Lege Artis Medicinae

[Urinary diversion - bladder replacement]

RÉPÁSSY Dénes

FEBRUARY 20, 2003

Lege Artis Medicinae - 2003;13(02)

[Author gives a review of the surgical procedures, advantages and disadvantages of urinary diversion and bladder replacement techniques. Orthotopic bladder replacement is presented in detail, outlining also the complications. The questions affecting general practitioners, as well as gynaecologists, surgeons and internists are also discussed at length. The different techniques of bladder replacement have become widely accepted in Hungary within the past few years. It is important therefore that all physicians involved in the care of these patients become well acquainted with the possible complications and the changes in the lifestyle of these patients.]

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[INTRODUCTION - The most frequent manifestations of primary hyperparathyroidism are renal stones or calcipenic osteopathy. The aim of authors was to examine how bones are affected (change of bone mineral density and frequency of fractures) in the renal form of primary hyperparathyroidism. METHODS - Mean age of the patients was 57 years (26 -81 years), (4 men, 33 women). Bone mineral density was measured in the lower third of the radius, femoral neck and lumbar 2-4 vertebrae by densitometers. Moreover, occurrence of fractures and biochemical parameters characteristic for hyperparathyroidism (serum parathyroid hormone levels, calcium, phosphorus, alkaline phosphatase, urinary calcium/ creatinine) were examined. RESULTS - Bone mineral density was normal in 6 cases, osteopenic in 10 patients and 21 patients had osteoporosis. Altogether five patients had fractures. Bone mineral density and biochemical parameters were not different in patients with or without fractures. CONCLUSIONS - Bone mineral density decreases in renal form of primary hyperparathyroidism even if there is no bone disease in the clinical picture. Therefore, bone mineral density measurement is advisable for every patient with hyperparathyroidism.]

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