title: [Twenty years of urology in a children's hospital (1954--1974). Together with an epicrisis of 101 children with bilateral anomalies of the urinary passages, operated on in the first year of life (author's transl)].
abstract: This work encompasses a 20-year period, during which a urologist spent an important part of his time in a children's hospital, because of his conviction that attemps at effective treatment of urinary passage anomalies in childhood have a chance only when treatment is begun as early as possible. A report is presented on 101 children with bilateral, severe urinary passage anomalies, who were operated on in the first year of life, with the goal of early, total correction. The following experiences are of general significance: 1. The earlier the symptoms -- in 90% of cases, pyuria -- the more severe are the findings. -- 2. Males are primarily affected, here at a ratio of 7:3. As a result, pyuria in infants must be explained urologically, particularly when it occurs in males. -- This report is a plea for early, total correction and against periodic urinary drainage. Results show a 50% decrease in infections, flow disturbances, and biochemical changes, as well as a postoperative burst of growth also in 50% of cases. Cinematographic examinations show normal peristalsis even after skeletization and drastic reduction of a megaureter. The mortality was 9%, in the first year of life, 6%. Surprisingly, the result was not influenced by the presence or absence of reflux, but rather by stigmas and inferior development. Reflux had probably already played its fateful part in this severe bilateral disease, so that antireflux plastic surgery loses its prophylactic value. Compared with reports of experiences with periodic urinary drainage, our aim is to disprove the argument that, in difficult cases, total correction is dangerous: on the contrary, our results are better and coincide with the experiences of Hendren. Although Bischoff did not live to see the results of this work, in retrospect, our results bear out his pioneering concepts and ideas.
mesh_terms: D002648:Child; D002675:Child, Preschool; D004200:Diseases in Twins; D005260:Female; D005860:Germany, West; D049673:History, 20th Century; D006776:Hospitals, Pediatric / Q000266:history*; D006782:Hospitals, Special / Q000266:history*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D014551:Urinary Tract / Q000002:abnormalities* / Q000601:surgery; D014572:Urology / Q000266:history*
vernacular_title: 20 Jahre Urologie in einem Kinderkrankenhaus (1954 bis 1974). Zugleich eine Epikrise von 101 im 1. Lebensjahr operierten Kindern mit doppelseitigen Harnweganomalien (HWA).