The state of the upper urinary tracts has been assessed in 181 adolescents and young adults with myelomeningocele. At the age of 16 years, abnormalities were present in 75 patients (41 per cent); the risk of these complications was related to the extent of the neurological deficit and the presence of a urinary diversion. During follow-up into early adult life, fresh or further deterioration of the upper renal tracts occurred in 48 patients (27 per cent); the pattern of this deterioration was influenced by whether or not previous urinary diversion had been performed.

The efficacy of epiduralfentanyl combined with lignocaine 1.5% with adrenaline 1:200,000 was studied in a randomised, double-blind, controlled trial of two hundred patients undergoing extracorporeal shock wave lithotripsy with or without ancillary procedures. The quality of anaesthesia was assessed using linear analogue pain scores, the patient's impression, and the rate of intra-operative intervention by the anaesthetist. Postoperative symptomatology was also recorded. The only significant difference lay postoperatively in that the fentanyl-ancillary procedure subgroup had less pain approximately one hour postoperatively (P = 0.01).