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[Transitory postoperative anuria after transvesical prostatic adenomectomy: review of the literature, description of new clinical cases and physiopathological considerations].

Anuria is a rare complication after prostate adenomectomy. Three cases of complete bilateral anuria and one case of monolateral anuria are reported following transvesical prostate adenomectomy, characterized by immediate onset without any apparent cause and by spontaneous resolution within 48 hours. After a thorough review of the literature, the authors analyze the pathophysiological and clinical aspects of post-prostate-adenomectomy anuria and postulate an "obstructive" aetiology for the anuria cases observed in their series.

Aged

Anuria in infants and children.

The urologist may be involved in the initial evaluation of a child with anuria. In our experience the most common cause of anuria in neonates was perinatal hypoxia and in older children it was the hemolytic uremic syndrome. Obstructive uropathy as a cause of anuria in infants and children appears to be uncommon.

Anuria

Increased intraabdominal pressure and anuria in the newborn.

Elevated intraabdominal pressure as a cause of anuria in the critically ill newborn with ascites should be considered after hypovolemia and other causes of intrinsic renal disease or obstruction have been excluded. In the rare patient with ascites who develops anuria, paracentesis should be considered if urine output cannot be established.

Anuria

Anuria following silver nitrate irrigation for intractable bladder hemorrhage.

Intravesical silver nitrate has been used for intractable bladder hemorrhage. A case of anuria resulting from this technique is reported. The etiology of anuria in this patient was probably owing to obstruction from deposition of silver salts. The level of obstruction was the ureterovesical junction on 1 side and the collecting ducts at the renal papillae on the other side. Therapy consisted of vigorous endoscopic evacuation of deposited silver salts from the bladder and hemodialysis with good results.

Adult

Unilateral renal agenesis presenting as anuria.

The most common cause of sudden and total cessation of urine output is obstructive uropathy, usually at the bladder outlet. Bilateral ureteral obstruction is a much less common cause of anuria. In additioh, unilateral obstruction in the presence of a solitary kidney must be considered in the differential diagnosis. Primary renal parenchymal disorders and pre-renal azotemia occasionally may be anuric but more commonly are oliguric. A case of unilateral renal agenesis presenting as anuria and obstruction of the solitary kidney is described.

Anuria

Anuria resulting from extrinsic ureteral compression.

Two recent patients presenting with anuria due to abdominal aortic aneurysm and metastatic retroperitoneal tumor and illustrating this dramatic aspect of obstructive uropathy, provide the basis for this paper. Other reported causes of ureteral compression resulting in anuria are mentioned; these include billharzial strictures, iatrogenic ligatures, idiopathic retroperitoneal fibrosis, primary retroperitoneal tumors, and perirenal lymphocele.

Abdomen

Anuria in childhood due to bilateral urolithiasis. A report of four cases.

Four children with anuria due to occlusion of both ureters by calculi are presented. A plain film of the abdomen revealed faintly radiopaque urinary calculi bilaterally in three patients. In the fourth case, one calculus was visualized in the right ureter, but further contralateral exploration showed an obstructing ureteral calculus in the left ureter as well. It is concluded that in children with acute anuria, the possibility of bilateral ureteral obstruction due to calculi should be the physician's first consideration.

Acute Disease

Giant vesical calculas and anuria.

A 50-year-old fisherman developed uremia and anuria, due to a giant vesical calculus. He was treated with suprapubic lithotomy, and a calculus weighing 1 640 g was removed. This may be the largest calculus ever removed with recovery of the patient. No other reports of giant stones leading to anuria has been found in the available literature. More than 4 years later an inoperable carcinoma of the bladder was discovered. The long delay in diagnosis of the giant stone, as later of the carcinoma, was due to the patient's lack of confidence in doctors and hospitals.

Anuria

Recovery after prolonged anuria following septic abortion.

