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1

Ectopic Ureter  

MedlinePLUS

... the need for stitches. Frequently asked questions: Are boys or girls more likely to have an ectopic ureter? This condition is more common in girls than boys, but can occur in either sex. What is ...

2

Single ectopic ureter.  

PubMed

We report on 17 female and 4 male patients with single ectopic ureters, 9 of whom also had vaginal ectopic ureters. The clinicopathological features and surgical management are presented, with particular emphasis on the associated renal dysplasia and the complete excision of the ectopic ureteral stump. Although single ureteral ectopia with drainage to the vagina is rare in the English literature the condition is common in Japan. PMID:6834486

Gotoh, T; Morita, H; Tokunaka, S; Koyanagi, T; Tsuji, I

1983-02-01

3

Extrinsic Obstruction of the Ureter  

MedlinePLUS

... The ureter is a thick-walled tube that transfers urine from the kidney to the bladder. It ... infection. inflammatory: Characterized or caused by swelling, redness, heat and/or pain produced in an area of ...

4

Renal Pelvis and Ureter Cases - MP/H Rules  

Cancer.gov

RP/Ureter Case 1 SURGICAL PATHOLOGY REPORT Surgical Pathology Report October 20, 2007 Specim en: A. Left ureter biopsy B. Uterus and bladder C. Right ureter Final Diagnosis: A. Left ureter biopsy - invasive high grade urothelial carcinoma. B.

5

Retrocaval ureter with stone in the retrocaval segment of the ureter  

Microsoft Academic Search

Retrocaval ureter is abnormal looping of the proximal ureter behind the inferior vena cava. The aberrant anatomy results in\\u000a the compression of the ureter causing hydronephrosis. This is a very infrequent cause of hydronephrosis in children. Association\\u000a of retrocaval ureter with a stone in the looping segment of the ureter is extremely rare. We report one such pediatric case\\u000a which

Ravi Prakash Kanojia; Monika Bawa; Abhilasha T. Handu; Bikas K. Naredi; Prema Menon; K. L. N. Rao

2010-01-01

6

Myofibroepithelial Polyp of the Ureter  

PubMed Central

Ureteral tumors are rare and benign tumors are even rarer. Most of such tumors are diagnosed after nephroureterectomy assuming a malignant lesion, but with modern technological advancements like contrast enhanced CT scan or MR urography and ureteroscopic biopsy, benign nature of such tumors can be established preoperatively with an aim to preserve the renal unit. Here we report a case of 10-year old boy who presented with chronic right loin pain. DTPA scan showed complete loss of function of the right kidney. He was diagnosed to have an inflammatory myofibroepithelial polyp of right lower ureter and treated by nephroureterectomy.

Sarkar, Kaushik; Chakrabortty, Debasis

2014-01-01

7

Tissue engineering and ureter regeneration: is it possible?  

PubMed

Large ureter damages are difficult to reconstruct. Current techniques are complicated, difficult to perform, and often associated with failures. The ureter has never been regenerated thus far. Therefore the use of tissue engineering techniques for ureter reconstruction and regeneration seems to be a promising way to resolve these problems. For proper ureter regeneration the following problems must be considered: the physiological aspects of the tissue, the type and shape of the scaffold, the type of cells, and the specific environment (urine). ?This review presents tissue engineering achievements in the field of ureter regeneration focusing on the scaffold, the cells, and ureter healing. PMID:23645581

Kloskowski, Tomasz; Kowalczyk, Tomasz; Nowacki, Maciej; Drewa, Tomasz

2013-06-25

8

[Surgical treatment of primary mega-ureter].  

PubMed

Primary megaureter is a congenital dilatation of the ureter secondary to obstruction of its terminal portion. It must be corrected surgically only when its obstructive nature can be demonstrated and/or in the presence of complications (especially when it is associated with vesicoureteric reflux). Surgical treatment must always include resection of the obstructive part and ureterovesical reimplantation with an anti-reflux device. Compliance with these 2 principles may require remodelling of the ureter depending on the size of the urethra and bladder. Many surgical procedures can be performed, but 3 procedures are proposed allowing the management of the great majority of situations: 1. Transtrigonal reimplantation according to Cohen without remodelling of the ureter, when the ureteric calibre is less than 1 cm. 2. Transtrigonal reimplantation according to Cohen with remodelling of the transmural portion of the ureter. 3. Suprahiatal reimplantation with extravesical remodelling of the ureter according to Hendren in the case of dolichomegaureter. The other ureteric remodelling or plication techniques are indicated more rarely. PMID:9116728

Biserte, J

1997-02-01

9

COMPASS-based ureter segmentation in CT urography (CTU)  

NASA Astrophysics Data System (ADS)

We are developing a computerized system for automated segmentation of ureters in CT urography (CTU), referred to as COmbined Model-guided Path-finding Analysis and Segmentation System (COMPASS). Ureter segmentation is a critical component for computer-aided diagnosis of ureter cancer. A challenge for ureter segmentation is the presence of regions not well opacified with intravenous (IV) contrast. COMPASS consists of three stages: (1) adaptive thresholding and region growing, (2) path-finding and propagation, and (3) edge profile extraction and feature analysis. One hundred fourteen ureters in 74 CTU scans with IV contrast were collected from 74 patient files. On average, the ureters spanned 283 CT slices (range: 116 to 399, median: 301). More than half of the ureters contained malignant or benign lesions and some had ureter wall thickening due to malignancy. A starting point for each of the 114 ureters was selected manually to initialize the tracking by COMPASS. Path-finding and segmentation were guided by the anatomical knowledge of ureters in CTU. The segmentation performance was quantitatively assessed by estimating the percentage of the length that was successfully tracked and segmented for each ureter. Of the 114 ureters, 110 (96%) were segmented completely (100%), 111 (97%) were segmented through at least 70% of its length, and 113 (99%) were segmented at least 50%. In comparison, using our previous method, 79 (69%) ureters were segmented completely (100%), 92 (81%) were segmented through at least 70% of its length, and 98 (86%) were segmented at least 50%. COMPASS improved significantly the ureter tracking, including regions across ureter lesions, wall thickening and the narrowing of the lumen.

Zick, David; Hadjiiyski, Lubomir; Chan, Heang-Ping; Cohan, Richard H.; Caoili, Elaine M.; Zhou, Chuan; Wei, Jun

2014-03-01

10

Transitional cell carcinoma of ureter in a solitary functioning kidney.  

PubMed

We present a 60 years old male with transitional cell carcinoma of the left ureter. The right kidney was non excretory while the left one was the solitary functioning kidney with multiple renal cysts. He had presented with significantly deranged renal profile and left obstructed ureter. The ureterorenoscope could not be negotiated so exploration of the left ureter was done. This showed a growth in left ureter, confirmed as transitional cell carcinoma (TCC) on histopathology. Subsequently excision of the distal left ureter alongwith the tumour and the cuff of bladder (segmental ureterectomy) was contemplated. Proximally transureteroureterostomy was performed. Postoperative recovery was smooth and the renal profile became normal within 3 months. PMID:24718012

Ahmad, Hussain; Mahmood, Arshad; Murtaza, Badar; Akmal, Muhammad; Niaz, Waqar Azim

2014-03-01

11

Effects by silodosin on the partially obstructed rat ureter in vivo and on human and rat isolated ureters  

PubMed Central

Background and Purpose ?1-adrenoceptor (-AR) antagonists may facilitate ureter stone passage in humans. We aimed to study effects by the ?1A-AR selective antagonist silodosin (compared to tamsulosin and prazosin) on ureter pressures in a rat model of ureter obstruction, and on contractions of human and rat isolated ureters. Experimental Approach After ethical approval, ureters of male rats were cannulated beneath the kidney pelvis for in vivo ureteral intraluminal recording of autonomous peristaltic pressure waves. A partial ureter obstruction was applied to the distal ureter. Mean arterial blood pressure (MAP) was recorded. Approximate clinical and triple clinical doses of the ?1-AR antagonists were given intravenously. Effects by the ?1-AR antagonists on isolated human and rat ureters were studied in organ baths. Key Results Intravenous silodosin (0.1–0.3 mg kg?1) or prazosin (0.03–0.1 mg kg?1) reduced obstruction-induced increases in intraluminal ureter pressures by 21–37% or 18–40% respectively. Corresponding effects by tamsulosin (0.01 or 0.03 mg kg?1) were 9–20%. Silodosin, prazosin and tamsulosin reduced MAP by 10–12%, 25–26% (P < 0.05), or 18–25% (P < 0.05) respectively. When effects by the ?1A-AR antagonists on obstruction-induced ureter pressures were expressed as a function of MAP, silodosin had six- to eightfold and 2.5- to eightfold better efficacy than tamsulosin or prazosin respectively. Silodosin effectively reduced contractions of both human and rat isolated ureters. Conclusions and Implications Silodosin inhibits contractions of the rat and human isolated ureters and has excellent functional selectivity in vivo to relieve pressure-load of the rat obstructed ureter. Silodosin as pharmacological ureter stone expulsive therapy should be clinically further explored.

Villa, L; Buono, R; Fossati, N; Rigatti, P; Montorsi, F; Benigni, F; Hedlund, P

2013-01-01

12

Bilateral bifid ureter with unilateral renal vasculature variations.  

PubMed

During routine dissection of 82-year-old female cadaver with no known unfavorable medical history, we observed bilateral bifid ureter and variation in arterial supply of left kidney only. Careful examination revealed that there were bifid ureters on both sides enclosed in single facial sheath. It was also observed that both the ureter have different pattern of origin. On the right side, both the ureters were seen to be emerging from the hilum, one below another and joined together at the brim of the lesser pelvis just before crossing the right external iliac artery. Right kidney was supplied by single renal artery lying anterior to both the ureters. On the left side one ureter emerged from the hilum while the second one exited the kidney from a prominent lobule present below the inferior pole. PMID:23873247

Chawla, Kunal; Gupta, Richa; Singh, Harsimran Jit; Gupta, Tulika; Aggarwal, Anjali; Sahni, Daisy

2014-05-01

13

Schistosomal stricture of the ureter-diagnostic dilemma.  

PubMed

Chronic schistosomiasis of the urinary tract can present with symptoms unrelated to the disease. A 33-year-old man from Edo State Nigeria presented with recurrent left flank pain. Laboratory investigations did not reveal any cause. Radiological investigation revealed a stricture of the left ureter and hydronephrosis of the left kidney. Management included surgical excision and antischistosomiasis chemotherapy. Histopathological examination of specimen of the ureter obtained after surgical exploration revealed Schistosoma heamatobium ova in the wall of the ureter. PMID:22248959

Oranusi, C K; Nwofor, Ame; Onyiaorah, I V; Ukah, C O

2011-01-01

14

Transitional Cell Cancer of the Renal Pelvis and Ureter (PDQ): Treatment  

MedlinePLUS

General Information About Transitional Cell Cancer of the Renal Pelvis and Ureter Transitional cell cancer of the renal pelvis and ureter is a disease in which malignant (cancer) cells form in the renal pelvis and ureter. The ...

15

Laparoscopic dissection of the ureter for radical laparoscopic hysterectomy  

Microsoft Academic Search

The most important step in radical hysterectomy is freeing the ureter from the anterior parametrium. In this paper we describe our modified technique for freeing the ureter from the anterior parametrium for a Piver II–III radical hysterectomy by means of pure laparoscopic surgery. Our series consists of seventeen patients undergoing laparoscopic hysterectomy. In evaluating the technique, we considered its feasibility,

Eugenio Volpi; Annamaria Ferrero; Alice Peroglio Carus; Elena Jacomuzzi; Piero Sismondi

2005-01-01

16

Evidence for Alpha Receptors in the Human Ureter  

NASA Astrophysics Data System (ADS)

An immunohistochemical and western blot expression analysis of human ureters was performed in order to characterize the alpha-1-adrenergic receptor distribution along the length of the human ureteral wall. Mapping the distribution will assist in understanding the potential role alpha -1-adrenergic receptors and their subtype density might have in the pathophysiology of ureteral colic and stone passage. Patients diagnosed with renal cancer or bladder cancer undergoing nephrectomy, nephroureterectomy, or cystectomy had ureteral specimens taken from the proximal, mid, distal and tunneled ureter. Tissues were processed for fresh frozen examination and fixed in formalin. None of the ureteral specimens were involved with cancer. Serial histologic sections and immunohistochemical studies were performed using antibodies specific for alpha-1-adrenergic receptor subtypes (alpha 1a, alpha 1b, alpha 1d). The sections were examined under a light microscope and scored as positive or negative. In order to validate and quantify the alpha receptor subtypes along the human ureter. Western blotting techniques were applied. Human ureter stained positively for alpha -1-adrenergic receptors. Immunostaining appeared red, with intense reaction in the smooth muscle of the ureter and endothelium of the neighboring blood vessels. There was differential expression between all the receptors with the highest staining for alpha-1D subtype. The highest protein expression for all three subtypes was in the renal pelvis and decreased with advancement along the ureter to the distal ureter. At the distal ureter, there was marked increase in expression as one progressed towards the ureteral orifice. The same pattern of protein expression was exhibited for all three alpha -1-adrenergic receptor subtypes. We provide preliminary evidence for the ability to detect and quantify the alpha-1-receptor subtypes along the human ureter which to the best of our knowledge has never been done with immunohistochemistry and molecular techniques. These findings may lend support to the preliminary studies of the effectiveness of alpha-receptor blockade on ureteral colic and stone passage.

Madeb, Ralph; Knopf, Joy; Golijanin, Dragan; Bourne, Patricia; Erturk, Erdal

2007-04-01

17

The retroperitoneal, inguinal approach to distal part of the ureter  

PubMed Central

Introduction The inguinal approach to the distal part of the ureter allows the surgeon to perform various types of procedures and is considered to be one of the minimally invasive techniques in pediatric surgery. We aim to describe our initial experience with the surgery of the distal ureter performed through an inguinal mini–incision. Material and methods Between March 2012 and June 2013, 8 patients were treated using a minimally invasive inguinal technique. The indications for surgical correction were single system primary obstructive megaureter, obstructive megaureter of the upper pole in a duplex kidney and distal ureteral stones. In all patients with single system obstructive megaureter and significant hydronephrosis, ureterocutaneostomy was performed. In one patient with duplex system primary obstructive megaureter and significant hydronephrosis of the upper pole, ureteroureterostomy of the dilated ureter to the normal caliber ureter in the distal part was performed. In the second patient with duplex system primary obstructive megaureter and reduced marker excretion of the upper pole in renal scintigraphy, ureterocutaneostomy was performed. In both cases of distal ureteral stones, deposits were removed by a simple incision. Results We did not observe any perioperative or postoperative complications. The imaging studies have shown that ureteral dilatation decreased in all but one child in whom the upper pole and the ureter were resected due to lack of function. Conclusions The inguinal approach allows for the adequate visualization of the distal ureter, creating the conditions for implementation of the various procedures, reduces the risk of retrovesical plexus injury and minimizes visible scars.

Urbanowicz, Wieslaw; Sulislawski, Janusz; Dobrowolska-glazar, Barbara

2014-01-01

18

A quantitative histological analysis of the dilated ureter of childhood.  

PubMed

A quantitative histological study of the dilated ureter of childhood was performed on 26 ureters. The specimens were from 15 male and 11 female patients 10 days to 12 years old (mean age 2.0 years). A color image analysis system was used to examine and compare collagen and smooth muscle components of the muscularis layers to normal control ureters of similar age. In comparing primary obstructed (12) to primary refluxing (14) megaureters and control ureters (6), there was a statistically different collagen-to-smooth muscle ratio (p < 0.001) between the primary obstructed and primary refluxing megaureter groups. For patients with primary refluxing megaureter there was a 2-fold increase in the tissue matrix ratio of collagen-to-smooth muscle when compared to patients with primary obstructed megaureter. In the primary obstructed megaureters the amount of collagen and smooth muscle was not statistically different from controls (p > 0.01). The increased tissue matrix ratio of 2.0 +/- 0.35 (collagen-to-smooth muscle) in the refluxing megaureter group compared to 0.78 +/- 0.22 in the obstructed megaureter group and 0.52 +/- 0.12 in controls was found to be due not only to a marked increase in collagen but also a significant decrease in the smooth muscle component of the tissue. Primary obstructed and normal control ureters had similar quantitative amounts of smooth muscle with 60 +/- 5% and 61 +/- 6%, respectively, while refluxing megaureters had only 40 +/- 5% smooth muscle. The percentage collagen was 36 +/- 5 in the obstructed megaureter group and 30 +/- 5 in controls, with refluxing megaureters having 58 +/- 5% collagen on analysis. Our findings emphasize the significant differences in the structural components (collagen and smooth muscle) of the dilated ureter of childhood, and provide us with further insight into the pathological nature of these dilated ureters and their surgical repair. PMID:1433552

Lee, B R; Partin, A W; Epstein, J I; Quinlan, D M; Gosling, J A; Gearhart, J P

1992-11-01

19

Robot-assisted laparoscopic reconstruction of retrocaval ureter: description and video of technique.  

PubMed

Ureteral obstruction secondary to retrocaval ureter is rarely reported in the urologic literature. Symptomatic retrocaval ureters usually present in the 3rd and 4th decade of life. Standard treatment involves ureteroureterostomy approximating the ureter anterior to the vena cava. We describe the initial presentation, imaging, port placement, and operative technique including video presentation of a robot-assisted laparoscopic repair of a retrocaval ureter. PMID:21486152

LeRoy, Timothy J; Thiel, David D; Igel, Todd C

2011-05-01

20

Stone/ureter identification during alexandrite laser lithotripsy  

NASA Astrophysics Data System (ADS)

A spectroscopic stone/ureter identification system is already in clinical use for pulsed dye laser lithotripters (590 nm). Alexandrite lasers are believed to be a solid-state laser alternative to pulsed dye lasers in lithotripsy. We investigated different spectroscopic stone/ureter detection schemes for the q-switched alexandrite laser (750 nm and 375 nm), including plasma detection, spectral LIF analysis, and time resolved LIF intensity analysis. Additionally, we investigated the possibility to identify different stone types using laser induced fluorescence exited at UV wavelengths.

Scheu, M.; Flemming, Gabriela; Engelhardt, R.

1991-07-01

21

Ectopic insertion of the ureter into the seminal vesicle  

PubMed Central

We present a case of left ectopic ureter insertion into the left seminal vesicle which is a rare anomaly. The incidence of ectopic insertion of the ureter is more common in females and is usually associated with incontinence, leading to the diagnosis, while in males it is present with infection. Ectopic ureter is defined as abnormal insertion of the ureter, occurring in the posterior urethra in approximately 50% of cases in males. Other sites include the seminal vesicle (approximately one-third), vas deferens, bladder neck, prostate and epididymis, while the urethra and vagina are commonly affected in females. Management is usually addressed to the upper tract only; if there is incontinence it requires removal of the ureteric stump. Our case was initially diagnosed by magnetic resonance imaging and the diagnosis confirmed by computed tomography (CT) guided seminal vesiculography as transrectal guidance for seminal vesiculography was refused by the patient. CT guided seminal vesiculography is less painful and more tolerable than the transrectal route.

El-Ghar, Mohamed Abou; El-Diasty, Tarek

2013-01-01

22

Ectopic insertion of the ureter into the seminal vesicle.  

PubMed

We present a case of left ectopic ureter insertion into the left seminal vesicle which is a rare anomaly. The incidence of ectopic insertion of the ureter is more common in females and is usually associated with incontinence, leading to the diagnosis, while in males it is present with infection. Ectopic ureter is defined as abnormal insertion of the ureter, occurring in the posterior urethra in approximately 50% of cases in males. Other sites include the seminal vesicle (approximately one-third), vas deferens, bladder neck, prostate and epididymis, while the urethra and vagina are commonly affected in females. Management is usually addressed to the upper tract only; if there is incontinence it requires removal of the ureteric stump. Our case was initially diagnosed by magnetic resonance imaging and the diagnosis confirmed by computed tomography (CT) guided seminal vesiculography as transrectal guidance for seminal vesiculography was refused by the patient. CT guided seminal vesiculography is less painful and more tolerable than the transrectal route. PMID:24198914

El-Ghar, Mohamed Abou; El-Diasty, Tarek

2013-09-28

23

Biaxial Mechanical Properties of Human Ureter under Tension.  

PubMed

Purpose: The Mechanical properties of the ureteral wall may be altered by certain diseases such as megaureter. Ureter compliance and wall tension alterations can occur, leading to some abnormalities such as reflex mechanisms. Familiarizing with the mechanical properties of the ureter can help us advance in the understanding of urinary tract diseases. Materials and Methods: A constitutive model that can predict the mechanical response of ureteral tissue under complex mechanical loading is required. Parameters characterizing the mechanical behaviour of the material were estimated from planar biaxial test data, where human ureter specimens were simultaneously loaded along the longitudinal and circumferential directions. Results: The biaxial stress-stretch curve was plotted and fitted to a hyperelastic four-parameter Fung type model and five-parameter Mooney-Rivlin model. The average strength in the longitudinal direction was 3.48 ± 0.47 MPa and 2.31 ± 0.46 MPa (P <.05) for the circumferential direction.In the Fung model the value of parameter a2 (0.699 ± 0.17) was higher than a1 (0.279 ± 0.07), which may be due to the collagen fiber orientation’s preference along the longitudinal axis. Conclusion: According to this study, it seems that ureter tissue is stiffer in the longitudinal than in the circumferential direction and maybe the collagen fiber are along the axial axes. Also the specimens showed some degree of anisotropy.  PMID:25015616

Rassoli, Aisa; Shafigh, Mohammad; Seddighi, Amir Saeed; Seddighi, Afsoun; Daneshparvar, Hamidreza; Fatouraee, Nasser

2014-01-01

24

[Endoscopic ureteroureterostomy for a complete obstructed ureter: a case report].  

PubMed

We report a case in which the completely obstructed ureter was successfully treated by endourological procedure. The patient was a 66-year-old male who had been admitted for panperitonitis caused by diverticulitis perforation of the sigmoid colon. About one month later, leakage of both stool and urine and left hydronephrosis were observed. Therefore, left percutaneous nephrostomy was performed and the artificial anus was created. Radiographic examination showed about 1 cm defect on the lower one-third of the left ureter. (1st Operation) A 9.5 Fr. rigid ureteroscope was inserted into the left ureter transurethrally and a 7.5 Fr. flexible ureteroscope was inserted percutaneously. Antegrade puncture using a stiff end of a 0.038-inch guidewire into the obstructed segment was failed. Then, we bit off the obliterated tissue with a biopsy forceps transurethrally towards the light from the flexible scope, and a 12 Fr. double-J stent was indwell. (2nd Operation) Eight weeks after the first operation, a 12 Fr. ureteroresectoscope was inserted transurethrally. Full-thickness cold-knife incision of the re-established ureter was failed, however. (3rd Operation) Two weeks after the second operation, a 12.5 Fr. ureteroscope was inserted transurethrally, and a full-thickness incision in the lateral position of the re-established ureter was successfully made by KTP-laser. Then, a 12 Fr. endopyelotomy stent was placed. (Result) Six weeks after the third operation, the stent was removed and DIP revealed the improvement in hydronephrosis. The patient presented no recurrence at 2-year follow up. PMID:10658465

Kawabata, G; Haraguchi, T; Okamoto, Y; Mizuno, Y; Maeda, H

1999-12-01

25

Differential gene expression in the developing mouse ureter.  

PubMed

In many instances, kidney dysgenesis results as a secondary consequence to defects in the development of the ureter. Through the use of mouse genetics a number of genes associated with such malformations have been identified, however, the cause of many other abnormalities remain unknown. In order to identify novel genes involved in ureter development we compared gene expression in embryonic day (E) 12.5, E15.5 and postnatal day (P) 75 ureters using the Compugen mouse long oligo microarrays. A total of 248 genes were dynamically upregulated and 208 downregulated between E12.5 and P75. At E12.5, when the mouse ureter is comprised of a simple cuboidal epithelium surrounded by ureteric mesenchyme, genes previously reported to be expressed in the ureteric mesenchyme, foxC1 and foxC2 were upregulated. By E15.5 the epithelial layer develops into urothelium, impermeable to urine, and smooth muscle develops for the peristaltic movement of urine towards the bladder. The development of these two cell types coincided with the upregulation of UPIIIa, RAB27b and PPARgamma reported to be expressed in the urothelium, and several muscle genes, Acta1, Tnnt2, Myocd, and Tpm2. In situ hybridization identified several novel genes with spatial expression within the smooth muscle, Acta1; ureteric mesenchyme and smooth muscle, Thbs2 and Col5a2; and urothelium, Kcnj8 and Adh1. This study marks the first known report defining global gene expression of the developing mouse ureter and will provide insight into the molecular mechanisms underlying kidney and lower urinary tract malformations. PMID:16459152

Mitchell, Eleanor K L; Taylor, Darrin F; Woods, Kyra; Davis, Melissa J; Nelson, Amy L; Teasdale, Rohan D; Grimmond, Sean M; Little, Melissa H; Bertram, John F; Caruana, Georgina

2006-06-01

26

Numerical simulation of the urine flow in a stented ureter.  

PubMed

When a stent is implanted in a blocked ureter, the urine passing from the kidney to the bladder must traverse a very complicated flow path. That path consists of two parallel passages, one of which is the bore of the stent and the other is the annular space between the external surface of the stent and the inner wall of the ureter. The flow path is further complicated by the presence of numerous pass-through holes that are deployed along the length of the stent. These holes allow urine to pass between the annulus and the bore. Further complexity in the pattern of the urine flow occurs because the coiled "pig tails," which hold the stent in place, contain multiple ports for fluid ingress and egress. The fluid flow in a stented ureter has been quantitatively analyzed here for the first time using numerical simulation. The numerical solutions obtained here fully reveal the details of the urine flow throughout the entire stented ureter. It was found that in the absence of blockages, most of the pass-through holes are inactive. Furthermore, only the port in each coiled pig tail that is nearest the stent proper is actively involved in the urine flow. Only in the presence of blockages, which may occur due to encrustation or biofouling, are the numerous pass-through holes activated. The numerical simulations are able to track the urine flow through the pass-through holes as well as adjacent to the blockages. The simulations are also able to provide highly accurate results for the kidney-to-bladder urine flow rate. The simulation method presented here constitutes a powerful new tool for rational design of ureteral stents in the future. PMID:17408323

Tong, Jimmy C K; Sparrow, Ephraim M; Abraham, John P

2007-04-01

27

Interaction of mid-infrared laser radiation with soft ureter tissue  

NASA Astrophysics Data System (ADS)

Aim of the work was an investigation of ureter wall perforation possibility by various types of mid-infrared radiations (from 2.01 ?m (Tm:YAG) up to 2.94 ?m (Er:YAG)) and exploration of the interaction basic characteristic for ureter surface (epithelium) and its deep structures (mesenchym). From results follow that CTH:YAG, Er:YAG, and CTE:YAG laser radiations accomplish a good wall ureter perforation. A distinguished difference appeared in modifications of the ureter tissue - epithelium and mesenchym.

Jelinkova, Helena; Kohler, Oto; Nemec, Michal; Koranda, Petr; Sulc, Jan; Drlik, Pavel; Miyagi, Mitsunobu; Shi, Yi-Wei; Matsuura, Yuji; Kokta, Milan R.; Hrabal, Petr

2004-09-01

28

An assessment of the pulsed dye laser for fragmenting calculi in the pig ureter.  

PubMed

The pulsed dye laser was used to fragment ureteric calculi in 10 pig ureters, compared to electrohydraulic disintegration in six pig ureters. The stones were impacted in the proximal ureter and approached by rigid ureteroscopy. Four ureters did not have stones impacted but had ureteroscopes passed. The stones were fragmented and the particles left to pass spontaneously. The degree of inflammatory reaction was graded at the site of fragmentation as well as in the middle and lower ureter. The degree of inflammation seen at the site of fragmentation was significantly less in the laser group than in the electrohydraulic group (p = 0.0027). It was noted that the degree of inflammation seen in the lower ureter was significantly greater than that seen at the site of fragmentation (p = 0.01), and that this grade of inflammation correlated well with the size of ureteroscope used (p = 0.0026). Further, the degree of dilatation of the ureter and pelvicalyceal system was significantly greater when the larger calibre ureteroscope had been used (p = 0.0056) ranging up to hydronephrosis with flattening of the papillae. If there is any parallel which can be drawn between the pig ureter and the human ureter then it suggests that ureteroscopy is more significant than the modality of fragmentation used. The contribution of the laser may therefore be more by the miniaturization of instrumentation which will be made possible than by any advantage it may have as a fragmenter. PMID:2885427

Watson, G; Murray, S; Dretler, S P; Parrish, J A

1987-07-01

29

Interaction of Er:YAG laser radiation with ureter tissue  

NASA Astrophysics Data System (ADS)

The aim of the work was to investigate the possibility of the ureter wall perforation by Er:YAG laser radiation and to explore the basic interaction characteristics for ureter surface and its deep structures. For these experiments Er:YAG laser system (wavelength 2.94 ?m) working in free-running and Q-switched regime was utilized. Laser radiation was delivered to the investigated tissue by a special waveguide system. The basic part was a cyclic olefin polymer-coated silver hollow glass waveguide (inner/outer diameter 700/850 ?m or 320/450 ?m). Sealed cap of the waveguide was used for contact treatment. Maximum interaction pulse energy and length for free-running Er:YAG I laser with the 700?m waveguide were 100mJ and 200?s, respectively (corresponding intensity was 130 kW/cm2). Similarly the maximum interaction pulse energy and length for free-running Er:YAG II laser with the 320 ?m waveguide were 80 mJ and 200 ?s , respectively (corresponding intensity was 500 kW/cm2). Maximum interaction pulse energy and length in Q-switched regime were 17 mJ and 70 ns, respectively (corresponding intensity 63 MW/cm2). The number of pulses needed to perforate the ureter wall tissue (thickness ~1 mm) for using long 200 ?s Er:YAG pulses (thermal ablation) and short 70 ns Er:YAG pulses (photoablation) was found. From the histological evaluation it follows that the application of Q-switched Er:YAG laser radiation on ureteral tissue resulted in minimum adjacent tissue alteration (up to 50?m from the surface) without any influence on the deeper layers.

Jelínkova, Helena; Koranda, Petr; N?mec, Michal; Šulc, Jan; Köhler, Oto; Drlík, Pavel; Miyagi, Mitsunobu; Shi, Yi-Wei; Matsuura, Yuji

2005-11-01

30

Technical report: the use of the reformed sidewinder loop in the dilated ureter.  

PubMed

A case is presented of a patient requiring percutaneous stenting of a ureteroenteric stricture. A hairpin bend between the strictured ureter and the ileal conduit was easily negotiated by reforming a Sidewinder loop within the contralateral ureter and withdrawing it until the tip entered the conduit. This technique does not appear to have been described before. PMID:2070583

Kabala, J E; Watkinson, A F

1991-06-01

31

Sensitivity of the Ureter to Radiation Before and after Ureterojejuno-Implantation. Comparative Animal Experiments.  

National Technical Information Service (NTIS)

The investigation refers to dexhal ureterosigmoidostomies, carried out on 15 dogs. The implanted right ureters and the left ureters left in the bladders of 5 dogs were then treated with radiation of a total focal dose of 60 Gy. The investigation referred ...

K. J. Schenk

1981-01-01

32

Ectopic ureter presenting as anterior wall vaginal prolapse.  

PubMed

The differential diagnoses for anterior wall vaginal prolapse (AWVP) include cystocele, enterocele, urethral diverticulum, and Gartner duct cyst. We present a case of a patient with a known solitary right kidney (congenital absence of a left kidney) presenting with lower urinary tract symptoms, absence of urinary incontinence, and feeling of bulge in the vagina. Physical examination revealed grade II AWVP. Because congenital solitary kidney can be associated with other possible genitourinary abnormalities, a pelvic magnetic resonance imaging was obtained. Magnetic resonance imaging demonstrated a tubular structure spanning the left retroperitoneum to the region of the AWVP. Urodynamics revealed an obstructive voiding pattern during pressure-flow phase. The combination of transvaginal and transabdominal surgical excision of the tubular structure resolved the patient's lower urinary tract and prolapse symptoms. Anatomically, her AWVP was corrected. Histopathologic examination of the tubular structure revealed presence of urothelium lining the lumen of the tubular structure consistent with a ureter. This case represents the rare situation in which an ectopic ureter presented as an AWVP. However, patients with congenital solitary kidney presenting with vaginal prolapse should raise the suspicion for other associated genitourinary anomalies, whether these anomalies are related to the prolapse or not. Cross-sectional imaging should be performed in these situations to delineate precise anatomy. PMID:24978091

Chai, Toby C; Davis, Rachel; Hawes, Lisa N; Twaddell, William S

2014-01-01

33

Renal calculi with retrocaval ureter: is percutaneous nephrolithotomy sufficient?  

PubMed

A 60-year-old woman presented with complaints of intermittent right flank pain which had begun one year ago. Ultrasonography and intravenous urogram showed right pelvic (15 mm) and inferior calyceal (6 mm) calculi along with suspected retrocaval course of right ureter, which was confirmed by contrast CT scan. Tc-99m diethylene-triamine-penta-acetic acid (DTPA) scan showed normal function and normal drainage of right kidney. Percutaneous nephrolithotomy (PCNL) was performed for right renal calculi. Because of curved ureteric course, negotiation of ureteric catheter in pelvis was anticipated to be troublesome, so intraoperative retrograde pyelogram (RGP) was performed to delineate the anatomy. Puncture was performed safely after air contrast pyelography. No complications occurred intraoperatively and postoperatively. On follow-up of up to 1 year patient was asymptomatic and renal scan showed normal function and drainage. So in the presence of retrocaval ureter and associated renal calculi, PCNL is a safe and optimal procedure and in condition of non-obstructive drainage, management of calculi only is adequate. PMID:23536623

Prakash, Jai; Raj, Anubhav; Sankhwar, Satyanarayan; Singh, Vishwajeet

2013-01-01

34

Computed tomography of the abdomen in Saanen goats: III. kidneys, ureters and urinary bladder.  

PubMed

This study describes the findings of computed tomography (CT) of the kidneys, ureters, urinary bladder and adrenal glands in 28 healthy female Saanen goats. CT examination and anatomical slice preparation postmortem was performed as described in the first communication. After subjective evaluation of the CT images, various variables including the size, volume and density of the kidneys, the diameter of the ureters and the size of the adrenal glands were measured. The targeted organs could be accurately visualised using CT and there was very good topographical agreement between the CT images and the anatomical preparations. The kidneys, renal vessels, ureters, urinary bladder and adrenal glands were seen in all goats. PMID:21728163

Braun, U; Irmer, M; Augsburger, H; Ohlerth, S

2011-07-01

35

Dissecting the pelvic retroperitoneum and identifying the ureters. A laparoscopic technique.  

PubMed

A technique for dissecting the pelvic retroperitoneum and identifying the ureters and uterine arteries is described that makes use of the obliterated hypogastric arteries. The obliterated arteries are readily identified laparoscopically and, as relatively fixed structures, are easily dissected free of the bladder and surrounding areolar tissues. Once freed by blunt dissection, they are traced proximally to where they are joined by the uterine arteries to form the internal iliac arteries. Blunt dissection just proximal and medial to the uterine artery will open the pararectal space, the medial border of which is bounded by the ureter. The uterine arteries are then traced to where they cross the ureters and are freed from them by blunt dissection. The site at which the uterine arteries are divided and the extent to which the extraperitoneal spaces are developed and ureters mobilized off the medial leaf of the broad ligament are tailored to the operation performed. PMID:7738920

Kadar, N

1995-02-01

36

Localized amyloidosis of the ureter: A case report and literature review.  

PubMed

Localized amyloidosis of the ureter is a rare disease and can easily be confused with a neoplasm. We report the case of a 55-year-old woman who presented with loin pain and painless gross hematuria. We also reviewed the English literature about localized ureteral amyloidosis. Middle-aged women were likely to suffer from this disorder. Loin pain and hematuria were the main clinical features. There were no specific performance on radiologic imaging and ureteral calcification was not widespread. Compared to upper ureter and middle ureter, the lower ureter was the easiest involved part. Nephroureterectomy was the predominant treatment. Biopsies via a ureteroscope prior to surgery or intraoperative frozen section examination, which yielded the diagnosis of amyloidosis, could help to avoid unnecessary surgery. The use of dimethyl sulfoxide or follow-up with serial imaging may become a promising treatment. PMID:24282473

Ding, Xiaobo; Yan, Xu; Ma, Xiaobo; Wang, Chunxi; Du, Yujun; Wang, Haifeng; Wang, Yan; Wang, Yanbo

2013-01-01

37

Experimental Investigations of Radiological and Nuclear Functional Diagnosis of the Ureter.  

National Technical Information Service (NTIS)

A new nuclear method for reflux and motility investigations of the ureter is described, and its diagnostic potential is determined in model experiments. Thresholds of visualisation of a urine spindle are considered. The following results were obtained in ...

M. Wolf

1980-01-01

38

Membrane Properties of the Smooth Muscle of Guinea-Pig Ureter.  

National Technical Information Service (NTIS)

The membrane properties of the guinea-pig ureter were studied in physiological Krebs solution by intra- and extracellular stimulating methods. The mean membrane potential was 50 mV. Action potentials triggered by external stimulation were composed of repe...

H. Kuriyama T. Osa N. Toida

1968-01-01

39

Unilateral Diverticulum of the Ureter: A Case Report and Scanning Electron Microscopic Study.  

National Technical Information Service (NTIS)

The surface ultrastructure of a unilateral ureteral diverticulum was studied by scanning electron microscopy and compared to that of normal ureters. Although the normal ureteral urothelial cells present a squamoid appearance, the cells of the diverticulum...

M. A. Clark K. J. O'Connell T. A. Maclean T. M. Conner

1973-01-01

40

Localized amyloidosis of the ureter: A case report and literature review  

PubMed Central

Localized amyloidosis of the ureter is a rare disease and can easily be confused with a neoplasm. We report the case of a 55-year-old woman who presented with loin pain and painless gross hematuria. We also reviewed the English literature about localized ureteral amyloidosis. Middle-aged women were likely to suffer from this disorder. Loin pain and hematuria were the main clinical features. There were no specific performance on radiologic imaging and ureteral calcification was not widespread. Compared to upper ureter and middle ureter, the lower ureter was the easiest involved part. Nephroureterectomy was the predominant treatment. Biopsies via a ureteroscope prior to surgery or intraoperative frozen section examination, which yielded the diagnosis of amyloidosis, could help to avoid unnecessary surgery. The use of dimethyl sulfoxide or follow-up with serial imaging may become a promising treatment.

Ding, Xiaobo; Yan, Xu; Ma, Xiaobo; Wang, Chunxi; Du, Yujun; Wang, Haifeng; Wang, Yan; Wang, Yanbo

2013-01-01

41

Laparoscopic ureteric reimplantation of a single-system ectopic ureter in a girl: A rarity  

PubMed Central

A 14-year-old girl presented with continuous dribbling of urine along with normal voiding pattern since childhood. Cystourethroscopy showed absence of right ureteric opening, and vaginoscopy showed right ureter opening into vaginal vault. Radiological images showed small right kidney with normal excretory function with single-system ectopic ureter. Patient underwent laparoscopic transperitoneal extravesical ureteric reimplantation. At 3 months’ follow-up, intravenous urography (IVU) and micturating cystourethrogram (MCU) showed no obstruction and reflux.

Kumar, Suresh; Bera, Malay Kumar; Bera, Keya Pal; Vijay, Mukesh Kumar; Kundu, Anup Kr

2010-01-01

42

A case of complete renal duplex with h-shaped ureter.  

PubMed

We present a case of complete renal duplex with H-shaped double ureter opening into the bladder with 2 separate orifices. It is an extremely rare variety of renal duplex which was reported only once in the literature. Fifty-four-year-old male presented to our department with right renal pain. Noncontrast CT revealed stone midthird right ureter with duplex right kidney. Retrograde ureteropyelography and ureteroscopy revealed this rare anomaly. PMID:22754706

Ghobashy, A; El-Shazly, M; Lari, A; Al-Hunaidy, O; Allam, A; Alenezy, N; Yordanov, E; Hathout, B

2012-01-01

43

A Case of Complete Renal Duplex with H-Shaped Ureter  

PubMed Central

We present a case of complete renal duplex with H-shaped double ureter opening into the bladder with 2 separate orifices. It is an extremely rare variety of renal duplex which was reported only once in the literature. Fifty-four-year-old male presented to our department with right renal pain. Noncontrast CT revealed stone midthird right ureter with duplex right kidney. Retrograde ureteropyelography and ureteroscopy revealed this rare anomaly.

Ghobashy, A.; El-Shazly, M.; Lari, A.; Al-Hunaidy, O.; Allam, A.; Alenezy, N.; Yordanov, E.; Hathout, B.

