Biomedical subjects
Publications and source records attributed to P Szönyi.
ESWL treatment for renal calculi was used in 19 occasion in 16 children aged 6-15 years. 13 children were stone free 3 months after the treatment. All of the stones were located in the renal calices or in the renal pelvis. The possibilities of the procedure, as well as its effects were examined with the use of urography, ultrasound, isotop studies and magnetic resonance imaging.
Extracorporeal shock-wave lithotripsy (ESWL) performed on 19 occasions in 6--15-year-old nephrolithic children is reported. The stones were present in the calyceal ends in the renal pelvis. The possibilities of treatment and its effects were examined by urography, ultrasound, camerarenography and magnetic resonance imaging procedures. After three months 13 children are free of stones.
A total of 1386 operations for undescended testis was made in 1250 boys. In 774 of them an apparently intact testis and epididymis were found. In 612, such epididymal developmental abnormalities were detected which exclude or do not make possible the passage of sperms from these organs to the deferent duct. It is believed to be plausible that the large number of cases with infertility is due, also in individuals with a unilateral cryptorchidism, to the abnormal fusion of the epididymis in both testes.
Deficiency in the enzyme adenine-phosphoribosyltransferase (APRT) has given rise to the formation of 2,8-dihydroxyadenine calculi, which are extremely rare. It is the first case of this kind reported in Hungary.
The cause of megaureter (hydroureter) is inadequacy of the ureterovesical junction. The only possible means of its therapy consists in a surgical reconstruction of the ureterovesical junction. A technical modification of ureterocystoplasty for megaureter, having been employed since 1976, is described. It basically consists in the construction of a tunnel from the ureter within the bladder, the ureter being sutured to the wall of the bladder only loosely. In 150 children 182 ureteroneocystoplastic operations were done. As confirmed by the postoperative course, as well as by the results of the follow-up studies, the technique may be used with benefit even in case of infection, impaired renal function or bladder wall fibrosis.
Pyeloureteral obstructions of various pathogeneses and their complications can be visualized satisfactorily be means of intravenous urography. Of the other diagnostic methods angiography was found to be the most useful, no retrograde examination was carried out. When distension of the end of the calyx or obvious parenchymal lesion appears, plastic operation must be performed irrespective of the patient's age, the presence of infection or anomaly of the localization. Only kidneys which have lost their functions should be removed. In the operation the pyeloureteral boundary is always excised, the new transition is secured by splinting and a transrenal drain is used. Secondary nephrectomy had to be performed in a single case. One-year and three-year intravenous urographic check-ups showed in 72 of the 100 cases good, in 19 satisfactory results, in 8 cases the pyeloureteral boundary was funnel-shaped, but the dilatations of the calyx-ends remained unchanged. Pyeloplasty is no longer a high-risk operation.
In 8 children with ambiguous external genitals, sex chromosome, hormonal and histological examinations were performed. On this basis the registered sex and the surname of the child were changed from the registered male to female in 3 cases and from female to male in one case. Diagnosis and the decision about the gender are urgent tasks, since prolonged waiting may have serious consequences in psychosexual development.
Seventy-four children with double ureters were observed in the past three and a half years, out of whom 12 were operated because of vesico-ureteral reflux, 2 for lithiasis, 6 for hydronephrosis and 15 because of ureterocele, while in 10 cases operation was indicated by ectopic ureters opening into the area of the vulva. In these diseases intercurrent infection represents the greatest danger which might cause in children a toxic, septic and dystrophic state.