Frank C. Hamm, M.D.
JAMA. 1958;166(9):1023-1026. doi:10.1001/jama.1958.02990090031007.
Text Size: A A A
Published online

Reconstructive surgery about the renal pelvis in the past has been assumed to call for the use of splinting catheters and nephrostomy tubes. Recent experience has convinced the authors that better results are obtained without these aids provided certain principles are followed. The kidney should be completely mobilized and the ureteropelvic juncture exposed for inspection. Nephropexy is done to elevate the kidney and hold the ureter in a straight line. The continuity of the pelvic and ureteral wall should be preserved, for transection is followed by weeks of dysfunction. Excessive stitching is avoided, and no attempt is made to obtain a water-tight closure. Rubber drains extending down to the renal pelvis are left in the abdomen for at least nine days. Eleven patients treated surgically in this way were able to leave the hospital on or before the 14th day in every case. One patient with a long history of lithiasis had recurrences that finally necessitated nephrectomy. The others showed steady improvement after operation with respect to both the function and the appearance of the renal pelvis.


Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours




Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).


Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.