various lesions is discussed.--1. H. Johnston. ECTOPIC URETER IN THE MALE CHILD. 13. Innes Williams and M. Royle. Brit. .I. Urol. 41:421-427. (August) 1969. Twenty-nine boys with ectopic ureter were reviewed. Four groups of cases were recognized: High-level ectopic ureter without ureterocele (six cases). The ureter. which was always dilated and allowed retlux, opened at the bladder neck or in the posterior urethra. The kidney might be duplex or single. The affected element was always hydronephrotic or pyelonephritic. The presentation is with urinary infection. One boy dribbled urine by day but was dry at night: High-level ectopic ureter with ureterocele (15 cases). Three boys had bilateral ureteroceles. In three a single ureter was involved: Ectopic ureter with terminal extravesical saccular dilatation (two cases). The ectopic ureter which terminated in the posterior urethra had a large saccular dilatation at its lower end but remained outside the muscularis of the bladder and did not cause a ureterocele within the bladder lumen. In each, a single ureter was involved. The dilated lower ureter displaced and partly ohstrutted the bladder outlet; Low-level ectopic ureter involving the genital tract (six cases). Epididymitis was the presenting symptom. Reflux occurs during micturition. Cystic abnormalities of the seminal vesicle exist which render operative dissection difficult. The kidney is dysplastic.-H. /o/r,tston. THE RESULTS OF URINARY DIVERSION USING THE COLONIC CONDUIT. R. A. Mogg arrd