2012-01-01

44

Analgesics, Cigarette Smoking, and Other Risk Factors for Cancer of the Renal Pelvis and Ureter1  

Microsoft Academic Search

Results from a population-based case-control study of cancer of the renal pelvis and ureter are reported. Telephone interviews were conducted with 187 residents of Los Angeles County diagnosed with cancer of the renal pelvis and ureter over a 4-year period ending December 31, 1982, and with individually sex-, age- and race-matched neighborhood controls. The major risk factor identified for cancer

Ronald K. Ross; Annlia Paganini-Hill; Joseph Landolph; Vibeke Gerkins; Brian E. Henderson

1989-01-01

45

Stones lodge at three sites of anatomic narrowing in the ureter: clinical fact or fiction?  

PubMed

Abstract Background and Purpose: Throughout the literature, the ureter is described as having three anatomic sites of narrowing at which kidney stones typically become lodged: The ureteropelvic junction (UPJ), the ureteral crossing of the iliac vessels, and the ureterovesical junction (UVJ). There is little evidence to support this notion, however. The purpose of our study is to evaluate whether three peaks in stone distribution corresponding to these anatomic landmarks exist. Methods: We retrospectively reviewed the kidneys-ureters-bladder (KUB) films of 622 patients with solitary ureteral calculi referred for shockwave lithotripsy (SWL). Pretreatment KUB films were used to categorize the location of their ureteral stone relative to 1 of 19 levels referenced to the axial skeleton. CT scans of 74 patients were used to determine the location of the UPJ, ureteral crossing of the iliac vessels, and UVJ relative to the 19 levels on KUB radiography. Histograms were then constructed to plot the distribution of stones within the ureter relative to these 19 levels. The effect of sex, stone size and side, and presence of a stent on stone distribution were analyzed. Results: There are two peaks in the distribution of stones within the ureter in patients referred for SWL that correspond to the UPJ/proximal ureter and intramural ureter/UVJ. In patients with larger stones (?100?mm(2)) or a ureteral stent in place, stones were distributed more proximally (P<0.0001). When comparing sexes, there was a difference in stone distribution that approached significance (P=0.0523), with a greater peak more distally in males compared with females. Conclusions: Our review demonstrates a peak in the distribution of stones corresponding to the UPJ/proximal ureter and the intramural ureter/UVJ. We failed to demonstrate a peak in stone distribution corresponding with the ureteral crossing of the iliac vessels. PMID:22984899

Ordon, Michael; Schuler, Trevor D; Ghiculete, Daniela; Pace, Kenneth T; Honey, R John D'A

2013-03-01

46

Developmental and species differences in the response of the ureter to metabolic inhibition  

Microsoft Academic Search

The effect of inhibiting oxidative phosphorylation on electrically stimulated phasic and high-K+ depolarization-induced tonic contractions in ureteric smooth muscle has been investigated. Intracellular [Ca2+] and pH were monitored fluorimetrically with simultaneous tension measurement, in adult and neonatal rat and guinea-pig ureter.\\u000a Little difference was found in the response of adult or neonatal rat ureters; cyanide abolished phasic contractions and intracellular

A. J. Bullock; Susan Wray

1998-01-01

47

Ectopic ureter with urinary incontinence. An unusual presentation of Mayer–Rokitansky–Kuster–Hauser syndrome  

Microsoft Academic Search

Ectopic ureter occurs most commonly in association with ureterocele or duplication of the ureter. It is caused by a delay\\u000a in or failure of separation of the ureteric bud from the mesonephric duct during embryologic development. Vaginal agenesis\\u000a is the second most common cause of primary infertility in women after gonadal dysgenesis. Agenesis of the vagina in karyotypic\\u000a females may

M. S. Ansari; N. P. Gupta; A. Kriplani

2003-01-01

48

Laparoscopic dissection of the intramural ureter to repair a complete transection of the distal ureter: Initial experience with a new minimally invasive technique that preserves the anatomy of the urinary tract  

PubMed Central

We report 2 patients with ureteral injury after a simple total laparoscopic hysterectomy for uterine myoma with a complete resection of the distal ureter. One patient had unilateral injury and the other 2 patients had bilateral injury. The surgical laparoscopic repair procedure was carried out 3 to 5 days after the injury. Surgery involved intramural dissection of the distal ureteral stump to expose at least 1 cm of the ureter, percutaneous ureteral stent placement, elimination of tension between the proximal ureter and the dissected distal stump, end-to-end anastomosis, and reinsertion of the distal ureter into the bladder muscle layer, which was previously dissected for the anastomosis.

Juarez-Soto, Alvaro; Arroyo-Maestre, Jose Miguel; Soto-Delgado, Manuel; Beardo-Villar, Pastora; Arrabal-Polo, Miguel Angel; Sanchez-Margallo, Francisco Miguel

2014-01-01

49

Identification and characterisation of regional variations in the material properties of ureter according to microstructure.  

PubMed

There are few previous studies on the elastic properties of ureter and most have been limited to essentially one-dimensional deformation measurements. The object of this study was, therefore, to identify regional variations in the multiaxial behaviour of rabbit ureter, subjected to in vitro inflation/extension testing under a physiological range of intraluminal pressures and longitudinal forces. A microstructure-motivated material model (via two- and four-fibre families in turn for elastin and collagen) was implemented and its capacity to mathematically characterise the experimental data contrasted favourably with that of the well-established phenomenological models, but it was compromised by parameter covariance. Extensive optimisation studies confirmed that the reduced model without contribution to the elastin and circumferential-fibre (collagen) families characterised the data equally well without over-parameterisation. In view of the fitted parameters, the ureteral tissue was stiffer longitudinally, justified by the preferential alignment of collagen along that axis and the lower ureter was stiffer than the upper ureter, justified by the histological observation of a thickest lamina propria, i.e. of highest collagen content, there. The lower ureter was less anisotropic than the upper ureter, possessing a comparatively larger amount of diagonally arranged collagen fibres in tunica mucosa, while having the usual amounts of longitudinally arranged fibres in tunica adventitia and of circumferentially arranged fibres in tunica muscularis. The present data may be used as inputs to mathematical models of the ureter, assessing regional and intramural stress distributions, through which it is hoped that an improved appreciation of ureteral function may be attained in both health and disease. PMID:23439210

Sokolis, Dimitrios P

2014-11-01

50

Initial experience with a newly developed antirefluxive ureter stent.  

PubMed

The objective of this study was to assess the functional efficacy of newly developed antirefluxive ureter stents (DJ), by performing immediate post-stenting cystograms on patients with acute ureteral obstruction requiring a DJ stent, and assessing stent-related symptoms by means of ureteral stent symptoms questionnaire (USSQ). Patients with acute hydronephrosis requiring internal drainage were randomized to receive either an antirefluxive DJ or a conventional DJ (7 Fr., 26 cm, polyurethane, Urovision(®), Germany). Mean stone size was 6.64 ± 3.33 and 6.5 ± 3.54 mm. Immediately after correct placement of the DJ, 200 ml of diluted contrast media was introduced into the bladder under fluoroscopic control to detect vesicoureteral reflux (VUR). Patients completed German versions of the USSQ on days 2 and 7 following stent placement, and 1 week after stent removal. The results were analyzed. 13 conventional and 16 antirefluxive stents were placed in 29 patients. Reflux was documented in eight conventionally stented patients (62.5%). Two of the 16 patients with antirefluxive stents (22%) presented reflux. 1 week after stent implantation, the mean pain value was 1.1 in the antirefluxive group and 3 in the standard group (p < 0.062). Flank pain during micturition occurred after 2 days in seven patients (58%) with standard stents and in three patients (33%) with antirefluxive stents (p < 0.23). 1 week after stent insertion, flank pain had dropped to 40% in the standard group and 11% in the antirefluxive group (p < 0.3). Our initial experience showed that the antirefluxive system might be effective in terms of reflux prevention and reduction of stent related symptoms especially during sexual intercourse. PMID:21850408

Ritter, Manuel; Krombach, Patrick; Knoll, Thomas; Michel, Maurice Stephan; Haecker, Axel

2012-08-01

51

Preset ureter catheter in laparoscopic radical hysterectomy of cervical cancer.  

PubMed

The aim of this study was to evaluate the clinical efficacy of a temporary ureteral catheter in preventing iatrogenic ureteral damage in cervical cancer patients undergoing laparoscopic radical hysterectomy. All cases had confirmed diagnoses of cervical cancer preoperatively between December 2008 and December 2012 in our hospital and were in clinical stages IA2 to IIA. In total, 176 laparoscopic radical hysterectomy and lymphadenectomy procedures were performed. The 176 cases were divided into two groups: ureteral catheters were installed using cystoscopy before the operation in 86 patients (group A), and ureteral catheters were not placed in 90 patients (group B). These cases were retrospectively analyzed based on postoperative hospitalization time and intraoperative and postoperative complications. A total of 6 cases (3.41%) had ureteral injuries, and 4 of the cases (4.65%) of ureteral injuries occurred in group A. In two of these cases, urinary leaking appeared at the post-operative 8th and 9th days and at the 10th and 25th days, respectively. There were 2 cases (2.22%) of ureteral injuries in group B: 1 case of intraoperative direct injury and the other of urinary leaking, which appeared at post-operative day 21. Statistically significant differences between the two groups were observed in operating time and the incidence of hemorrhage, hematuria (including microscopic hematuria), post-operative urinary tract infection, and pain (P < 0.05). A ureteral catheter that is placed preoperatively can help to identify the ureter in laparoscopic radical hysterectomy, but does not decrease the incidence of ureteral injury. PMID:24854443

Han, L; Cao, R; Jiang, J Y; Xi, Y; Li, X C; Yu, G H

2014-01-01

52

Metachronous Primary Adenocarcinoma of Distal and Proximal Ureter within Two Years  

PubMed Central

Primary adenocarcinoma of the upper urinary tract, particularly of the ureter, is an extremely rare entity. We are reporting on the first case of metachronous appearance in one patient. The 71-year-old man underwent partial ureterectomy (R0 resection) for primary adenocarcinoma of the left distal ureter. 3 years later, nephroureterectomy had to be performed because of metachronous primary adenocarcinoma of the left proximal ureter. Extensive examinations revealed no evidence for further malignancies at both times. Primary adenocarcinoma of the upper urinary tract is rare but should be kept in mind, especially in patients with chronic inflammation and urinary tract obstruction. Due to the low incidence, there is a lack of data regarding its pathogenesis, diagnosis, and optimal treatment.

Abt, Dominik; Mullhaupt, Gautier; Mordasini, Livio; Diener, Pierre Andre; Schmid, Hans-Peter

2014-01-01

53

Comparison of a New Polytetrafluoroethylene-Covered Metallic Stent to a Noncovered Stent in Canine Ureters  

SciTech Connect

The aim of this study was to determine the feasibility of using a newly designed polytetrafluoroethylene (PTFE)-covered metallic stent in the ureter by comparing its effectiveness with that of the noncovered stent in a canine model. We placed 14 stents in the ureters of seven mongrel dogs that weighed 30-40 kg each. The covered and noncovered stents were deployed in the right and left ureters, respectively, of six dogs. In the seventh dog, a covered stent and a double-J catheter were inserted in the right ureter, and a covered stent only was inserted in the left ureter. The first six dogs were sacrificed at 5, 10, and 15 weeks after deployment of the stents (two for each follow-up period), and the seventh dog was sacrificed at 30 weeks. There was no migration or poor expansion of any of the stents observed on plain radiography. On intravenous pyelogram and retrograde pyelogram, all of the covered stents at each follow-up period had patent lumens at the stented segments without hydronephrosis, and the passage of contrast material through it was well preserved. The noncovered stents in the dogs sacrificed at 5 and 10 weeks and one of the two dogs sacrificed at 15 weeks showed near-complete occlusion of the stent lumen due to ingrowth of the soft tissue, and severe hydronephrosis was also noted. The noncovered stent in the other dog sacrificed at 15 weeks showed the passage of contrast material without hydronephrosis, but the lumen of the stent was still nearly occluded by the soft tissue. There was no evidence of hydronephrosis or passage disturbance of the contrast material in both ureters of the dog sacrificed at 30 weeks. We conclude that the newly designed PTFE-covered stent effectively prevented the luminal occlusion caused by urothelial hyperplasia compared to the near-total occlusion of the noncovered stents, and no migration of the covered stents was noted.

Chung, Hwan-Hoon, E-mail: chungmic@korea.ac.kr; Lee, Seung Hwa; Cho, Sung Bum [Ansan Hospital, Korea University College of Medicine, Department of Radiology (Korea, Republic of); Park, Hong Suk [Korea University, Ansan Hospital, Department of Urology (Korea, Republic of); Kim, Young Sik [Korea University, Ansan Hospital, Department of Pathology (Korea, Republic of); Kang, Byung Chul [Ewha Women's University, Mokdong Hospital, Department of Radiology (Korea, Republic of); Frisoli, Joan K.; Razavi, Mahmood K. [Stanford University Medical Center, Department of Vascular and Interventional Radiology (United States)

2008-05-15

54

Comparison of a new polytetrafluoroethylene-covered metallic stent to a noncovered stent in canine ureters.  

PubMed

The aim of this study was to determine the feasibility of using a newly designed polytetrafluoroethylene (PTFE)-covered metallic stent in the ureter by comparing its effectiveness with that of the noncovered stent in a canine model. We placed 14 stents in the ureters of seven mongrel dogs that weighed 30-40 kg each. The covered and noncovered stents were deployed in the right and left ureters, respectively, of six dogs. In the seventh dog, a covered stent and a double-J catheter were inserted in the right ureter, and a covered stent only was inserted in the left ureter. The first six dogs were sacrificed at 5, 10, and 15 weeks after deployment of the stents (two for each follow-up period), and the seventh dog was sacrificed at 30 weeks. There was no migration or poor expansion of any of the stents observed on plain radiography. On intravenous pyelogram and retrograde pyelogram, all of the covered stents at each follow-up period had patent lumens at the stented segments without hydronephrosis, and the passage of contrast material through it was well preserved. The noncovered stents in the dogs sacrificed at 5 and 10 weeks and one of the two dogs sacrificed at 15 weeks showed near-complete occlusion of the stent lumen due to ingrowth of the soft tissue, and severe hydronephrosis was also noted. The noncovered stent in the other dog sacrificed at 15 weeks showed the passage of contrast material without hydronephrosis, but the lumen of the stent was still nearly occluded by the soft tissue. There was no evidence of hydronephrosis or passage disturbance of the contrast material in both ureters of the dog sacrificed at 30 weeks. We conclude that the newly designed PTFE-covered stent effectively prevented the luminal occlusion caused by urothelial hyperplasia compared to the near-total occlusion of the noncovered stents, and no migration of the covered stents was noted. PMID:18214599

Chung, Hwan-Hoon; Lee, Seung Hwa; Cho, Sung Bum; Park, Hong Suk; Kim, Young Sik; Kang, Byung Chul; Frisoli, Joan K; Razavi, Mahmood K

2008-01-01

55

Simultaneous bilateral iliac artery-to-ureter fistulae--an unusual case report.  

PubMed

Formation of an artery-to-ureter fistula (AUF) is a rare event caused by pelvic surgery or ureteral instrumentation. This presentation details the unique occurrence and treatment of simultaneous bilateral iliac artery-to-ureter fistulae. A 55-year-old man developed significant arterial hemorrhage during ureteral stent removal initially from the right and, subsequently, from the left side. Following expedient ureteral balloon tamponade, endovascular management via femoral approach with vein-covered stents was successful for each fistula without adverse long-term effects. Endoluminal therapy using autologous tissue-covered stents represents a simple, yet durable, treatment option in these challenging cases. PMID:15064851

Uzieblo, Matthew R; Rubin, Brian G

2004-01-01

56

[Ectopia of the right ureter as the cause of a cystic abdominal space-occupying lesion].  

PubMed

Ureteral ectopias, which mostly occur in ureteral duplications, become noticeable in women quite early by characteristic clinical signs (dribble, or urinary incontinence). In males, it is usually only a stenosis-conditioned dilatation of the ureter that results in an uncharacter-istic pattern of complaints. The article presents the clinical pattern of signs and the x-ray findings in a man of 42 year of age, who had not reported any complaints until then, with an excessive dilatation of an extopically discharging single ureter. PMID:2315638

Will, C W

1990-01-01

57

Segmental replacement of the left ureter using a pedicted and tapered gastric flap in dogs  

Microsoft Academic Search

Segmental replacement of the left ureter was done using a pedicted and tapered gastric flap in ten dogs. All were followed up for 12 weeks. The results of the operation were good. Serum electrolyte imbalance was not observed in any dog. Intravenous pyelograms were normal except in one animal that had mild calyceal dilatation. Postoperative values of blood urea nitrogen

Mehmet Pul; Nuran Yilmaz Pul; Naci Giirses

1992-01-01

58

The response of the urinary bladder, urethra, and ureter to radiation and chemotherapy  

Microsoft Academic Search

A comprehensive review of the physiological and clinical response of the urinary bladder, ureter, and urethra to radiation and chemotherapy is presented. The clinical syndromes that follow therapy for cancer of the bladder, prostate, and cervix are reviewed in detail. Methods of assessing, scoring, and managing toxicity are discussed.

Lawrence B. Marks; Peter R. Carroll; Thomas C. Dugan; Mitchell S. Anscher

1995-01-01

59

Three-Dimensional Imaging of Ureter with Endoscopic Optical Coherence Tomography  

PubMed Central

OBJECTIVES To verify the ability to identify the layered structures of ureteral wall and to image a segment of ureter in three dimensions with a high speed endoscopic optical coherence tomography (EOCT). METHODS We imaged a porcine ureter ex vivo using a spectral domain EOCT with an specially designed circumferential scanning fiber catheter. The images were correlated with the histology to identify corresponding structures. Three-dimensional images and en face images at different depths from the luminal surface were reconstructed from the multiple cross-sectional images to visualize the layered structure of a segment of the ureter from different perspectives. RESULTS EOCT images can clearly reveal all layers of the ureteral wall as shown in the histological images. Especially, with the specially designed fiber catheter, the light beam was well centered during the rotation and pull back, which allowed constant acquisition of high fidelity images and unambiguous identification of the smooth muscle layers in all images. With high speed EOCT, a segment of ureter (20 mm) can be imaged in less than 90 seconds at a high resolution. CONCLUSIONS With its ability to visualize all layers of the ureteral wall, EOCT imaging offers the potential to stage urothelial cancers that have infiltrated the muscular wall (stage T2). This information will be complimentary to the diagnostic information obtained through ureteroscopic biopsy and CT urogram.

Wang, Hui; Kang, Wei; Zhu, Hui; MacLennan, Gregory; Rollins, Andrew M.

2010-01-01

60

Laparoscopic Transvesical Resection of an En Bloc Bladder Cuff and Distal Ureter during Nephroureterectomy  

PubMed Central

Objective. The most appropriate technique for excising the distal ureter and bladder cuff during laparoscopic nephroureterectomy is still debated. We report our experience with a pure laparoscopic transvesical method that duplicates the long-standing open transvesical approach. Materials and Methods. Seven men and three women diagnosed with upper tract transitional cell carcinoma were treated with this procedure. Three intravesical ports were inserted, and pneumovesicum was established at 12?mmHg. Transvesical laparoscopic circumferential detachment of the bladder cuff and en bloc mobilization of the last centimeters of the distal ureter were performed, followed by the closure of the bladder defect. Subsequently, a nephrectomy was performed either laparoscopically or using an open flank approach. Results. The median age was 68.5 years. The procedure was completed uneventfully in all cases. The median operating time for distal ureter excision was 82.5 minutes (range 55–120). No complications directly related to the pneumovesicum method were recorded. The median follow-up period was 31 months (range 12–55). During the follow-up period, two patients (20%) died from the disease, and a bladder tumor developed in three cases (30%). Conclusion. The laparoscopic transvesical resection of the en bloc bladder cuff and distal ureter is a reliable, effective, and oncologically safe technique, at least in the midterm.

Giannakopoulos, Stilianos; Toufas, George; Dimitriadis, Charalampos; Giannopoulos, Stavros; Kalaitzis, Christos; Bantis, Athanasios; Patris, Emmanuel; Touloupidis, Stavros

2012-01-01

61

[Ureteral invagination caused by a fibroepithelial polyp of the ureter. Apropos of a case].  

PubMed

This article reports a new case of intussusception due to a ureteral polyp. The diagnosis was based on the preoperative radiological aspects. The polyp was both invaginated and twisted, and was removed along with a segment of the ureter. PMID:4096515

Haupert, S; Janin-Mercier, A; Camillieri, L; Baills, J P; Olier, C

1985-01-01

62

[Carcinomatous meningitis from urothelial carcinoma of bladder and ureter: case report].  

PubMed

Carcinomatous meningitis from urothelial carcinoma of the bladder and ureter is rare. A 77-year-old man with invasive bladder cancer and right ureter cancer had been treated with 3 courses M-VAC (methotrexate, vinblastine, epirubicin, cisplatin) chemotherapy. After chemotherapy we performed radical cystectomy and right nephroureterectomy (ileal-neobladder) (TCC, G3, pT3, N0, M0). Sixteen months after operation, patient complained of anorexia, muscular weakness, stiff neck. CT of chest and abdomen, and bone scintigraphy showed no metastasis. Brain CT and MRI showed hydrocephalus but no evidence of parenchymal metastasis. Because we suspected carcinomatous meningitis, we performed lumbar puncture. Cerebrospinal fluid cytology revealed class V (urothelial carcinoma). Patient died 6 days after diagnosis of carcinomatous meningitis. PMID:15624493

Matsushita, Mabumi; Kawasaki, Yoshihide; Okada, Yasuhiro

2004-11-01

63

Ileal bladder augmentation combined with ileal ureter replacement in advanced urogenital tuberculosis.  

PubMed

We report a case of active tuberculosis associated with a right nonfunctioning kidney and nearly total loss of bladder capacity. Percutaneous nephrostomy and right nephroureterectomy were performed while the patient was undergoing triple drug therapy. Definitive surgical treatment consisted of ileal bladder augmentation and ileal ureter replacement. Normal urodynamics of the upper urinary tract and normal voiding with complete return of bladder capacity were achieved. Metabolic acidosis was treated successfully by sodium hydrogen carbonate. PMID:8158783

Carl, P; Stark, L

1994-05-01

64

Dilated ureters, renal dysplasia, and chronic renal failure in an African elephant (Loxodonta africana).  

PubMed

An ultrasonographic reproductive health examination of a 26-yr-old female African elephant (Loxodonta africana) revealed bilateral ureteral wall thickening and dilatation. On ultrasonographic examination, the bladder and both ureters were normal near the trigone; however, the cranial-most aspect of each ureter was dilated and thickened for a length of 30-50 cm. The same month, elevated blood creatinine (3.0 mg/dl), and urine protein-creatinine ratio (4.0) were observed. Chronic renal failure was diagnosed based on these abnormalities, and the persistent ureteral dilatation was seen on subsequent ultrasound examinations. Complete blood cell counts, serum chemistries, and urinalyses remained relatively unchanged until 24 mo after diagnosis, at which time azotemia, hypophosphatemia, and hypercalcemia (including elevated ionized calcium) developed. Hydronephrosis of both kidneys and prominent sacculation of the left ureter were noted on ultrasonographic examination. Lethargy, ventral edema, and oral mucosal ulceration acutely developed 30 mo after diagnosis. Although blood urea nitrogen remained elevated, creatinine, total calcium, and ionized calcium returned to within reference ranges at that time. Due to rapid clinical decline and grave prognosis, humane euthanasia was elected. Bilateral ureteral dilatation, dysplasia of the right kidney, and chronic nephritis of the left kidney were identified postmortem. PMID:22448523

Jankowski, Gwen; Langan, Jennifer N; Adkesson, Michael J; Terio, Karen A; Mylniczenko, Natalie D; Meehan, Tom; Schmitt, Dennis

2012-03-01

65

Retroperitoneal sarcoma involving unilateral double ureter: management, treatment and psychological implications.  

PubMed

The case of a 45-year-old woman who was admitted to our university hospital for polymenorrhea, weight gain and pain in the left iliac region is reported. An abdominal ultrasound revealed a 9.5 × 5.2-cm, hypoechoic and inhomogeneous mass located on the left side of the pelvis and behind the ovary. The patient underwent surgery. The pelvic mass was firmly anchored to the small intestine, colon, sigma and uterine fundus. After removing the adhesions, double ureters, which had been incorporated in the mass, were observed on the left side. Resection of the unilateral double ureters was necessary in order to remove the entire mass, and thereafter, a left salpingoophorectomy was performed. A histological examination showed a malignant retroperitoneal mass. Termino-terminal ureteral anastomosis with two double-J stents was carried out. Total hysterectomy with preservation of the right adenexum and regional lymphadenectomy was performed. The purpose of this case report is to discuss the physical and psychological implications related to the combination of two rare entities: leiomyosarcoma and a double ureter located within the mass. A literature review on the clinical management and psychological aspects from a female cancer patient's perspective undergoing surgery with the aforementioned disorders will be discussed. PMID:24932171

Leanza, Vito; Garraffo, Claudia; Leanza, Gianluca; Leanza, Antonio

2014-05-01

66

Retroperitoneal Sarcoma Involving Unilateral Double Ureter: Management, Treatment and Psychological Implications  

PubMed Central

The case of a 45-year-old woman who was admitted to our university hospital for polymenorrhea, weight gain and pain in the left iliac region is reported. An abdominal ultrasound revealed a 9.5 × 5.2-cm, hypoechoic and inhomogeneous mass located on the left side of the pelvis and behind the ovary. The patient underwent surgery. The pelvic mass was firmly anchored to the small intestine, colon, sigma and uterine fundus. After removing the adhesions, double ureters, which had been incorporated in the mass, were observed on the left side. Resection of the unilateral double ureters was necessary in order to remove the entire mass, and thereafter, a left salpingoophorectomy was performed. A histological examination showed a malignant retroperitoneal mass. Termino-terminal ureteral anastomosis with two double-J stents was carried out. Total hysterectomy with preservation of the right adenexum and regional lymphadenectomy was performed. The purpose of this case report is to discuss the physical and psychological implications related to the combination of two rare entities: leiomyosarcoma and a double ureter located within the mass. A literature review on the clinical management and psychological aspects from a female cancer patient's perspective undergoing surgery with the aforementioned disorders will be discussed.

Leanza, Vito; Garraffo, Claudia; Leanza, Gianluca; Leanza, Antonio

2014-01-01

67

Retroperitoneal Lymph Nodes in Transitional Cell Carcinoma of the Kidney and Ureter  

PubMed Central

The incidence of transitional cell carcinoma of the kidney and ureter is low and for that reason limited data exists regarding the appropriate management of regional retroperitoneal lymph nodes. Lymph node metastases have consistently been associated with an adverse prognosis. However, five-year cancer-specific survival following nephroureterectomy and lymphadenectomy for patients with lymph node involvement ranges from 0–39%, suggesting a therapeutic benefit. This review covers the primary tumor characteristics associated with lymph node involvement, imaging of the lymph nodes, as well as the rationale, role, patient selection, suggested anatomic templates, and technical considerations for lymphadenectomy.

Kundu, Shilajit D.; Eggener, Scott E.

2009-01-01

68

Immunoglobulin G4-Related Systemic Sclerosing Disease: A Case Involving the Ureter and Kidney  

PubMed Central

Immunoglobulin (Ig) G4-related sclerosing disease is a newly defined clinicopathological entity characterized by lymphoplasmacytic infiltration of IgG4-positive plasma cells and varying degrees of fibrosis within affected tissues. Patients usually exhibit multisystem involvement and often respond well to steroid and immunosuppressive therapy. This report presents a case of IgG4-related sclerosing disease involving the ureter and kidney. We hope to bring IgG4-related sclerosing disease to the attention of urologists, because it is an uncommon disease that commonly responds to systemic corticosteroids.

Kim, Sunchan; Kim, Tae Gu; Choi, Seung-Kwon; Kim, Myung Joon; Min, Gyeong Eun; Lee, Hyung-Lae

2013-01-01

69

Mixed epithelial and stromal tumor of the kidney with polypoid component extending into renal pelvis and ureter  

PubMed Central

Mixed epithelial and stromal tumor (MEST) of the kidney is an unusual benign neoplasm that predominantly occurs in middle-aged females. It typically appears as a well-circumscribed multiseptate mass with solid components on computed tomography (CT) or magnetic resonance image (MRI), reflecting its characteristics of an admixture of stromal proliferation and epithelial cells consisting of multiple cysts. We present a rare case of 61-year-old woman with MEST, which manifested as a multilocular cystic mass with a polypoid component protruding into the renal pelvis and ureter. To our best knowledge, this is the first case of MEST extending into the ureter.

Horikawa, Masahiro; Shinmoto, Hiroshi; Kuroda, Kenji; Shiomi, Eisuke; Soga, Shigeyoshi; Ito, Keiichi; Tachi, Kazuyoshi; Katsurada, Yuka; Simazaki, Hideyuki; Asano, Tomohiko; Kaji, Tatsumi

2012-01-01

70

A Patient with Fibroepithelial Polyp of the Ureter--A Rare Condition Mimicking Malignancy: A Case Report  

PubMed Central

A 61-year-old man presented with hematuria and intermittent right pelvic pain. Intravenous urography showed a tubular filling defect and ureteroscopy a tumor in the right mid ureter. Urine cytology and tumor biopsy showed nonmalignant results. Open surgery was performed, and an intraoperative frozen section revealed a fibroepithelial polyp of the right mid ureter. A fibroepithelial polyp is a rare benign lesion that can occur in childhood but is an important differential diagnosis of an upper urinary tract urothelial cell carcinoma in adults.

Brummeisl, Wolfgang; Fritsche, Hans-Martin; Huber, Elisabeth; Wieland, Wolf F.; Ganzer, Roman

2012-01-01

71

Jejunal torsion around the right ureter presenting as postoperative bowel obstruction: a case report  

PubMed Central

Introduction Since abdominal radical hysterectomy was first described by Clark and Reis in 1895, it has been commonly used in the primary surgical treatment of carcinoma of the cervix. We report the case of a 45-year-old woman who was diagnosed with a small bowel obstruction due to jejunal torsion to her right ureter mimicking postoperative adhesion ileus. Case presentation A 45-year-old Turkish woman was admitted to our emergency department with complaints of abdominal pain, constipation, nausea and vomiting. She had undergone an abdominal radical hysterectomy for cervical carcinoma three years earlier. Computed tomography scans revealed intestinal dilatation, a large amount of free fluid in the abdominal cavity and an area suspicious for jejunal perforation. Because of these radiological findings suggestive of obstruction and bowel ischemia, our patient underwent emergency surgery. Operative findings that showed a jejunal segment was turned around her right ureter so that it was mimicking a fibrous band. Conclusions In this current case, we present the first determined complication of radical hysterectomy. According to our case report, surgical oncologists should be aware of this complication and review the surgical technique. It is considered that readaptation of the dorsolateral peritoneal layer after extended pelvic lymph node dissection resulted in fewer complications.

2014-01-01

72

A rare complication: misdirection of an indwelling urethral catheter into the ureter.  

PubMed

We report 3 patients with the rare complication of an indwelling urethral catheter misdirected into the ureter. This is the largest series to date. Patients were referred to us for a variety of reasons following exchange of their chronic indwelling urinary catheters. CT in all cases demonstrated the urinary catheters residing in the left ureter. The ages of the patients were 37, 67 and 81 years old. All patients suffered from neurogenic bladder. Two patients were female, one was male, and 2 of the 3 had a sensory disorder inhibiting their pain response. The catheters were replaced with open-end Foley catheters. Extensive follow-up CT scans were obtained in one case, demonstrating improvement of hydronephrosis and no evidence of ureteral stenosis. Cystoscopy in this patient demonstrated normally positioned and functioning ureteral orifices. Although the placement of an indwelling urethral catheter is a comparatively safe procedure, one must keep in mind that this complication can occur, particularly in female patients with neurogenic bladder. CT without contrast is a noninvasive, definitive diagnostic tool. PMID:24553489

Ishikawa, Tsutomu; Araki, Motoo; Hirata, Takeshi; Watanabe, Masami; Ebara, Shin; Watanabe, Toyohiko; Nasu, Yasutomo; Kumon, Hiromi

2014-02-01

73

Maturation of ureter-bladder connection in mice is controlled by LAR family receptor protein tyrosine phosphatases  

Microsoft Academic Search

Congenital anomalies affecting the ureter-bladder junction are frequent in newborns and are often associated with other developmental defects. However, the molecular and morphological processes underlying these malformations are still poorly defined. In this study, we identified the leukocyte antigen-related (LAR) family protein tyrosine phosphatase, receptor type, S and F (Ptprs and Ptprf [also known as Lar], respectively), as crucially important

Noriko Uetani; Kristen Bertozzi; Melanie J. Chagnon; Wiljan Hendriks; Michel L. Tremblay; Maxime Bouchard

2009-01-01

74

Congenital vesicovaginal fistula with transverse vaginal septum and ectopic ureter opening in proximal vagina: case report and brief review.  

PubMed

Congenital vesicovaginal fistula is an extreme rarity. We report on a case of a 22-year-old lady who presented with menouria and infertility. On evaluation, she was found to have congenital vesicovaginal fistula, a nonfunctioning right kidney with ectopic ureter and transverse vaginal septum. Abdominal repair of the fistula, right nephroureterectomy, and excision of the vaginal septum was performed. PMID:17143654

Kumar, Santosh; Mandal, Arup; Acharya, Naveen; Jain, Vanita; Kalra, Jaswinder; Singh, Shrawan

2007-08-01

75

Endoscopic treatment of vesicoureteric reflux with dextranomer/hyaluronic acid copolymer (Deflux): Single-surgeon experience with 48 ureters  

PubMed Central

Purpose: VUR is a common urologic problem in children. Cystoscopic injection of bulking agents (most commonly Deflux) has gained popularity as the first line treatment in the west. However, primarily due to cost factors, it has not gained much popularity in our country. We present our initial experience with cystoscopic Deflux injection for VUR. Materials and Methods: We reviewed our 3-yr experience with the use of Dx/HA (Deflux) for correction of VUR in children and adolescents. All children were evaluated with Ultrasound, MCUG and DMSA renal cortical scan. The indications for surgical correction of VUR included breakthrough infections while on antibiotic prophylaxis, persistent high-grade VUR beyond 3 yrs of age, and presence of significant renal damage on DMSA at diagnosis (in those children presenting with UTI). All children underwent cystoscopic Deflux injection using the standard technique of subureteral injection (0.4-1 ml per ureter). All children received antibiotic prophylaxis for 3-6 months after the injection. USG was done at 1 month and MCUG at 3-6 months after the injection. Results: 33 patients (48 ureters) underwent cystoscopic Deflux injection for correction of VUR. Mean age was 4.5 yrs (1-17 yrs); there were 12 boys and 21 girls. Thirteen children had antenatally diagnosed HDN, while 20 children presented with febrile UTI. All children had primary VUR except one child with persistent VUR 4 yrs after PUV fulguration. The VUR was grade 1-2 in 8, grade 3-4 in 37, and grade 5 in 3 ureters. Every child had at least one ureter with dilating reflux (grades 3,4 or 5). When present, low grade VUR (grade 1or 2) was always on the contralateral side. Only one child received a 2nd injection after 6 months. Follow-up MCUG was done in 28 children (41 ureters). Complete reflux resolution was achieved in 27 ureters (65%), and the reflux was downgraded in 2 (5%). There were no complications of Deflux injection. Conclusions: Endoscopic correction of VUR in children is a safe and effective minimally invasive treatment for VUR. It stops or downgrades VUR in 70% of ureters. At present, we recommend it as a first-line treatment for grades 1-4 VUR requiring surgical management. Cost is the major factor limiting its use in our country.

Chandrasekharam, V. V. S.

2013-01-01

76

Inverted papilloma of the ureter: study of a rare case with emphasis on clinicopathologic implications.  

PubMed

A 62-year old male patient presented complaining of intermittent macroscopic hematuria. The ultrasonographic investigation revealed a hydronephrosis of remarkable degree with indiscrete renal parenchyma. The abdominal computed tomography scan identified a ureteral lesion with proximal dilatation, hydronephrosis and a functionless ipsilateral renal unit. The retrograde urography showed a 4-cm lesion with multiple filling defects and a smooth contour. The endoscopic examination showed an exophytic lesion, highly suspicious for malignancy. Urine cytology revealed atypia. Right nephroureterectomy was performed and the pathology revealed a ureteral inverted papilloma (UIP). Polymerase chain reaction examination for the presence of human papilloma virus, using GP5+/6+ consensus primers, was negative. The presence UIP should be considered in patients with urotheleal lesions in the ureter when the diagnostic workup for malignancy is inconclusive. The clinical course of the disease seems to be favorable. PMID:23283103

Mertziotis, Nikolaos; Kozyrakis, Diomidis; Petrolekas, Andreas; Terzi, Maria; Kapranos, Nikiforos

2012-12-01

77

Absence of vagina and hypoplasia of the urethra and ectopia of the ureter.  

PubMed

A 16-year-old Japanese girl was admitted for evaluation of complaints of primary amenorrhea, cyclic lower abdominal pain, and urinary incontinence. Her vaginal introitus appeared rudimentary with a depth of 0.5 cm and hypoplasia of the hymenal ring. A hypoplastic urethra (diameter: 1 cm; length: 0.5 cm) and 1 of 2 right ectopic ureters opened into the introitus. Transabdominal ultrasonography demonstrated fluid distending the uterus, the proximal 1/3 of the vagina, and the pouch of Douglas. Computed tomography (CT) and magnetic resonance imaging (MRI) confirmed the presence of hematometrocolpos and fluid collection in the pouch of Douglas. These associated anomalies can be due to faulty growth of the urogenital sinus. In addition to the transabdominal ultrasonography and CT, MRI was useful in the diagnosis and evaluation of vaginal agenesis. PMID:8987327

Nasu, K; Yoshimatsu, J; Miyakawa, I; Nakagawa, M; Nomura, Y

1996-10-01

78

Hepatoid adenocarcinoma of the ureter: unusual case presenting hepatic and ovarian metastases.  

PubMed

Hepatoid adenocarcinoma is a rare neoplasm, which has a striking morphologic similarity to hepatocarcinoma. It has been described in different organs, the most common are stomach, lung, and pancreas. In some cases, it is characterized by high serum levels of ?-fetoprotein. This tumor has a pattern similar to the hepatocarcinoma. The typical features are a combination of histopathologic aspects of solid nests and trabecular structures of polygonal atypical cells with eosinophil and granular cytoplasm and immunohistochemical expression of ?-fetoprotein and of carcinoembryonic antigen in half of cases. Here, we report the case of an old female patient affected by hepatoid adenocarcinoma of the ureter with ovarian, small intestine, and hepatic involvement. We discuss the clinical aspects, the morphologic features, and the immunoistochemical staining useful for differential diagnosis. PMID:21558843

Rotellini, Matteo; Messerini, Luca; Stomaci, Niceta; Raspollini, Maria Rosaria

2011-10-01

79

Suprapubic transvesical single-port technique for control of lower end of ureter during laparoscopic nephroureterectomy for upper tract transitional cell carcinoma  

PubMed Central

Context: Various minimally invasive techniques – laparoscopic, endoscopic or combinations of both - have been described to handle the lower ureter during laparoscopic nephroureterectomy but none has received wide acceptance. Aims: We describe an endoscopic technique for the management of lower end of ureter during laparoscopic nephroureterectomy using a single suprapubic laparoscopic port. Materials and Methods: Transurethral resectoscope is used to make a full thickness incision in the bladder cuff around the ureteric orifice from 1 o’clock to 11 o’clock. A grasper inserted through the transvesical suprapubic port is used to retract the ureter to complete the incision in the bladder cuff overlying the anterior aspect of the ureteric orifice. The lower end of ureter is subsequently sealed with a clip applied through the port. This is followed by a laparoscopic nephrectomy and the specimen is removed by extending the suprapubic port incision. Our technique enables dissection and control of lower end of ureter under direct vision. Moreover, surgical occlusion of the lower end of the ureter prior to dissection of the kidney may decrease cell spillage. The clip also serves as a marker for complete removal of the specimen. Results: Three patients have undergone this procedure with an average follow up of 19 months. Operative time for the management of lower ureter has been 35, 55 and 40 minutes respectively. A single recurrence was detected on the opposite bladder wall after 9 months via a surveillance cystoscopy. There has been no residual disease or any other locoregional recurrence. Conclusions: The described technique for management of lower end of ureter during laparoscopic nephroureterectomy adheres to strict oncologic principles while providing the benefit of a minimally invasive approach.

