Taking all cases together, the deficiency is more
common on the left than on the right side; but while in males the
left kidney is far more commonly absent than the right, in
females the two sides show the defect equally. The renal vessels
were generally absent, as also the ureter, on the abnormal side
(the latter in all except 15 cases); the suprarenal was missing
in 31 cases. The solitary kidney was almost always normal in
shape and position, but much enlarged. Microscopically the
enlargement would seem to be due rather to hyperplasia than to
hypertrophy. The bladder, except for absence of the opening of
one ureter, was generally normal. In a large number of cases
there were associated deformities of the organs of generation,
especially of the female organs, and these were almost invariably
on the side of the renal defect; they affected the conducting
portion much more than the glandular portion--that is, uterus,
vagina, and Fallopian tubes in the female, and vas deferens or
vesiculae seminales in the male, rather than the ovaries or
testicles. Finally, he points out the practical bearing of the
subject--for example, the probability of calculus causing sudden
suppression of urine in such cases--and also the danger of
surgical interference, and suggests the possibility of diagnosing
the condition by ascertaining the absence of the opening of one
ureter in the bladder by means of the cystoscope, and also the
likelihood of its occurring where any abnormality of the genital
organs is found, especially if this be unilateral.
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