These findings indicate that, although HTLV-I-seroindeterminate donors mainly are HTLV-I-noninfected, the rate of seroconversion in a repeat blood donor population from an endemic region must be taken into consideration. Moreover, the case of delayed seroconversion observed in this study suggests the difficulty of counseling seroindeterminate blood donors in endemic regions.

No abstract

Ureteropelvic junction obstruction when associated with other congenital anomalies of the kidney often presents a diagnostic and therapeutic dilemma. These anomalies include fusion abnormalities, malrotation, renal ectopia and duplicated systems. We report our experience in the management of 27 patients with ureteropelvic junction obstruction and associated renal anomalies, including horseshoe kidney in 9, duplicated systems in 12, ectopic kidney in 5 and malrotation in 1.

A case of ureteral ectopia into a cystic seminal vesicle with ipsilateral renal dysgenesis is presented. Related embryologic events, clinical manifestations, diagnosis and management are discussed. Associated ipsilateral absence of the testes with this syndrome has not been reported previously.

Of 269 patients with bladder neoplasms treated during a 20-year period 47 had associated vesicoureteral reflux. All 47 patients were followed for 3 years or more, or until death. Upper urinary tract transitional cell cancer developed in 3, each of whom had recurrent bladder cancer. Among the 222 patients who had vesical cancer without reflux transitional cell carcinoma of the ureter developed in only 1, 11 years after transurethral resection for a bladder tumor. The incidences of upper tract transitional cell cancer in patients with and without vesicoureteral reflux were 6.4 and 0.44 per cent, respectively, which support the suggested role of reflux in disseminating or seeding of cancer cells from the bladder into the upper urinary tract. Patients with bladder cancer and associated vesicoureteral reflux have an approximately 15-fold greater risk of upper tract cancer developing compared with those without reflux. We recommend vigilant scrutiny of patients with recurrent bladder cancer and associated vesicoureteral reflux for early detection of upper urinary tract transitional cell carcinoma.