Ahlawat, Rajesh K.; Gautam, Gagan

2011-01-01

80

Effect of Bay K 8644 and ryanodine on the refractory period, action potential and mechanical response of the guinea-pig ureter to electrical stimulation  

Microsoft Academic Search

We have investigated the effect of the dihydropyridine calcium channel agonist, Bay K 8644, and of the plant alkaloid blocker\\u000a of calcium-induced calcium release (CICR) from the sarcoplasmic reticulum, ryanodine, on the refractory period, action potential\\u000a and mechanical response of the guinea-pig isolated ureter to electrical stimulation. All experiments were performed in ureters\\u000a pre-exposed to 10 ?M capsaicin to eliminate

Carlo Alberto Maggi; Sandro Giuliani; Paolo Santicioli

1994-01-01

81

A Rare Presentation of the Double Inferior Vena Cava with an Anomalous Retrocaval Right Ureter: Embryogenesis and Clinical Implications  

PubMed Central

On dissection of the abdomen of an adult male cadaver, in addition to the normal inferior vena cava on the right side, an unusual venous channel which connected the left renal vein with the left common iliac vein was found; (probably the left inferior vena cava). The left testicular and the left suprarenal veins were opening into the left renal vein as usual. Other than this, a retrocaval ureter was found on the right side. The works of previous authors have highlighted the incidence of a venacaval duplication and its surgical implications, but here, we are presenting a unique case of a double inferior vena cava with an anomalous retrocaval ureter. A conglomeration of such vascular malformations is of immense surgical importance, and it is indicative of a grossly defective angiogenesis. Keeping in mind the clinical relevance of the variations which were observed, an attempt was made to explain them in the light of the embryogenic development.

Gupta, Pratibha; Khullar, Meenakshi; Sharma, Ravikant; Singh, Richhpal

2013-01-01

82

Two thermoformable spiral metallic ureteral stents in a patient with ileal conduit and distal stenosis of the ureters.  

PubMed

The insertion of two thermoformable ureteral titanium spiral stents (Memokath® 051) through ileal conduit due to bilateral ureteral stenosis distally has not been described in the English literature so far. We present the case of a young female patient with a history of ileal conduit urinary diversion due to congenital urinary bladder exstrophy, who had multiple previous surgeries and the insertion of two Memokath® ureteral stents in both ureters due to distal ureteral stenosis. PMID:23154754

Al-Mahmid, M; Ahrens, U; Zimmer, S; Winand, S; Özgür, E; Engelmann, U H; Wille, S

2013-01-01

83

Congenital vesicovaginal fistula with transverse vaginal septum and ectopic ureter opening in proximal vagina: case report and brief review  

Microsoft Academic Search

Congenital vesicovaginal fistula is an extreme rarity. We report on a case of a 22-year-old lady who presented with menouria\\u000a and infertility. On evaluation, she was found to have congenital vesicovaginal fistula, a nonfunctioning right kidney with\\u000a ectopic ureter and transverse vaginal septum. Abdominal repair of the fistula, right nephroureterectomy, and excision of the\\u000a vaginal septum was performed.

Santosh Kumar; Arup Mandal; Naveen Acharya; Vanita Jain; Jaswinder Kalra; Shrawan Singh

2007-01-01

84

Characterization of the 5-hydroxytryptamine receptors mediating contraction in the pig isolated intravesical ureter  

PubMed Central

This study was designed to investigate the effect of 5-hydroxytryptamine (5-HT) and to characterize the 5-HT receptors involved in 5-HT responses in the pig intravesical ureter. 5-HT (0.01–10 ?M) concentration-dependently increased the tone of intravesical ureteral strips, whereas the increases in phasic contractions were concentration-independent. The 5-HT2 receptor agonist ?-methyl 5-HT, mimicked the effect on tone whereas weak or no response was obtained with 5-CT, 8-OH-DPAT, m-chlorophenylbiguanide and RS 67333, 5-HT1, 5-HT1A, 5-HT3 and 5-HT4 receptor agonists, respectively. 5-HT did not induce relaxation of U46619-contracted ureteral preparations. Pargyline (100 ?M), a monoaminooxidase A/B activity inhibitor, produced leftward displacements of the concentration-response curves for 5-HT. 5-HT-induced tone was reduced by the 5-HT2 and 5-HT2A receptor antagonists ritanserine (0.1 ?M) and spiperone (0.2 ?M), respectively. However, 5-HT contraction was not antagonized by cyanopindolol (2 ?M), SDZ–SER 082 (1 ?M), Y-25130 (1 ?M) and GR 113808 (0.1 ?M), which are respectively, 5-HT1A/1B, 5-HT2B/2C, 5-HT3, and 5-HT4 selective receptor antagonists. Removal of the urothelium did not modify 5-HT-induced contractions. Blockade of neuronal voltage-activated sodium channels, ?-adrenergic receptors and adrenergic neurotransmission with tetrodotoxin (1 ?M), phentolamine (0.3 ?M) and guanethidine (10 ?M), respectively, reduced the contractions to 5-HT. However, physostigmine (1 ?M), atropine (0.1 ?M) and suramin (30 ?M), inhibitors of cholinesterase activity, muscarinic- and purinergic P2-receptors, respectively, failed to modify the contractions to 5-HT. These results suggest that 5-HT increases the tone of the pig intravesical ureter through 5-HT2A receptors located at the smooth muscle. Part of the 5-HT contraction is indirectly mediated via noradrenaline release from sympathetic nerves.

Hernandez, Medardo; Barahona, Maria Victoria; Simonsen, Ulf; Recio, Paz; Rivera, Luis; Martinez, Ana Cristina; Garcia-Sacristan, Albino; Orensanz, Luis M; Prieto, Dolores

2003-01-01

85

Catheter-based intraluminal optical coherence tomography (OCT) of the ureter: ex-vivo correlation with histology in porcine specimens.  

PubMed

Intraluminal optical coherence tomography (OCT) applies coherent light to provide cross-sectional images with a spatial resolution of 10-25 microm. We compared OCT and matching whole-mount histology microscopy sections of porcine upper ureters ex vivo for visualization and delineation of different tissue layers of the ureteral wall. Porcine ureters (six specimens, 24 quadrants) were flushed with normal saline solution prior to insertion of the OCT catheter (diameter, 0.014 inch, OCT wavelength, 1,300+/-20 nm). Cross-sectional OCT images were obtained in marked locations before specimens were fixed in 4% formalin, cut at marked locations, whole-mounted, and stained with hematoxilin and eosin. Visualization and delineation of different tissue layers of the ureteral wall by OCT was compared with matching histology by two independent observers (O1,O2). OCT distinguished tissue layers of the ureteral wall in all quadrants. In OCT images, O1/O2 delineated urothelium and lamina propria in 23/24 quadrants, lamina propria and muscle layer in 19/16 quadrants, inner and outer muscle layer in 13/0 quadrants, and urothelial cell layers in 13/2 quadrants, respectively. Intraluminal OCT provides histology-like images of the ureter in porcine specimens ex vivo and reliably distinguishes between urothelium and deeper tissue layers of the ureteral wall. PMID:16572332

Mueller-Lisse, Ulrike L; Meissner, Oliver A; Babaryka, Gregor; Bauer, Margit; Eibel, Roger; Stief, Christian G; Reiser, Maximilian F; Mueller-Lisse, Ullrich G

2006-10-01

86

Renal dysplasia with single system ectopic ureter: Diagnosis using magnetic resonance urography and management with laparoscopic nephroureterectomy in pediatric age  

PubMed Central

Single system ureteral ectopia and associated congenital dysplastic kidney is surgically curable etiology of incontinence with other wise normal pattern of voiding in female child. We share our experience of eight cases in last one year and its management with laparoscopic nephroureterectomy at a tertiary care hospital in India which is one of the largest series in such a short duration of this rare anomaly. Materials and Methods: Patients presented with clinical features of continence with otherwise normal pattern of voiding were clinically examined and investigated by ultrasound (USG), nuclear renal scan, magnetic resonance urography (MRU). Laparoscopic nephroureterectomy was done in all the eight cases and renal dysplasia was confirmed on histological examination. Results: All the patients were females in the age group of five months to five years. USG detected the renal dysplasia in three out of eight cases; however, it could not detect the course of the ectopic ureter in any of the cases. MRU picked up the dysplastic moieties and their location as well as functional status and also depicted the course of the ectopic ureter opening into the vaginal wall in all the eight cases. Laparoscopic nephroureterectomy was done in all the cases and patients were cured off their symptoms. Conclusion: Single system ectopic ureter associated with congenital renal dysplasia is exceedingly rare. MRU is definitely the better investigation for the diagnosis of this condition as compared to the conventional radiological investigations. Laparoscopic nephroureterectomy is a very good procedure for the management of these cases.

Joshi, Milind; Parelkar, Sandesh; Shah, Heemanshi

2009-01-01

87

Bilateral Single Ectopic Ureters Draining Into a Grossly Dilated Vagina in an Adolescent Female  

PubMed Central

A 16-year-old female presented with dribbling of urine along with voluntary voiding since birth. Renal imaging revealed hydroureteronephrosis on the right side; the uterus and ovary were normal. A radionuclide scan showed a left nonfunctional kidney. On cystovaginoscopy, the urethra was shown to be normal and the urinary bladder was tubular with small capacity and an absent trigone. Although the vagina was capacious, no ureteric orifices were found. Computed tomography corroborated the diagnosis of bilateral, single ectopic ureters draining into a grossly dilated vagina. This case is unique because it is a bilateral single-system ureteral ectopia in a completely differentiated female genital tract that presented late in adolescence. To the best of our knowledge, this is the second such ureteral abnormality reported in the literature so far. The patient underwent ileocystoplasty with right ureteric reimplantation and nephroureterectomy for the left nonfunctional kidney, which histopathology showed to be tuberculosis. The patient is continent with cystometric capacity of more than 300 mL.

Mandal, Soumendra Nath; Kamal, Mir Reza; Mukherjee, Satyadip; Das, Ranjit Kumar; Karmakar, Dilip

2013-01-01

88

CA125-producing clear cell adenocarcinoma arising from the upper ureter and renal pelvis.  

PubMed

Clear cell adenocarcinomas similar to those found in the female genital organs can arise in the lower urinary tract of both women and men. Clear cell adenocarcinomas occurring in the upper urinary system are exceedingly rare. Here, we present a case of clear cell adenocarcinoma arising from the upper ureter and renal pelvis of a postmenopausal woman with a ureteral stone. The patient had elevated serum levels of cancer antigen (CA) 125 (103.80 U/mL) and CA19-9 (151.96 U/mL). The tumor showed typical features of tubulopapillary structures lined with clear-to-eosinophilic cytoplasm and frequent hobnail configuration. The tumor cells were immunoreactive for cytokeratin 7, cytokeratin 20, carcinoembryonic antigen and CA125, but negative for PAX-2 and alpha-methylacyl coenzyme A racemase. Given the presence of intestinal and squamous metaplasia of the adjacent urothelium, we propose that this clear cell adenocarcinoma developed through a metaplastic process. The tumor behaved so aggressively that the patient developed multiple metastases and died of the disease 5 months after radical nephroureterectomy. PMID:20103490

Shih, Chi-Min; Huang, Chuan-Te; Chi, Ching-Huang; Lin, Jui-Wei; Pan, Chin-Chen

2010-01-01

89

Particle motion in unsteady two-dimensional peristaltic flow with application to the ureter  

NASA Astrophysics Data System (ADS)

Particle motion in an unsteady peristaltic fluid flow is analyzed. The fluid is incompressible and Newtonian in a two-dimensional planar geometry. A perturbation method based on a small ratio of wave height to wavelength is used to obtain a closed-form solution for the fluid velocity field. This analytical solution is used in conjunction with an equation of motion for a small rigid sphere in nonuniform flow taking Stokes drag, virtual mass, Faxén, Basset, and gravity forces into account. Fluid streamlines and velocity profiles are calculated. Theoretical values for pumping rates are compared with available experimental data. An application to ureteral peristaltic flow is considered since fluid flow in the ureter is sometimes accompanied by particles such as stones or bacteriuria. Particle trajectories for parameters that correspond to calcium oxalates for calculosis and Escherichia coli type for bacteria are analyzed. The findings show that retrograde or reflux motion of the particles is possible and bacterial transport can occur in the upper urinary tract when there is a partial occlusion of the wave. Dilute particle mixing is also investigated, and it is found that some of the particles participate in the formation of a recirculating bolus, and some of them are delayed in transit and eventually reach the walls. This can explain the failure of clearing residuals from the upper urinary tract calculi after successful extracorporeal shock wave lithotripsy. The results may also be relevant to the transport of other physiological fluids and industrial applications in which peristaltic pumping is used.

Jiménez-Lozano, Joel; Sen, Mihir; Dunn, Patrick F.

2009-04-01

90

Bilateral single ectopic ureters draining into a grossly dilated vagina in an adolescent female.  

PubMed

A 16-year-old female presented with dribbling of urine along with voluntary voiding since birth. Renal imaging revealed hydroureteronephrosis on the right side; the uterus and ovary were normal. A radionuclide scan showed a left nonfunctional kidney. On cystovaginoscopy, the urethra was shown to be normal and the urinary bladder was tubular with small capacity and an absent trigone. Although the vagina was capacious, no ureteric orifices were found. Computed tomography corroborated the diagnosis of bilateral, single ectopic ureters draining into a grossly dilated vagina. This case is unique because it is a bilateral single-system ureteral ectopia in a completely differentiated female genital tract that presented late in adolescence. To the best of our knowledge, this is the second such ureteral abnormality reported in the literature so far. The patient underwent ileocystoplasty with right ureteric reimplantation and nephroureterectomy for the left nonfunctional kidney, which histopathology showed to be tuberculosis. The patient is continent with cystometric capacity of more than 300 mL. PMID:23878693

Mandal, Soumendra Nath; Jagadheesan, Gokulakrishnan Puttuthakku; Kamal, Mir Reza; Mukherjee, Satyadip; Das, Ranjit Kumar; Karmakar, Dilip

2013-07-01

91

Particle motion in unsteady two-dimensional peristaltic flow with application to the ureter.  

PubMed

Particle motion in an unsteady peristaltic fluid flow is analyzed. The fluid is incompressible and Newtonian in a two-dimensional planar geometry. A perturbation method based on a small ratio of wave height to wavelength is used to obtain a closed-form solution for the fluid velocity field. This analytical solution is used in conjunction with an equation of motion for a small rigid sphere in nonuniform flow taking Stokes drag, virtual mass, Faxén, Basset, and gravity forces into account. Fluid streamlines and velocity profiles are calculated. Theoretical values for pumping rates are compared with available experimental data. An application to ureteral peristaltic flow is considered since fluid flow in the ureter is sometimes accompanied by particles such as stones or bacteriuria. Particle trajectories for parameters that correspond to calcium oxalates for calculosis and Escherichia coli type for bacteria are analyzed. The findings show that retrograde or reflux motion of the particles is possible and bacterial transport can occur in the upper urinary tract when there is a partial occlusion of the wave. Dilute particle mixing is also investigated, and it is found that some of the particles participate in the formation of a recirculating bolus, and some of them are delayed in transit and eventually reach the walls. This can explain the failure of clearing residuals from the upper urinary tract calculi after successful extracorporeal shock wave lithotripsy. The results may also be relevant to the transport of other physiological fluids and industrial applications in which peristaltic pumping is used. PMID:19518250

Jiménez-Lozano, Joel; Sen, Mihir; Dunn, Patrick F

2009-04-01

92

Extracorporeal shock-wave lithotripsy (ESWL) monotherapy for stones in lower ureter.  

PubMed

Extracorporeal shock-wave lithotripsy (ESWL) has been accepted as the method of choice for most upper urinary tract calculi. However, in cases of stones in the lower ureter, ureteroscopic procedures have generally been preferred. Using the Dornier HM3 lithotriptor with modifications in the patient's position, we were able to successfully treat 155 unselected cases of lower ureteral calculi. The average stone size was 9.6 mm (range 5-23 mm). One hundred forty-three patients had stones located below the lower margin of the sacroiliac joint. These patients were placed in a supine position. The stones were visualized radiologically without use of a ureteral catheter in 78 percent of the patients; in 22 percent a ureteral catheter was inserted prior to ESWL to aid in stone localization. In 145 patients (94%) treatment was completed in one session; 10 patients (6%) required two sessions. Of the patients, 38 percent were free of stones one day after ESWL; 97 percent became stone free within three months, and only 3 patients required endoscopic manipulation, after ESWL. Twelve patients had stones in the midureter overlying the sacroileum. They were placed in the prone position, and the calculi were visualized with the aid of a ureteral catheter. All these patients became free of stones one month after treatment. There were no significant treatment-related complications except for bacteremia in 1 case. In view of the remarkable efficacy, negligible complication rate, and shorter hospital stay as compared to ureteroscopic stone manipulations, we recommend high energy ESWL as the primary monotherapy of mid and lower ureteral stones. PMID:1502748

Landau, E H; Pode, D; Lencovsky, Z; Katz, G; Meretyk, S; Shapiro, A

1992-08-01

93

Optical coherence tomography provides images similar to histology and allows the performance of extensive measurements of drug-eluting metal stents in animal ureters.  

PubMed

Optical coherence tomography (OCT) images and histology images of metal stents (MSs) inserted in animal ureters were compared, and the reliability of an OCT-based automated method for the performance of quantitative evaluation of ureteral MSs was evaluated. A zotarolimus-eluting metal stent (ZES) and a bare metal stent (BMS) were inserted in each ureter of ten pigs and six rabbits. OCT was performed in unobstructed stented ureters. Histopathologic examination of the stented ureters embedded in glycol-methacrylate took place. Quadrants of OCT images were compared to their respective histologic images by employing two independent observers who delineated different layers in the quadrants of OCT images and correlated them to the respective histologic quadrants. Manual (integrated OCT device software) and automated measurements of the OCT images using an automated strut detection method were compared. The observers highly agreed on the delineation of urothelium from the lamina propria and the lamina propria from the muscle layer of the ureteral wall. The algorithm measurements were similar to the manual measurements, and the algorithm proved to be reliable in the evaluation of ureteral MSs. Significantly higher endothelial hyperplasia of the BMSs in comparison to the ZESs was also quantitatively demonstrated by the strut detection method. OCT proved to be a reliable method for the evaluation of ureteral MSs. OCT provided images of the stented ureteral lumen similar to light microscopy quality. Measurements of the stented ureter are reliably performed by the automated strut detection method. PMID:24590241

Kallidonis, P; Kagadis, G C; Kitrou, P; Tsamandas, A; Kyriazis, I; Georgiopoulos, I; Karnabatidis, D; Tsantis, S; Liourdi, D; Al-Aown, A; Liatsikos, E

2014-07-01

94

DLG1 influences distal ureter maturation via a non-epithelial cell autonomous mechanism involving reduced retinoic acid signaling, Ret expression, and apoptosis.  

PubMed

The absence of Discs-large 1 (DLG1), the mouse ortholog of the Drosophila discs-large tumor suppressor, results in congenital hydronephrosis characterized by urinary tract abnormalities, reduced ureteric bud branching, and delayed disconnection of the ureter from the common nephric duct (CND). To define the specific cellular requirements for Dlg1 expression during urogenital development, we used a floxed Dlg1 allele and Pax2-Cre, Pax3-Cre, Six2-Cre, and HoxB7-Cre transgenes to generate cell type-restricted Dlg1 mutants. In addition, we used Ret(GFP) knockin and retinoic acid response element-lacZ transgenic mice to determine the effects of Dlg1 mutation on the respective morphogenetic signaling pathways. Mutation of Dlg1 in urothelium and collecting ducts (via HoxB7-Cre or Pax2-Cre) and in nephron precursors (via Pax2-Cre and Six2-Cre) resulted in no apparent abnormalities in ureteric bud branching or in distal ureter maturation, and no hydronephrosis. Mutation in nephrons, ureteric smooth muscle, and mesenchyme surrounding the lower urinary tract (via the Pax3-Cre transgene) resulted in congenital hydronephrosis accompanied by reduced branching, abnormal distal ureter maturation and insertion, and smooth muscle orientation defects, phenotypes very similar to those in Dlg1 null mice. Dlg1 null mice showed reduced Ret expression and apoptosis during ureter maturation and evidence of reduced retinoic acid signaling in the kidney. Taken together, these results suggest that Dlg1 expression in ureter and CND-associated mesenchymal cells is essential for ensuring distal ureter maturation by facilitating retinoic acid signaling, Ret expression, and apoptosis of the urothelium. PMID:24699546

Kim, Sung Tae; Ahn, Sun-Young; Swat, Wojciech; Miner, Jeffrey H

2014-06-15

95

The difficult ureter: what is the incidence of pre-stenting?  

PubMed Central

INTRODUCTION Difficulty may be encountered with retrograde access for rigid and flexible ureterorenoscopy (URS) due to anatomic abnormalities, a narrow ureteric lumen, tortuous ureteric path or previous instrumentation. Ureteric dilatation using a balloon or tapered dilator can occasionally fail and will usually lead to the placement of a ureteric stent. We present our experience and incidence of pre-stenting after failed standard access and dilatation techniques, the aim being to quote a figure for the patient at the time of consent. PATIENTS AND METHODS Data were collected prospectively from a single surgeon at a regional tertiary referral stone unit. The outcomes of those patients pre-stented, for failed access, were recorded. RESULTS Between December 2007 and December 2008, a total of 119 patients underwent flexible and rigid URS. Mean patient age was 49 years (range, 19–86 years). Of these, 107 cases were undertaken for urolithiasis and 12 cases for diagnosis of upper tract malignancy. 12% (13/107) of cases were for pain and non-diagnostic imaging and 8.4% (9/107) of patients were pre-stented because of failed access, without complication, and subsequently had successful interval treatment. Of the remaining successful cases of confirmed urolithiasis, 33% (28/85) and 67% (56/85) were undertaken for ureteric and renal calculi, respectively. Stone clearance rates were 83% (19/23) and 75% (3/4) for lower pole renal calculi 5–10 mm and > 10 mm in size, respectively. The overall clearance rate for lower pole calculi was 81% (22/27). The ureteric stone clearance rate was 86% (24/28) rising to 92% (24/26) in those solitary stones less than 10 mm in size. CONCLUSIONS The incidence of ureteric pre-stenting in a tertiary referral unit was 8% and should be considered and indeed discussed with patients when obtaining pre-operative consent, especially for purely elective, non-urgent, upper tract cases. The alternative for these difficult, tight ureters is extensive balloon dilatation, with the risk of trauma and the potential for long-term stricture formation.

Cetti, RJ; Biers, S; Keoghane, SR

2010-01-01

96

Complete scrotal urinary bladder hernia with both ureters and small intestine presenting as dysuria, bilateral ureterohydronephrosis, and acute renal insufficiency.  

PubMed

We report a case of a complete scrotal bladder hernia with both ureters presenting as dysuria, bilateral ureterohydronephrosis, and acute renal insufficiency. A 37-year-old man with a recurrent large scrotal mass after two surgeries, suffering with small urinary symptoms as a dysuria and nocturia, was examined before the third surgery on an outpatient basis. Urological examination revealed a negative urine, bilateral large ureterohydronephrosis on USG, and serum creatinine 231-250 µmol/l. CT displayed the urinary bladder completely herniated into the scrotum with distal parts of both ureters and small intestine, and bilateral large ureterohydronephrosis. After admission to urological department on retrograde cystography a completely herniation of the urinary bladder with residual urine more than 250 ml was confirmed. A permanent catheter was indwelled. The hernia was explored with urinary bladder repositioning. Because bilateral ureteral obstruction on USG did not retreat, a bilateral percutaneous nephrostomy was done. The patient's serum creatinine markedly improved, also hernia and ureterohydronephrosis was repaired with normally moisten without residual urine (Fig. 2, Ref. 26). PMID:24236434

Nagy, V; Kilar, I

2013-01-01

97

Identification of c-kit-positive cells in the mouse ureter: the interstitial cells of Cajal of the urinary tract.  

PubMed

The existence of a pacemaker system in the urinary tract capable of orchestrating the movement of filtrated urine from the ureteral pelvis to the distal ureter and lower urinary tract seems intuitive. The coordinated activity necessary for such movement or "peristalsis" would likely require an intricate network of cells with pacemaker-like activity, as is the case with the interstitial cells of Cajal (ICC) of the gut. We investigated whether these putative pacemaker cells of the urinary tract are antigenically similar to ICC of the gut by using immunofluorescence staining for c-kit, a cell-surface marker specific for ICC. Ureteral, urinary bladder, and urethral tissues were harvested from female mice of the WBB6F1 strain, and fixed sections were prepared and stained for c-kit. Cell networks composed of stellate-appearing, c-kit-positive, ICC-like cells were found in the lamina propria and at the interface of the inner longitudinal and outer circular muscle layers of the ureteral pelvis but not in the urinary bladder or urethra. Thus, like in the gut, c-kit-positive, ICC-like cells are present in the urinary tract but appear to be restricted to the proximal ureter of this murine species. PMID:12540363

Pezzone, Michael A; Watkins, Simon C; Alber, Sean M; King, William E; de Groat, William C; Chancellor, Michael B; Fraser, Matthew O

2003-05-01

98

[Transitional cell carcinoma of the ureter with inverted proliferation: a difficult case to make a differential diagnosis with ureteral polyp].  

PubMed

A 59-year-old man was admitted to our hospital in June 2001 for evaluation of an asymptomatic microscopic hematuria. One year prior to presentation, he had a spontaneous discharge of a left ureteral stone. Excretory urography and retrograde pyelography showed a filling defect in the middle portion of the left ureter. Cystoscopic examination did not reveal any abnormality, and urinary cytology was class I. Cold cup biopsy was performed under ureteroscopy, and pathology revealed inflammatory fibrovascular tissue but with no malignancy. Selective washing cytology was class III, whereas selective washing cytology done at the referring hospital was reported to be class V. Under a preoperative diagnosis of a left fibroepithelial ureteral polyp or a transitional cell carcinoma, left segmental ureterectomy was performed. The tumor was 5 x 5 x 5 mm in size, pedunculated, and smooth-surfaced. Intraoperative pathological examination of a frozen section showed an inverted type transitional cell carcinoma. Therefore, a left nephroureterectomy was performed, and the final histopathological examination confirmed an inverted type transitional cell carcinoma of grade 2. The patient is healthy and free of disease 15 months after operation. We also reviewed the current literature relating to transitional cell carcinomas of the ureter with inverted proliferation. PMID:14655609

Hirata, Hiroshi; Eguchi, Ken; Ohmi, Chietaka; Matsuyama, Hideyasu; Naito, Katsusuke

2003-10-01

99

An investigation of sodium-calcium exchange in the smooth muscle of guinea-pig ureter.  

PubMed Central

1. After application of ouabain (10(-4) M), the intracellular Na+ activity (alpha iNa) of smooth muscle cells in the guinea-pig ureter stabilizes at a relatively low level which can be rapidly lowered by reduction of external Na+ (Na+o) or elevation of Ca2+o. Both these procedures also elicit a transient contracture. These observations have previously been interpreted as evidence for Na+-Ca2+ exchange. The presence of such an exchange mechanism has now been further investigated by measurements of alpha iNa, tension, ion analysis and 22Na efflux. 2. Ion analysis demonstrated that tissues were able to maintain a high cellular K+ content in the presence of ouabain, but slowly lost K+ and gained Na+ if K+o was also removed, as expected for an infinite outward gradient for K+ and a fully inhibited Na+ pump. 3. Tissues were only able to maintain a low cellular Na+ and high cellular K+ in the presence of ouabain if Ca2+ was present in the bathing solution. Reduction of Ca2+o to very low levels also caused a continual slow rise in alpha iNa in the presence of ouabain, provided that the prolonged depolarization caused by these low levels was prevented by elevation of Mg2+o. Alteration of the membrane potential by changing K+o at constant Na+o showed that alpha iNa decreased by about 1.2 mM for a 10 mV depolarization, within the range from -70 to -30 mV. 4. A small Ca2+o-activated 22Na efflux was observed in ouabain-treated tissues in the absence of Na+o. 40 mM-Ca2+ was not more effective at activating this efflux than was 2.5 mM-Ca2+, while 40 mM-Mg2+ was ineffective. Restoration of the normal Na+o caused a large increase in the rate of 22Na loss. 5. Application of Mn2+ in the presence of ouabain caused a slow rise in alpha iNa and a small decline in resting tension. The fall in alpha iNa on reduction of Na+o was slowed by the presence of Mn2+ (mean half-time increased from 1.7 to 5.0 min) and the concomitant contracture was almost abolished. These results are consistent with a Mn2+-induced inhibition of Na+-Ca2+ exchange. However, the fall in alpha iNa induced by elevation of Ca2+o was unaffected by the presence of Mn2+ and the attendant contracture was, if anything, enhanced. 6. Observation of changes in alpha iNa and tension at various Mn2+ and Ca2+ concentrations demonstrated a competitive interaction between the two divalent cations.(ABSTRACT TRUNCATED AT 400 WORDS)

Aickin, C C; Brading, A F; Walmsley, D

1987-01-01

100

[Upper tract urothelial carcinoma associated with giant hydronephrosis due to ligation of a ureter: a case report].  

PubMed

A 73-year-old woman was referred to our hospital with a complaint of left lumbar backache. Computed tomography (CT) revealed left giant hydronephrosis containing high-density fluid suspected of hemorrhage in the renal pelvis and swelling of cervical and mediastinal lymph nodes. Positron emission tomography (PET)-CT showed a small high uptake lesion in the left kidney parenchyma, and cervical and mediastinal lymph nodes. Percutaneous pelvic puncture yielded discharge of hemorrhagic fluid with negative cytology. Preoperative diagnosis was left giant hydronephrosis due to ligation of a left ureter at uterine myomectomy 43 years ago with renal hemorrhage caused by recent back injury, and cervical and mediastinal lymph node involvement of unknown origin. Because severe lumbar backache persisted, we performed palliative left nephrectomy and biopsy of cervical lymph nodes. The pathological diagnosis was invasive urothelial carcinoma with squamous differentiation and lymph node involvement. PMID:24759501

Kuromoto, Akito; Namiki, Shunichi; Satake, Yohei; Yamashita, Shinichi; Mitsutzuka, Koji; Saito, Hideo; Kaiho, Yasuhiro; Arai, Yoichi

2014-03-01

101

Desensitization and capsaicin-induced release of substance P-like immunoreactivity from guinea-pig ureter in vitro.  

PubMed

Substance P-like immunoreactivity was assayed in superfusates of guinea-pig ureters following stimulation of afferent fibres with capsaicin, potassium chloride and the calcium channel agonist Bay K 8644. Capsaicin-evoked release of substance P-like immunoreactivity was calcium-dependent but unaffected by cobalt. Under appropriate conditions release was dose-related (ED50 = 610 nM) and reproducible. Selective desensitization to capsaicin could be demonstrated following prolonged exposure to different doses of capsaicin. No desensitization to capsaicin was observed following afferent fibre stimulation with a combination of Bay K 8644 and K+, which released a similar amount of substance P-like immunoreactivity as a desensitizing capsaicin stimulus. These data suggest that depletion of releasable substance P-like reactivity is unlikely to account for selective desensitization of ureteric primary afferent fibres to capsaicin. PMID:2477771

Dray, A; Hankins, M W; Yeats, J C

1989-01-01

102

TSHZ3 and SOX9 Regulate the Timing of Smooth Muscle Cell Differentiation in the Ureter by Reducing Myocardin Activity  

PubMed Central

Smooth muscle cells are of key importance for the proper functioning of different visceral organs including those of the urogenital system. In the mouse ureter, the two transcriptional regulators TSHZ3 and SOX9 are independently required for initiation of smooth muscle differentiation from uncommitted mesenchymal precursor cells. However, it has remained unclear whether TSHZ3 and SOX9 act independently or as part of a larger regulatory network. Here, we set out to characterize the molecular function of TSHZ3 in the differentiation of the ureteric mesenchyme. Using a yeast-two-hybrid screen, we identified SOX9 as an interacting protein. We show that TSHZ3 also binds to the master regulator of the smooth muscle program, MYOCD, and displaces it from the coregulator SRF, thereby disrupting the activation of smooth muscle specific genes. We found that the initiation of the expression of smooth muscle specific genes in MYOCD-positive ureteric mesenchyme coincides with the down regulation of Sox9 expression, identifying SOX9 as a possible negative regulator of smooth muscle cell differentiation. To test this hypothesis, we prolonged the expression of Sox9 in the ureteric mesenchyme in vivo. We found that Sox9 does not affect Myocd expression but significantly reduces the expression of MYOCD/SRF-dependent smooth muscle genes, suggesting that down-regulation of Sox9 is a prerequisite for MYOCD activity. We propose that the dynamic expression of Sox9 and the interaction between TSHZ3, SOX9 and MYOCD provide a mechanism that regulates the pace of progression of the myogenic program in the ureter.

Martin, Elise; Caubit, Xavier; Airik, Rannar; Vola, Christine; Fatmi, Ahmed; Kispert, Andreas; Fasano, Laurent

2013-01-01

103

TSHZ3 and SOX9 regulate the timing of smooth muscle cell differentiation in the ureter by reducing myocardin activity.  

PubMed

Smooth muscle cells are of key importance for the proper functioning of different visceral organs including those of the urogenital system. In the mouse ureter, the two transcriptional regulators TSHZ3 and SOX9 are independently required for initiation of smooth muscle differentiation from uncommitted mesenchymal precursor cells. However, it has remained unclear whether TSHZ3 and SOX9 act independently or as part of a larger regulatory network. Here, we set out to characterize the molecular function of TSHZ3 in the differentiation of the ureteric mesenchyme. Using a yeast-two-hybrid screen, we identified SOX9 as an interacting protein. We show that TSHZ3 also binds to the master regulator of the smooth muscle program, MYOCD, and displaces it from the coregulator SRF, thereby disrupting the activation of smooth muscle specific genes. We found that the initiation of the expression of smooth muscle specific genes in MYOCD-positive ureteric mesenchyme coincides with the down regulation of Sox9 expression, identifying SOX9 as a possible negative regulator of smooth muscle cell differentiation. To test this hypothesis, we prolonged the expression of Sox9 in the ureteric mesenchyme in vivo. We found that Sox9 does not affect Myocd expression but significantly reduces the expression of MYOCD/SRF-dependent smooth muscle genes, suggesting that down-regulation of Sox9 is a prerequisite for MYOCD activity. We propose that the dynamic expression of Sox9 and the interaction between TSHZ3, SOX9 and MYOCD provide a mechanism that regulates the pace of progression of the myogenic program in the ureter. PMID:23671695

Martin, Elise; Caubit, Xavier; Airik, Rannar; Vola, Christine; Fatmi, Ahmed; Kispert, Andreas; Fasano, Laurent

2013-01-01

104

Massive gastrointestinal bleeding and obstruction of the ureter caused by the migration of a swallowed toothpick from the sigmoid colon--a case report.  

PubMed

In this study, a case of an ingested toothpick partially migrating from the sigmoid colon, causing massive lower gastrointestinal bleeding due to arterial-colic fistula, and stricture of the left ureter is presented. A 70-year-old male was admitted to the emergency department after having feces mixed with fresh and coagulated blood for the past two days. Computed tomography and retrograde ureteropyelography showed the stricture of the left ureter, 1.5 cm below the branching of iliac artery, without any signs of malignancy. Colonoscopy showed fresh blood in the rectum and sigmoid colon up to the neoplasm like granulation tissue mixed with fresh and coagulated blood, which almost obstructed the lumen. Explorative laparotomy showed a foreign body (toothpick) perforating the sigmoid colon through the mesenterial wall, and being stocked with one-third into the left internal iliac artery, causing arterial-colic fistula. The remaining part of the toothpick was surrounded by granulation tissue and chronic inflammatory process, pressing on the distal third of the left ureter. We conclude that a swallowed toothpick may cause a significant gastrointestinal injury with a wide variety of clinical manifestations, and it must be treated with caution. The imaging studies are often inadequate in detecting toothpicks, and thus, we insist on a physical examination, as the best indicator of injury. PMID:18494220

Maras-Simuni?, Marina; Grandi?, Leo; Brni?, Darko; Simuni?, Miroslav; Druzijani?, Nikica

2008-03-01

105

Correlation of Traditional Point a With Anatomic Location of Uterine Artery and Ureter in Cancer of the Uterine Cervix  

SciTech Connect

Purpose: Point A, used for dose specification for intracavitary brachytherapy for cervical cancer, is the point at which the uterine artery and ureter cross. This study assessed compatibility of commonly used traditional point A (TPA) and actual anatomic point A (APA). Methods and Materials: We visualized and placed radiopaque clips at the APA during pelvic and paraaortic lymphadenectomy in 11 patients with cervical carcinoma. Orthogonal and oblique radiographs were obtained after insertion of brachytherapy applicators. We measured the distance between the TPA and APA and estimated the brachytherapy dose to each of the two points. Results: A total of 64 brachytherapy treatments were performed. The mean distances between the TPA and APA were 5.2 {+-} 1.0 cm on the right and 5.4 {+-} 1.1 cm on the left. The estimated brachytherapy doses delivered to the APA as a percentage of the presumed 500-cGy fraction size to the TPA were 35.2% (176.6 {+-} 59.0 cGy) on the right and 30.0% (150.2 {+-} 42.9 cGy) on the left. The marked discrepancy in the position of the two points was not related to individual kinetic variations during brachytherapy treatment, tumor size, or bladder filling. Conclusions: The conventional TPA does not provide an accurate estimate of the APA determined during lymphadenectomy, indicating a need to reevaluate the current practice for determining the brachytherapy prescription for cervical cancer. ( (ClinicalTrials.gov) Identifier, NCT00319462)

Wang, K.-L. [Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan (China); Department of Health Care Management, National Taipei College of Nursing, Taipei, Taiwan (China); Department of Early Childhood Care and Education, Mackay Medicine, Nursing, and Management College, Taipei, Taiwan (China); Yang, Y.-C. [Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan (China); Department of Obstetrics and Gynecology, Taipei Medical University, Taipei, Taiwan (China); Department of Early Childhood Care and Education, Mackay Medicine, Nursing, and Management College, Taipei, Taiwan (China); Chao, K. S. Clifford [Department of Radiation Oncology, University of Texas, M. D. Anderson Cancer Center, Houston, TX (United States)], E-mail: cchao@mdanderson.org; Wu, M.-H.; Tai, H.-C. [Department of Radiation Oncology, Mackay Memorial Hospital, Taipei, Taiwan (China); Chen, T.-C.; Huang, M.-C.; Chen, J.-R. [Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan (China); Su, T.-H. [Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan (China); Department of Early Childhood Care and Education, Mackay Medicine, Nursing, and Management College, Taipei, Taiwan (China); Chen, Y.-J. [Department of Radiation Oncology, Mackay Memorial Hospital, Taipei, Taiwan (China); Graduate Institute of Sport Coaching Science, Chinese Culture University, Taipei, Taiwan (China)], E-mail: chenmdphd@yahoo.com

2007-10-01

106

Obstructive uropathy due to prolapsed lower ureters and bladder in patients with severe procidentia: A report of two cases  

PubMed Central

INTRODUCTION Pelvic organ prolape is not uncommon in multi-parous or elderly women. It is one of the rare but important causes of obstructive uropathy. Herein, we report two cases of severe procidentia that were referred with obstructive uropathy due to prolapsed bladder and ureters. PRESENTATION OF CASE The first case was a 78-year-old woman, with severe pelvic organ prolape and secondary bilateral hydroureteronephrosis and post-renal failure. She was treated successfully by bilateral nephrostomy insertion and then pessary insertion. The second case was a 75-year-old woman who referred with the same presentation, but treated surgically with burch colposuspention and synchronous bilateral ureteral stent insertion. DISCUSSION Pelvic organ prolapse is not uncommon in old women. In addition to physical problems of procidentia, it may cause acute renal failure (ARF), chronic renal failure (CRF), and finally end stage renal disease (ESRD) if undiagnosed. CONCLUSION In every aged female case with obstructive uropathy and/or bilateral hydroureteronephrosis with unknown causes, gynecologic examination should be performed for early detection of possible pelvic organ prolapse. Appropriate management is necessary to prevent renal failure from uterine prolapse (UP).

Moslemi, Mohammad Kazem; Abedinzadeh, Mehdi; Nazari, Alireza

2013-01-01

107

Impact of Tamsulosin on Ureter Stone Expulsion in Korean Patients: A Meta-Analysis of Randomized Controlled Studies  

PubMed Central

Purpose Using meta-analysis, the study's aim was to evaluate the efficacy of tamsulosin, an alpha-blocker, in the treatment of ureteral stones with or without shockwave lithotripsy (SWL) in Korean patients. Materials and Methods Relevant randomized controlled studies published through June 2011 were identified in a search of MEDLINE, KoreaMed, and the Korean Medical Database. No language restriction was applied. Only randomized controlled trials conducted with Korean patients were eligible for the analysis. The primary outcome assessed was the stone clearance rate. Two reviewers independently assessed the quality of the study and extracted the data. Meta-analysis was conducted by using R, version 2.13.0. Results A total of 6 articles were selected as being suitable for evaluation. Pooling of the trials demonstrated a 43% higher expulsion rate for tamsulosin treatment compared to a control group (risk ratio [RR], 1.43; 95% confidence interval [CI]: 1.24 to 1.65). Similar results were obtained in all subgroup analyses according to stone location (upper: RR, 1.31; 95% CI, 1.02 to 1.68, lower: RR, 1.50; 95% CI, 1.20 to 1.88) or concomitant SWL (yes: RR, 1.38; 95% CI, 1.14 to 1.68, no: RR, 1.48; 95% CI, 1.21 to 1.83). Conclusions This meta-analysis of randomized controlled studies provides a high level of evidence supporting the suggestion that treatment with tamsulosin augments the stone expulsion rate for ureter stones with or without SWL in a Korean population. However, a high-quality, large-scale, multicenter, randomized controlled trial is warranted to fully support this hypothesis.