After a criminal abortion, a 21-year-old woman developed clostridial sepsis, massive hemolysis, shock, and protracted renal failure. Anuria was present for 3 weeks and hemodialysis was required for 35 days. Because of the prolonged anuria, the patient was thought to have irreversible renal cortical necrosis. A renal biopsy demonstrated tubular necrosis only. Shortly after the biopsy procedure, urinary volumes began to increase, and renal function gradually returned to normal levels. This case demonstrates that a protracted course of renal failure following clostridial infection is not necessarily due to cortical necrosis but may result from tubular necrosis, and renal function may return to normal.

Abortion, Illegal

[Anuria--a geriatric emergency situation].

The missing output of urine is an emergency case which is problematic with regard to old patients. This situation is caused by disturbances of renal function (anuria) or by acute ureteric obstruction or by complete ischuria. The possibilities of differential diagnosis and etiology have been illustrated. Anuria and acute ureteric obstruction need a treatment by urological or nephrological specialists, but each doctor must be able in cases of complete ischuria to empty the bladder by catheterization or by suprapubic puncture.

Anuria

Malignant fibrous histiocytoma of the aorta complicated by anuria.

Tumors of the aorta have been reported infrequently in the literature. We report a case of a 63-year-old woman diagnosed with malignant aortic fibrous histiocytoma (also known as fibroxanthosarcoma). She was referred to us with suspected occlusion of the right renal artery in a single functioning kidney, with a clinical picture of anuria during the previous 48 hours. We also review 31 previously published cases in the literature.

Anuria

Nonobstructive anuria in children: hemolytic uremic syndrome.

The hemolytic uremic syndrome (HUS) must be considered as a cause of oligo-anuria in a previously healthy young child. This syndrome consists of a viral-like prodromal illness, followed by acute renal failure, thrombocytopenia, and an abnormal blood smear with fragmented erythrocytes. Awareness of this syndrome will permit earlier diagnosis and management and will minimize unneccessary investigation in the anuric child.

Anuria

Anuria secondary to renal artery obstruction in a solitary kidney: 9-year followup.

A patient with a prior nephrectomy for renovascular hypertension experienced complete anuria secondary to renal artery occlusion. Revascularization 75 hours later resulted in prompt diuresis, recovery of renal function and a 9-year survival. Serial preoperative renal function studies are presented. Deterioration of renal function and recurrent hypertension are believed to have heralded the onset of arterial obstruction to a solitary kidney. The literature concerning the etiology of renal artery occlusion and the rationale for therapy are reviewed.

Adult

Bilateral localized amyloidosis of the ureter presenting with anuria.

A patient with bilateral localized amyloidosis of the ureters is described. This is the first case to be reported in which anuria was the presenting symptom, the second case with bilateral involvement and the thirteenth case of amyloidosis localized to the ureter. Careful urologic and hematologic followup is indicated.

Amyloidosis

Anuria secondary to balloon catheters in children.

Two unusual cases of balloon catheter-induced anuria are presented. Certain pediatric patients and neonates, especially those with spastic neurogenic bladders or those who have had bilateral ureteral reimplantation, are more susceptible to this form of urinary obstruction. The use of non-balloon catheters or infant feeding tubes is recommended.

Anuria

Thromboendarterectomy for anuria 4 1/2 years post-renal transplant: a case report.

A 45-year-old woman with a functioning renal transplant for more than 4 years presented with an acute myocardial infarction and anuria. Arteriograms demonstrated an occluded hypogastric artery. Thromboendarterectomy and instillation of fibrinolysin restored renal blood flow. Although death followed recurrent myocardial infarction 1 week postoperatively, urine output was improving and autopsy revealed viable renal tissue.

Anuria

Acute anuria secondary to renal artery stenosis.

Three patients with acute onset of anuria secondary to renal malperfusion were successfully treated by revascularization. Twelve such patients have previously been reported. The role of surgery for prophylaxis in stenosing renal artery disease is advocated.

Acute Disease