Lee, Jung Keun; Jeong, Seong Jin; Hong, Sung Kyu; Byun, Seok-Soo; Lee, Sang Eun

2012-01-01

108

Functional characterization of the vertebrate primary ureter: Structure and ion transport mechanisms of the pronephric duct in axolotl larvae (Amphibia)  

PubMed Central

Background Three kidney systems appear during vertebrate development: the pronephroi, mesonephroi and metanephroi. The pronephric duct is the first or primary ureter of these kidney systems. Its role as a key player in the induction of nephrogenic mesenchyme is well established. Here we investigate whether the duct is involved in urine modification using larvae of the freshwater amphibian Ambystoma mexicanum (axolotl) as model. Results We investigated structural as well as physiological properties of the pronephric duct. The key elements of our methodology were: using histology, light and transmission electron microscopy as well as confocal laser scanning microscopy on fixed tissue and applying the microperfusion technique on isolated pronephric ducts in combination with single cell microelectrode impalements. Our data show that the fully differentiated pronephric duct is composed of a single layered epithelium consisting of one cell type comparable to the principal cell of the renal collecting duct system. The cells are characterized by a prominent basolateral labyrinth and a relatively smooth apical surface with one central cilium. Cellular impalements demonstrate the presence of apical Na+ and K+ conductances, as well as a large K+ conductance in the basolateral cell membrane. Immunolabeling experiments indicate heavy expression of Na+/K+-ATPase in the basolateral labyrinth. Conclusions We propose that the pronephric duct is important for the subsequent modification of urine produced by the pronephros. Our results indicate that it reabsorbs sodium and secretes potassium via channels present in the apical cell membrane with the driving force for ion movement provided by the Na+/K+ pump. This is to our knowledge the first characterization of the pronephric duct, the precursor of the collecting duct system, which provides a model of cell structure and basic mechanisms for ion transport. Such information may be important in understanding the evolution of vertebrate kidney systems and human diseases associated with congenital malformations.

2010-01-01

109

Rho-kinase inhibition and electromechanical coupling in rat and guinea-pig ureter smooth muscle: Ca2+-dependent and -independent mechanisms.  

PubMed

Recent data have shown Ca(2+)-dependent activation of Rho-kinase by sustained depolarization of arterial smooth muscle. Visceral smooth muscles, however, contract phasically in response to action potentials and it is unclear whether Ca(2+)-dependent or -independent Rho-kinase activation occurs. We have therefore investigated this, under physiologically relevant conditions, in intact ureter. Action potentials, ionic currents, Ca(2+) transients, myosin light chain (MLC) phosphorylation and phasic contraction evoked by action potentials in guinea-pig and rat ureter were investigated. In rat, but not guinea-pig ureter, three Rho-kinase inhibitors, Y-27632, HA-1077 and H-1152, significantly decreased phasic contractions and Ca(2+) transients. Voltage- and current-clamp data showed that Rho-kinase inhibition reduced the plateau component of the action potential, inhibited Ca(2+)-channels and, indirectly, Ca(2+)-activated Cl(-) channels. The Ca(2+) channel agonist Bay K8644 could reverse these effects. The K(+) channel blocker TEA could also reverse the inhibitory effect of Y-27632 on the action potential and Ca(2+) transient. Ca(2+) transients and inward current, activated by carbachol-induced sarcoplasmic reticulum Ca(2+)release, were not affected by Rho-kinase inhibition. Rho-kinase inhibition produced a Ca(2+)-independent increase in the relaxation rate of contraction, associated with acceleration of MLC dephosphorylation, which was sensitive to calyculin A. These data show for the first time that: (1) Rho-kinase has major effects on Ca(2+) signalling associated with the action potential, (2) this effect is species dependent and (3) Rho-kinase controls relaxation of phasic contraction of myogenic origin. Thus Rho-kinase can modulate phasic smooth muscle in the absence of agonist, and the mechanisms are both Ca(2+)-dependent, involving ion channels, and Ca(2+)-independent, involving MLC phosphorylation activity. PMID:15331677

Shabir, S; Borisova, L; Wray, Susan; Burdyga, T

2004-11-01

110

Injury - kidney and ureter  

MedlinePLUS

... such as uric acid (which can occur with gout or treatment of bone marrow, lymph node, or ... lower uric acid in the blood due to gout) Pain medicines Stopping medications or exposure to substances ...

111

Non-muscle invasive transitional cell carcinoma of the distal ureter and bladder with lung metastasis: A case report and literature review  

PubMed Central

INTRODUCTION Non-muscle invasive transtitional cell carcinoma (TCC) with metastases is exceedingly rare. PRESENTATION OF CASE We report the case of a 78-year old man with an incidental finding of a non-muscle invasive TCC of the left distal ureter during treatment for Duke's B Colon cancer. Following laparoscopic nephro-ureterectomy (LNU) he had two further superficial recurrences in the bladder over a 14-month period which underwent transurethral resection (TUR). On surveillance imaging for his colorectal cancer follow-up a lung nodule was detected and video-assisted thoracic surgical (VATS) resection of the lesion showed it to be TCC in origin. He was referred to oncology for chemotherapy and remains clinically well. DISCUSSION A Literature search found only three other such cases and the ureteric TCC is the most likely source of the metastasis. CONCLUSION This occurrence is exceedingly rare.

Nkwam, Nkwam; Chen, Terng F.

2013-01-01

112

Variable pulsewidth erbium:YAG laser ablation of the ureter and urethra in vitro and in vivo: optimization of the laser fluence, pulse duration, and pulse repetition rate  

NASA Astrophysics Data System (ADS)

Stricture recurrence frequently occurs due to mechanical or thermal insult during endourologic treatment of ureteral and urethral strictures. Optimization of the Er:YAG laser for precise incision of strictures was conducted using ureteral and urethral tisssue samples, ex vivo, and a laparoscopic porcine ureteral model with exposed ureter, in vivo. Erbium:YAG laser radiation with a wavelength of 2.94 microns, pulse lengths of 8, 70, and 220 microseconds, output energies of 2 - 35 mJ, fluences of 1 - 25 J/cm2, and pulse repetition rates of 5 - 30 Hz, was delivered through germanium oxide optical fibers in contact with the tissue. Incision of the ureteral wall was achieved in vivo with less than 20 pulses at a laser fluence of 4 J/cm2. Thermal damage was reduced from 30 - 60 microns to 10 - 20 microns by shortening the laser pulse duration from 220 to 70 microseconds. Pulse repetition rates above 20 Hz resulted in larger thermal damage zones ranging from 60 - 120 microns. The Er:YAG laser, operating at a pulse duration of approximately 70 microseconds, a fluence of 4 J/cm2 or greater, and a repetition rate less than 20 Hz, is capable of rapidly incising urethral and ureteral tissues, in vivo, with minimal thermal and mechanical side-effects.

Fried, Nathaniel M.; Tesfaye, Zelalem; Ong, Albert M.; Rha, Koon H.; Hejazi, Pooya

2004-07-01

113

Nephrogenic adenoma of the ureter  

PubMed Central

Nephrogenic adenoma (NA) is an uncommon benign lesion of the urothelial tract. The diagnostic features that are useful in the recognition of this benign entity are: the characteristic mixture of various architectural patterns, associated stromal edema and inflammation, hyaline sheath around tubules, and lack of mitotic activity. Although NA appears with hematuria or obstruction, frequently found incidentally in endoscopy or imaging modalities.

Doluoglu, Omer Gokhan; Acarer, Ercument Yasar; Yavuz, Ayse; Hoscan, Mustafa Burak; Gonulalan, Umut

2012-01-01

114

Expression of carbohydrate antigens (SSEA-1, sialyl-Lewis X, DU-PAN-2 and CA19-9) and E-selectin in urothelial carcinoma of the renal pelvis, ureter, and urinary bladder.  

PubMed

Carbohydrate antigens and E-selectin play important roles in the invasion and metastasis of cancers. We examined the expression of these antigens and their ligand protein, E-selectin, in urothelial carcinomas to evaluate whether their staining is correlated with the grade and stage of cancer. We studied the expression of carbohydrate antigens (type 1 and type 2 blood-group antigens) and E-selectin in urothelial carcinomas of the renal pelvis, ureter, and urinary bladder in 52 patients by staining SSEA-1 (LeX), sialyl LeX (sLeX), DU-PAN-2, CA19-9, and E-selectin with 5 different monoclonal antibodies (MAbs) to evaluate whether their staining correlated with cancer grade and stage. The differences between organs with regard to the degree of expression of these antigens were not evident. Type 2 antigens (SSEA-1 and sialyl LeX) are frequently expressed in the tumor cells regardless of atypical grade. The expression level of type 1 antigens (DU-PAN-2 and CA19-9) is lower than that of type 2 antigens. However, the presence of DU-PAN-2 tends to correlate with the grade of atypia; however, that of CA19-9 is inversely proportional to the grade of atypia. The lack of CA19-9 and appearance of DU-PAN-2 in urothelial carcinoma implies a high malignant potential. The expression of E-selectin can be correlated with stage and grade of tumor atypia. Type 2 antigen and E-selectin may be involved in tumor invasion and metastasis. PMID:16285609

Kajiwara, Hiroshi; Yasuda, Masanori; Kumaki, Nobue; Shibayama, Taro; Osamura, Yoshiyuki

2005-09-01

115

Nieren en pyelum-ureter: anatomie en fysiologie  

Microsoft Academic Search

\\u000a De nieren liggen min of meer goed beschermd in de retroperitoneale ruimte en zij worden samen met de bijnieren omgeven door\\u000a de fascia van Gerota. Aan de achterzijde van de nieren liggen de twaalfde rib, het diafragma, de pleura en de long. De nieren\\u000a rusten als het ware op de musculus quadratus lumborum en de musculus psoas, waarbij de rechternier

Th. Reijke; F. J. Bemelman

116

Percutaneous retrieval of an inferior vena cava filter causing right ureter obstruction.  

PubMed

Retrievable inferior vena cava filters (IVCFs) are known to provide safe and effective pulmonary embolism protection when used appropriately. Long-term complications have been reported over the past 10 years, including vena cava perforation, filter migration, strut fracture, and injury to adjacent structures. This article describes the case of a 44-year-old woman who presented with right ureteral obstruction from strut impingement by a Bard Recovery IVCF (Tempe, AZ, USA). The filter had been in place for 6 years, and the authors were successful in retrieving it using a percutaneous endovascular approach, despite an unexpected chronic right innominate vein occlusion. In addition to highlighting the technical feasibility of long-term retrieval, this case underscores the importance of an IVCF registry to improve retrieval rates. This close monitoring and timely retrieval of filters may help prevent serious long-term complications. PMID:24332261

Thornburg, Kristina; Obmann, Melissa; Batool, Amber; Nikam, Shivprasad; Mariner, David

2014-01-01

117

A retroperitoneal enteric duplication cyst communicating with the right upper ureter in an infant.  

PubMed

We report an extremely rare case of isolated retroperitoneal enteric duplication cyst with gastric mucosa causing haematuria and dysuria by communicating with the urinary system. A 9-month-old male child was admitted to our hospital with persistent haematuria, dysuria and anaemia. Investigations revealed a retroperitoneal cyst abutting the hydronephrotic non-functioning right kidney. At surgery an isolated retroperitoneal cyst communicating with the right pelviureteric junction was found. The kidney and associated cyst were excised. Histology of the cystic lesion revealed an enteric duplication cyst lined by ectopic gastric mucosa. Isolated retroperitoneal enteric duplication cyst communicating with the urinary tract has not been previously reported in the English literature. We propose that acid secretion into the right renal system was the cause of the haematuria-dysuria syndrome which promptly resolved postoperatively. PMID:24813198

Bal, Harshjeet Singh; Kisku, Sundeep; Sen, Sudipta; Masih, Dipti

2014-01-01

118

Malignant lymphoma of the ureter: A case report and literature review  

PubMed Central

A 38-year-old male was admitted to Renji Hospital (Shanghai, China) with the major complaint of back pain due to left hydronephrosis. Imaging analysis revealed an area of nodular soft-tissue density in the left ureteral wall. The patient’s left kidney was non-functional. Thus, a left nephroureterectomy was performed for the purpose of pathological diagnosis, and histopathological examination revealed follicular lymphoma. The patient received R-CHOP chemotherapy (rituximab, cyclophosphamide, doxorubicin, vincristine and prednisolone) every three weeks. Following six courses of chemotherapy, positron emission tomography-computed tomography revealed that the patient was in complete remission. From this case we showed that in cases where a partial ureteral stenosis with ureteral wall thickening was observed by imaging analysis, further histological examination of tissue samples should be assigned as soon as possible.

NI, BEI-WEN; ZHONG, LU; WANG, TING; CHEN, FANG-YUAN

2014-01-01

119

The pelvis-kidney junction contains HCN3, a hyperpolarization-activated cation channel that triggers ureter peristalsis  

PubMed Central

Peristaltic waves of the ureteric smooth muscles move urine down from the kidney, a process that is commonly defective in congenital diseases. To study the mechanisms that control the initiation and direction of contractions, we used video microscopy and optical mapping techniques and found that electrical and contractile waves began in a region where the renal pelvis joined the connective tissue core of the kidney. Separation of this pelvis–kidney junction from more distal urinary tract segments prevented downstream peristalsis, indicating that it housed the trigger for peristalsis. Moreover, cells in the pelvis–kidney junction were found to express isoform 3 of the hyperpolarization-activated cation on channel family known to be required for initiating electrical activity in the brain and heart. Immunocytochemical and real-time PCR analyses found that hyperpolarization-activated cation-3 is expressed at the pelvis–kidney junction where electrical excitation and contractile waves originate. Inhibition of this channel caused a loss of electrical activity at the pelvis–kidney junction and randomized the origin of electrical activity in the urinary tract, thus markedly perturbing contractions. Collectively, our study demonstrates that hyperpolarization-activated cation-3 channels play a fundamental role in coordinating proximal-to-distal peristalsis of the upper urinary tract. This provides insight into the genetic causes of common inherited urinary tract disorders such as reflux and obstruction.

Hurtado, Romulo; Bub, Gil; Herzlinger, Doris

2014-01-01

120

Antenatal mild hydronephrosis with subsequent polyp of the upper ureter in a child presenting with recurrent Dietl's crisis.  

PubMed

We report a 7-year-old boy who had antenatally diagnosed and postnatally confirmed asymptomatic right congenital hydronephrosis secondary to ureteropelvic junction obstruction with the anteroposterior diameter ranging from 7 to 15 mm on serial ultrasound scans till the age of 6 years. He then presented with recurrent attacks of Dietl's crisis almost every month in the seventh year of his life and eluded diagnosis for over a year at various national hospitals, and ended up with an international referral to us. Investigations of the acute attacks clinched the diagnosis of ureteral polyp causing intermittent crisis and he underwent segmental resection and reconstruction in the form of dismembered Anderson-Hyne pyeloplasty with good recovery. Our case revealed that prenatally detected hydronephrosis may worsen after spontaneous postnatal improvement and a polyp acting as a flip valve may produce intermittent hydronephrosis and symptoms later in life. The child should undergo urgent investigations during acute symptoms. PMID:24832709

Patel, Ramnik V; Johal, Navroop; Evans, Kathryn; Mushtaq, Imran

2014-01-01

121

MP/H Rules Presentation - Urinary  

Cancer.gov

1 Renal Pelvis, Ureter, Bladder and Other Urinary 2 Equivalent Terms, Definitions, Tables and Illustrations 3 Introduction • Change in groupings – Previous: Kidney, ureter, renal pelvis • Bladder, ureter, renal pelvis – Lower urinary tract – Lined by

122

Reflux nephropathy  

MedlinePLUS

Urine flows from each kidney through tubes called ureters and into the bladder. When the bladder is ... of the urine should flow back into the ureter when the bladder is squeezing. Each ureter has ...

123

Economic evaluation of six scenarios for the treatment of stones in the kidney and ureter by surgery or extra-corporeal shock wave lithotripsy.  

PubMed

Health policy makers in the U.K. have had to respond to the advent of a new, high technology, method of treating stones. In order to assist the definition of an appropriate policy this evaluative study of the new technique was undertaken. The economic benefits of extracorporeal shock wave lithotripsy (ESWL) were compared with those of conventional open surgery for the treatment of upper urinary tract stones considering 6 possible 'scenarios', or intuitively plausible combinations of prices and levels of diffusion. It was concluded that second generation ESWL machines operated and financed at designated 'stone coalitions of health regions for a supra-regional population of about 12-15 million would be the most cost efficient option. Use of the currently available Dornier machine on the same supra-regional basis would be the, somewhat more expensive, second best option. These results, along with a range of supplementary documentation, were presented to both the national Department of Health and Social Security, and to the North Western Regional Health Authority. The NWRHA in turn presented its case to a supra-regional committee. The most cost-effective solution was adopted by this supra-regional committee. PMID:10284584

Patel, M S; Blacklock, N J; Rao, P N

1987-01-01

124

Vorinostat in Treating Patients With Locally Recurrent or Metastatic Cancer of the Urothelium  

ClinicalTrials.gov

Localized Transitional Cell Cancer of the Renal Pelvis and Ureter; Metastatic Transitional Cell Cancer of the Renal Pelvis and Ureter; Recurrent Transitional Cell Cancer of the Renal Pelvis and Ureter; Regional Transitional Cell Cancer of the Renal Pelvis and Ureter; Transitional Cell Carcinoma of the Bladder

2014-01-06

125

Automated detection of ureteral wall thickening on multi-detector row CT urography  

NASA Astrophysics Data System (ADS)

We are developing a computer-aided detection (CAD) system for automated detection of ureteral wall thickening on multi-detector row CT urography, which potentially can assist radiologists in detecting ureter cancer. In the first stage of our CAD system, given a starting point, the ureter is tracked based on the CT values of the contrast-filled lumen. In the second stage, the ureter wall is segmented and the ureter wall thickness is estimated based on polar transformation, separation of the ureter wall from the background and measuring the wall thickness. In this pilot study, a limited data set of 20 patients with 22 abnormal ureters was used. Fourteen patients had a total of 16 ureters with malignant ureteral wall thickening. Two of the patients had malignant wall thickening in both the left and right ureters. The other six patients had 6 ureters with benign ureteral wall thickening. All malignant wall thickenings were biopsy-proven. The benign thickenings were determined by biopsy or by 2-year follow-up. In addition 3 normal ureters were used to determine the false positive (FP) detection rate of the CAD system. The tracking program successfully tracked the 25 ureters (22 abnormal and 3 normal) and detected 90% (20/22) of the ureters having wall thickening with 2.3 (7/3) FPs per ureter. 93% (15/16) of the ureters with malignant wall thickening and 83% (5/6) of the ureters with benign wall thickening were detected. The missed ureteral wall thickenings were developed asymmetrically around the part of the ureter filled with contrast and the detection criteria in our current CAD system was not able to identify them reliably. The preliminary results show that our detection system can track the ureter and can detect ureteral wall thickening.

Hadjiiski, Lubomir; Sahiner, Berkman; Caoili, Elaine M.; Cohan, Richard H.; Zhou, Chuan; Chan, Heang-Ping

2008-04-01

126

Site of impaction of ureteric calculi requiring surgical intervention.  

PubMed

Textbooks describe three narrowest anatomic sites in the ureter as the most likely places for ureteral calculi to lodge, these are: the pelvi-ureteric junction (PUJ), the point where the ureters cross over the iliac vessels and the ureterovesical junction (UVJ). The purpose of this study is to determine whether calculi causing ureteric obstruction and requiring surgical treatment are found mostly at these three narrowest anatomic points of the ureter. Three hundred consecutive patients with impacted ureteric calculi who required surgical intervention were studied. The location of the impacted calculus on the day of surgical intervention was categorized according to nine predetermined levels outlined in a designed diagram based on findings on non-contrast CT of kidneys, ureters and bladder. Two peaks in stone distribution in the ureters were encountered; the first was above the ischial spine in the proximal part of the lower third ureter (84 patients, 28%), while the second was at the level between L3 and L4 lumbar vertebrae (66 patients, 22%). Overall, the location of impacted calculi was as follows, 53, 34, 10 and 3% in the lower third ureter, upper third ureter, PUJ and mid ureter, respectively. This study demonstrates two peaks of calculi distribution in the ureter where ureteric calculi become impacted: the upper ureter below the PUJ and a second in the lower ureter, more proximal than the UVJ. There was an absence of the peak in stone location over the iliac vessels, that is, the mid ureter. PMID:24057120

El-Barky, Ehab; Ali, Yusuf; Sahsah, Mohammed; Terra, Ali A; Kehinde, Elijah O

2014-02-01

127

Trastuzumab and Combination Chemotherapy in Treating Patients With Locally Recurrent or Metastatic Urinary Tract Cancer  

ClinicalTrials.gov

Metastatic Transitional Cell Cancer of the Renal Pelvis and Ureter; Recurrent Bladder Cancer; Recurrent Transitional Cell Cancer of the Renal Pelvis and Ureter; Squamous Cell Carcinoma of the Bladder; Stage IV Bladder Cancer; Transitional Cell Carcinoma of the Bladder

2013-01-11

128

21 CFR 876.4020 - Fiberoptic light ureteral catheter.  

Code of Federal Regulations, 2010 CFR

...fiberoptic bundle that emits light throughout its length and is shaped so that it can be inserted into the ureter to enable the path of the ureter to be seen during lower abdominal or pelvic surgery. (b) Classification. Class II...

2010-04-01

129

21 CFR 876.4020 - Fiberoptic light ureteral catheter.  

Code of Federal Regulations, 2010 CFR

...fiberoptic bundle that emits light throughout its length and is shaped so that it can be inserted into the ureter to enable the path of the ureter to be seen during lower abdominal or pelvic surgery. (b) Classification. Class II...

2009-04-01

130

Ureteral retrograde brush biopsy  

MedlinePLUS

... tissue from the lining of the kidney or ureter (tube that connects a kidney to the bladder) ... wire is inserted through the cystoscope into the ureter (the tube between the bladder and kidney). The ...

131

Vesicoureteral reflux (image)  

MedlinePLUS

When the ureters enter the bladder, they travel through the wall of the bladder for a distance in such a way ... valve prevents urine from backing-up into the ureters and kidneys. In some children, the valves may ...

132

Veliparib, Paclitaxel, and Carboplatin in Treating Patients With Solid Tumors That Are Metastatic or Cannot Be Removed by Surgery and Liver or Kidney Dysfunction  

ClinicalTrials.gov

Bladder Cancer; Breast Cancer; Endometrial Cancer; Esophageal Cancer; Head and Neck Cancer; Lung Cancer; Melanoma; Ovarian Neoplasm; Testicular Lymphoma; Transitional Cell Cancer of the Renal Pelvis and Ureter; Unspecified Adult Solid Tumor, Protocol Specific; Ureter Cancer; Urethral Cancer

2014-06-30

133

Eribulin Mesylate in Treating Patients With Locally Advanced or Metastatic Cancer of the Urothelium and Kidney Dysfunction  

ClinicalTrials.gov

Distal Urethral Cancer; Metastatic Transitional Cell Cancer of the Renal Pelvis and Ureter; Proximal Urethral Cancer; Recurrent Bladder Cancer; Recurrent Transitional Cell Cancer of the Renal Pelvis and Ureter; Recurrent Urethral Cancer; Regional Transitional Cell Cancer of the Renal Pelvis and Ureter; Stage III Bladder Cancer; Stage IV Bladder Cancer; Transitional Cell Cancer of the Renal Pelvis and Ureter; Urethral Cancer; Urethral Cancer Associated With Invasive Bladder Cancer

2014-06-27

134

Gemcitabine Hydrochloride and Cisplatin or High-Dose Methotrexate, Vinblastine, Doxorubicin Hydrochloride, and Cisplatin in Treating Patients With Urothelial Cancer  

ClinicalTrials.gov

Anterior Urethral Cancer; Localized Transitional Cell Cancer of the Renal Pelvis and Ureter; Posterior Urethral Cancer; Recurrent Bladder Cancer; Recurrent Urethral Cancer; Regional Transitional Cell Cancer of the Renal Pelvis and Ureter; Stage III Bladder Cancer; Transitional Cell Carcinoma of the Bladder; Ureter Cancer; Urethral Cancer Associated With Invasive Bladder Cancer

2014-01-27

135

Phase II Trial Of PS-341 (Bortezomib) In Patients With Previously Treated Advanced Urothelial Tract Transitional Cell Carcinoma  

ClinicalTrials.gov

Metastatic Transitional Cell Cancer of the Renal Pelvis and Ureter; Recurrent Bladder Cancer; Recurrent Transitional Cell Cancer of the Renal Pelvis and Ureter; Recurrent Urethral Cancer; Stage III Bladder Cancer; Stage III Urethral Cancer; Stage IV Bladder Cancer; Stage IV Urethral Cancer; Transitional Cell Carcinoma of the Bladder; Ureter Cancer

2013-06-04

136

Sorafenib in Treating Patients With Advanced or Metastatic Cancer of the Urinary Tract  

ClinicalTrials.gov

Metastatic Transitional Cell Cancer of the Renal Pelvis and Ureter; Recurrent Bladder Cancer; Recurrent Transitional Cell Cancer of the Renal Pelvis and Ureter; Regional Transitional Cell Cancer of the Renal Pelvis and Ureter; Stage III Bladder Cancer; Stage IV Bladder Cancer; Transitional Cell Carcinoma of the Bladder

2013-05-06

137

Study of Genes and Environment in Patients With Cancer in East Anglia, Trent, or West Midlands Regions of the United Kingdom  

ClinicalTrials.gov

Bladder Cancer; Brain and Central Nervous System Tumors; Esophageal Cancer; Intraocular Melanoma; Kidney Cancer; Lymphoma; Melanoma (Skin); Pancreatic Cancer; Transitional Cell Cancer of the Renal Pelvis and Ureter

2013-08-23

138

Spontaneous Renal Pelvis Rupture: Unexpected Complication of Urolithiasis Expected to Passage with Observation Therapy  

PubMed Central

Seventy percent of ureteral stones are located at distal ureter. Effective and safe passage of distal ureter stones is mediated by observation or medical expulsive treatment. Most of stones located at distal ureter pass spontaneously under observation; however, some are complicated with urinary tract infection, hydronephrosis, and renal function disturbances. Spontaneous perforation of the upper ureter is a rare condition that poses diagnostic and therapeutic problems. This case is reported, because the patient developed an unexpected spontaneous renal pelvis rupture (SRPR), while she was under observation and expected to pass her right ureteral stone spontaneously through hydration and analgesic treatment.

Tas, Tuncay; Cak?roglu, Basri; Aksoy, Suleyman Hilmi

2013-01-01

139

Analgesic nephropathy  

MedlinePLUS

Acute renal failure Chronic renal failure Interstitial nephritis Renal papillary necrosis (tissue death) Urinary tract infections , chronic or recurrent Hypertension Transitional cell carcinoma of the kidney or ureter

140

Comparative gene expression profiling analysis of urothelial carcinoma of the renal pelvis and bladder  

Microsoft Academic Search

BACKGROUND: Urothelial carcinoma (UC) can arise at any location along the urothelial tract, including the urethra, bladder, ureter, or renal pelvis. Although tumors arising in these various locations have similar morphology, it is unclear whether the gene expression profiles are similar between the upper-tract (ureter and renal pelvis) and lower-tract (bladder and urethra) carcinomas. Because differences may facilitate different screening

Zhongfa Zhang; Kyle A Furge; Ximing J Yang; Bin T Teh; Donna E Hansel

2010-01-01

141

Gemcitabine Hydrochloride and Cisplatin With or Without Bevacizumab in Treating Patients With Advanced Urinary Tract Cancer  

ClinicalTrials.gov

Distal Urethral Cancer; Metastatic Transitional Cell Cancer of the Renal Pelvis and Ureter; Proximal Urethral Cancer; Recurrent Bladder Cancer; Recurrent Prostate Cancer; Recurrent Transitional Cell Cancer of the Renal Pelvis and Ureter; Recurrent Urethral Cancer; Stage IV Bladder Cancer; Stage IV Prostate Cancer; Transitional Cell Carcinoma of the Bladder; Urethral Cancer Associated With Invasive Bladder Cancer

2014-06-23

142

Aircraft conflict probe sensitivity to weather forecasts errors  

Microsoft Academic Search

This study investigated the user request evaluation tool's (URET) prediction sensitivity to weather forecast error. A quantitative experiment was designed and performed by the Federal Aviation Administration's Conflict Probe Assessment Team (CPAT) to evaluate the impact of weather forecast errors on URET trajectory and conflict predictions. The experiment used approximately two hours of traffic data recorded at the Indianapolis en

Mike Paglione; Hollis F. Ryan

2007-01-01

143

Trastuzumab in Treating Patients With Previously Treated, Locally Advanced, or Metastatic Cancer of the Urothelium  

ClinicalTrials.gov

Distal Urethral Cancer; Metastatic Transitional Cell Cancer of the Renal Pelvis and Ureter; Proximal Urethral Cancer; Recurrent Bladder Cancer; Recurrent Transitional Cell Cancer of the Renal Pelvis and Ureter; Recurrent Urethral Cancer; Stage IV Bladder Cancer; Transitional Cell Carcinoma of the Bladder; Urethral Cancer Associated With Invasive Bladder Cancer

2013-05-01

144

Ureteroscopic Lithotripsy Using Swiss Lithoclast for Treatment of Ureteral Calculi: 12-Years Experience  

PubMed Central

Ureteroscopic lithotripsy using Swiss Lithoclast was performed in 411 cases from January 1996 to September 2007 in a single hospital. Medical records of 341 cases, in which Swiss Lithoclast was successfully applied, were available for this retrospective study. We used 9.5Fr and 10Fr Storz rigid ureteroscopes. A success was defined as being free of stone-related symptoms and residual stones larger than 2 mm. Sixty one stones were located in the upper ureter, 49 stones were in the mid ureter, and 231 stones were in the lower ureter. The overall success rate was 93.5%. The success rate of upper ureter stone (80.3%) was significantly lower compared with those of mid (93.8%) and lower (96.9%) ureter stones (P=0.001). The higher the calculi was located within the ureter, the more chance of upward migration there was (P<0.001). The success rate in male patients was lower than in female patients without a statistical significance (P=0.068). The success rate decreased as the size of the stone increased (P<0.001), and as the degree of hydronephrosis increased (P=0.03). Perforation rates were 4.9%, 4.1%, and 2.6% from upper to lower ureter stone group. Ureteroscopic lithotripsy using Swiss Lithoclast is a safe and useful treatment modality for ureteral calculi.

Park, Dong Soo

2009-01-01

145

Lack of usefulness of ureteral reconstruction with free bladder mucosa flap in dogs confirmed by microangiography  

PubMed Central

Background There is a paucity of data addressing the blood supply in the surgically reconstructed ureter, and complete lack of microangiographic studies of the reconstructed ureter with the use of a free bladder mucosa flap. The present study evaluated the blood supply in the reconstructed dog ureter after a 5-centimeter segment resection, supplemented by a tube constructed from a free bladder mucosa flap. Material/Methods Female mongrel dogs (n=29) were used in this study. Under general anaesthesia, a 5-centimeter autologous free bladder mucosa flap was used to construct a tube, which was afterwards grafted to replace a 5-centimeter ureter resection. After a period of 3 months (n=2) and after 1 year (n=2), microangiography was performed to assess the revascularization of the grafted ureter. Results In our study, we observed the continuity of the ureter, but the grafted reconstruction was narrowed by the cicatrization in about 86% (n=25) of cases. This resulted in the development of hydronephrosis, as described in previous publications. The ureteral wall was covered by a normal urothelium, but consisted of fibrous connective tissue, which failed to restore a regular (normal) coat. The reconstructed segment showed no smooth muscle cells. A few smooth monocytes were found only at the border with intact portions of the ureter. The microangiography performed at the end of the experiments showed no vascularization of the restored segment of the ureter. Conclusions The experiments showed a whole regeneration of urothelium in the transected and reanastomosed ureters. However, there was no regeneration of the muscular coat and a complete lack of revascularization.

Kuzaka, Boleslaw; Borkowski, Tomasz; Kuzaka, Piotr; Szostek, Grzegorz

2014-01-01

146

Appendicocalicostomy: A case of mistaken identity.  

PubMed

Anatomical structures with similar appearance may at times be confused for each other. This situation can be compounded by lack of normal anatomical planes. We did ureterocalicostomy on a 32-year-female with secondary pelvi-ureteral junction obstruction. Post-operatively, it was discovered that she had a long appendix running parallel to ureter in retroperitoneum, which was misidentified as ureter and anastomosed to the lower pole of the kidney. She was re-explored, appendix was removed, ureter was identified and ureterocalicostomy was done. Patient is asymptomatic at 1 year follow-up. PMID:24744527

Sharma, S; Shah, K; Santhosh, B S; Rizvi, S J

2014-04-01

147

[Flexible ureteroscopy. Diagnostic and therapeutic significance. Apropos of 15 cases].  

PubMed

The authors analyse the results of a preliminary report of 15 cases of ureteric stones treated by flexible ureterorenoscopy and one case of radiolucent renal stone in the left lower renal calyx. Stone fragmentation was complete in 11 cases with 1 small residual fragment in the lower ureter, 1 perforation was immediately operated without any further complication and in one case, it was impossible to advance into the ureter. Flexible ureterorenoscopy is valuable for diagnosis of filling defects in the lower calyx and for treatment of stones in the upper and middle ureter. PMID:2624440

Dore, B; Orget, J; Grange, P; Aubert, J

1989-01-01

148

Afatinib in Advanced Refractory Urothelial Cancer  

ClinicalTrials.gov

Distal Urethral Cancer; Proximal Urethral Cancer; Recurrent Bladder Cancer; Recurrent Urethral Cancer; Stage III Bladder Cancer; Stage III Urethral Cancer; Stage IV Bladder Cancer; Stage IV Urethral Cancer; Ureter Cancer

2014-04-23

149

Renovascular Disease  

MedlinePLUS

... The cause of FMD is unknown, although many theories have been advanced including those involving a genetic ... bladder through tubes called ureters. malignant: A cancerous growth that is likely to grow and spread which ...

150

Urinary Tract Infections  

MedlinePLUS

... kidneys, two ureters, a bladder, and a urethra. Urinary tract infections (UTIs) are the second most common type of infection in the body. You may have a UTI if you notice Pain or burning when you ...

151

21 CFR 876.5470 - Ureteral dilator.  

Code of Federal Regulations, 2010 CFR

...dilator is a device that consists of a specially shaped catheter or bougie and is used to dilate the ureter at the place where a stone has become lodged or to dilate a ureteral stricture. (b) Classification. Class II (performance...

2009-04-01

152

MPH Urinary Rules: Breeze Training Transcript: Feb 16 07  

Cancer.gov

NATIONAL INSTITUTES OF HEALTH NATIONAL CANCER INSTITUTE SURVEILLANCE, EPIDEMIOLOGY AND END RESULTS (SEER) PROGRAM Breeze Session Multiple Primary and Histology Coding Rules—Renal Pelvis, Ureter and Bladder and Other Urinary Sites February 16, 2007

153

Study of the ureterovesical jet flow by means of dupplex Doppler ultrasonography in patients with residual ureteral stone after extracorporeal shock wave lithotripsy.  

PubMed

The aims of our study are to evaluate ureterovesical jet flow Doppler ultrasound (US) in patients with residual ureteral stone after extracorporeal shock wave lithotripsy (ESWL) and to compare with unobstructed contralateral ureter. Patients who have residual ureteral stone in intravenous pyelography (IVP) and/or computed tomography (CT) after ESWL and unobstructed contralateral ureter in 20 patients were prospectively evaluated with Doppler US. The mean peak velocity of the Doppler waveforms was obtained on the residual ureteral stone and contralateral non-obstructed ureter (17.10 +/- 20), (56.0 +/- 32), respectively (P < 0.05). In conclusion, due to the absence of contraindications and side-effects, Doppler US is sensitive and highly specific that can contribute significantly to the diagnosis of residual ureteral stone after ESWL. It can replace IVP and/or CT, in condition where IVP is undesirable and in addition Doppler US can supply a functional investigation of the obstructed ureter. PMID:19940988

Ciftci, Halil; Cece, Hasan; Dusak, Abdurrahim; Savas, Murat; Verit, Ayhan; Yeni, Ercan

2010-02-01

154

Urine and Urination  

MedlinePLUS

Your kidneys make urine by filtering wastes and extra water from your blood. The waste is called urea. Your blood carries it to the kidneys. From the kidneys, urine travels down two thin tubes called ureters to ...

155

Same-session endourological removal of upper and impacted lower urinary tract stones with the aid of prone flexible cystoscopy.  

PubMed

Calculi were removed from the upper urinary tracts and the distal ureter in single sessions in 2 patients with the aid of prone flexible cystoscopy and a through-and-through stone basket. PMID:3599194

Eshghi, M; Addonizio, J C

1987-07-01

156

Double J ureteral stent displaced through the right ventricle.  

PubMed

We report a 59-year old patient with a double J ureteral catheter displaced out of the ureter through the inferior vena cava and right ventricle. The catheter was removed successfully under cardiopulmonary bypass. PMID:24632423

Hastaoglu, Ismail Oral; Tokoz, Hamdi; Kavlak, Ela; Bilgen, Fuat

2014-06-01

157

21 CFR 876.4680 - Ureteral stone dislodger.  

Code of Federal Regulations, 2010 CFR

...flexible tip, or other special construction. It is inserted through a cystoscope and used to entrap and remove stones from the ureter. This generic type of device includes the metal basket and the flexible ureteral stone dislodger. (b)...

2010-04-01

158

Observation of Ureteric Diameter in Negative Intravenous Urogram in Hospital Universiti Kebangsaan Malaysia  

PubMed Central

Background: This study observed the widest ureteric diameter in negative intravenous urogram (IVU) examinations using low osmolar contrast media. Methods: We reviewed a total of one hundred and eighty four ureters from 92 negative IVUs. Results: The results show a mean diameter for the abdominal ureter of 4.19 mm with an SD of 1.27 mm and a mean pelvic ureteric diameter of 4.45 mm with an SD of 1.37 mm. The upper limits for abdominal ureter and pelvic ureter based on a confidence interval of 95% were 4.37 mm and 4.64 mm, respectively. Conclusions: There was no significant difference between the right and left ureteric diameter in both female and male subjects. There was no significant correlation between ureteric diameters and the age of subjects, from the second to the eighth decades.

Wong, Siong Lung; Abdul Hamid, Hamzaini

2010-01-01

159

MPH Urinary Practicum : Breeze Training Transcript: Feb 20 07  

Cancer.gov

NATIONAL INSTITUTES OF HEALTH NATIONAL CANCER INSTITUTE SURVEILLANCE, EPIDEMIOLOGY AND END RESULTS (SEER) PROGRAM BREEZE SESSION Multiple Primary and Histology Coding Rules—Renal Pelvis, Ureter, Bladder and Other Urinary Sites Practicum February

160

Enuresis (Bed-Wetting)  

MedlinePLUS

... their development. Bed-wetting is more common among boys than girls. What causes bed-wetting? A number of things ... valves in boys or in the ureter in girls or boys Abnormalities in the spinal cord A small bladder ...

161

No Visible Scar Colectomy  

MedlinePLUS Videos and Cool Tools

... very similar to our standard laparoscopic colectomy. It’s app licable to right and left sigmoid colons. The ... down that lateral attachments, and boom, it’s totally mobile. Okay. And you’re protecting the left ureter ...

162

Study of the ureterovesical jet flow by means of dupplex Doppler ultrasonography in patients with residual ureteral stone after extracorporeal shock wave lithotripsy  

Microsoft Academic Search

The aims of our study are to evaluate ureterovesical jet flow Doppler ultrasound (US) in patients with residual ureteral stone\\u000a after extracorporeal shock wave lithotripsy (ESWL) and to compare with unobstructed contralateral ureter. Patients who have\\u000a residual ureteral stone in intravenous pyelography (IVP) and\\/or computed tomography (CT) after ESWL and unobstructed contralateral\\u000a ureter in 20 patients were prospectively evaluated with

Halil Ciftci; Hasan Cece; Abdurrahim Dusak; Murat Savas; Ayhan Verit; Ercan Yeni

2010-01-01

163

Ultrasound-guided percutaneous antegrade pyelography with computed tomography for the diagnosis of spontaneous partial ureteral rupture in a dog  

PubMed Central

A 10-year-old spayed female dalmatian dog developed acute vomiting and abdominal pain. Ultrasound examination of the abdomen showed right hydronephrosis and proximal ureter dilation with mild retroperitoneal free fluid. Computed tomography (CT) of the abdomen confirmed the ultrasonographic findings and revealed, additionally, a right ureteral stone. Spontaneus rupture of the right ureter was confirmed with CT post ultrasound-guided percutaneous antegrade pyelography. Pyeloureteral rupture and the presence of a ureteral stone were confirmed at surgery.

Specchi, Swan; Lacava, Giuseppe; d'Anjou, Marc-Andre; Zini, Eric; Auriemma, Edoardo

2012-01-01

164

A Giant Pedunculated Urothelial Polyp Mimicking Bladder Mass in a Child: A Rare Case  

PubMed Central

Ureteral fibroepithelial polyps are rarely seen benign tumors with mesodermal origin. These polyps can involve kidney, pelvis, ureter, bladder, and urethra. The most common symptoms are hematuria and flank pain. The choice of treatment is either endoscopic or surgical resection of polyp by sparing kidney. Here, we presented a pediatric case with giant, fibroepithelial polyp that mimics bladder tumor, originating from middle segment of the ureter.

Kaba, Mehmet; Kaba, Sultan; Kaya, Tacettin Yekta; Eren, Huseyin; Pirincci, Necip

2014-01-01

165

Laparoscopic Repair of a Ureteric Sciatic Hernia: Report of a Case  

PubMed Central

Ureteric sciatic hernias are extremely rare. Here we report a case of a 78-year-old woman presented with colicky left abdominal pain. Computed tomography revealed a ureteric sciatic hernia, and drip infusion pyelography revealed dilated left ureter with herniation of the ureter into the sciatic foramen. The hernia was successfully repaired laparoscopically. We have described the diagnosis and management of the patient, followed by a review of the literature on sciatic hernias.

Saisu, Kazuhiro; Tsuru, Nobuo; Homma, Yukio; Ihara, Hiroyuki

2014-01-01

166

Robot-Assisted Pyeloplasty  

Microsoft Academic Search

\\u000a Ureteropelvic junction obstruction (UPJO) is defined as a significant, functional alteration in the “transit” of urine due\\u000a to an intrinsic or extrinsic obstruction at the junction between the ureter and the renal pelvis. In the majority of cases,\\u000a its origin is congenital. UPJO is the most common congenital abnormality of the ureter, with an annual reported incidence\\u000a of 5\\/100,000 (Eden

Raymond J. Leveillee; Jorge Bracho; Steve K. Williams; John M. Shields; Charles R. Moore

167

Extracorporeal shock wave lithotripsy of proximal and distal ureteral stones.  

PubMed

Extracorporeal shock wave lithotripsy (ESWL) was used for treatment of 105 patients with ureteral stones. There were 77 stones in the upper part of the ureter, i.e. above the pelvic brim, and 28 in the lower part, i.e. below the sacroiliac joint. Successful fragmentation was attained in 101 (96%). In 93% of the patients with stones in the upper ureter and in 100% with stones in the lower ureter the fragments were eliminated completely. In 87% of the patients with stones in the upper ureter, a ureteral catheter was introduced under local anesthesia but without fluoroscopic control. It was thereby possible to remove 30% of the stones from the ureter to the kidney. For the remaining stones, saline was infused through the catheter during ESWL. For patients with stones in the lower part of the ureter, a ureteral catheter was passed in 79% and saline infused during treatment. Whereas some form of anesthesia was used for treatment of all upper ureteral stones, 89% of the treatments for lower ureteral stones were performed without anesthesia. Auxiliary procedures after ESWL were limited to four ureteral catheter manipulations for distal stones. Four proximal stones which remained unaffected by ESWL had to be treated by open surgery (3 stones) or percutaneous surgery (1 stone). Of 82 ureteric stones treated in situ the success fragmentation rate was 95%. The average number of ESWL sessions was 1.04 for both proximal and distal ureteral stones. PMID:3383929

Pettersson, B; Tiselius, H G

1988-01-01

168

Compensatory hypertrophy of the contralateral kidney after unilateral ureteral ligation  

PubMed Central

1. The ligation of one ureter is accompanied by compensatory hypertrophy of the contralateral kidney. 2. The rate of growth of the contralateral kidney after ligation of the opposite ureter is similar to that observed after unilateral nephrectomy. 3. Ligation of one ureter produced ipsilateral hydronephrosis. 4. The development of hydronephrosis was accompanied by a marked increase of DNA, suggesting hyperplasia, and of the rate of anaerobic glycolysis, while the rate of oxygen uptake decreased, especially in the cortex. 5. During compensatory hypertrophy of the contralateral kidney, after ligation of the opposite ureter, there were increases of RNA/DNA ratios and of oxygen uptake, especially marked in the cortex, and in every respect similar to those observed after unilateral nephrectomy. 6. Ligation of one ureter resulted in an increase of glomerular filtration rate of the contralateral kidney similar to that observed after unilateral nephrectomy. 7. The mechanisms of contralateral renal hypertrophy after ligation of one ureter and after unilateral nephrectomy are discussed. It is suggested that in both cases the prime mover to compensatory hypertrophy is the increase of glomerular filtration rate.

Dicker, S. E.; Shirley, D. G.

1972-01-01

169

Socioeconomic evaluation of the treatment of ureteral lithiasis  

PubMed Central

Background and aim: This study attempts to estimate the socioeconomic differences between three major alternatives for the management of upper and lower ureteral lithiasis. Material and methods: Two hundred and forty patients with upper and lower ureteral lithiasis, have been studied retrospectively, divided in six equal groups of forty. These patients have been treated either by extracorporeal shockwave lithotripsy (SWL), or with ureteroscopy with semirigid ureteroscope and the use of pneumatic lithoclast, or with ureteroscopy with flexible ureteroscope and the use of Holmium YAG Laser. For cost calculation, the reimbursement fee paid by insurance to the hospital was taken into account. For the estimation of the social burden, the length of hospital stay and the number of outpatient visits have been included as countable parameters. Results: The percentage of effective stone removal for upper ureter was 81.0% for SWL, 62.5% for ureteroscopy with semirigid ureteroscope and the use of pneumatic lithoclast and, 82.5% for ureteroscopy with flexible ureteroscope and the use of Holmium YAG Laser. The same percentages for lower ureter were 82.5%, 92.5% and 97.5% respectively. The cost of stone removal for both the upper and lower ureter using extracorporeal lithotripsy was significantly higher compared to the other two procedures (median cost for upper ureter 828 € vs 474.50 € and 396 € respectively, and for lower ureter 826 € vs 396 € and 271 €, p<0.001). Regarding the social aspect, SWL is mainly an outpatient procedure, requiring a short hospital stay (for upper ureter 1.63 vs 2.48 and 2.45 respectively and for lower ureter 1.35 vs 2.43 and 2.13days), but needing more and prevailing clinic visits (for upper ureter 1.43 vs 1.45 and 1 respectively and for lower ureter 1.45 vs 1.15 and 0.55 visitsgive numbers, compare), both in outpatient and in accident and emergency (A&E) department. Conclusion: The increase in the expenses with regard to health management indicates the necessity of cost accounting the health programs including the medical procedures as a means to improve the relation between cost and benefit.

Rombi, T; Triantafyllidis, A; Fotas, A; Konstantinidis, T; Touloupidis, S

2011-01-01

170

Use of Ileum as Ureteral Replacement in Urological Reconstruction  

PubMed Central

Purpose We reviewed indications and outcomes in patients undergoing ileal ureter replacement for ureteral reconstruction. Materials and Methods Between December 1989 and September 2007, 105 patients underwent ileal ureter replacement, of whom 14 were excluded from study due to incomplete data. The remaining 91 patients (99 renal units) comprised the study cohort. Results Mean patient age was 46.8 years and mean followup was 36.0 months. Indications for an ileal ureter were stricture following genitourinary surgery in 29 cases (31.9%), radiation induced stricture in 17 (18.7%), nonurological surgery iatrogenic injury in 16 (17.6%) and retroperitoneal fibrosis in 11 (12.1%). Only 4 patients (4.4%) had primary ureteral cancer. Long-term complications included anastomotic stricture in 3 patients (3.3%) and fistula in 6 (6.6%). Serum creatinine decreased or remained stable in 68 patients (74.7%) and hyperchloremic metabolic acidosis developed in 3. No patient complained of excessive urinary mucous production. Conclusions In 68.1% of patients indications for an ileal ureter included radiation induced stricture or iatrogenic injury. The ileal ureter is a reasonable option for long-term ureteral reconstruction with preserved renal function in carefully selected patients.

Armatys, Sandra A.; Mellon, Matthew J.; Beck, Stephen D. W.; Koch, Michael O.; Foster, Richard S.; Bihrle, Richard

2009-01-01

171

[Effect of urethral stenoses on the urinary tract].  

PubMed

Intrauterine operations were carried out in fetal sheep varying from 50-122 days of gestation. Silk, catgut and polyglycolicacid sutures were used to produce varying degrees of stenosis. The urachus was ligated with a silk suture in all cases. Urachal ligation alone produces no ill effects on the upper urinary tract. The addition of urethral stenosis results in dilatation of the upper tract depending on the degree of infravesical obstruction. Partial ligation of the urethra produces a pyelocalyectasis which may disappear later. More severe degrees of obstruction are followed by hydronephrosis, hydroureter and megacystis. Dilatation begins in the region of the renal pelvis and proceeds in the antegrade manner towards the bladder. Histologically the parenchyma was reduced in thickness and showed dilated tubules. In the ureter and the bladder muscular hypertrophy was noticed. Depending on the time of the experiment, there was an increase of connective tissue within the ureter and bladder. In cases of extreme obstruction the ureter showed muscular atrophy. No infection, ureteral reflux, bladder diverticulosis, extravesicalisation of the ureter or narrowing of the ureter by hypertrophied musculature was seen. These experiments may throw some light on the pathogenesis of the megaureter syndrome occurring in childhood. PMID:7250874

Osterhage, H R

1981-06-01

172

Distant Ureteral Metastasis from Colon Adenocarcinoma: Report of a Case and Review of the Literature  

PubMed Central

Carcinomas arising from organs neighbouring the ureter can directly infiltrate the ureter. Distant ureteral metastasis from colon adenocarcinoma is extremely rare and usually an incidental finding in performed autopsies. We report a case of a right ureteral metastasis in a 65-year-old Caucasian male with a history of rectal cancer for which he had been treated 4 years before. He presented with asymptomatic moderate right hydronephrosis. The patient underwent a right nephroureterectomy. Histology of the ureter revealed transmural adenocarcinoma with infiltration of the mucosa. Infiltration of the muscular coat of the bladder was found 2 years later. Thus, cystectomy and left ureterocutaneostomy were performed. The patient died 6 months later due to toxic megacolon during chemotherapy. The differential diagnosis of ureteral adenocarcinoma, especially in patients with previous history of colon adenocarcinoma, should include the possibility of distant metastasis from the primary colonic tumor.

Nikolaos, Ferakis; Panagiotis, Anastasopoulos; Konstantinos, Bouropoulos; Vassilios, Samaras; Iraklis, Poulias

2014-01-01

173

[Ureteral stenosis in pancreatitis. Role and value of the double J tube].  

PubMed

One case of right ureteral stenosis due to a flow of necrosis from an acute lithiasic pancreatitis, treated with the insertion of a double J tube, is reported. 14 cases of ureteral stenosis following pancreatitis have been found in the literature. They occur whatever the severity of pancreatitis and can either reveal it or, on the contrary, be asymptomatic. The ureteral lesions are of three kinds: compression by a pseudocyst of the pancreas, sheathing of the ureter and "ureteritis" in the flows of necrosis, necrosis of the ureteral wall. The management of these ureteral stenoses involves treating both the pancreatitis and the obstruction, according to its type. In cases of compression or sheathing of the ureter, ureteral endoprostheses inserted in an early stage allow maintaining the patency of the ureter during the healing phase. In case of ureteral necrosis, nephrostomy, then ureteral resection prove to be necessary. PMID:2290039

Janin, P; Haillot, O; Vannier, J; Berton, C; Lanson, Y

1990-01-01

174

An Everting Ureteral Access Sheath: Concepts and In Vitro Testing  

NASA Astrophysics Data System (ADS)

Ureteral access sheaths have been a recent innovation in facilitating ureteral stone surgery. Once properly placed, access sheaths allow the movement of ureteroscopes and other instruments through the ureter with minimal injury to the urothelium. However, there are shortcomings of the current device designs. Initial sheath placement requires significant force, and shear stress can injure the ureter. In addition, inadvertent advancement of the outer sheath without the inner introducer stylet can tear and avulse the ureter. A novel eversion design incorporating a lubricous film provides marked improvement over current access sheaths. In bench top and animal models, the eversion shealths require less force during advancement, cause less injury to the urothelial tissue, and have a lower potential of introducing extraneous materials (e.g., microbes) into a simulated urinary tract. While, the everting design provides important advantages over traditional non-everting designs, further preclinical and clinical trials are required.

Lee, Keith L.; Stoller, Marshall L.

2007-04-01

175

Four miniature kidneys: supernumerary kidney and multiple organ system anomalies.  

PubMed

More than 350 years after Martius's first reported case in 1656, supernumerary kidney (SNK) continues to fascinate the world of medicine, generating new ideas in the domain of embryogenesis. Association of a normal kidney with a second or third ipsilateral smaller kidney is an extremely rare anomaly with only a total of 81 cases reported until today. We are reporting a case of SNK, clinically diagnosed as right hydronephrosis, associated with an ipsilateral ectopic ureter, a contralateral partially duplicated ureter, and a multiseptate gallbladder. Pathologic examination of the nephrectomy revealed 4 miniature kidneys, joining a dilated ureter through 4 separate conduits. Our patient is the first reported case of SNK with absent ipsilateral normal kidney, presence of more than 3 kidneys on 1 side, and associated anomaly in the gallbladder. This case represents a unique combination of rarities, suggesting insights in the domain of molecular embryology. PMID:24593866

Afrouzian, Marjan; Sonstein, Joseph; Dadfarnia, Tahereh; Sreshta, J Nicholas; Hawkins, Hal K

2014-05-01

176

Diagnosis and management of urinary ectopia.  

PubMed

Ectopic ureters are the most common cause of urinary incontinence in young dogs but should be considered as a differential in any incontinent dog for which the history is not known. Ectopic ureters can be diagnosed with excretory urography, fluoroscopic urethrography or ureterography, abdominal ultrasonography, cystoscopy, helical computed tomography, or a combination of these diagnostic procedures. Other congenital abnormalities can also occur in dogs with ectopic ureters, including renal agenesis or dysplasia, hydronephrosis, and/or hydroureter and vestibulovaginal anomalies; therefore, the entire urinary system must be evaluated with ultrasonography if cystoscopy is the only other diagnostic tool used before surgery. Novel surgical techniques and adjunctive medical management have improved the prognosis for dogs with urinary ectopia. PMID:24580995

Davidson, Autumn P; Westropp, Jodi L

2014-03-01

177

Urolithiasis in primary obstructive megaureter: a management dilemma.  

PubMed

Megaureter with urolithiasis is an uncommon entity. These stones may be located in the kidney, ureter or both. Management of these cases is difficult due to free mobility and stone multiplicity. As there are no guidelines about the management, the surgeon usually manages according to her/his experience, stone location or burden. The goal is to remove the stones and reimplant the ureters in the same session, if possible. We describe single-stage management of one such patient who presented with bilateral multiple ureteral and left renal stones. The left ureteral stones were first flushed into the kidney by the ureteroscope. Percutaneous nephrolithotomy was then performed and stones were removed intact. The patient was then turned supine and the location of right ureteral stones was confirmed by fluoroscopy in the same location (right lower ureter). The patient underwent successful bilateral ureteroneocystostomy with simultaneous removal of right lower ureteral stones. PMID:24879732

Kumar, Arvind; Goel, Apul; Singh, Manmeet; Sankwar, Satya Narayan

2014-01-01

178

Urinary Concentration in the Papillary Collecting Duct of the Rat  

PubMed Central

Urine was observed to flow intermittently in the collecting ducts of the extrarenal papilla of antidiuretic rats. The purpose of this investigation was to test Reinking and Schmidt-Nielsen's hypothesis that intermittent flow plays an important role in the production of maximally concentrated urine. Samples of collecting duct fluid were obtained from the base and tip of the papilla by micropuncture through the intact ureter. Fluid osmolality rose sharply from base, 894±120 mosmol/kg H2O?1 (mean±SE), to tip, 1,667±114 (P<0.001), a distance of only 2 mm, and was due exclusively to reabsorption of water. After excision of the ureter, which abolished intermittent flow, osmolality fell modestly at the base to 723±82 mosmol/kg H2O?1 (P < 0.02), but strikingly at the tip to 1,012±103 (P < 0.001). The pelvic ureter was paralyzed by topical verapamil and dimethylsulfoxide, which abolished intermittent flow. Osmolality of urine at the tip was not changed (1,959±184 mosmol/kg H2O?1 before, vs. 1,957±126 after paralysis). The ureter was severed just beyond the papillary tip, a maneuver which preserved intermittent flow but abolished urinary reflux over the papilla. Urinary osmolality fell from 1,876±134 mosmol/kg H2O?1 to 1,284±115 (P < 0.005). These findings demonstrate that when the ureter is intact, over half of the increase in urinary osmolality above isotonicity occurs in the terminal one-fourth of the medullary collecting duct and is due exclusively to water reabsorption (no net solute addition). It is the continuity of the ureter, rather than intermittent flow due to ureteral peristalsis, which is essential for the formation of a maximally concentrated urine.

Oliver, Richard E.; Roy, Denis R.; Jamison, Rex L.

1982-01-01

179

Inguinoscrotal hernias involving urologic organs: A case series  

PubMed Central

We report 2 cases of inguinoscrotal hernias involving urologic organs. The first case involved an elderly gentleman with a history of micturition by squeezing his scrotum. He was diagnosed as having a right-sided indirect inguinal hernia involving the right ureter and bladder. Treatment was surgical. The second case involved an achondroplastic male who presented with acute kidney injury. He had bilateral hydronephrosis and ureteric obstruction secondary to an ureteroinguinal herniation bilaterally. The presentation, diagnosis, and treatment of inguinoscrotal hernias involving the bladder and ureters are discussed.

McKay, Jeffrey Peter; Organ, Michael; Bagnell, Scott; Gallant, Christopher; French, Christopher

2014-01-01

180

Acute renal failure caused by bilateral ureteral herniation through the sciatic foramen.  

PubMed

Ureteral herniation is rare. Only a few cases of bilateral ureterosciatic herniation have been reported. We report the case of a 74-year-old woman with flank pain and acute renal failure. The initial ultrasound scan showed bilateral hydronephrosis. Follow-up computed tomography imaging demonstrated sciatic herniation of both ureters, causing bilateral hydronephrosis and hydroureter. The patient underwent bilateral retrograde ureterography and ureteral stent placement, with improvement in renal function to normal limits. Observation after stent removal demonstrated recurrent sciatic herniation of both ureters. Definitive surgical correction was performed by way of laparoscopic bilateral ureterolysis and sciatic notch hernia repair using mesh. PMID:23602799

Whyburn, James J; Alizadeh, Ahmadreza

2013-06-01

181

Radionuclide imaging of rare congenital renal fusion anomalies.  

PubMed

Demonstration of a congenital renal anomaly plays an important role in the treatment of patients with renal infection. These patients are prone to infections because of coexisting urinary tract anomalies such as duplicated ureter, ureter opening anomalies, and urinary stasis. Assessment of renal parenchymal damage resulting from acute or chronic renal infection is the primary indication for radionuclide imaging with Tc-99m DMSA. In addition, this technique allows congenital anomalies to be identified. The authors review congenital renal fusion anomalies identified in children through Tc-99m DMSA imaging. They conclude that Tc-99m DMSA imaging can reveal important diagnostic information about various congenital anomalies, including fusion anomalies. PMID:12592127

Volkan, Bilge; Ceylan, Emel; Kiratli, Pinar Ozgen

2003-03-01

182

Veliparib, Cisplatin, and Gemcitabine Hydrochloride in Treating Patients With Advanced Biliary, Pancreatic, Urothelial, or Non-Small Cell Lung Cancer  

ClinicalTrials.gov

Advanced Adult Primary Liver Cancer; Localized Unresectable Adult Primary Liver Cancer; Metastatic Transitional Cell Cancer of the Renal Pelvis and Ureter; Regional Transitional Cell Cancer of the Renal Pelvis and Ureter; Stage III Bladder Cancer; Stage III Pancreatic Cancer; Stage IIIA Non-small Cell Lung Cancer; Stage IIIB Non-small Cell Lung Cancer; Stage IV Bladder Cancer; Stage IV Non-small Cell Lung Cancer; Stage IV Pancreatic Cancer; Transitional Cell Carcinoma of the Bladder; Unresectable Extrahepatic Bile Duct Cancer; Unresectable Gallbladder Cancer

2013-07-01

183

Rpc of the Month from the Afif.  

National Technical Information Service (NTIS)

The radiographic findings in an intravenous urogram of a 50-year-old man: Represent multiple foci of a transitional-cell carcinoma of the kidney pelvis and ureter; Represent the 'beaded' appearance typical of long-standing tuberculous pyeloureteritis; Occ...

E. G. Theros

1970-01-01

184

The Prune Belly syndrome: urological aspects and long-term outcomes of a rare disease  

PubMed Central

Prune-Belly syndrome is a disorder characterized by the following triad of symptoms: deficiency of the abdominal muscles, malformations of the urinary tract and bilateral cryptorchidism. This study included a total of 16 patients. The findings included clinical characteristics, diagnostics, therapy and long-term clinical outcomes. All patients were asked to complete a questionnaire and, in some cases, were given further examination. All patients were diagnosed with congenital aplasia of the abdominal wall and a variety of urogenital malformations. Cryptorchidism was present in 11 patients (68.8%), malformations of the prostate in 3 (18.8%), urethral malformations in 8 (50%) and mega-ureter in 14 patients (87.5%). A mega-bladder was observed in 13 patients (81.3%). Distinctive renal malformations, such as renal dysplasia, in 3 patients (18.8%) and hydronephrosis in 9 patients (56.3%), respectively. Abdominoplasty was performed on 4 patients (25%). Urethral surgery was performed in 10 patients (62.5%). Seven patients (43.8%) required ureter surgery, most of which involved re-implantation of the ureter and, in some cases, additional ureter modeling. Renal surgery was performed on 5 patients. Four patients with non-functioning kidneys with hydronephrosis underwent a nephrectomy and one patient pyeloplasty. We demonstrate that successful treatment is possible even in cases of serious and complex malformations, such as those of the Prune-Belly syndrome. Treatment must be tailored to the individual patient. The severity of the renal dysplasia is the main prognostic factor.

Zugor, Vahudin; Schott, Gunter E.; Labanaris, Apostolos P.

2012-01-01

185

Urinary diversion via a continent ileal reservoir: Clinical results in 12 patients  

Microsoft Academic Search

Urinary diversion via a continent ileal reservoir has been performed in 12 patients. An isolated ileal reservoir was constructed using the technique described for patients with a continent ileostomy. The ureters were implanted into an afferent segment provided with a reflux-preventing nipple valve. There were few operative complications and no operative mortality. Late complications involving malfunction of the nipple valves

N. G. Kock; A. E. Nilson; L. O. Nilsson; L. J. Norlén; B. M. Philipson

2002-01-01

186

Your Kidneys  

MedlinePLUS

... the parts of the urinary system: the kidneys: filters that take the waste out of the blood and make urine the ureters: tubes that carry the urine from each kidney to the bladder the bladder: a bag that collects the urine the urethra: a tube ...

187

EGF AND TGF ALPHA EXPRESSION INFLUENCE THE DEVELOPMENTAL TOXICITY OF TCDD: DOSE RESPONSE AND AHR PHENOTYPE IN EGF, TGF ALPHA AND EGF+TGF ALPHA KNOCKOUT MICE  

EPA Science Inventory

Abstract The environmental toxicant 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) produces cleft palate (CP) and hydronephrosis (HN) in mice. The etiology of these defects involves hyperproliferation of epithelial cells of the secondary palatal shelf and ureter, respectively. ...

188

Long-term nephrostomy in an adult male spinal cord injury patient who had normal upper urinary tracts but developed bilateral hydronephrosis following penile sheath drainage: pyeloplasty and balloon dilatation of ureteropelvic junction proved futile: a case report  

Microsoft Academic Search

INTRODUCTION: The consequences of spinal cord injury upon urinary bladder are readily recognised by patients and health care professionals, since neuropathic bladder manifests itself as urinary incontinence, or retention of urine. But health care professionals and persons with spinal cord injury may not be conversant with neuropathic dysmotility affecting the ureter and renal pelvis. We report an adult male patient

Subramanian Vaidyanathan; Bakul M Soni; Peter L Hughes; Gurpreet Singh; Paul Mansour; Tun Oo

2009-01-01

189

Career of the Month: An Interview With Urologist Chad DeRosa  

NSDL National Science Digital Library

The organs, tubes, muscles, and nerves that work together to create, store, and carry urine make up the urinary system. Urologists are surgeons that focus on diseases of this system--which includes the kidneys, ureters, bladder, supporting muscles and liga

Sullivan, Megan

2009-11-01

190

Effects of Prostaglandins and Prostaglandin Synthetase Inhibitors on Acutely Obstructed Kidneys in the Dog  

Microsoft Academic Search

An intact canine model was developed to study the effects of prostaglandins (PG) and prostaglandin synthetase inhibitors on acutely obstructed kidneys. Totally implanted nephrostomy tubes were placed to measure renal pelvic pressure. Complete ureteral obstruction was obtained with a Fogarty balloon catheter inflated in the distal ureter; by this method renal pelvic pressure reached 40–50 mm Hg. Renal pelvic pressure

Ulrike Zwergel; Thomas Zwergel; Manfred Ziegler

1991-01-01

191

Ureteroscopic treatment of urological calculi under sacral block anesthesia.  

PubMed

We evaluated the effectiveness and safety of ureteroscopic pneumatic lithotripsy (URS-PL) for the treatment of urological calculi under sacral block anesthesia. URS-PL was performed with a semirigid ureteroscope under sacral block anesthesia in 90 patients between January 2006 and April 2010. Calculi were located in the middle ureter in 20 patients, the distal ureter in 48 patients, the bladder in 20 patients, and the urethra in 2 patients. We carried out URS-PL in all patients under sacral block anesthesia with 20 ml 2% lidocaine. An objective pain score scale was used to assess patient pain and anxiety. Adverse events were recorded. The results showed the overall stone-free rate was 97.8%, the rate being 100% for calculi in the bladder, urethral and distal ureter, 90.0% for calculi in the midureter. The mean operative time was 25.2 min (range 10-60 min). We had perfect pain control in the majority of the patients. Patients' acceptance was very high. Only two patient required conversion to epidural block anesthesia. No anesthetic-related side effects occurred in all patients. These finding suggest that sacral block anesthesia is a safe and efficacious mend during URS-PL in urological calculi, especially those patients in the distal ureter and calculi <1 cm. PMID:21842292

Zhu, Hongjian; Xiao, Xuren; Chen, Xianglong; Feng, Guohui; Zhang, Qingjiang; Wang, Hua; Zhang, Xiaoming

2012-08-01

192

Appendiceal Abscess Revealed by Right Renal Colic and Hydronephrosis  

PubMed Central

Reported is the case of a patient who had an appendiceal abscess revealed by right renal colic with fever and general fatigue. The abdominal computed tomography scan showed hydronephrosis and an appendiceal abscess surrounding and compressing the ureter. The appendix contained a stercolith and was perforated.

Khallouk, Abdelhak; Ahallal, Younes; Ahsaini, Mustapha; Elfassi, Mohamed Jamal; Farih, Moulay Hassan

2011-01-01

193

[Changes in the kidney in a case of neurofibromatosis (author's transl)].  

PubMed

In a case of an 18-yr-old girl with generalized neurofibromatosis there was an unilateral hydronephrosis due to polypoid neurofibromas in the ureter and urinary bladder. In the kidney were interstitial neurofibromas, a great number of dysontogenetic adenomas and also neurofibromatosis of the vessels. PMID:810993

Fladerer, H; Vilits, P

1975-01-01

194

Treatment of vesicoureteral reflux in children by endoscopic injection of Teflon  

Microsoft Academic Search

From November 1986 to April 1990, 326 refluxing ureters in 197 children were treated by endoscopic injection of Teflon paste. Complications were observed in only 3 cases: 1 child had immediate bilateral ureteral stenosis requiring surgery at 48 h. In 1 case it was impossible to probe 1 ureteral orifice after injection, and Cohen reimplantation was immediately performed; in a

H. Dodat; P. Takvorian; E. Sabatier; V. Frering; A. Ennassih

1991-01-01

195

Nissen-type colonic bladder wall ureteral wraparound for reimplantation in a complex reconstructive case  

Microsoft Academic Search

We have applied a technique patterned after the Nissen gastroesophageal fundoplication to accomplish an antireflux mechanism in a girl who had had several failed operations that left her with a microbladder augmented with colon and both ureters replaced by small bowel and implanted without any antireflux procedure. Anchoring of the wrapped colonic bladder wall to the ureteral musculature and the

R. V. Pieretti; R. V. Pieretti-Vanmarcke

1996-01-01

196

Ureteral Substitution Using Appendix for a Ureteral Defect Caused by a Retroperitoneal Rhabdomyosarcoma in a Child  

PubMed Central

A 7-year-old boy was diagnosed with a recurrent embryonal rhabdomyosarcoma in the retroperitoneum. After resection of the mass, direct end-to-end anastomosis of the ureter was not possible owing to the length of the resected segment. Accordingly, we performed ureteral substitution by using the appendix to repair the ureteral defect.

Yoon, Byung Il; Hong, Chan Gyu; Kim, Seol; Ha, U-Syn; Chung, Jae Hee; Kim, Sae Woong; Cho, Yong-Hyun

2014-01-01

197

A proliferation-dependent bystander effect in primary porcine and human urothelial explants in response to targeted irradiation  

Microsoft Academic Search

The aim of this study was to test whether radiation-induced bystander effects are involved in the response of multicellular systems to targeted irradiation. A primary explant technique was used that reconstructed the in vivo microarchitecture of normal urothelium with proliferating and differentiated cells present. Sections of human and porcine ureter were cultured as explants and irradiated on day 7 when

O V Belyakov; M Folkard; C Mothersill; K M Prise; B D Michael

2003-01-01

198

Fibrose rétropéritonéale idiopathique et spondylarthrite ankylosante. Une nouvelle observation  

Microsoft Academic Search

The case of a 52-year-old man with retroperitoneal fibrosis and ankylosing spondylitis is described. Inflammatory low back pain and acute renal insufficiency prompted a computed tomography scan of the abdomen with contrast agent injection. A fibrous sheath surrounding the aorta and attracting the ureters toward the midline was seen, strongly suggesting retroperitoneal fibrosis. The diagnosis of ankylosing spondylitis was based

A Bezza; A El Maghraoui; M Ghadouane; F Tabache; A Abouzahir; M Abbar; D Ghafir; V Ohayon; M. I Archane

2002-01-01

199

Idiopathic retroperitoneal fibrosis and ankylosing spondylitis. A new case report  

Microsoft Academic Search

The case of a 52-year-old man with retroperitoneal fibrosis and ankylosing spondylitis is described. Inflammatory low back pain and acute renal insufficiency prompted a computed tomography scan of the abdomen with contrast agent injection. A fibrous sheath surrounding the aorta and attracting the ureters toward the midline was seen, strongly suggesting retroperitoneal fibrosis. The diagnosis of ankylosing spondylitis was based

A Bezza; A El Maghraoui; M Ghadouane; F Tabache; A Abouzahir; M Abbar; D Ghafir; V Ohayon; M. I Archane

2002-01-01

200

Enhanced Dendroaspis Natriuretic Peptide Immunoreactivity in Experimental Ureteral Obstruction  

Microsoft Academic Search

Whether the postobstructive diuresis can in part be related to an altered regulation of Dendroaspis natriuretic peptide (DNP) was investigated. Male Sprague-Dawley rats were bilaterally obstructed of their ureters. Control group was with sham ureteral obstruction. Forty-eight h later, tissue levels of DNP immunoreactivity were determined in the plasma, heart, and kidneys. Urine samples were collected in some rats under

Soo Wan Kim; Jong Un Lee; Sung Zoo Kim; Ki Chul Choi; Nam Ho Kim; Kyung Woo Cho

2002-01-01

201

General Information about Bladder Cancer  

MedlinePLUS

... cancer is present in these organs. A contrast dye is injected into a vein . As the contrast dye moves through the kidneys, ureters, and bladder, x- ... computer linked to an x-ray machine. A dye may be injected into a vein or swallowed ...

202

B-Type Natriuretic Peptide (BNP) and N-Terminal Pro-BNP in Obese Patients without Heart Failure: Relationship to Body Mass Index and Gastric Bypass Surgery  

Microsoft Academic Search

Background: Further investigations are warranted to better characterize variables that may confound the clinical interpretation of plasma natriuretic peptide measurements, which are increasingly recognized to have diagnostic and predictive importance. Methods: Blood samples (EDTA plasma) from patients (n 206) attending clinics for the medical treatment and follow-up of obesity were analyzed for B-type natri- uretic peptide (BNP; Bayer assay) and

Guilford G. Hartley; MaryAnn M. Murakami; Fred S. Apple

203

An unusual presentation of enzootic bovine leukosis.  

PubMed Central

A 6-year-old, Holstein x Simmental cow diagnosed with pyelonephritis had increasing difficulty rising and became recumbent, despite treatment with antibiotics. A serological test for the bovine leukemia virus was positive; at necropsy, the left kidney and ureter and the myocardium showed lesions of lymphosarcoma, confirmed by histology.

Sparling, A M

2000-01-01

204

LAD1, the Linear IgA Bullous Dermatosis Autoantigen, Is a Novel 120-kDa Anchoring Filament Protein Synthesized by Epidermal Cells  

Microsoft Academic Search

This study characterizes a novel basement membrane component that is the target of autoantibodies in patients with linear IgA bullous dermatosis. Tissue surveys showed that this protein localized to the epidermal side of 1 M NaCl split skin and to basement membranes in cornea, oral mucosa, esophagus, intestine, kidney collecting ducts, ureter, bladder, urethra, and thymus, but was absent in

M. Peter Marinkovich; Ted B. Taylor; Douglas R. Keene; Robert E. Burgeson; John J. Zone

1996-01-01

205

Unusual bilateral obstructive uropathy with kidney failure in an adolescent with ulcerative colitis  

Microsoft Academic Search

Extrarenal manifestation and complications of inflammatory bowel disease may be detected in a significant number of patients. It is known that the genitourinary tract may be affected but data from childhood population are scarce. We present an unusual bilateral obstruction of ureters, inflammation of bladder wall and vesicoureteral reflux in a boy with ulcerative colitis. Obstructions led to recurrent acute

Marcin Tkaczyk; Anna Ka?u?y?ska; Emeryk Samolewicz

206

Ureteral rhabdomyosarcoma  

Microsoft Academic Search

Rhabdomyosarcoma is a malignant tumor well known to urologists. These tumors arise from the genitourinary system in 20% to 25% of cases, most commonly from the bladder, prostate, vagina, and paratesticular region. This is the first reported case of a rhabdomyosarcoma arising from the ureter. The radiographic findings and ureteroscopic appearance of this tumor suggested a benign fibroepithelial polyp; however,

Murphy F Townsend; Anthony A Gal; William W Thoms; John L Newman; John N Eble; Sam D Graham

1999-01-01

207

The management of upper urinary tract calculi by piezoelectric extracorporeal shock wave lithotripsy in spinal cord injury patients  

Microsoft Academic Search

From May 1988 to September 1994, 15 spinal cord injury patients were treated by piezoelectric extracorporeal shock wave lithotripsy. Aged from 23 to 71 years (mean = 39), they presented with a total of 23 stones, of which 18 were located in the calyces, three in the renal pelvis and two in the proximal ureter. The maximum dimensions of calculi

M Robert; A Bennani; F Ohanna; J Guiter; M Avérous; D Grasset

1995-01-01

208

Major avoidable risk factors of cancer  

Microsoft Academic Search

With an aim of promoting primary prevention of cancer, major avoidable risk factors as well as protective factors of cancer are reviewed based on previous epidemiological studies. Among various risk factors of cancer, tobacco is the most important avoidable risk factor for cancers of the oral cavity, larynx, lung, pharynx, esophagus, stomach, liver, pancreas, kidney (pelvis), ureter, bladder, and cervix.

S. Tominaga

1999-01-01

209

C-Type Natriuretic Peptide Relaxes Human Coronary Artery Bypass Grafts Preconstricted by Endothelin1  

Microsoft Academic Search

Background. Endothelin is implicated in graft spasm after coronary artery bypass grafting. We assessed rever- sal by the endothelium-derived vasodilator C-type natri- uretic peptide of prior contraction of radial artery and other vessels commonly used for coronary artery bypass surgery. Methods. Segments of human radial artery, saphenous vein, and internal mammary artery were mounted in organ baths after removal from

Christopher J. Kelsall; Adrian H. Chester; Mohammed Amrani; Donald R. J. Singer

2005-01-01

210

Nuclear-Medical Examination of the Ureteric Peristalsis with Sup(99M)Tc-MDP as an Additional Finding to the Bone Scintigrams of Patients with Healthy Kidneys.  

National Technical Information Service (NTIS)

A new nuclear-medical examination method is described at 42 patients. In order to obtain more exact information about the mobility of the ureter the Urokinetogram (UKG) developed by Mueller-Schauenburg was prepared and evaluated after a routine serial ren...

R. Lindenberger

1981-01-01

211

21 CFR 876.5470 - Ureteral dilator.  

Code of Federal Regulations, 2010 CFR

...Identification. A ureteral dilator is a device that consists of a specially shaped catheter or bougie and is used to dilate the ureter at the place where a stone has become lodged or to dilate a ureteral stricture. (b) Classification. Class II...

2010-04-01

212

21 CFR 876.4620 - Ureteral stent.  

Code of Federal Regulations, 2010 CFR

...4620 Ureteral stent. (a) Identification. A ureteral stent is a tube-like implanted device that is inserted into the ureter to provide ureteral rigidity and allow the passage of urine. The device may have finger-like protrusions or hooked...

2010-04-01

213

Ultrafiltration Versus Intravenous Diuretics for Patients Hospitalized for Acute Decompensated Heart Failure  

Microsoft Academic Search

Background Early ultrafiltration may be an alternative to intravenous diuretics in patients with decompensated HF and volume overload. Methods Patients hospitalized for HF with ! 2 signs of hypervolemia were randomized to ultrafiltration or intravenous di- uretics. Primary end points were weight loss and dyspnea assessment at 48 h after randomization. Secondary end points included net fluid loss at 48

Maria Rosa Costanzo; Maya E. Guglin; Mitchell T. Saltzberg; Mariell L. Jessup; Bradley A. Bart; John R. Teerlink; Brian E. Jaski; James C. Fang; Erika D. Feller; Garrie J. Haas; Allen S. Anderson; Michael P. Schollmeyer; Paul A. Sobotka

2007-01-01

214

Kidney stones - what to ask your doctor  

MedlinePLUS

A kidney stone is a solid piece of material that forms in your kidney. The kidney stone may be stuck in your ureter (the tube ... from your bladder to outside your body). A stone can block the flow of your urine and ...

215

Lithotripsy  

MedlinePLUS

Lithotripsy is a procedure that uses shock waves to break up stones in the kidney, bladder, or ureter (tube that carries urine from your kidneys to your bladder). After the procedure, the tiny pieces of stones pass out of your body ...

216

Bardet-biedl syndrome with urogenital sinus presenting with acute renal failure in a neonate.  

PubMed

This is a case report of Bardet-Biedl syndrome with a urogenital sinus and an ectopic right ureter presenting with acute renal failure in the neonatal period in a female baby. Acute renal failure in these patients is commonly known to occur around 5-7 y of age and neonatal presentation is extremely rare. PMID:23918321

Bedi, Nandini K; Grover, Dhruv

2014-07-01

217

Pathology of Tangier disease  

Microsoft Academic Search

Two cases of Tangier disease are described in children from families unrelated to each other. Necropsy in one case, the first to be reported in this condition, showed large collections of cholesterol-laden macrophages in tonsils, thymus, lymph nodes, and colon, and moderate numbers in pyelonephritic scars and ureter. As the storage cells may be scanty in marrow, jejunum, and liver,

Patricia M. Bale; P. Clifton-Bligh; B. N. P. Benjamin; H. M. Whyte

1971-01-01

218

[Treatment of childhood vesicoureteral reflux with sub-ureteral injection of teflon paste].  

PubMed

From March 1989 to october 1990, 35 refluxing ureters in 25 children were treated by submucosal injection of Teflon (STING). The overall success rate was 54% after the first injection. The authors detail the procedure and analyse their results which demonstrate that Teflon injection can be safe and effective treatment of vesicoureteral reflux in most cases can replace antireflux surgery. PMID:8295773

Jainsch, M; Jászai, V; Pintér, A; Farkas, A

1994-01-01

219

A new technique for simultaneous and in situ measurements of Ca 2+ signals in arteriolar smooth muscle and endothelial cells  

Microsoft Academic Search

We report here the first local and global Ca2+ measurements made from in situ terminal arterioles. The advantages of the method are that there is minimal disturbance to the vessels, which retain their relationship to the tissue they are supplying (rat ureter) and the small size of vessel that can be studied. Good loading with the Ca2+ indicator, Fluo-4 was

T. Burdyga; A. Shmygol; D. A. Eisner; Susan Wray

2003-01-01

220

Emergency Decompressive Craniotomy with Banked Skull Flap in Subcutaneous Pocket.  

National Technical Information Service (NTIS)

The abdominal KUB (Kidneys, Ureters, and Bladder, also sometimes referred to as 'Flat Plate') demonstrates a smooth, large, calcific opacity in the left lower quadrant (see figure 1). An enteric tube is also noted with its tip in stomach; surgical staples...

B. Adams B. Singleton L. Folio S. Craig

2006-01-01

221

Government and Academia Partnership to Test and Evaluate Air Traffic Control Decision Support Software  

Microsoft Academic Search

In the current air transportation system, decision support tools aid air traffic controllers in monitoring air traffic to maintain minimum separation standards between aircraft. These automated systems provide this service by predicting aircraft flight paths (trajectories) to foretell potential conflicts. The User Request Evaluation Tool (URET), developed by MITRE Corporation's Center for Advanced Aviation System Development, is an example of

Confesor Santiago; Chu Yao; Andrew Crowell; Adrian Rusu

222

Generation of realistic air traffic scenarios using a genetic algorithm  

Microsoft Academic Search

Traffic flow management decision support tools such as the user request evaluation tool (URET), developed by the MITRE Center for Advanced Aviation Systems Development, and the Center-TRACON automation system (CTAS), developed by the NASA\\/Ames Research Center, use simulation as a tool for development, technical assessment, and field evaluation. Air traffic scenarios, based on recorded live data, are used to test

R. D. Oaks; M. Paglione

2002-01-01

223

Endoscopic treatment of vesicoureteral reflux in children with subureteral dextranomer/hyaluronic acid injection: a single-centre, 7-year experience  

PubMed Central

Background The goals of medical intervention in patients with vesicoureteral reflux are to allow normal renal growth, prevent infections and pyelonephritis, and prevent renal failure. We present our experience with endoscopic treatment of vesicoureteral reflux in children by subureteral dextranomer/hyaluronic acid copolymer injection. Methods Under cystoscopic guidance, dextranomer/hyaluronic acid copolymer underneath the intravesical portion of the ureter in a subureteral or submucosal location was injected in patients undergoing endoscopic correction of vesicoureteral reflux. Results A total of 282 patients (120 boys and 162 girls) underwent the procedure. There were 396 refluxed ureters altogether. The mean age of patients was 4.9 years. The mean overall follow-up period was 44 months. Among the 396 ureters treated, 76% were cured with a single injection. A second and third injection raised the cure rate to 93% and 94%, respectively. Twenty-two (6%) ureters failed all 3 injections, and were converted to open surgery. Conclusion Endoscopic treatment of vesicoureteral reflux can be recommended as a first-line therapy for most cases of vesicoureteral reflux, because of the short hospital stay, absence of complications and the high success rate.

Biocic, Mihovil; Todoric, Jakov; Budimir, Drazen; Roic, Andrea Cvitkovic; Pogorelic, Zenon; Juric, Ivo; Susnjar, Tomislav

2012-01-01

224

Efficacy and outcome of surgical intervention in patients with nephrolithiasis and chronic renal failure  

Microsoft Academic Search

Aim: To prospectively evaluate the efficacy and outcome of surgical intervention in patients with renal stones and chronic renal insufficiency.Methods: The study was carried out from January 1999 till January 2001. Only patients with chronic renal failure without medical renal disease were taken up for study. All patients were subjected to an ultrasound assessment of the kidney, ureter and bladder.

Iqbal Singh; N. P. Gupta; A. K. Hemal; M. Aron; P. N. Dogra; A. Seth

2001-01-01

225

Renal morphology and function immediately after extracorporeal shock-wave lithotripsy  

Microsoft Academic Search

The acute effects of extracorporeal shock-wave lithotripsy (ESWL) on morphology and function of the kidney were evaluated by excretory urography, quantitative radionuclide renography (QRR), and magnetic resonance imaging (MRI) in 33 consecutive patients. Excretory urograms demonstrated an enlarged kidney in seven (18%) of 41 treatments and partial or complete obstruction of the ureter by stone fragments after 15 (37%) of

Jun V. Kaude; Clyde M. Williams; Michael A. Millner; K. N. Scott; Birdwell Finlayson

1985-01-01

226

Technetium99m-DMSA Renal Cortical Scintigraphy to Detect Experimental Acute Pyelonephritis in Piglets: Comparison of Planar (Pinhole) and SPECT Imaging  

Microsoft Academic Search

The purpose of this study was to directly compare the sensitivity and specificity of SPECT and pinhole imaging for the detection of acute pyelonephritis using histology as the standard of reference. Methods: Bilateralvesicoureteralreflux of infected urine was in duced in 16 piglets (32 kidneys) by unroofing the intravesical ureter and subsequently instilling a broth culture of £coli into the bladder.

Massoud Majd; H. Gil Rushton; Roma Chandra; Mary P. Andrich; Chris P. Tardif; Fariborz Rashti

227

Ionizing radiation and kidney cancer among Japanese atomic bomb survivors.  

PubMed

Understanding of the role of radiation as a cause of kidney cancer remains limited. The most common types of kidney cancer are renal cell carcinoma and renal pelvis carcinoma. It has been posited that these entities differ in their degree of radiogenicity. Recent analyses of cancer incidence and mortality in the Life Span Study (LSS) of Japanese atomic bomb survivors have examined associations between ionizing radiation and renal cell carcinoma, but these analyses have not reported results for cancer of the renal pelvis and ureters. This paper reports the results of analyses of kidney cancer incidence during the period 1958-1998 among 105,427 atomic bomb survivors. Poisson regression methods were used to derive estimates of associations between radiation dose (in sievert, Sv) and cancer of the renal parenchyma (n = 167), and cancer of the renal pelvis and ureter (n = 80). Heterogeneity by cancer site was tested by joint modeling of cancer risks. Radiation dose was positively associated with cancers of the renal pelvis and ureter [excess relative rate (ERR)/Sv = 1.65; 90% confidence interval (CI): 0.37, 3.78]. The magnitude of this association was larger than the estimated association between radiation dose and cancer of the renal parenchyma (ERR/Sv = 0.27; 90% CI = -0.19, 0.98). While the association between radiation and cancer of the renal parenchyma was of greater magnitude at ages <55 years (ERR/Sv = 2.82; 90% CI = 0.45, 8.89) than at older attained ages (ERR/Sv = -0.11; 90% CI = nd, 0.53), the association between radiation and cancers of the renal pelvis and ureter varied minimally across these categories of attained age. A test of heterogeneity of type-specific risks provides modest support for the conclusion that risks vary by kidney cancer site (LRT = 2.34, 1 d.f., P = 0.13). Since some studies of radiation-exposed populations examine these sites in aggregate, results were also derived for the combined category of cancer of the renal parenchyma, renal pelvis and ureters. Overall, there was a positive association between radiation and the combined category of cancer of the renal parenchyma, renal pelvis and ureters (ERR/Sv = 0.60, 90% CI: 0.09, 1.30). Updated follow-up of the LSS cohort provides substantial additional information on the association between radiation and cancer of the renal pelvis and ureter, a site not examined in recent reports on analyses of these data. The results are suggestive of differences between the different regions of the kidney in sensitivity to the carcinogenic effects of ionizing radiation. PMID:20518663

Richardson, David B; Hamra, Ghassan

2010-06-01

228

Impact of Ureteral Length on Urological Complications and Patient Survival After Kidney Transplantation  

PubMed Central

Background Urologic complications are of the most important complications after kidney transplantation which increases mortality and morbidity significantly. Objectives We designed this study to evaluate the association between ureteral length and postoperative complications. Patients and Methods We recorded the length of the transplanted ureter during the operation. Ureter-to-bladder anastomosis was performed using modified Lich-Gregoir method on the ureteral stent. Complications like urine leakage and increased creatinine were evaluated. We used both univariate and multivariate analyses and survival analysis according lengths of ureter. It means that the main variable is ureteral length and other variables are studied based on it. Result A total of 395 patients with the mean age of 37 years (range, 18 to 68 years) were enrolled in the study, twenty six graft lost during the follow-up period. The Mean age of recipients was 37 ± 13 years. Urinary stenosis was seen in 6 patients (1.5%) and urinary leakage in 4 (1%) patients. The complication rate was not significantly different between these groups (P = 0.67). We found that there were no significant difference among complication (P = 0.25), hospitalization (P = 0.31) and survival (P = 0.84) at 5.5 cm length cut off. Conclusions The length of transplanted ureter does not affect the postoperative urologic complications (including urinary fistula and ureter-to-bladder anastomosis stricture), and it seems that decreased rate of complication frequency during the recent years is due to technical improvement, surgeon’s skillfulness and development in use of immunosuppressant’s postoperatively.

Ali-Asgari, Majid; Dadkhah, Farid; Ghadian, Alireza; Nourbala, Mohammad Hossein

2013-01-01

229

In situ extracorporeal shock wave lithotripsy of ureteral calculi with the MPL-9000X lithotriptor.  

PubMed

Within the wide armamentarium of urinary stone treatment modalities extracorporeal shock wave lithotripsy (ESWL) has been established as the first line procedure. With the Dornier MPL-9000X lithotriptor one has the choice of ultrasound or fluoroscopic localization of calculi throughout the entire urinary tract. Except for the kidney, ultrasound guidance is preferred for calculi in the distal ureter, while fluoroscopy is generally used on the proximal two-thirds of the ureter. Between January and December 1990, 123 ESWL treatments were performed on 83 patients suffering from ureteral calculi with an average stone size of 9.3 x 6 mm. Median treatment parameters were 1,597 shock waves at 19.3 kv. for 43 minutes. For stones in the upper two-thirds of the ureter sedation analgesia was given, while ESWL on the pelvic ureter did not create intolerable pain. Of the treatments 69% were done on an outpatient basis. In situ ESWL treatment of urinary calculi was successful in 72 patients (86.7%), and 20 patients (24.1%) were treated with multiple treatment sessions. ESWL therapy for 47 stones in the distal ureter showed better results than for 33 stones plus 2 steinstrasse in the proximal part (95.5% versus 80% stone-free rate). Of 4 patients with mid ureteral calculi 2 could be rendered stone-free by ESWL alone. Auxiliary procedures, such as percutaneous nephrostomy or ureteral splints, had to be performed in 15.7%. Final endoscopic stone extraction was done in 7 cases and open surgery in 4, constituting a 13.3% failure rate for ESWL therapy. The results prove that the MPL-9000X lithotriptor is effective for primary noninvasive stone treatment. PMID:1507342

Rauchenwald, M; Colombo, T; Petritsch, P H; Vilits, P; Hubmer, G

1992-09-01

230

Complete laparoscopic nephroureterectomy with intravesical lockable clip  

PubMed Central

Introduction We present a cohort of patients with low-stage pelviureteric neoplastic disease who underwent complete laparoscopic nephroureterectomy (CLNUE) with intravesical lockable clip (IVLC). Due to the absence of a standard technique of NUE, the study was not randomized. Materials From 1/2010 to 1/2012, 21 patients were subjected to CLNUE-IVLC. The first step was transurethral excision of the ureterovesical junction with Collin's knife deep into the paravesical adipose tissue. The ureter was grasped with biopsy forceps and the distal end of the ureter was occluded with lockable clip. The applicator was introduced through a 5 mm port inserted as an epicystostomy. The patients were rotated to flank position and CLNUE followed. The endoscopically introduced clip on the distal ureter is proof of completion of the total ureterectomy. Results The mean operation time was 161 (115-200) min. In four (19.0%), the application of the clip failed and CLNUE was completed with non-occluded ureter. In three cases, subsequent laparoscopic nephrectomy was converted to open surgery. In two cases, the distal ureterectomy was completed with pluck technique through a lower abdominal incision that was also used for extraction of the specimen. There were four complications (Clavien II 2x, IIIb, V). Follow-up was available for all – mean 10.6 (range: 0-25) months. One died of disease generalization within 11 months. Conclusion CLNUE-IVLC is fast and safe. If needed, the endoscopic phase can be switched to open NUE. Disadvantages include: the need to change the position of the patient, the risk of inability to apply the clip on the distal ureter, and the risk of an unclosed defect of the urinary bladder.

Eret, Viktor; Urge, Tomas; Klecka, Jiri; Travnicek, Ivan; Hes, Ondrej; Petersson, Fredrik; Stransky, Petr

2012-01-01

231

Clinical outcome of transperitoneal ureterocutaneostomy using the transverse mesocolon  

PubMed Central

The aim of the present study was to demonstrate that the treatment outcome of transperitoneal ureterocutaneostomy using the transverse mesocolon is not inferior to that of conventional retroperitoneal ureterocutaneostomy. The enrolled subjects were 26 patients who underwent ureterocutaneostomy among a total of 160 cases of urinary diversion performed at our institution between March, 2004 and November, 2011. A total of 11 cases and 18 ureters were treated by transperitoneal ureterocutaneostomy via the transverse mesocolon, with 7 bilateral ureterocutaneostomy cases. All the cases of retroperitoneal ureterocutaneostomy were unilateral, totaling 15 patients and 15 ureters. Postoperative adverse events (ileus, acute pyelonephritis), catheter-free status and renal function [blood urea nitrogen (BUN) and serum creatinine (Cr) values] were retrospectively evaluated between the groups treated by the different surgical procedures. Ileus was only observed in 1 case and improvement was achieved through conservative therapy alone (P=0.827). Acute pyelonephritis developed in 3 (27.3%) transperitoneal and 8 (53.3%) retroperitoneal cases, with all the cases recovering following treatment with antibiotics alone (P=0.199). A catheter-free status was achieved in 3 cases (27.3%) and 4 ureters (22.2%) in the transperitoneal group and in 2 cases and 2 ureters (13.3%) in the retroperitoneal group (P=0.393). There was no significant change in renal function (BUN and serum Cr values) in the transperitoneal ureterocutaneostomy cases at the postoperative, early postoperative (1 month following surgery) or the final follow-up examination (P=0.739 and 0.078). In conclusion, transperitoneal ureterocutaneostomy allows for the construction of a cutaneous stoma using a shorter ureter, with a treatment outcome that is comparable to that of retroperitoneal ureterocutaneostomy.

FURUBAYASHI, NOBUKI; NEGISHI, TAKAHITO; KASHIWAGI, EIJI; FUKUDA, ATSUSHI; NAKAMURA, MOTONOBU

2013-01-01

232

Durability of anti-reflux effect of ureteral reimplantation for primary vesicoureteral reflux: findings on long-term cystography  

PubMed Central

Objectives Ureteral reimplantation (UR) is the gold standard for the surgical treatment of vesicoureteral reflux (VUR) but few studies have documented its long-term results. We reviewed late cystography (LC) results following successful UR. Methods We performed a retrospective chart review of all children with primary VUR who underwent successful open UR (grade 0 VUR into the reimplanted ureter(s) on initial cystogram) at our institution from January 1990 – December 2002. We identified successful UR patients who underwent LC ? 1 year after UR and reviewed the results for the presence of recurrent VUR into the reimplanted ureter(s). Results 794 patients underwent successful open UR for primary VUR, of whom 60 (7.6%) had a subsequent LC. Preoperative VUR grade was ?II in 20 (34.5%), ?III in 38 (65.5%). Median age at UR was 3.5 years (IQR: 1.3–6.2 years); 51 (85%) were female. UR was intravesical in 45 (75%) and bilateral in 19 (32%). LC was performed at a median of 38.7 months after UR (IQR: 19.6–66.1 months). Indication for LC was febrile UTI in 16 (27%), non-febrile UTI’s in 15 (25%), follow-up of contralateral VUR in 16 (27%) and other clinical indications in 13 (21%). The recurrence rate was 0%; of the 79 reimplanted ureters, 100% (95% CI: 95.4–100) had no VUR (grade 0). Conclusions Among children who underwent successful open UR for primary VUR, there was no VUR recurrence on extended follow-up. This suggests that the late durability of open anti-reflux surgery is excellent.

Hubert, Katherine C.; Kokorowski, Paul J.; Huang, Lin; Prasad, Michaella M.; Rosoklija, Ilina; Retik, Alan B.; Nelson, Caleb P.

2013-01-01

233

Endoscopic Subureteral Injection for the Treatment of Vesicoureteral Reflux in Children: Polydimethylsiloxane (Macroplastique(R)) versus Dextranomer/Hyaluronic Acid Copolymer (Deflux(R))  

PubMed Central

Purpose The aim of this study was to compare cure rates and complications of polydimethylsiloxane (Macroplastique®) and dextranomer/hyaluronic acid copolymer (Deflux®) in the treatment of vesicoureteral reflux (VUR). Materials and Methods From April 2001 to March 2008, 29 boys and 42 girls (total of 115 ureters) with a mean age of 6 years who had undergone endoscopic subureteral transurethral injection for VUR were enrolled. A single subureteral injection of Macroplastique was performed in 31 ureters in 23 children (group I; grade II: 4; grade III: 12; grade IV: 9; grade V: 6), and a single subureteral injection of Deflux was performed in 84 ureters in 48 children (group II; grade II: 24; grade III: 14; grade IV: 25; grade V: 21). Renal ultrasound was done 1 day after injection, and voiding cystourethrography (VCUG) was done at 3 months. Successful reflux correction was defined as absent or grade I reflux on follow-up VCUG. Results No significant difference in success rates was observed between group I and group II [80.6% (25/31) vs. 78.6% (66/84), respectively, p>0.05]. The following postoperative complications developed: ureteral obstruction in 2 ureters of group I and 3 ureters of group II, asymptomatic urinary tract infection in 3 patients of group I and 2 patients of group II, and bladder calcification by erosion or mucosal necrosis in 2 patients of group I. Conclusions Despite differences in material properties, both Macroplastique and Deflux were safe for the treatment of children with VUR. Because of the risk of bladder mucosal necrosis and substantial decreases in volume after implantation, long-term follow-up is required.

Bae, Young Dae; Park, Min Gu; Oh, Mi Mi

2010-01-01

234

In vitro evaluation of the occlusive properties of latex-covered amplatzer vascular plugs for transrenal ureteral occlusion.  

PubMed

Abstract Purpose: To evaluate the occlusive properties of latex-covered Amplatzer Vascular Plugs (AVPs) for transrenal ureteral occlusion in vitro. Materials and Methods: Latex-covered AVPs type I and II (diameter 8, 10, 12, 14, and 16?mm) were used as occlusive devices. Radial force of an AVP was measured using simulated ureteral diameters of 4 to 12?mm. Occlusive properties were examined in a silicone tube (inner diameter 6?mm) with measurement of drainage time of a 40?cm water column. In complete occlusion, the maximum pressure that the plug was able to withstand was determined at different temperature levels. Statistical analysis of drainage time was performed in a general linear model (GLM) and using correlation analyses. Explanted porcine ureters were used to simulate physiologic conditions. Pressure measurements were performed until leakage, plug dislocation, or rupture of the ureter occurred. Results: Radial force depended on AVP type, size, ureteral diameter, and temperature. The 16-mm AVP II showed the highest radial force of more than 5?N (ureteral diameter 4?mm, body temperature). All AVP I showed water leakage and plug dislocation. Drainage time of the AVP II depended significantly on plug size and temperature and correlated with radial force (r=0.731, P<0.001). In complete occlusion, water leakage occurred at 500 to 1000?cm H2O and dislocation between 500 to more than 2000?cm H2O. In porcine ureters, leakage occurred at room temperature between 19 to 93?cm H2O. At body temperature, all AVP II occluded the ureter completely. Conclusion: Latex-covered AVP II (diameter 8-16?mm) can effectively occlude the ureter, especially considering remodeling of the nitinol at body temperature. Large plug diameters can exert enough radial force even in dilated ureters to allow for successful occlusion. Because deployment of a 16-mm latex-covered AVP II can be technically difficult, we advocate the use of 12- or 14-mm AVP II for transrenal ureteral occlusion. AVP Is are not suitable for ureteral occlusion. PMID:24564487

Pieper, Claus Christian; Schild, Hans Heinz

2014-06-01

235

Ureteral rupture from aberrant Foley catheter placement: A case report  

PubMed Central

We present the case of a 59 year old female with history of severe neurologic dysfunction from advanced multiple sclerosis who presented with lethargy and oliguria several hours after urethral Foley catheterization. A contrast-enhanced CT scan of the abdomen/pelvis showed an aberrantly placed Foley catheter with its balloon inflated in the proximal left ureter, a rare complication of Foley catheterization with only 5 other cases reported. Incomplete ureteral rupture was demonstrated and confirmed by a followup CT scan in the urographic phase. One of our institution’s Interventional Radiologists then placed a nephroureteral stent across the injured ureter to facilitate healing. The patient expired 9 days after the procedure from unrelated sepsis from a chronic stage IV decubitus ulcer, so long term monitoring could not be performed. Following description of our case, we conduct a literature review of presentations, imaging characteristics, and treatment of ureteral Foley catheter placement.

Baker, Kevin S; Dane, Bari; Edelstein, Yudell; Malhotra, Ajay; Gould, Elaine

2013-01-01

236

Two-years follow-up of low-dose methotrexate and 6-methylprednisolone therapy in a patient with idiopathic retroperitoneal fibrosis.  

PubMed

Retroperitoneal fibrosis (RPF), also known as Ormond's disease, is a rare fibroinflammatory disease with uncertain etiology. RPF is characterized by the presence of a particular retroperitoneal fibrotic tissue which is white, woody and involving retroperitoneal structures such as the great vessels, ureters and psoas muscle. The main complication of RPF is the obstruction of local structures such as the ureters due to the fibrosis and the treatment of this aspect represents the main challenge for this pathology. RPF medical treatment consists of corticosteroids or/and immunosuppressive therapy. We report a case of a patient affected by idiopathic RPF treated with low-dose methotrexate (MTX) and 6-methylprednisolone (6-MP) for two years, describing and confirming the effectiveness and safety of a long-term low-dose MTX and 6-MP treatment associated to ureteral Double-J stenting avoiding more invasive surgical approaches. PMID:23280036

Sili Scavalli, A; Di Rocco, G; Giannotti, D; Patrizi, G; Frezzotti, F; Bernieri, M G; Cantisani, V; Redler, A

2012-12-01

237

Computed tomography of the abdomen of calves during the first 105 days of life: III. Urinary tract and adrenal glands.  

PubMed

Computed tomographic (CT) findings of the urinary tract and adrenal glands of five healthy male calves in the first 105 days of life were compared with corresponding cadaver slices. The structures seen on CT images were identified using the corresponding cadaver slices. CT produced exact images of the kidneys, urinary bladder, urethra and adrenal glands, but reliable images of the ureters were only obtained near the renal hilus. There was excellent agreement between the structures on the CT images and the tissue slices. The structure and vessels of the kidneys, the origin of the ureters, the location, size and content of the urinary bladder and the course of the urethra in the pelvis and penis were evident on images. The size and volume of the kidneys and the length and width of the adrenal glands increased significantly during the study, but the ureteral and urethral diameters changed little. PMID:24794237

Braun, U; Schnetzler, C; Augsburger, H; Bettschart, R; Ohlerth, S

2014-05-01

238

Idiopathic retroperitoneal fibrosis presenting as recurrent scrotal edema: Report of a case and review of the literature.  

PubMed

Primary or idiopathic retroperitoneal fibrosis, first described by Ormond in 1948, is a rare and elusive diagnosis, requiring a high level of suspicion. Patients usually present with entrapment of retroperitoneal organs, the most common being the ureters, causing hydronephrosis and acute kidney injury. Here, we present the case of a 56-year-old male presenting for recurrent and intermittent scrotal edema. Upon routine laboratory workup, he was found to have an elevated creatinine level. Imaging showed encasement of bilateral ureters. Bilateral ureteral stents were placed with relief of his obstructive uropathy, followed by normalization of creatinine. The patient later underwent laparoscopic release of retroperitoneal adhesions. Biopsies taken from the operative site showed fibroblast proliferation and elements of acute and chronic inflammation. With further workup of etiologies being negative, he was diagnosed with idiopathic retroperitoneal fibrosis. PMID:24684126

Saab, Rawan; Khoury, Mansour; Afif, Claude; Bou, Khalil Roula; Bechara, Chadi; Ghaoui, Albert; Ghabach, Maroun; Riakos, Wajih; Obeid, Sleiman; Obeid, Jean; Aftimos, Georges; Farhat, Said

2014-01-01

239

Ureteral rupture from aberrant Foley catheter placement: a case report.  

PubMed

We present the case of a 59 year old female with history of severe neurologic dysfunction from advanced multiple sclerosis who presented with lethargy and oliguria several hours after urethral Foley catheterization. A contrast-enhanced CT scan of the abdomen/pelvis showed an aberrantly placed Foley catheter with its balloon inflated in the proximal left ureter, a rare complication of Foley catheterization with only 5 other cases reported. Incomplete ureteral rupture was demonstrated and confirmed by a followup CT scan in the urographic phase. One of our institution's Interventional Radiologists then placed a nephroureteral stent across the injured ureter to facilitate healing. The patient expired 9 days after the procedure from unrelated sepsis from a chronic stage IV decubitus ulcer, so long term monitoring could not be performed. Following description of our case, we conduct a literature review of presentations, imaging characteristics, and treatment of ureteral Foley catheter placement. PMID:23372873

Baker, Kevin S; Dane, Bari; Edelstein, Yudell; Malhotra, Ajay; Gould, Elaine

2013-01-01

240

Supernumerary kidney with ipsilateral cryptorchidism in a cat.  

PubMed

An 8 wk old male domestic longhair was presented with an abdominal mass and cryptorchidism. A 2 cm mass was palpable in the midabdomen. Ultrasonography confirmed a complex, septated, cystic mass adjacent and caudal to the right kidney. A normally appearing left kidney was present. Pathologic examination of the excised abdominal mass revealed it to be a kidney with an attached, normal caliber ureter. At surgery, this kidney was separate from the parenchyma of the second, cranial, right kidney. Subsequently, the second right kidney became hydronephrotic and was removed together with the cryptorchid testis and an apparently hypoplastic ureter. This is the first report of a supernumerary kidney in a cat, adding it to the differential diagnoses of abdominal masses. PMID:23861269

Paradise, Danielle; Clark, David

2013-01-01

241

Unilateral occlusion of duplicated uterus with ipsilateral renal anomaly in young girls: a study with MRI.  

PubMed

Twenty-four young girls (mean age 13.0 years) with unilateral occlusion of a duplicated uterus and ipsilateral renal agenesis, dysplasia or hypoplasia were studied with magnetic resonance imaging (MRI) following ultrasound examination. Hydrocolpos (n = 4), hydrometrocolpos (n = 2), hematocolpos (n = 11), hematometrocolpos (n = 5), hematocolpometra, hematosalpinx (n = 3) and hematometra, hematosalpinx (n = 1) were noted (two of these patients had presented with hydrocolpos and hematocolpos before and after the menarche). Twenty-two of these girls presented with ipsilateral renal agenesis (right 11, left 11) with ectopic ureters to Gartner's duct cysts (GDC) in two, in one renal hypoplasia and in one renal dysplasia with ectopic ureters to GDC. MRI offered specific images of the genital tract, showing the exact type of müllerian duct anomaly and providing high diagnostic accuracy. Such preoperative identification of a uterine anomaly, complemented with appropriate surgical intervention, can assist young girls in achieving normal fertility in the future. PMID:8577555

Li, Y W; Sheih, C P; Chen, W J

1995-11-01

242

[Autotransplantation of the kidney in ureteral injuries].  

PubMed

In 1988-2003 we operated 156 patients with various ureteral lesions. Of them 7 patients (6 males and 1 female, mean age 34-43 years) received kidney transplant (autotransplantation). Ureteral lesions were caused by previous surgery (n=3), gunshot wound (n=2), urolithiasis (n=2. The follow-up results (for 15 period maximum) show that operative outcomes were satisfactory in 6 patients. One transplant was removed 7 days after the transplantation because of purulent pyelonephritis and necrosis of the ureter. The rest patients retain good function of the transplanted kidney and passability of the upper urinary tract. Thus, surgical autotransplantation of the kidney performed in affected middle and low thirds of the ureter is an alternative to life-long nephrostomy and nephrectomy and has a good long-term prognosis in relation to function of a transplanted kidney. PMID:15989023

Galeev, R Kh; Galeev, Sh R

2005-01-01

243

[Peritoneal mesothelioma presented with bilateral hydronephrosis: a case report].  

PubMed

We report a case of peritoneal mesothelioma presenting with bilateral hydronephrosis, which was difficult to be diagnosed. A 43-year-old woman was admitted to our hospital with acute renal failure. Ultrasonography revealed bilateral hydronephrosis. Retrograde pyelography revealed the stenosis of bilateral lower ureter. Pelvic magnetic resonance imaging demonstrated only a small mass lesion around the bilateral ureter. Other examinations showed no findings of malignancy. Under the diagnosis of retroperitoneal fibrosis, steroid therapy was performed. After 3 months, computed tomography (CT) revealed multiple abdominal masses. Percutaneous needle biopsy of tumor was performed. Pathological diagnosis was peritoneal mesothelioma. Chemotherapy based on the pleural mesothelioma was done but not effective, she died 9 months after the first medical examination. PMID:16758726

Yoshida, Takahiro; Nishimura, Kensaku; Uemurai, Motohide; Harada, Yasunori; Kanno, Nobuhumi; Miyoshi, Susumu; Kawano, Kiyoshi

2006-05-01

244

Vesico-ureteric reflux in adults with neuropathic bladders treated with Polydimethylsiloxane (Macroplastique®)  

Microsoft Academic Search

Objective: To establish the efficacy of Macroplastique® in treating vesico-ureteric reflux (VUR) in adults with neuropathic bladder dysfunction.Patients and methods: Fifteen patients (12 male and three female), age range 19 to 80 years (mean age 38) were included in this study. Diagnosis was confirmed by videourodynamics. In seven patients reflux was present bilaterally. Twenty-two refluxing ureters were treated. Twelve patients

N Shah; MJ Kabir; S Avenell; PJR Shah

2001-01-01

245

Ureteroscopic removal of forgotten ureteral stent  

PubMed Central

A 69-year-old female had a right ureteral stent placed due to ureteral stricture resulting from cervical cancer in March 2008. The ureteral stent migrated to the ureter and was not exchanged. A new ureteral stent was inserted, and was exchanged every 3 months. The patient was referred to our department to remove the forgotten ureteral stent. In January 2012, her old ureteral stent was removed ureteroscopically, and no ureteral stent encrustation was found.

Kawahara, Takashi; Ishida, Hiroaki; Kubota, Yoshinobu; Matsuzaki, Junichi

2012-01-01

246

[False postvoid residual volume diagnosed by videourodynamics].  

PubMed

We present a case report of a young male patient, with a bilateral vesico renal reflux. The urodynamic study findings suggested the possibility of a non-neurogenic bladder-external spincter dissinergya producing a valuable residual volume. After biofeedback treatment, the dissinergia disappeaed, but residual volume persisted. The videourodynamic assessment allowed us the accurate diagnosis of a false residual volume, produced by the voiding of the refluxed urine from the ureters into the bladder. PMID:15666527

Musquera Felip, M; Errando Smet, C; Prados Saavedra, M; Arañó Bertrán, P; Villavicencio Mavrich, H

2004-01-01

247

Shock wave lithotripsy for distal ureteric stones: supin or prone  

Microsoft Academic Search

Shock Wave Lithotripsy (SWL) has become the preferred first-line approach to most patients with symptomatic urolithiasis.\\u000a The purpose of this study is to assess the ideal patient position during SWL for the treatment of distal ureter stones. A\\u000a total of 342 patients included in this retrospective study. 148 (108 men, 40 women) patients were included in the first group\\u000a and

Mustafa Okan Istanbulluoglu; Mustafa Burak Hoscan; Mehmet Ilteris Tekin; Tufan Cicek; Bulent Ozturk; Hakan Ozkardes

2011-01-01

248

DIDMOAD syndrome with megacystis and megaureter.  

PubMed

A case of DIDMOAD syndrome (diabetes insipidus, diabetes mellitus, optic atrophy and nerve deafness) is described. There was unusually severe urinary tract dilatation which led to an ileal conduit diversion. Immunohistological study of the bladder wall and ureter revealed a marked diminution in nerve fibres, which may have been primary or secondary to the muscle hypertrophy. The possible pathogenesis of the urinary tract dilatation is discussed in relation to this finding. PMID:3809079

Chu, P; Staff, W G; Morris, J A; Polak, J M

1986-09-01

249

Case report: Antenatal MRI diagnosis of cloacal dysgenesis syndrome  

PubMed Central

Cloacal dysgenesis sequence (CDS) is a lethal malformation with a highly variable presentation. CDS is characterized by direct communication between the gastrointestinal, urinary, and genital structures, resulting in a single perineal opening. Prenatal diagnosis of a cloacal anomaly is often difficult because of the highly variable imaging features. Here, we report a case in which a diagnosis of CDS was made with fetal MRI on the basis of a meconium-containing, bilobed, abdominopelvic cystic mass communicating with the ureters and the colon.

Gupta, P; Kumar, S; Sharma, Raju; Gadodia, A

2010-01-01

250

Relationship Between Obesity and B-Type Natriuretic Peptide Levels  

Microsoft Academic Search

Background: The relationships among B-type natri- uretic peptide (BNP) levels, body mass index (BMI), and congestive heart failure (CHF) as an emergency diagno- sis are unknown. Methods: Of 1586 participants in the Breathing Not Properly Multinational Study who had acute dyspnea, 1369 (86.3%) had BNP values and self-reported height and weight. Two independent cardiologists masked to the BNP results adjudicated

James McCord; Brian J. Mundy; Michael P. Hudson; Alan S. Maisel; Judd E. Hollander; William T. Abraham; Philip G. Steg; Torbjørn Omland

2004-01-01

251

Molecular Classification of Human Carcinomas by Use of Gene Expression Signatures1  

Microsoft Academic Search

Classification of human tumors according to their primary anatomical site of origin is fundamental for the optimal treatment of patients with cancer. Here we describe the use of large-scale RNA profiling and super- vised machine learning algorithms to construct a first-generation molec- ular classification scheme for carcinomas of the prostate, breast, lung, ovary, colorectum, kidney, liver, pancreas, bladder\\/ureter, and gastroe-

Andrew I. Su; John B. Welsh; Lisa M. Sapinoso; Suzanne G. Kern; Petre Dimitrov; Hilmar Lapp; Peter G. Schultz; Steven M. Powell; Christopher A. Moskaluk; Henry F. Frierson; Garret M. Hampton

2001-01-01

252

Umbrella Cell — Surface Specialisations  

Microsoft Academic Search

\\u000a The wall of the urinary passages including the surfaces of the renal pelvis, the ureters, the urinary bladder, and proximal\\u000a parts of the urethra is covered by a unique specialised epithelium, the transitional epithelium or urothelium. The urothelium\\u000a is stratified and composed of three types of cells: basal precursor cells, intermediate cells, and large superficial umbrella\\u000a cells. The latter line

Margit Pavelka; Jürgen Roth

253

Pediatric Robotic (Infant, Pre-pubertal, and Teenager) Pyeloplasty for Ureteropelvic Junction Obstruction  

Microsoft Academic Search

\\u000a Ureteropelvic junction obstruction (UPJO) is characterized by a functionally significant impairment of urinary transport caused\\u000a by an intrinsic or an extrinsic obstruction in the area where the ureter joins the renal pelvis. This results in the gradual\\u000a dilatation of the renal collecting system (hydronephrosis) and may lead to deterioration of renal function and pain. Therefore,\\u000a the main goals of treatment

Yoshiyuki Kojima; Pasquale Casale

254

Endoscopic treatment of vesico-ureteral reflux: Experience of 99 ureteric moieties  

PubMed Central

Aims: To study the outcome of endoscopic hyaluronic acid/dextranomer injection in patients with vesico-ureteric reflux (VUR). Materials and Methods: Sixty-three children were evaluated with a median follow up of 18 months (12-55 months) before injecting hyaluronic acid/dextranomer in a total of 99 ureteric moieties. Median age at presentation was 24 months (6-72 months). Primary VUR was the main presenting diagnosis in 60%. Patients were monitored for urinary tract infection (UTI), glomerular filtration rate (GFR), renal scarring, persistence, or appearance of contra-lateral reflux. Results: Grade III VUR was the most common (38%) followed by Grade IV (24%), Grade V (17%), Grade II (14%), and Grade I (7%). Most common cause for VUR was Primary (60%), followed by posterior urethral valve (PUV) (19%), bladder exstrophy (5%), anorectal malformation (ARM), epispadias, and duplex system. Analysis of patients characteristics at presentation revealed renal scarring (40%), split renal functions <35% (35%), recurrent UTI (15%), GFR <50 ml/min/1.73 m2 (15%), serum creatinine >1.4 mg/dL (10%). Complete resolution (100%) of Grade I and Grade II VUR was achieved after single injection. For Grade III VUR, single injection resolved reflux in 85.5% ureters, 100% resolution was seen after 2nd injection. In Grade IV VUR, 1st injection resolved VUR in 83.3% ureters, 95.8% ureters were reflux free after 2nd injection, and 100% resolution was seen after 3rd injection. In Grade V VUR, 94% ureters showed absent reflux after three injections. Conclusion: Hyaluronic acid/dextranomer injection holds promise even in higher grades of VUR.

Bajpai, Minu; Verma, Ajay; Panda, Shasanka S.

2013-01-01

255

Creation of effective antireflux mechanism without creation of submucosal tunnel in surgical correction of vesicoureteric reflux: Myth or reality?-An experimental study  

PubMed Central

Objective: To evaluate the possibility of creating an effective antireflux mechanism without the need to create submucosal tunnel in surgical correction of vesicoureteric reflux. Materials and Methods: Ethical clearance was obtained from the institute ethical committee. The prospective experimental study was conducted on fresh postmortem specimens comprising of intact ureter-bladder-urethra of slaughtered lamb. Through perurethral tube, bladder distension revealed intact antireflux mechanism which disappeared following a cephalad slit of ureteric orifice. After intravesical advancement, mobilized ureters were anchored to the hiatus and the exposed detrusor along the proposed submucosal tunnel after stripping the bladder mucosa. Limited nonobstructed narrowing of the advanced ureteric ends was fashioned. After closure, bladder was distended and reflux was observed through proximal transected ureteric orifices with check cystogram. In second part of experiment, in a rectal reservoir, two intestinal segments as dilated ureters were implanted without creating submucosal tunnel, but anchoring the intrarectal segment to exposed submucosa. Intraluminal end of one segment was narrowed, while other left as such. Reservoir distension test was done to notice the status of reflux. In 24 months, 12 experiments were conducted. Results: In first part of experiment, successful antireflux mechanism was created in 11 ureters. In second part of experiment, reflux persisted in the ureteral segment implanted with obliquity but without distal nonobstructed narrowing, while there was no reflux in the ureteral segment with both obliquity and narrowing. Conclusion: Advancement and anchoring of the ureteral segment to the exposed detrusor with creation of nonobstructive and limited narrowing can create effective antireflux mechanism without the need to create submucosal tunnel.

Gupta, Archika; Kureel, Shiv Narain

2014-01-01

256

Disappearance of vesicoureteric reflux during long-term prophylaxis of urinary tract infection in children  

Microsoft Academic Search

Seventy-five children aged 3 weeks to 12 years and found on investigation of symptomatic urinary infection to have vesicoureteric reflux were managed conservatively with continuous low-dose prophylaxis. Serial cystographic and renal growth studies were performed during seven to 15 years' follow-up. Reflux disappeared spontaneously in 53 children (71%) and from 79% of the affected ureters. This occurred at any age

D Edwards; I C Normand; N Prescod; J M Smellie

1977-01-01

257

Pitfalls of cholescintigraphy. A case report  

SciTech Connect

A /sup 99m/Tc PIPIDA scan was performed in a young auto accident victim who had a transient rise in serum bilirubin level. Initially, the stasis of activity in the right ureter was mistaken for activity in the common bile duct. Misinterpretation of biliary imaging studies can be prevented with awareness of pitfalls and readiness to obtain delayed images and additional images in different projections.

Strickler, S.; Park, H.M.

1982-12-01

258

Vesicoureteral reflux in a nonfunctioning kidney detected by 99mTc-DTPA study.  

PubMed

Vesicoureteral reflux (VUR) is a well-recognized condition in the pediatric population, but is less well described in the adult population, and its prevalence decreases with increasing age. We describe the case of a 53-year-old male with nonfunctional kidney in which accumulation of radioactivity was observed in the ureter and renal pelvis owing to VUR, which was detected by technetium-99m diethylenetriamine pentaacetic acid dynamic renal scintigraphy. PMID:24178153

Orsal, Ebru; Seven, Bedri; Subasi, Irmak Durur; Ayan, Arif Kursad; Akkan, Zeynep

2013-12-01

259

Encrusted Ureteral Stent Retrieval Using Flexible Ureteroscopy with a Ho: YAG Laser  

PubMed Central

A 23-year-old female had bilateral ureteral stents placed due to bilateral renal stones and hydronephrosis. The bilateral ureteral stents were changed every 3 months. A kidney ureter bladder (KUB) film showed left encrustation along the ureteral stent thus necessitating removal; however, the ureteral stent could not be removed cystoscopically. The ureteral stent was, therefore, extracted using flexible ureteroscopy (URS) with a holmium (Ho): yttrium aluminum garnet (YAG) laser.

Kawahara, Takashi; Ito, Hiroki; Terao, Hideyuki; Ogawa, Takehiko; Uemura, Hiroji; Kubota, Yoshinobu; Matsuzaki, Junichi

2012-01-01

260

Can the CT planning image determine whether a kidney stone is radiopaque on a plain KUB?  

Microsoft Academic Search

Almost all kidney stones are CT positive. Before a CT scan can be done a CT planning image (CTI) is generated in order to\\u000a select the exact scanning area. The CTI looks approximately like a normal kidney–ureter–bladder abdominal radiography (KUB)\\u000a but with reduced quality. It has been used as a guide, assuming that if the kidney stone could be seen

Ole Graumann; Susanne S. Osther; Diana Spasojevic; Palle J. S. Osther

261

Gastric, pancreatic, and ureteric duplication  

PubMed Central

We report a case of an 8-month-old, asymptomatic child who was incidentally detected to have two cystic structures in the abdomen. Surgical exploration revealed a gastric and pancreatic duplication cyst along with a blind-ending duplication of the right ureter. Excision of the duplications was relatively straightforward, and the child made an uneventful recovery. This constellation of duplications has not been reported before.

Chattopadhyay, Anindya; Mitra, S. K.; Dutta, Soumitra; Chakraborty, Hema

2010-01-01

262

Unusual bilateral obstructive uropathy with kidney failure in an adolescent with ulcerative colitis.  

PubMed

Extrarenal manifestation and complications of inflammatory bowel disease may be detected in a significant number of patients. It is known that the genitourinary tract may be affected but data from childhood population are scarce. We present an unusual bilateral obstruction of ureters, inflammation of bladder wall and vesicoureteral reflux in a boy with ulcerative colitis. Obstructions led to recurrent acute kidney injury with need of surgical intervention to prevent kidney function deterioration. PMID:22325180

Tkaczyk, Marcin; Ka?u?y?ska, Anna; Samolewicz, Emeryk

2012-03-01

263

A huge bladder calculus causing acute renal failure  

Microsoft Academic Search

We present a 39-year-old man with repeated urinary tract infection and lower abdominal pain. Kidney–ureter–bladder (KUB) and\\u000a IVU film showed a huge 450-g elliptical pelvic calculus that was surgically removed with excellent results. Surgical intervention\\u000a by cystolithotomy or endoscopic cystolithotripsy can achieve satisfactory results. Bladder outlet obstruction should be treated\\u000a simultaneously. Bladder stone is a common disease, but it is

Wuran WeiJia Wang; Jia Wang

2010-01-01

264

Acute renal failure due to bilateral ureteral stone impaction in an HIV-positive patient  

Microsoft Academic Search

A 51-year-old HIV-positive man treated with atazanavir for 9 months presented with anuria following right flank pain. Laboratory\\u000a examination indicated renal insufficiency, and abdominopelvic computed tomography scanning showed bilateral hydroureteronephrosis,\\u000a but no stones were visualized. Endoscopic procedures were performed to investigate the causes of ureteral obstruction and,\\u000a if possible, to insert Double-J stents in the ureters. A yellowish stone composed of

Yoji Moriyama; Yuzuru Minamidate; Mitsuru Yasuda; Hidetoshi Ehara; Mina Kikuchi; Tomohiro Tsuchiya; Takashi Deguchi; Hisashi Tsurumi

2008-01-01

265

Applications of the peel-away introducer sheath.  

PubMed

The peel-away introducer sheath set, originally designed for the antegrade insertion of the silicone rubber Universal stent, also is useful for antegrade or retrograde basketing of ureteral stones, negotiation of a dilated renal pelvis and tortuous ureter with minimal trauma, retrograde flushing of ureteral stones for percutaneous extraction, removal of dislodged stents from the renal pelvis and ureteral examination with a flexible endoscope or rigid ureteropyeloscope. PMID:3820373

Rich, M; Lee, W J; Smith, A D

1987-03-01

266

Increased expression of atrial natriuretic peptide in the kidney of rats with bilateral ureteral obstruction  

Microsoft Academic Search

Increased expression of atrial natriuretic peptide in the kidney of rats with bilateral ureteral obstruction.BackgroundWhether the postobstructive diuresis can be related to an altered regulation of local atrial natriuretic peptide (ANP) in the kidney was investigated.MethodsThree groups of rats had both of their ureters obstructed for 48 hours. The kidneys were taken without releasing the obstruction in one group [bilateral

Soo Wan Kim; Jongun Lee; Jong Wook Park; Jung Hee Hong; Hyun Kook; Chan Choi; Ki Chul Choi

2001-01-01

267

Experimental defect in rabbit urethra repaired with acellular aortic matrix  

Microsoft Academic Search

Urethral reconstruction following failed hypospadias repair or post-traumatic chronic stricture requires adequate amounts\\u000a of tissue. Many surgical techniques utilizing different types of biological tissues have been attempted: (a) vascularized\\u000a skin flaps from the prepuce, scrotum or penile shaft; (b) full-thickness free skin grafts; (c) vesical or buccal mucosa grafts;\\u000a (d) ureter; artery; vein and appendix tissue. More recently, biodegradable polymers

P. P. Parnigotto; M. T. Conconi; P. G. Gamba; P. Midrio

2000-01-01

268

Growth and characterization of normal human urothelium in vitro  

Microsoft Academic Search

Summary  A method for initiating rapidly growing cultures of normal human transitional cells from ureter and embryonic bladder specimens\\u000a has been developed and quantified. A new microdissection technique was used to nonenzymatically separate the urothelium. The\\u000a use of enriched medium containing 10 ?g\\/ml insulin, 5 ?g\\/ml transferrin, and 1 ?g\\/ml hydrocortisone resulted in improved growth.\\u000a The use of thin collagen gel

Catherine A. Reznikoff; Mark D. Johnson; Diane H. Norback; George T. Bryan

1983-01-01

269

Sulfasalazine reduces inflammatory renal injury in unilateral ureteral obstruction  

Microsoft Academic Search

The purpose of this study was to test whether sulfasalazine has a protective action against interstitial inflammation and\\u000a the development of renal fibrosis in obstructive nephropathy. Female rats were subjected to a sham (n?=?10) or unilateral ureteral obstruction (UUO, n?=?30). UUO was induced in rats by ligating the left ureter. Three days after operation, rats subjected to UUO were randomized

Savas Demirbilek; Memet Hanefi Emre; Engin Nasuhi Ayd?n; Mehmet Naci Edali; Rauf Tu?rul Aksoy; Melih Ak?n; Kubilay Gürünlüo?lu; Erkan Tas; Selma Ay; Zümrüt Yilmaz

2007-01-01

270

Er:YAG laser radiation for soft and hard urological tissue treatment  

NASA Astrophysics Data System (ADS)

Er:YAG laser (wavelength 2.94 ?m) operating both in free-running and Q-switched regime was designed and developed for the purpose of ureter wall perforation or incision, and urinary stones fragmentation. Component of this system was a special transfer part consisted of a cyclic olefin polymer-coated silver (COP/Ag) hollow glass waveguide (inner/outer diameter 700/850 ?m or 320/450 ?m) with a sealed cap for a contact treatment. Maximum pulse interaction energy and length for free-running Er:YAG laser were 100 mJ and 200 ?s, respectively (corresponding intensity was 130 kW/cm2 for the 700 ?m waveguide and 500 kW/cm2 for the 320 ?m waveguide). Maximum interaction pulse energy and length in Q-switched regime were 30 mJ and 70 ns, respectively (corresponding intensity was 111 MW/cm2 for the 700 ?m waveguide and 357 MW/cm2 for the 320 ?m waveguide). Basic interaction characteristics and parameters of ureter wall perforation and urinary stones fragmentation were found. For that reason the number of pulses needed for the perforation of the ureter wall tissue (thickness ~1mm), ablation threshold and ablation rate were measured for free-running and Q-switched Er:YAG laser radiation. Subsequently, the investigated tissue samples were histologically evaluated after the interaction. The ablation rate of the Q-switched Er:YAG laser radiation was higher compared to the free-running radiation. The application of Q-switched Er:YAG laser radiation on ureter tissue resulted in minimum tissue alteration (up to 50 ?m from the surface) without any influence on the deeper layers. The possibility of urinary stones perforation with free-running Er:YAG laser radiation (with maximum interaction energy) was also demonstrated.

Koranda, Petr; Jelínkova, Helena; N?mec, Michal; Köhler, Oto; Drlík, Pavel; Pokorný, Jan; Miyagi, Mitsunobu; Iwai, Katsumasa; Shi, Yi-Wei; Matsuura, Yuji

2006-03-01

271

Iatrogenic ureteral injury due to lumbar sympathetic block.  

PubMed

Lumbar sympathetic block (LSB) is used in the management of sympathetically maintained pain states. Complications of LSB may include infection, injury of spinal cord or somatic nerve, kidney trauma, hypotension, paraplegia and genitofemoral neuralgia. We present a case of a 53-year-old woman who had undergone LSB for the relief of reflex sympathetic dystrophy and subsequently a disrupted right proximal ureter. She was treated with ureteroureterostomy and an indwelling ureteral stent. PMID:19230175

Dirim, Ayhan; Kumsar, Sükrü

2008-01-01

272

Iatrogenic ureteral injury due to lumbar sympathetic block.  

PubMed

Lumbar sympathetic block (LSB) is used in the management of sympathetically maintained pain states. Complications of LSB include infection, injury of spinal cord or somatic nerve, kidney trauma, hypotension, paraplegia and genitofemoral neuralgia. This report presents the case of a 53-year-old woman who had undergone LSB for relief of reflex sympathetic dystrophy and subsequently disrupted right proximal ureter. She was treated with ureteroureterostomy and indwelling ureteral stent. PMID:18609289

Dirim, Ayhan; Kumsar, Sükrü

2008-01-01

273

Ureteral pseudodiverticulosis: a unique case diagnosed by multidetector computed tomography.  

PubMed

Presented is a case of ureteral pseudodiverticulosis diagnosed by multidetector computed tomography (CT). Axial and coronal reformatted CT images revealed multiple small (2-4 mm) outpouchings of both ureters, characteristic of ureteral pseudodiverticulosis. The unenhanced CT also revealed a 6-mm stone at the left ureterovesical junction and a high attenuation lesion at the right ureterovesical junction suspect for an associated uroepithelial neoplasm. PMID:19346860

Spalluto, Lucy Boyd; Woodfield, Courtney A

2009-01-01

274

Phaeochromocytoma of the urinary bladder.  

PubMed

The occurrence of urinary bladder paragangliomas is rare. A 12-year-old Chinese girl who presented with history of blurring of vision was found to have grade IV hypertensive retinopathy. Investigations revealed a phaeochromocytoma on the posterior wall of the urinary bladder. A partial cystectomy with right ureter reimplantation was undertaken and her hypertension was promptly controlled. The diagnosis and management of this rare tumour is discussed. PMID:15968447

Naqiyah, I; Rohaizak, M; Meah, F A; Nazri, M J; Sundram, M; Amram, A R

2005-07-01

275

Laparoscopic nephroureterectomy for adult incontinence caused by functioning ectopic pelvic kidney draining into vagina.  

PubMed

A 29-year-old woman had been continent of the majority of her urine for her entire life but had constant, uncontrollable dribbling. A contrast CT scan showed a solitary functioning left kidney and a dysplastic right pelvic kidney with a tortuous dilated ureter running close to the vaginal vault. The kidney was removed whole at transperitoneal laparoscopy, rendering the patient continent. This is the first such case reported in an adult. PMID:15253815

Challacombe, Ben; Kelleher, Con; Sami, Tariq; Scott, Helena; Chandra, Ashish; O'Brien, Tim; Dasgupta, Prokar

2004-06-01

276

Transurethral fulguration for empyema of ectopic ureteral stump.  

PubMed

A 55-year-old woman who had undergone left nephrectomy 7 years prior because of pyonephrosis, suffered from refractory cystitis and was diagnosed with empyema of the left ureteral stump associated with ectopic ureter. Although removal of the stump is a popular treatment for this disease, transurethral fulguration of the stump lumen was performed in the patient described here. The procedure was technically easy and safe, resulting in the disappearance of the dilated stump and cessation of recurring cystitis. PMID:14633071

Ikeda, Daisuke; Matsutani, Ryo; Fukuda, Mamoru; Fuse, Haruki; Hirano, Shoji

2003-12-01

277

Ureterosciatic hernia with compression of the sciatic nerve  

Microsoft Academic Search

Ureterosciatic herniation is a rare cause of ureteral obstruction. Sciatic hernia is a well-defined anatomic defect that is\\u000a the result of atrophy or abnormal development of piriform muscle. Patients with sciaitic hernias commonly present with symptoms\\u000a of flank, abdominal, pelvic, lower back or thigh pain. The hernia sack can contain small bowel, ureter, ovary, colon or bladder.\\u000a Ureterosciatic hernia causing

Stavros Touloupidis; Christos Kalaitzis; Andreas Schneider; Emmanuel Patris; Anastasios Kolias

2006-01-01

278

Biodegradable Ureteral Stents  

NASA Astrophysics Data System (ADS)

Ureteral stents have been associated with painful symptoms and require a secondary procedure for removal if the suture tether is removed. Biodegradable stents have been attempted in the past, but are no longer used since they resulted in histological inflammation or unpredictable variability in degradation time. This article reviews past degradable materials used in both the prostatic urethra and ureter as well as identifies a new degradable ureteral stent that lasts between 2 to 4 weeks in a porcine model.

Chew, Ben H.; Hadaschik, Boris A.; Paterson, Ryan F.; Lange, Dirk

2008-09-01

279

The Prune Belly syndrome: urological aspects and long-term outcomes of a rare disease.  

PubMed

Prune-Belly syndrome is a disorder characterized by the following triad of symptoms: deficiency of the abdominal muscles, malformations of the urinary tract and bilateral cryptorchidism. This study included a total of 16 patients. The findings included clinical characteristics, diagnostics, therapy and long-term clinical outcomes. All patients were asked to complete a questionnaire and, in some cases, were given further examination. All patients were diagnosed with congenital aplasia of the abdominal wall and a variety of urogenital malformations. Cryptorchidism was present in 11 patients (68.8%), malformations of the prostate in 3 (18.8%), urethral malformations in 8 (50%) and mega-ureter in 14 patients (87.5%). A mega-bladder was observed in 13 patients (81.3%). Distinctive renal malformations, such as renal dysplasia, in 3 patients (18.8%) and hydronephrosis in 9 patients (56.3%), respectively. Abdominoplasty was performed on 4 patients (25%). Urethral surgery was performed in 10 patients (62.5%). Seven patients (43.8%) required ureter surgery, most of which involved re-implantation of the ureter and, in some cases, additional ureter modeling. Renal surgery was performed on 5 patients. Four patients with non-functioning kidneys with hydronephrosis underwent a nephrectomy and one patient pyeloplasty. We demonstrate that successful treatment is possible even in cases of serious and complex malformations, such as those of the Prune-Belly syndrome. Treatment must be tailored to the individual patient. The severity of the renal dysplasia is the main prognostic factor. PMID:22802998

Zugor, Vahudin; Schott, Günter E; Labanaris, Apostolos P

2012-04-01

280

Obstructed ureterocele with milk of calcium  

Microsoft Academic Search

Milk of calcium is rare in the urinary tract. It is usually associated with stasis in pyelogenic cysts and infrequently with\\u000a obstruction. This report describes radiographic and sonographic findings in a 15-year-old girl with milk of calcium in a simple\\u000a ureterocele, ureter, and hydronephrotic kidney. Milk of calcium has not been previously reported in a ureterocele and is extremely\\u000a rare

Ivy A. Engel; Paula W. Brill; Patricia Winchester

1981-01-01

281

Sirenomelia apus with vestigial tail.  

PubMed

Sirenomelia is an exceptionally rare congenital malformation characterized by complete or near complete fusion of lower limbs. A newborn with clinical features of sirenomelia including fused lower limbs in medial position, absent fibula, anal atresia, complete absence of urogenital system (bilateral renal agenesis, absent ureters, urinary bladder, absent internal and external genitalia), a single umbilical artery and a vestigial tail is reported. Association of vestigial tail with sirenomelia is not described in the literature. PMID:15876775

Parikh, Tushar B; Nanavati, Ruchi N; Udani, Rekha H

2005-04-01

282

Ureteral muscle tone in prevention of vesicoureteral reflux.  

PubMed

Three experiments were devised to examine three aspects of the mechanism of the ureterovesical valve in dogs: muscle defects, orientation of muscle in the submucosal segment of the ureter, and the support afforded by the firm bladder base. The ureterovesical valve mechanism of the dog was found to be inefficient when the roof of the submucosal segment was denuded in situ of its muscle. The valve remained efficient when the extravesical ureter, with its circular and oblique arrangement of muscle, was substituted for the normal submucosal ureter with its longitudinally disposed muscle. The efficiency of the ureterovescial junction was not impaired by substituting a floating bed of bladder muscle for the firm platform of the bladder base in which it is normally embedded. The bladder muscle of the hiatus was not effective in the prevention of vesicoureteral reflux if the submucosal segment was rendered inefficient as a sphincter by excision of the muscle in its roof or by excision of the segment. Muscle in the submucosal segment, arranged in either longitudinal or circular fashion, was an effective activator of the mechanical valve. Presumably, the tonic action of the smooth muscle is the activator that ensures the efficiency of the one-way flow flap-trap regulator of the ureterovesical junction. PMID:858666

King, P A; Stephens, F D

1977-05-01

283

Treatment of Ureteroarterial Fistulae with Covered Vascular Endoprostheses and Ureteral Occlusion  

SciTech Connect

Background. Ureteroarterial fistulae (UAFs) are a rare entity, often difficult to identify, and associated with a high mortality rate. This fact has been attributed to a delay in diagnosis and treatment. Five conditions that can predispose to the development of this uncommon entity have been described: prior pelvic surgery, prolonged ureteral stenting, radiation therapy, previous vascular surgery and vascular pathology. Methods. We present 4 patients with UAFs and at least three of the above-mentioned conditions. Ureteral ischemia and subsequent necrosis promote the formation of these fistulae. The constant pulsation of the iliac artery is transmitted to an already compromised ureter containing a stiff intraluminal foreign body, resulting in pressure necrosis, most likely where the ureter crosses the iliac artery. Results and Conclusion. Cases were managed percutaneously with a combination of the deployment of a covered prosthesis and, when needed, with mechanical occlusion of the ureter. Hematuria stopped in all the patients with no evidence of immediate rebleeding. One patient presented a new episode of vaginal bleeding 13 months after endograft placement and ureteral embolization. Arteriography showed the presence of a hypogastric artery pseudoaneurysm that was occluded using coils. No new bleeding has occurred in this patient 12 months after the second embolization. At present all 4 patients are alive with follow-up periods of 5, 9, 11 and 25 months since the first procedure.

Bilbao, Jose I., E-mail: jibilbao@unav.es; Cosin, Octavio; Bastarrika, Gorka [Clinica Universitaria de Navarra, Universidad de Navarra, Department of Radiology (Spain); Rosell, David; Zudaire, Javier [Clinica Universitaria de Navarra, Universidad de Navarra, Department of Urology (Spain); Martinez-Cuesta, Antonio [Clinica Universitaria de Navarra, Universidad de Navarra, Department of Radiology (Spain)

2005-04-15

284

A peculiar complication of suprapubic catheterization: Recurrent ureteral obstruction and hydronephrosis  

PubMed Central

Context Suprapubic cystostomy (SPC) catheterization is a common and important technique for the management of vesicular drainage, especially in patients with neurogenic bladder. Some serious complications include bowel perforation and obstruction. Findings A 55-year-old man with C6 American Spinal Injury Association B tetraplegia and a urethral stricture requiring a chronic SPC was admitted for recurrent urosepsis. Computed tomography (CT) of the abdomen revealed severe right hydronephrosis and hydroureter due to obstruction of the right distal ureter by the SPC tip. The SPC (30 French/10-mm silicone catheter with a 10-ml balloon) was removed and replaced with a similar suprapubic catheter (30 French/10-mm silicone catheter with an 8-ml balloon). Symptoms recurred 2 months later and he was readmitted for urosepsis. CT of the abdomen again revealed severe right hydronephrosis and hydroureter due to obstruction of the right distal ureter by the SPC tip. The SPC was removed, and the patient was given a 14 French/4.67-mm urethral silicone catheter with a 5-ml balloon. Follow-up CT of the abdomen 2 months later showed complete resolution of the hydronephrosis and hydroureter. Of note, urodynamic studies 2 years earlier revealed an extremely small bladder with a capacity less than 20 ml. Conclusion This case illustrates that obstruction of the ureter by the tip of an SPC can be a cause of recurrent hydronephrosis and urosepsis.

Adeyemo, Bamidele; Makovitch, Steven; Foo, Dominic

2013-01-01

285

Case-control study of arsenic in drinking water and kidney cancer in uniquely exposed Northern Chile.  

PubMed

Millions of people worldwide are exposed to arsenic in drinking water. The International Agency for Research on Cancer has concluded that ingested arsenic causes lung, bladder, and skin cancer. However, a similar conclusion was not made for kidney cancer because of a lack of research with individual data on exposure and dose-response. With its unusual geology, high exposures, and good information on past arsenic water concentrations, northern Chile is one of the best places in the world to investigate the carcinogenicity of arsenic. We performed a case-control study in 2007-2010 of 122 kidney cancer cases and 640 population-based controls with individual data on exposure and potential confounders. Cases included 76 renal cell, 24 transitional cell renal pelvis and ureter, and 22 other kidney cancers. For renal pelvis and ureter cancers, the adjusted odds ratios by average arsenic intakes of <400, 400-1,000, and >1,000 µg/day (median water concentrations of 60, 300, and 860 µg/L) were 1.00, 5.71 (95% confidence interval: 1.65, 19.82), and 11.09 (95% confidence interval: 3.60, 34.16) (Ptrend < 0.001), respectively. Odds ratios were not elevated for renal cell cancer. With these new findings, including evidence of dose-response, we believe there is now sufficient evidence in humans that drinking-water arsenic causes renal pelvis and ureter cancer. PMID:23764934

Ferreccio, Catterina; Smith, Allan H; Durán, Viviana; Barlaro, Teresa; Benítez, Hugo; Valdés, Rodrigo; Aguirre, Juan José; Moore, Lee E; Acevedo, Johanna; Vásquez, María Isabel; Pérez, Liliana; Yuan, Yan; Liaw, Jane; Cantor, Kenneth P; Steinmaus, Craig

2013-09-01

286

Endogenous cryogen excreted by the kidneys.  

PubMed

Injection (iv) of human urine into rabbits results in a fall in body temperature accompanied by peripheral vasodilation in a thermoneutral ambient temperature and suppression of shivering metabolism in the cold. There were no consistent changes in mean arterial pressure in response to the injection of urine. If the production of urine is prevented by occlusion of the ureters of rabbits, body temperature falls. Injection of endogenous pyrogen (iv) into rabbits, which have had their ureters occluded, results in a significant attenuation in the magnitude of the fever as compared to controls. These observations suggest that there is an endogenously produced cryogenic substance ("endogenous cryogen") normally excreted in an active form by the kidneys and which when either injected, or prevented from being excreted (by clamping the ureters), results in a regulated fall in body temperature. In addition, in human patients on regular dialysis treatment who still had residual renal function, the oral temperature was slightly below normal before hemodialysis and slightly above normal after hemodialysis, a difference averaging 0.39 degrees C (P less than 0.001). These data are in agreement with the hypothesis that endogenous cryogen is a dialyzable substance, and that its concentration is reduced (and therefore the patient's body temperature rises) during hemodialysis. PMID:7304770

Kluger, M J; Turnbull, A J; Cranston, W I; Wing, A J; Gross, M P; Rothenburg, B A

1981-11-01

287

Our experience with the Mainz pouch II: 40 patients; follow-up and complications.  

PubMed

Authors used the Mainz pouch II technique for urinary diversion in 40 patients suffering from bladder cancer. They made minor modifications to the original surgical technique: a longer, 40 cm bowel is detubularized, the ureters are pulled through the mesosigma and embedded in a groove of the bowel's mucosa, the sigma pouch is fixed to the dorsal peritoneum, a straight suture is used. Single-row on the dorsal wall and two-rows on the ventral wall. Within a few days after the surgery suture insufficiency occurred in the abdominal wall in 5 cases, in the bowel in 2 cases. To treat suture disrupture of the bowel authors transformed the pouch, added a newly detubularized bowel segment to create a spheric rectum pouch and performed a definitive colostomy. During the follow-up period of six months to four years 8 of the 40 patients died from bladder cancer, 2 from cardiac failure, 1 from pulmonary embolism, and 6 have had a recurrence of the tumor. In the 23 tumor free patients we found no reflux, one has a slight stenosis of the ureter, febrile pyelonephritis did not occur, the pouch did not slip, the ureter had no kinking, and all patients are continent. Hyper-chloraemic acidosis has been prevented by regular administration of sodium bicarbonate or kalium citrate. Authors believe that Mainz pouch II is to be the most appropriate continent urinary diversion if an orthotopic substitution is not possible. PMID:8554296

Pajor, L; Kelemen, Z

1995-01-01

288

Management of ureteral stones by extracorporeal shock wave lithotripsy using Lithostar lithotriptor.  

PubMed

In 282 patients 290 ureteral stones were treated with extracorporeal shock wave lithotripsy using the Lithostar lithotriptor. Stones were in the upper ureter in 198 units (68.3%), middle ureter in 36 (12.4%) and lower ureter in 56 (19.3%). The average stone mass was 11.9 mm. and the mean number of shock waves was 4,913 for all levels with a mean kv. of 16.9. The average number of sessions was 1.5 for all sites. Auxiliary measures in the form of ureteral catheterization were done in 24 patients (8.5%) and internal stenting in 12 (4.25%), all of whom had upper or middle ureteral stones. Disintegration of the stones was achieved in 99% of the upper, 93.7% of the middle and 91.7% of the lower ureteral stones. However, clearance of fragments within 3 months from the last session was achieved in 94.8% of the upper, 87.5% of the middle and 91.7% of the lower ureteral stones for an overall stone-free rate of 93.3%. PMID:1507339

el-Gammal, M Y; Fouda, A A; Meshref, A W; Abu-el-Magd, A N; Farag, F A; el-Katib, S E

1992-09-01

289

[Treatment of ureteral calculi with extracorporeal lithotripsy. Comparison between the original Dornier HM3 and the modified lithotriptor].  

PubMed

From January 1985 till June 1989, 222 patients with ureteral stones, underwent ESWL treatment. 109 patients were treated with the original Dornier HM3 under general or epidural anaesthesia and 113 patients were treated with the modified Dornier HM3 under anglosedation. 156 stones were in the upper ureter, 15 in the middle ureter, 51 in the lower ureter. We performed a total of 269 ESWL treatments. Out of 109 patients treated with the original HM3 and 113 patients treated by the modified HM3 12 (11%) and 28 (24.7%) needed, respectively, two or more ESWL sessions. In 89.9% and 88.5% of the patients, respectively, has been performed an ureteral manipulation before the treatment to push up or to localize the stone. The treatment was unsuccessful in 10 patients of whom 3 underwent anterograde lithotripsy by percutaneous access, 4 transureteral lithotripsy and 3 surgery. At three months the percentage of patients stone free was as follows: original HM3 patients 88% modified HM3 patients 92.9%. The extracorporeal lithotripsy is now-day the treatment of choice for the ureteral stone without any limitation, due to the stone localisation. The clinical use of modified HM3 on ureteral stones didn't low our success rate, but increased the shock wave out of session. PMID:1830419

Zanetti, G; Montanari, E; Mazza, L; Ceresoli, A; Guarneri, A; Mandressi, E; Pisani, E

1991-03-01

290

In Situ extracorporeal shock-wave lithotripsy as a primary treatment for ureteral stones.  

PubMed

Background: The aim of the study was to evaluate the results of extracorporeal shock-wave lithotripsy (ESWL) as a primary treatment for ureteral calculi at different levels. Materials and Methods: We treated 166 consecutive patients with solitary ureteral stones (73 at the upper, 4 at the middle, and 89 at the lower ureter) by primary in situ ESWL on an outpatient basis. A maximum of three treatments were give individually before adopting ureteroscopy as an alternative treatment. The success rate was calculated on the basis of complete stone clearance and resolution of any associated obstruction. Re-treatment rates, complications and time to complete stone clearance were recorded. Results: Complete stone clearance was achieved in 152 patients (91.6%) after an average of 10.2 days (range 1280. The average treatment rate was 1.3 sessions per patient. As a whole groups, lower ureteral stones required more treatment sessions than those in the upper ureter, and the difference was statistically significant. However the differences in the final success rate and time to stone clearance were statistically nonsignificant. When stratified according to size, the success rate was lowest for lower ureteral stones >1 cm in diameter. Conclusion: We believe ESWL is a safe and simple non-invasive option of choice for most ureteral calculi at different levels. Ureteroscopy represents an alternative choice in case of ESWL failure, or in cases of larger stones in the lower ureter when it might be the first option. PMID:17146219

Maghraby, Hisham

2003-01-01

291

[Clinical experience of extracorporeal shock wave lithotripsy with lithodiagnost M for upper urinary tract stones].  

PubMed

Between August 1995 and March 1997, 197 patients underwent 257 treatments for 217 stones by extracorporeal shock wave lithotripsy (ESWL) using a Lithodiagnost M (Philips, Holland). There were 149 males and 48 females with an average age of 50.6 years, ranging from 15 to 85 years. There were 53 stones located in the renal pelvis and calices (R2), 20 stones at the pelvi-ureteric junction (PUJ) (R3), 101 stones in the upper ureter (U1), 15 stones in the middle ureter (U2) and 28 stones in the lower ureter (U3). The average number of sessions was 1.18 and the average number of shock waves per stone was 3,546. Efficacy was evaluated 3 months after the final ESWL. The success rate was 95.4% (207/217), with complete disappearance of stones in 71.4% (155/217) and residual stones of less than 4 mm diameter in 24% (52/217). No severe complications, except for subcapsular renal hematoma in one patient, were observed. These results indicate that almost all upper urinary tract stones can be successfully treated by ESWL monotherapy. PMID:9503199

Un-no, T; Ohhira, T; Takayama, T; Mugiya, S; Hata, M; Suzuki, K; Fujita, K

1998-01-01

292

Ureteropyeloscopy and homium: YAG laser lithotripsy for treatment of ureteral calculi (report of 356 cases)  

NASA Astrophysics Data System (ADS)

Objective: To evaluate the efficacy and safety of holmium YAG laser lithotripsy for the treatment of ureteral calculi. Methods: A total of 356 patients underwent ureteropyeloscopic lithotripsy using holmium YAG laser with a semirigid uretesopyeloscope, 93 upper, 135 middle, and 128 lower ureteral stones were treated. Results: The overall successful fragmentation rate for all ureteral stones in a single session achieved 98% (349/356). The successful fragmentation rate stratified by stone location was 95% 88/93 in the upper ureter, 99% (134/135) in the mid ureter , and 99%(127/128) in the distal ureter. 12 cases with bilateral ureteral stones which caused acute renal failure and anuria were treated rapidly and effectively by the holmium YAG laser lithotripsy. No complications such as perforation and severe trauma were encountered during the operations. 2 weeks 17months (with an average of 6.8 month ) follow up postoperatively revealed that the overall stone-free rate was 98%(343/349) and no ureteral stenosis was found. Conclusions Holmium YAG laser lithotripsy is a highly effective, minimally invasive and safe therapy for ureteral calculi. It is indicated as a first choice of treatment for patients with ureteral calculi, especially for the ones with mid- lower levels of ureteral calculi.

Wu, Zhong; Din, Qiang; Jiang, Hao-wen; Zen, Jing-cun; Yu, Jiang; Zhang, Yuanfang

2005-07-01

293

Discrimination between urinary tract tissue and urinary stones by fiber-optic-pulsed photothermal radiometry method in vivo  

NASA Astrophysics Data System (ADS)

To minimize urotherial tissue injuries by false laser irradiation during the laser stones fragmentation, a novel fiber-optic analytical system was developed which was able to distinguish urotherial tissues from urinary stones in vivo. This system was composed of the fiber-optic pulsed photo-thermal radiometry (PPTR) system together with a thin-fiber endoscope. The ultraviolet Ar laser was employed as the excitation light source. The catheter of this system was 6F in diameter and consisted of SiO2 glass fiber (400 micrometers (phi) ) as an excitation line, an As-S glass fiber (400 micrometers (phi) ) as a detection line, and a thin-fiber endoscope (610 micrometers (phi) ). A urinary stone was introduced into the canine ureter uneter under general anesthesia. The catheter system was inserted through an opening of the ureter distal to the stone. The e-folding decay time of the PPTR waveform of which optical and/or thermal properties of the tissues and stones were characterized was measured in vivo. The e-folding decay times were significantly different between urinary stones and the canine ureter. These results suggest that the fiber-optic PPTR analysis might be significantly useful procedure to prevent urotherial tissue from false irradiation injuries in clinical laser stone fragmentation.

Daidoh, Yuichiro; Arai, Tsunenori; Suda, Akira; Kikuchi, Makoto; Komine, Yukikuni; Murai, Masaru; Nakamura, Hiroshi

1991-07-01

294

Application of hollow glass waveguides in urological treatment  

NASA Astrophysics Data System (ADS)

The application of specially designed delivery system consisted of cyclic olefin polymer coated silver hollow glass waveguide (inner/outer diameter 700/850 ?m) with protector in one side and sealed cap in the output is shown for treatment of ureter wall perforation by Er:YAG laser radiation. For this purpose Er:YAG laser system (wavelength 2.94 ?m) working in free-running and Q-switched regime was utilized. The basic characteristic of the interaction of Er:YAG laser radiation with the ureter surface and its deep structures was found. Maximum interaction pulse energy and length in free-running regime were 100 mJ and 200 ?s, respectively (corresponding intensity 130kW.cm-2). Maximum interaction pulse energy and length in Q-switched regime were 30 mJ and 70 ns, respectively (corresponding intensity 111 MW.cm-2). From the histological evaluation it follows that the application of Q-switched Er:YAG laser radiation on ureter tissue resulted in minimum tissue alteration without any influence on the deeper layers.

Nemec, Michal; Koranda, Petr; Jelinkova, Helena; Kohler, Oto; Drlik, Pavel; Miyagi, Mitsunobu; Shi, Yi-Wei; Matsuura, Yuji

2005-03-01

295

Laparoscopic conservative management of ureteral endometriosis: a survey of eighty patients submitted to ureterolysis  

PubMed Central

Background this study aims to evaluate the effectiveness and safety of laparoscopic conservative management of ureteral endometriosis. Methods Eighty cases of histologically confirmed endometriosis affecting the ureter, 10 of which with bladder involvement were prospectively studied. In detail, patients were 13 women with ureteral stenosis (7 with hydronephrosis), 32 with circular lesions totally encasing the ureter, and 35 with endometriotic foci on the ureteral wall, but not completely encasing it. They were submitted to laparoscopic ureterolysis with or without partial cystectomy, ureteroneocistostomy. The rate of surgical complications, the recurrence rate, the patients' satisfaction rate was assessed during 22 months (median) follow-up. Results Laparoscopic ureterolysis was employed for all patients and set free the ureter from the disease in 95% of cases, whereas ureteroneocystostomy was necessary for 4 patients showing severe stenosis with hydronephrosis, among which 2 had intrinsic endometriosis of the ureteral muscularis. Three post-surgery ureteral fistulae occurred in cases with ureteral involvement longer than 4 cm: two cases were successfully treated placing double J catheter, the third needed ureteroneocistostomy. During follow-up, ureteral endometriosis recurred in 2 patients who consequently underwent ureteroneocystostomy. Most patients expressed high satisfaction rate throughout the whole follow-up period. Conclusion laparoscopic ureterolysis is effective and well tolerated in most cases of ureteral endometriosis. Ureteroneocystostomy is a better strategy for patients with extended (more than 4 cm) ureteral involvement or with severe stenosis with or without hydronephrosis.

Camanni, Marco; Bonino, Luca; Delpiano, Elena Maria; Berchialla, Paola; Migliaretti, Giuseppe; Revelli, Alberto; Deltetto, Francesco

2009-01-01

296

Construction of ureteral grafts by seeding urothelial cells and bone marrow mesenchymal stem cells into polycaprolactone-lecithin electrospun fibers.  

PubMed

The aim of the present study was to investigated the construction of polycaprolactone-lecithin (PCL-L) electrospun fibers as a novel scaffold material for a tissue-engineered ureter. The effect of bone marrow mesenchymal stem cells (BM-MSCs) on the neovascularization of the scaffolds and the viability of planted urothelial cells (UCs) on PCL-L were also studied. UCs were obtained from New Zealand rabbit bladders, cultured and then seeded onto the lumen of the tubular scaffolds before being subcutaneously transplanted into the space of nude mice. The cultured UCs showed vacuolar degeneration after 7 days of transplantation and they gradually degraded thereafter. To facilitate the regeneration of the tissue-engineered ureter and the survival of UCs in the implant, MSCs were seeded into the tubular grafts by rolling up the nanofibrous membrane, followed by the seeding of UCs. This facilitated the survival of the UCs, which formed several cellular layers after 30 days. The mean microvessel density was significantly increased in tissues seeded with MSCs. Cell-tracking experiments revealed that the transplanted MSCs did not integrate directly into capillaries for angiogenesis. Our results demonstrated that the PCL-L electrospun fibrous scaffold has a high potential for a tissue-engineered ureter especially when seeded with BM-MSCs, which enhanced angiogenesis. PMID:20383857

Shen, Jie; Fu, Xiaoling; Ou, Lailiang; Zhang, Min; Guan, Yong; Wang, Kai; Che, Yongzhe; Kong, Deling; Steinhof, Gustav; Li, Wenzhong; Yu, Yaoting; Ma, Nan

2010-03-01

297

Critical role of cyclooxygenase-2 activation in pathogenesis of hydronephrosis caused by lactational exposure of mice to dioxin  

SciTech Connect

Congenital hydronephrosis is a serious disease occurring among infants and children. Besides the intrinsic genetic factors, in utero exposure to a xenobiotic, 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD), has been suggested to induce hydronephrosis in rodents owing to anatomical obstruction in the ureter. Here, we report that hydronephrosis induced in mouse pups exposed lactationally to TCDD is not associated with anatomical obstruction, but with abnormal alterations in the subepithelial mesenchyma of the ureter. In the kidneys of these pups, the expressions of a battery of inflammatory cytokines including monocyte chemoattractant protein (MCP)-1, tumor necrosis factor {alpha} (TNF{alpha}) and interleukin (IL) -1{beta} were up-regulated as early as postnatal day (PND) 7. The amounts of cyclooxygenase (COX) -2 mRNA and protein as well as prostaglandin E2 (PGE{sub 2}) were conspicuously up-regulated in an arylhydrocarbon-receptor-dependent manner in the TCDD-induced hydronephrotic kidney, with a subsequent down-regulation of the gene expressions of Na{sup +} and K{sup +} transporters, NKCC2 and ROMK. Daily administration of a COX-2 selective inhibitor to newborns until PND 7 completely abrogated the TCDD-induced PGE{sub 2} synthesis and gene expressions of inflammatory cytokines and electrolyte transporters, and eventually prevented the onset of hydronephrosis. These findings suggest an essential role of COX-2 in mediating the TCDD action of inducing hydronephrosis through the functional impairment rather than the anatomical blockade of the ureter.

Nishimura, Noriko [Research Center for Environmental Risk, National Institute for Environmental Studies, Tsukuba 305-8506 (Japan)], E-mail: nishimura.noriko@nies.go.jp; Matsumura, Fumio; Vogel, Christopher F.A. [Department of Environmental Toxicology and Center for Environmental Health Sciences, University of California, Davis, CA 95616 (United States); Nishimura, Hisao [Department of Human Sciences, Aichi Mizuho University, Toyota 470-0394 (Japan); Yonemoto, Junzo [Research Center for Environmental Risk, National Institute for Environmental Studies, Tsukuba 305-8506 (Japan); Yoshioka, Wataru [Laboratory of Environmental Health Sciences, Center for Disease Biology and Integrative Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo 113-0033 (Japan); Tohyama, Chiharu [Research Center for Environmental Risk, National Institute for Environmental Studies, Tsukuba 305-8506 (Japan); Laboratory of Environmental Health Sciences, Center for Disease Biology and Integrative Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo 113-0033 (Japan)], E-mail: mtohyama@mail.ecc.u-tokyo.ac.jp

2008-09-15

298

Endoscopic holmium laser treatment for ureterolithiasis  

PubMed Central

Introduction The rapid development and invention of ever more technologically advanced ureterorenoscopes as well as other instruments used in fragmenting ureteral stones have made the traditional surgical treatment of ureterolithiasis very rare. Material and methods We investigated 727 patients treated for ureterolithiasis. 769 ureteroscopic lithotripsies (URSL) with the holmium laser were performed. We evaluated the relation of the stone size, the section of the ureter involved, length of time of the stone within the ureter and the condition of the urinary tract to the results of the ureterolithiasis treatment. Results A good result of breaking up the stone and passing its fragments out of the ureter within 3 months following the first URSL was observed in 642 (90.9%) out of 706 patients. The remaining 64 (9.1%) patients required additional procedures: ESWL was performed on 44 patients; URSL was repeated for 20 patients. The most serious early post-URSL complications involved: urinary tract infection with symptoms of urosepsis in 10 patients, leading to death in 1 case, ureteral perforation in 3 patients, including 1 case presenting a periureteral leak that necessitated a surgical intervention. Conclusions URSL with the holmium laser is an effective and safe method for treating ureterolithiasis.

Sosnowski, Marek

2012-01-01

299

Crossed renal ectopia presenting with suprapubic swelling and acute renal failure.  

PubMed

A 17-year-old male was admitted with a fluctuant suprapubic mass. A bladder scan demonstrated > 999 ml filling so he was catheterised. However, only 75ml of urine was drained. He was in acute renal failure with serum potassium of 6.5mmol/l. Computerised tomography (CT) scan showed a large midline 'cystic mass' separate from the bladder compressing the left ureter, causing left-sided hydronephrosis. Right kidney was not visualised. Percutaneous aspiration of the 'cyst' yielded 2000ml of straw-coloured fluid high in creatinine, urea and electrolytes indicating that it was urine. Having relieved the left ureter, the patient was subsequently diuresed, and renal function returned to normal. A CT urogram showed contrast uptake with renal parenchyma in the "cyst". Consequently, a diagnosis of right-sided crossed renal ectopia was made. Bilateral ureteric stents were inserted, and later a right-sided nephrectomy was performed. The patient made a full recovery. To the best of our knowledge, this is the only reported case of crossed renal ectopia causing obstruction of the normal ureter, resulting in acute renal failure.The role of modern imaging in the management of this condition is also highlighted in this report. PMID:24601204

Grewal, Sundeep Singh

2013-09-01

300

Lower urinary tract development and disease  

PubMed Central

Congenital Anomalies of the Lower Urinary Tract (CALUT) are a family of birth defects of the ureter, the bladder and the urethra. CALUT includes ureteral anomalies such as congenital abnormalities of the ureteropelvic junction (UPJ) and ureterovesical junction (UVJ), and birth defects of the bladder and the urethra such as bladder-exstrophy-epispadias complex (BEEC), prune belly syndrome (PBS), and posterior urethral valves (PUV). CALUT is one of the most common birth defects and is often associated with antenatal hydronephrosis, vesicoureteral reflux (VUR), urinary tract obstruction, urinary tract infections (UTI), chronic kidney disease and renal failure in children. Here, we discuss the current genetic and molecular knowledge about lower urinary tract development and genetic basis of CALUT in both human and mouse models. We provide an overview of the developmental processes leading to the formation of the ureter, bladder, and urethra, and different genes and signaling pathways controlling these developmental processes. Human genetic disorders that affect the ureter, bladder and urethra and associated gene mutations are also presented. As we are entering the post-genomic era of personalized medicine, information in this article may provide useful interpretation for the genetic and genomic test results collected from patients with lower urinary tract birth defects. With evidence-based interpretations, clinicians may provide more effective personalized therapies to patients and genetic counseling for their families.

Rasouly, Hila Milo; Lu, Weining

2013-01-01

301

Retroperitoneoscopic left upper moiety heminephroureterectomy for dribbling incontinence.  

PubMed

A 7-year-old girl underwent a prone, retroperitoneoscopic left upper moiety heminephroureterectomy for a non-functioning upper moiety associated with a dilated, ectopic ureter. The dilated ureter was noted prenatally, but postnatal investigations failed to demonstrate the duplex system. The child remained asymptomatic until she represented at 6 years of age, with dribbling of urine. She went on to have an ultrasound scan, dimercaptosuccinic acid and magnetic resonance urogram, which identified a grossly-dilated fluid-filled structure in proximity of the left kidney, but failed to demonstrate the small non-functioning left upper moiety. A computed tomography urogram was more helpful in establishing the diagnosis. Retroperitoneoscopy via three 5-mm ports allowed clear visualisation of both the left duplex ureters, as well as the small non-functioning upper moiety, which had been challenging on the pre-operative imaging. The procedure is described in the accompanying video. The child was discharged home the following day and has been completely well and dry at 6 months' follow-up. PMID:24321778

Chan, E; Steinbrecher, H; Madden, N; Farrugia, M-K

2014-02-01

302

Bilateral uric acid nephrolithiasis and ureteral hypertrophy in a free-ranging river otter (Lontra canadensis)  

USGS Publications Warehouse

We report the first case of uric acid nephrolithiasis in a free-ranging river otter (Lontra canadensis). A 7 yr old male river otter collected from the Skagit River of western Washington (USA) had bilateral nephrolithiasis and severely enlarged ureters (one of 305 examined [0.33%]). The uroliths were 97% uric acid and 3% protein. Microscopic changes in the kidney were confined to expansion of renal calyces, minor loss of medullary tissue, and multifocal atrophy of the cortical tubules. No inflammation was observed in either kidney or the ureters. The ureters were enlarged due to marked hypertrophy of smooth muscle plus dilation of the lumen. Fusion of the major calyces into a single ureteral lumen was several cm distal to that of two adult male otters used as histopathologic control specimens. This case report is part of a large contaminant study of river otters collected from Oregon and Washington. It is important to understand diseases and lesions of the otter as part of our overall evaluation of this population.

Grove, Robert A.; Bildfell, Rob; Henny, Charles J.; Buhler, D. R.

2003-01-01

303

Ureteral fibroepithelial polyps in four dogs.  

PubMed

Four dogs with ureteral fibroepithelial polyps, ranging from 9-12 years of age, are presented in this report. The patients presented with urinary incontinence, urinary tract infection, and/or polydypsia and pollakiuria. All dogs were intact at the time of diagnosis or for the majority of their lives and three were male. Various diagnostic procedures were performed including ultrasonography, contrast radiography, and nuclear scintigraphy. Not all procedures were performed in all patients. Findings included ureteral dilation proximal to the level of an intraluminal mass and ipsilateral hydronephrosis. Unilateral ureteronephrectomy was performed in three dogs with masses in the proximal ureter; ureteral resection and anastamosis was performed in the remaining patient with a mass located in the distal ureter. The same pathologist (RAP) reviewed all four lesions. The lesions appeared polypoid and were attached to the ureteral wall by a thin stalk. Histopathologically, they contained a superficial layer of well-differentiated transitional epithelial cells overlying a prominent fibrovascular stroma with a mild (three dogs) or marked (one dog) degree of lymphoplasmacytic inflammation. This disease may represent a benign neoplasm or a chronic inflammatory reaction and has a good prognosis with surgical removal. Its histopathological characteristics, higher incidence in males, and location more commonly within the upper third of the ureter is remarkably similar to the disease in humans. PMID:12939061

Reichle, Jean K; Peterson, Richard A; Mahaffey, Mary B; Schelling, Curtis G; Barthez, Paul Y

2003-01-01

304

Can we reduce secondary surgical interventions and length of hospitalization in percutaneous nephrolithotomy?  

PubMed

Purpose: To evaluate the success and complication rates of percutaneous nephrolithotomy (PNL) operations and to determine the effect of postoperative late removal of an open-end ureter catheter on hospital stay and on secondary interventions. Materials and Methods: The records of 198 patients (97 female, 101 male) who had PNL between May 2009 and February 2012 were retrospectively reviewed. The open-end ureter catheter which was placed during the operation was removed at the end of the operation in the first 53 patients ( group 1) and 12 hours after the nephrostomy catheter in 145 patients ( group 2). Results: PNL intervention was performed in 198 patients with a mean age of 40.83 ± 13.64 years and mean stone load of 9.82 ± 5.37cm2 (range 2 to 26 cm2). When clinically insignificant stone pieces < 4 mm were accepted as successful, the total success rate was 80.80 % (79.2% in group1 and 81.4% in group 2, P = .50). The hospitalization period was significantly reduced in group 2 (3.45 ± 0.95 days vs. 2.61 ± 0.65 days; P = .006). While secondary surgical intervention was not necessary in any of the patients in group 2 (0.0%), but 4 patients (7.5%) required ureterorenoscopy plus double-J stent placement following the primary procedure in group 1 (P = .006). Conclusion: PNL is a safe procedure with a high success rate and a short hospitalization period. There was a significant decrease in the hospitalization period and secondary surgical intervention rates with the postoperative late removal of the open-end ureter catheter. PMID:25015599

Delikta?, Hasan; Yapici, Onur; Ozen, Utku; Yalçin, Engin; Sahin, Hayrettin

2014-01-01

305

Luminal and basolateral uptake and degradation of insulin in the proximal tubules of the dog kidney.  

PubMed

In order to determine the major routes of insulin degradation in the body, insulin was labelled with a 'trapped' or 'residualizing' label: [125I]tyramine-cellobiose ([125I]TC) and injected intravenously in dogs. In contrast to conventional iodine-labelled insulin (131I-insulin), the [125I]TC-insulin allows measurements of total uptake in specific organs in vivo because the radioactive degradation products do not leave the cells. One h after the injection of trace doses, the amount of radioactivity recovered in the kidney from [125I]TC-insulin was nine times higher than when conventional [131I]insulin was used. In the blood, the amount of acid-precipitable radioactivity was the same for both labelled preparations, indicating similar clearance rates. A comparison of the uptake of insulin in filtering vs. non-filtering (ureter-occluded) kidneys indicated that the uptake of insulin is twice as high through the luminal than through the basolateral cell membrane; after 60 min, 8.9 +/- 0.8% of the injected [125I]TC-insulin dose remained in the filtering kidney and 3.2 +/- 0.2% of the dose was accumulated in the contralateral kidney, with occluded ureter but normal blood perfusion. In both filtering and non-filtering (ureter-occluded) kidneys, the subcellular distributions of [125I]TC-insulin were studied after various times by isopycnic sedimentation in sucrose gradients. No difference between peritubular and tubular uptake was discernible. The intracellular transport was rapid, leading to accumulation of radioactive label in dense lysosomes within 10 min. PMID:1442137

Hysing, J; Ostensen, J; Tolleshaug, H; Andersen, K J; Kiil, F

1992-10-01

306

Laparoscopic ureterocystoplasty with mitrofanoff system.  

PubMed

Abstract Purpose: To describe a laparoscopic surgical technique for ureterocystoplasty in pediatric patients with the Mitrofanoff procedure. Patients and Methods: The procedure was performed in 4 patients (2 females and 2 males), 8-11 years old (average, 9.5 years), with a history of myelomeningocele and secondary neurogenic bladder. The patients were evaluated before the surgery with renal ultrasound, voiding cystourethrography, and renal scintigraphy. All subjects reported left hydronephrosis with severe dilatation of ureter and the collector system, left megaureter with grade V vesicoureteral reflux, and left functional exclusion, with right renal normal function. The urodynamic investigations revealed low bladder size and bladder leak point pressure (BLPP) above 40?cm H2O. The laparoscopic ureterocystoplasty augmentation procedure and the Mitrofanoff procedure with the proximal ureter were performed in these patients. Complications and outcomes were recorded and compared with those of the postoperative urodynamic test. Results: The 2-4 years of follow-up of the patients and its urodynamic postoperative evaluation reported at least 75% of the capacity according to their age, compliance that varied between 15 to 20?mL/cm H2O, and a BLPP of less than 40?cm H2O. This last parameter is considered of low risk to damage the upper urinary tract. There was no leaking of urine by the stoma over the 4 hours of catheterization. Conclusions: Even though enterocystoplasty is the gold standard to increase the capacity of the neurogenic bladder, it has an elevated morbidity. So the use of a dilative ureter to increase bladder size and create a Mitrofanoff stoma in patients with neurogenic bladder, pop-off phenomenon, and renal ipsilateral atrophy could be considered by the laparoscopic approach. PMID:24475883

Landa Juárez, Sergio; Fernández, Ana María Castillo; Castro, Niccolo Ruiz; De La Cruz Yañez, Hermilo; Hernández, Carlos García

2014-06-01

307

Endoscopic correction of vesicoureteric reflux: 10-year experience of a tertiary care center.  

PubMed

Endoscopic treatment (ET) of vesicoureteric reflux (VUR) is becoming the new gold standard for surgical correction. ET for VUR using newly available bulking agents is a reliable and safe alternative procedure to open ureteral reimplantation for the treatment of VUR in children. We retrospectively reviewed our experience over 10 years of patients with primary VUR who underwent ET and had at least one year of follow-up at our center from 1998 to 2008. We looked at laterality, success rate, need for a second procedure and complication rate. We observed 321 patients with ET for VUR during this period; 115 (35.8%) of them were males and the total intervened ureters were 480. Correction of VUR was defined as either the resolution of reflux or a downgrading to grade 1 revealed with a follow-up voiding cystourethrogram and no ipsilateral renal or ureteric dilatation detected on renal ultrasound. At two to three months of follow-up, VUR was corrected in 393/480 (81.8%) refluxing ureters after a single endoscopic injection. With a second, repeated injection in the failed cases, VUR was corrected in a total of 418 (87.1%) refluxing ureters. Only three patients had post-operative complications (<1%). We conclude that our study suggests that the majority of patients will be cured after undergoing, as out-patients, this endoscopic procedure. We believe that the widely reported safety of bulking agents and the short learning curve will make ET the standard treatment for VUR once surgical correction is warranted. PMID:22237218

Neel, Khalid Fouda

2012-01-01

308

[Evaluation of the results of extracorporeal shock-wave lithotripsy (ESWL) for solitary upper urinary tract stone].  

PubMed

At Osaka City University Hospital, we performed extracorporeal shock-wave lithotripsy (ESWL) for 1277 patients in a total of 1788 sessions using Dornier kidney lithotripter Model HM III from July, 1985 to the end of December, 1988. Among the patients with a solitary stone, 911 cases were available for the follow-up study and we have compared the results among these cases in respect to the stone location and size. The results obtained were as follows: the ratio of kidney stone to ureter stone was found to be 2.2:1 in male, and 3.8:1 in female patients. This indicates that ureter stones are more frequently found in male than in female patients. In addition, we compared the size of kidney stones found in the patients including 415 male and 243 female patients. Stones larger than 20 mm were more frequently found in female than in male patients. Moreover, a stone composition study of these patients showed that the contents of both phosphate calcium and magnesium ammonium phosphate were higher in female than in male patients. ESWL performed against stones at pelvis and calyces exhibited the best results. The results obtained with the stones less than 20 mm in diameter were especially favorable with a success rate of 100% for the stones less than 10 mm and 83% for the stones 10-20 mm, in diameter, while the results with the stones larger than 20 mm in diameter were rather poor with a success rate of 31%. ESWL performed against ureter stones showed poor results with a success rate of 63% for the stones smaller than 20 mm in diameter. PMID:2264541

Wada, S; Kishimoto, T; Ameno, Y; Ohyama, A; Kamizuru, M; Iimori, H; Kanazawa, T; Asakawa, M; Yoshihara, H; Sakamoto, W

1990-10-01

309

Endoscopic spray cryotherapy for genitourinary malignancies: safety and efficacy in a porcine model  

PubMed Central

Objective: To examine the effects and safety of using endoscopic spray cryotherapy (ESC) on bladder, ureteral, and renal pelvis urothelium in a live porcine model. Subjects and methods: ESC treatments were systematically applied to urothelial sites in the bladder, ureter, and renal pelvis of eight female Yorkshire swine in a prospective trial. Freeze–thaw cycles ranged from 5 to 60 s/cycle for one to six cycles using a 7 French cryotherapy catheter. Tissue was evaluated histologically for treatment-related effects. Acute physiologic effects were evaluated with pulse oximetry, Doppler sonography, and postmortem findings. Results: In bladder, treatment depth was inconsistent regardless of dose, demonstrating urothelial necrosis in one, muscularis propria depth necrosis in two, and full thickness necrosis in all remaining samples. In ureter, full thickness necrosis was seen in all samples, even with the shortest spray duration (5 s/cycle for six cycles or 30 s/cycle for one cycle). Treatment to the renal pelvis was complicated by adiabatic gas expansion of liquid nitrogen to its gaseous state, resulting in high intraluminal pressures requiring venting to avoid organ perforation, even at the lowest treatment settings. At a planned dose of 5 s/cycle for six cycles of the first renal pelvis animal, treatment was interrupted by sudden and unrecoverable cardiopulmonary failure after three cycles. Repeated studies replicated this event. Ultrasound and immediate necropsy confirmed the creation of a large gaseous embolism and reproducible cardiopulmonary effects. Conclusion: ESC in a porcine urothelial treatment model results in full-thickness tissue necrosis in bladder, ureter, and renal pelvis at a minimal treatment settings of 5 s/cycle for six cycles. Adiabatic gas expansion may result in fatal pyelovenous gas embolism and collateral organ injury, as seen in both animals receiving treatment to the renal pelvis in this study. These results raise safety concerns for use of ESC as a treatment modality in urothelial tissues with current device settings.

Power, Nicholas E.; Silberstein, Jonathan L.; Tarin, Tatum; Au, Joyce; Thorner, Daniel; Ezell, Paula; Monette, Sebastien; Fong, Yuman; Rusch, Valerie; Finley, David

2013-01-01

310

Management of impacted proximal ureteral stone: Extracorporeal shock wave lithotripsy versus ureteroscopy with holmium: YAG laser lithotripsy  

PubMed Central

Objective: Prospective evaluation of the efficacy and safety of the extracorporeal shock wave lithotripsy (SWL) and ureteroscopy with Holmium: YAG laser lithotripsy (URSL) as a primary treatment for impacted stone in the proximal ureter. Patients and Methods: A total of 82 patients with a single impacted stone in the proximal ureter were included in the study. Patients were allocated into two groups according to patient preference for either procedure. The first group included 37 patients who were treated by SWL and the second group included 45 patients treated by URSL. The preoperative data and treatment outcomes of both procedures were compared and analyzed. Results: There was no difference as regards to patient and stone characters between the two groups. There was significantly higher mean session number and re-treatment rate in the SWL group in comparison to URSL group (1.5 ± 0.8 vs. 1.02 ± 0.15 session, and 43.2% vs. 2.2%, respectively). At one month, the stone-free rate of the URSL group was statistically significantly higher than that of the SWL group (80% vs. 67.6%, respectively). The stone-free rate at three months was still higher in the URSL group, but without statistically significant difference (80.2% vs. 78.4%, respectively). There was no statistically significant difference in the rate of complications between the SWL and URSL (24.3% vs. 15.6%, respectively). Conclusion: Both procedures can be used effectively and safely as a primary treatment for impacted stone in the proximal ureter; however, the URSL has a significantly higher initial stone-free rate and lower re-treatment rate.

Khalil, Mostafa

2013-01-01

311

Albumin uptake by renal lymphatics with and without obstruction of the renal vein  

SciTech Connect

Experiments involving injection of radio-iodinated albumin into the left renal arteries or left ureters of dogs indicate that the renal lymphatics are capable of a major contribution in returning to the circulation albumin (or other large molecules) escaping from renal capillaries. I-131-albumin was injected into the jugular vein of controls or into the left renal artery or in retrograde manner into the left ureter of female dogs. Experimental groups included those with no obstruction, occlusion of left renal veins or left renal lymphatics, or both. Collections were made from the right femoral artery, both renal veins, thoracic duct and both ureters at frequent intervals for 2 to 4 hours. Data analysis included I-131 concentration, specific activity, rate of recovery and selected ratios. After renal arterial injection, the percentage of I131 recovered in thoracic duct lymph of dogs without renal venous obstruction was 5 to 10 times that recovered in those that received injections into the jugular vein. In dogs with renal venous obstruction, recovery from the thoracic duct was 10 to 1,000 times that in control dogs. Most of the differences occurred during the first hour, after which time as recirculation and redistribution occurred the rates of appearance in thoracic duct lymph in each group were similar. The differences in the ratios of concentration in thoracic duct lymph to concentration in femoral arterial blood were also much greater when the renal vein was obstructed than in dogs with no obstruction. The greater return of albumin through the thoracic duct in those with impeded renal venous outflow was probably related to both sequestered concentration and increased intrarenal pressure.

Threefoot, S.A.; Pearson, J.E. Jr.; Georgiardis, A. (Tulane Univ. School of Medicine, New Orleans, LA (USA))

1989-08-02

312

Is stenting required before retrograde intrarenal surgery with access sheath  

PubMed Central

Background: Flexible ureterorenoscopies continue to assume an increasing role in the armamentarium of the endourologist. In many centers around the world, prior stenting is carried out before retrograde intrarenal surgery (RIRS) to passively dilate the ureter, which facilitates passage of a flexible ureteroscope with or without an access sheath. In our series, the first stage of passive dilatation with prior stenting was totally avoided without compromising the success of the procedure. Materials and Methods: From January 2004 to December 2007, 54 patients with 55 renal units underwent RIRS. The patients were between 28 and 65 years old. All patients had renal stones ranging in size from 8 mm to 22 mm. The mean serum creatinine level was 1.1 mg%. The lower ureter was dilated under ‘C - arm’ fluoroscopy guidance up to 14 FR. An access sheath of 10/12 Fr was passed over the working guide wire. RIRS (7.5/9.3 Fr) was introduced into the access sheath. The stones were fragmented using a holmium laser. The mean operating time was 85 mins (45-130 mins). Results: In 52 out of 55 renal units (94.5%), a flexible ureteroscope could be passed successfully into the kidney through an access sheath. In 3 of the cases (5.4%), the lower ureter could not be dilated. In these patients, the procedure was staged after passing a 6/26 JJ stent. An X-ray KUB was done at the 3-month follow-up visit. A total of 50 renal units (94.3%) were stone free at the 3-month follow-up visit. Conclusion: In a majority of the cases, RIRS could be accomplished successfully during the first sitting. Single stage RIRS did not alter the subsequent stone clearance or increase the incidence of morbidity or complications.

Mahajan, P. M.; Padhye, A. S.; Bhave, A. A.; Sovani, Y. B.; Kshirsagar, Y. B.; Bapat, S. S.

2009-01-01

313

[Nerve-sparing cystectomy technique in the woman].  

PubMed

With the advent of the nerve-sparing and urethral-support-sparing cystectomy technique, the urethral closure mechanism and the rhabdosphincter muscle of the lower urethra are left intact. The fibers of the interior hypogastric plexus supporting the urethra and the vagina remain intact. The autonomic nerve fibers are particularly at risk at two points: where they cross under the ureters between the uterine and vaginal arteries and in the bladder neck area. In both areas damage must bei avoided by careful dissection. The endopelvic fascia is incised immediately lateral to the posterior urethra at the urethrovesical junction. As much as possible of the urethropelvic ligament and the paraurethral vascular and nerve plexus must be saved. The urethrovesical junction is dissected off the anterior vaginal wall down to the posterior bladder wall. The cardinal ligaments are divided well anterior to avoid the pelvic plexus. The superior vesical artery and uterine vessels are cross-clamped, cut and tied. Once the uterine artery is transsected, the distal ureter comes into view and can be isolated, avoiding damage to the nerve fibers. The vaginal cavity is entered by a transverse incision, and the edges of the vaginal incision are held open with Ellis clamps. The distal stump of the ureter following its division is pulled medially to facilitate dissection of the lateral bladder wall. The perivesical vascular plexus and the inferior hypogastric plexus, which is located laterally to the vessels, are separated from the lateral wall of the bladder and vagina. (ABSTRACT TRUNCATED AT 250 WORDS) PMID:7610517

Hautmann, R E; de Petriconi, R

1995-05-01

314

Clinical Outcomes and Long-Term Resolution in Patients with Persistent Vesicoureteral Reflux after Open Ureteral Reimplantation  

PubMed Central

Purpose Success rates of ureteral reimplantation for primary vesicoureteral reflux (VUR) are high. Few studies document the natural history of children with persistent VUR. We reviewed their clinical outcomes and long-term resolution. Materials and Methods We performed a retrospective review of all children with persistent VUR (grade?1) into the reimplanted ureter(s) on initial cystogram after reimplantation for primary VUR at our institution from January 1990 - December 2002. We evaluated subsequent cystograms (graded on the 3-point radionuclide cystogram scale), surgery, and urinary tract infection (UTI). We performed survival analyses of time to resolution of persistent (grade?1) and clinically significant (grade?2) VUR in patients with >1 postoperative cystogram. Results Of 965 patients, 59 (94 ureters) had persistent VUR (6.1%): 19 grade 1/3, 29 grade 2/3 and 11 grade 3/3. Median age at reimplantation was 1.9 years; 62.7% were female. Preoperative VUR grade was 2/3 in 42.4% and 3/3 in 57.6%; 30.5% had ureteral tapering. Median follow-up was 47.1 months (IQR 19.3–65.3). 26/36 (72.2%) patients resolved; median time to resolution was 20.4 months. 21/32 with grade ? 2 on postoperative cystogram (65.6%) resolved; median time to resolution was 20.4 months. 10 had persistent VUR at last cystogram; grade 1 or 2 in 9 patients and 3/3 in 1 patient. One had repeat reimplantation for persistent VUR. 7 patients (13%) had postoperative febrile UTI at a median of 37 months postoperatively (IQR 1.7–64.4). Conclusions Persistent VUR after reimplantation resolves spontaneously in most children and can be managed non-operatively with good long-term outcomes.

Hubert, Katherine C.; Kokorowski, Paul J.; Huang, Lin; Prasad, Michaella M.; Rosoklija, Ilina; Retik, Alan B.; Nelson, Caleb P.

2013-01-01

315

Pure Laparoscopic and Robot-Assisted Laparoscopic Reconstructive Surgery in Congenital Megaureter: A Single Institution Experience  

PubMed Central

To report our experience of pure laparoscopic and robot-assisted laparoscopic reconstructive surgery in congenital megaureter, seven patients (one bilateral) with symptomatic congenital megaureter underwent pure laparoscopic or robot-assisted laparoscopic surgery. The megaureter was exposed at the level of the blood vessel and was isolated to the bladder narrow area. Extreme ureter trim and submucosal tunnel encapsulation or papillary implantations and anti-reflux ureter bladder anastomosis were performed intraperitoneally by pure laparoscopic or robot-assisted laparoscopic surgery. The clinical data of seven patients after operation were analyzed, including the operation time, intraoperative complications, intraoperative bleeding volumes, postoperative complications, postoperative hospitalization time and pathological results. All of the patients were followed. The operation was successfully performed in seven patients. The mean operation times for pure laparoscopic surgery and robotic-assistant laparoscopic surgery were 175 (range: 150–220) and 187 (range: 170–205) min, respectively, and the mean operative blood loss volumes were 20 (range: 10–30) and 28.75 (range: 15–20) ml, respectively. There were no intraoperative complications. The postoperative drainage time was 5 (range: 4–6) and 5.75 (range: 5–6) d, respectively, and the indwelling catheter time was 6.33 (range: 4–8) d and 7 (range: 7–7) d, respectively. The postoperative hospitalization time was 7.67 (range: 7–8) d and 8 (range: 7–10) d, respectively. There was no obvious pain, no secondary bleeding and no urine leakage after the operation. Postoperative pathology reports revealed chronic urothelial mucosa inflammation. The follow-up results confirmed that all patients were relieved of their symptoms. Both pure laparoscopic and robot-assisted laparoscopic surgery using different anti-reflux ureter bladder anastomoses are safe and effective approaches in the minimally invasive treatment of congenital megaureter.

Zhang, Peng; Gao, Jiangping; Dong, Jun; Chen, Guangfu; Xu, Axiang; Ma, Xin; Li, Hongzhao; Shi, Lixin

2014-01-01

316

Application of syntactic methods of pattern recognition for data mining and knowledge discovery in medicine  

NASA Astrophysics Data System (ADS)

This paper presents and discusses possibilities of application of selected algorithms belonging to the group of syntactic methods of patten recognition used to analyze and extract features of shapes and to diagnose morphological lesions seen on selected medical images. This method is particularly useful for specialist morphological analysis of shapes of selected organs of abdominal cavity conducted to diagnose disease symptoms occurring in the main pancreatic ducts, upper segments of ureters and renal pelvis. Analysis of the correct morphology of these organs is possible with the application of the sequential and tree method belonging to the group of syntactic methods of pattern recognition. The objective of this analysis is to support early diagnosis of disease lesions, mainly characteristic for carcinoma and pancreatitis, based on examinations of ERCP images and a diagnosis of morphological lesions in ureters as well as renal pelvis based on an analysis of urograms. In the analysis of ERCP images the main objective is to recognize morphological lesions in pancreas ducts characteristic for carcinoma and chronic pancreatitis, while in the case of kidney radiogram analysis the aim is to diagnose local irregularities of ureter lumen and to examine the morphology of renal pelvis and renal calyxes. Diagnosing the above mentioned lesion has been conducted with the use of syntactic methods of pattern recognition, in particular the languages of description of features of shapes and context-free sequential attributed grammars. These methods allow to recognize and describe in a very efficient way the aforementioned lesions on images obtained as a result of initial image processing of width diagrams of the examined structures. Additionally, in order to support the analysis of the correct structure of renal pelvis a method using the tree grammar for syntactic pattern recognition to define its correct morphological shapes has been presented.

Ogiela, Marek R.; Tadeusiewicz, Ryszard

2000-04-01

317

Endoscopic-guided laser ablation of vestibulovaginal septal remnants in dogs: 36 cases (2007-2011).  

PubMed

Objective-To describe the technique and evaluate short- and long-term outcomes in female dogs after endoscopic-guided laser ablation (ELA) of various vestibulovaginal septal remnants (VVSRs). Design-Retrospective case series. Animals-36 dogs. Procedures-Medical records of dogs with VVSRs that underwent ELA were retrospectively reviewed. All patients underwent complete cystourethrovaginoscopy for diagnosis and treatment. Endoscopic-guided laser ablation (with a holmium:yttrium-aluminum-garnet or diode laser) was used to transect the vaginal membrane. Patients with intramural ectopic ureters were concurrently treated with ELA of their ectopic ureters. Endoscopy was repeated 6 to 8 weeks after ELA of vaginal remnants in some patients, and the procedure sites were reassessed. Results-36 female dogs with persistent paramesonephric septal remnants (n = 19), vaginal septa (11), or dual vaginas (6) were included. Twenty-six dogs had urinary incontinence, 2 had recurrent UTIs, and 8 had both. Thirty of 36 (83%) dogs had concurrent ectopic ureters. Endoscopic-guided laser ablation was performed with holmium:yttrium-aluminum-garnet and diode lasers in 8 and 28 dogs, respectively. Five dogs had mild postoperative dysuria for < 24 hours. One patient developed a complication involving inadvertent laser perforation of the vaginal wall. There were no negative effects from this event, and the perforation was fully healed within 8 weeks. At the time of follow-up, all defects were fully healed with no sign of recurrence in the 18 (50%) patients reevaluated. There was a significant improvement in continence scores and a significantly decreased incidence of UTIs after ELA. The median follow-up time was 34 months (range, 8 to 57 months). Conclusions and Clinical Relevence-The results of the present study indicated that ELA provided an effective, safe, and minimally invasive treatment option for various VVSRs in dogs, avoiding the need for more invasive surgery. PMID:24697771

Burdick, Stacy; Berent, Allyson C; Weisse, Chick; Langston, Cathy

2014-04-15

318

Two Stage Complex Embolization of an Arteriovenous Fistula between the Right Common Iliac Artery and the Inferior Vena Cava.  

PubMed

We present an interesting case of a symptomatic high flow AV fistula between the right common iliac artery (CIA) and the inferior vena cava (IVC), successfully treated by endovascular coil embolization. The patient was found to have a right lower polar renal artery crossing the ipsilateral ureter arising from the CIA, causing pelvi-ureteric junction (PUJ) obstruction and recurrent pyelonephritis. It is hypothesized that this fistula arising from the lower polar renal artery and entering the IVC, may have occurred as a result of trauma during a previous pyeloplasty, or a pathologically induced process of angiogenesis stemming from recurrent pyelonephritis. PMID:22470611

Littlejohn, Marc Gingell; Allaf, Nile; Butterfield, Stephen

2009-01-01

319

Transcellular Diffusion of Non-Electrolytes across the Renal Tubular Epithelium  

PubMed Central

The stop flow technique was used to investigate the permeability characteristics of the dog nephron to various C14-labeled non-electrolytes. 12 minutes after clamping the ureter, creatinine, PAH, and C14 compound were injected intravenously. 2 minutes later, urine samples were collected. Urea and glycerol were able to enter the tubular urine along the entire nephron at rates which were commensurate with their molecular weights. No significant movement of larger molecules (D-arabinose, D-glucose, and mannitol) could be detected. However, after administration of twenty units of pitressin, D-arabinose was able to diffuse across the distal and proximal tubular epithelium.

Pena, Jose Carlos; Malvin, Richard L.

1962-01-01

320

Hydronephrosis of pregnancy associated with torsion of the fallopian tube: a case report.  

PubMed

Isolated tubal torsion accompanying pregnancy is an extremely rare condition. Preoperative diagnosis is generally difficult; most of the cases can be diagnosed intraoperatively. Here, we reported a 36-week pregnant with a complaint of acute pain in right lower quadrant that emanating to right lomber region. Abdominal utrasonography showed grade 3 hydronephrosis in right kidney, other findings were normal. A cesarean section was carried out and a twisted right tube were diagnosed. Right ovary was normal in appearance. The torsioned tube compressed the right ureter and caused ureteral dilatation. Right salpingectomy was performed. Postoperative follow-up of the patient was uneventful. PMID:21608441

Simsek, Y; Ustun, Y; Kaymak, O; Akbaba, E; Danisman, N; Sirvan, L

2011-04-01

321

Bilateral slipping of the upper femoral epiphysis in end-stage renal failure. A report of two cases.  

PubMed

Two cases of bilateral slipping of the upper femoral epiphysis in boys with end-stage renal failure due to megacystis and mega-ureter with severe renal osteodystrophy are reported. In one patient the lesion emerged after a dystonic reaction to drugs and in the other after bilateral nephro-ureterectomy. Neither showed marked elevation of growth hormone levels, but both had evidence of renal rickets with severe secondary hyperparathyroidism. Both had a satisfactory response to bilateral internal fixation. The complication should be borne in mind in all young patients with renal osteodystrophy. PMID:7351429

Nixon, J R; Douglas, J F

1980-02-01

322

Obturator Hernia with Ureteral Entrapment  

PubMed Central

Obturator hernia of the ureter is uncommon. Computed tomography of a 77-year-old woman with sudden-onset lower left abdominal pain and urinary symptoms showed an obturator hernia with ureteral entrapment. Obturator hernia is a diagnostic challenge because the hernial mass is very insidious. It should be suspected in emaciated, multiparous, elderly women presenting with unexplained pain in the groin, hip, thigh or knee. High levels of clinical suspicion of high-risk patients and recourse to investigation by computed tomography are important, as delay in diagnosis and treatment is associated with increased morbidity and mortality.

Izzo, Matteo; Regusci, Luca; Fasolini, Fabrizio

2014-01-01

323

Effects of unilateral ureteric occlusion on renal necrosis occurring in rats fed a methyl-deficient diet.  

PubMed Central

Wistar male rats were fed from weaning a methyl-deficient diet (groups I and II) or a standard commercial diet (groups III and IV). At the day 3 the left ureter was tied and divided in animals of groups I and III, while those in groups II and IV were sham operated. Rats of all groups were killed on days 8 and 10 to evaluate the incidence and extent of tubular necrosis (day 8) and tubular and cortical necrosis (day 10). The results of this study show that unilateral ureteric obstruction diminishes the incidence, severity and extent of necrosis in the same kidney. Images Fig. 3 Fig. 4

Roberti, M. F.; Perazzo, J. C.; Monserrat, A. J.

1988-01-01

324

Eccrine Porocarcinoma Presenting with Unusual Clinical Manifestations: A Case Report and Review of the Literature  

PubMed Central

Eccrine porocarcinoma is a rare neoplasm that originates from the intraepidermal ductal portion of the eccrine sweat gland, and it usually occurs on the pre-existing lesion of benign eccine poroma. Its occurrence is more common in females and elderly persons. We present a case of a 44-year-old man who suffered from eccrine porocarcinoma, which developed on the right scrotum and pelvic area with metastases to the lung, adrenal gland, esophagus, ureter, and distant lymph nodes. Here we report on a unique case of eccrine porocarcinoma that developed primarily on the scrotum, which is an uncommon site, and showed rapid metastasis to the internal organs.

Choi, Chang-Min; Cho, Hee-Ryung; Lew, Bark-Lynn

2011-01-01

325

Ureterocolic fistula secondary to a self-expanding retrievable ureteral stent  

PubMed Central

Self–expanding stents are relatively new in the field of urology and have primarily been used for permanent remodeling of benign or malignant stricture. We are presenting a rare and interesting case of a ureterocolic fistula that formed secondary to placement of an expandable, retrievable metal stent in the ureter. After multiple retrieval efforts, the self–expanding metal stent was finally retrieved and a ureterocolic fistula was appreciated on antegrade pyelography. The patient chose to manage it non–surgically, with routine nephroureteral catheter exchanges, and her creatinine continues to remain stable.

Ransford, George; Pan, David; Eldefrawy, Ahmed; Narayanan, Govindarajan

2013-01-01

326

Spontaneous Pelvic Rupture as a Result of Renal Colic in a Patient with Klinefelter Syndrome  

PubMed Central

We present the case of a young man with Klinefelter syndrome, who was admitted to our clinic with renal colic. Shortly after admittance, spontaneous decrease in pain has occurred. Ultrasound and intravenous contrast computed tomography were performed, which showed the evidence of urine extravasation at the level of left renal pelvis and a 4?mm stone in the lower third of the left ureter. The management with a double-J ureteric stent for three weeks was successful. Then, the stent was removed and computed tomography confirmed the absence of urine extravasation. We also analyze the literature related to this case and discuss the main mechanisms of collecting system rupture.

Reva, Sergey; Tolkach, Yuri

2013-01-01

327

A Case of Primary Hyperparathyroidism in Childhood Found by a Chance Hematuria  

PubMed Central

A 10-yr-old boy visited Minoh City Hospital complaining of gross hematuria. Laboratory investigations revealed hypercalcemia, hypophosphatemia, and elevated serum levels of parathyroid hormone. A stone was found in the right ureter with drip infusion pyelography. A parathyroid adenoma was successfully diagnosed with computed tomography, ultrasonography, and methoxy-2-isobutyl isonitrile (MIBI) scintigraphy. Multiple endocrine neoplasia was ruled out by normal results of endocrine laboratory examinations. Extracorporeal shock wave lithotripsy was performed to treat the urolithiasis, and the parathyroid adenoma was surgically removed. Primary hyperparathyroidism is rare in childhood; however, this case suggests that gross hematuria is an important sign of hyperparathyroidism.

Ohata, Yasuhisa; Yamamoto, Takehisa; Kitai, Yukihiro; Mizoguchi, Yoshimi; Iwaki, Masaru; Sumi, Kiyoaki; Fujikawa, Yasuhiro; Koga, Minoru; Sugao, Hideki; Shimotsuji, Tsunesuke; Ozono, Keiichi

2007-01-01

328

Spontaneous pelvic rupture as a result of renal colic in a patient with klinefelter syndrome.  

PubMed

We present the case of a young man with Klinefelter syndrome, who was admitted to our clinic with renal colic. Shortly after admittance, spontaneous decrease in pain has occurred. Ultrasound and intravenous contrast computed tomography were performed, which showed the evidence of urine extravasation at the level of left renal pelvis and a 4?mm stone in the lower third of the left ureter. The management with a double-J ureteric stent for three weeks was successful. Then, the stent was removed and computed tomography confirmed the absence of urine extravasation. We also analyze the literature related to this case and discuss the main mechanisms of collecting system rupture. PMID:23585981

Reva, Sergey; Tolkach, Yuri

2013-01-01

329

UPJ Obstruction in the Adult Population: Are Crossing Vessels Significant?  

PubMed Central

Ureteropelvic junction (UPJ) obstruction describes various causes of impaired drainage at the UPJ. Regardless of the cause, the end result is the same: impedance in the normal flow of urine from the renal pelvis into the proximal ureter, resulting in caliectasis and hydronephrosis. This may lead to progressive deterioration of renal function and, thus, often requires intervention to relieve the obstruction and restore the normal flow of urine. Defining the pertinent anatomy, the degree of obstruction, and differential renal function is key to determining whether and when intervention is necessary.

Grasso, Michael; Caruso, Robert P; Phillips, Courtney K

2001-01-01

330

Lumbar artery pseudoaneurysm caused by a Gunther Tulip inferior vena cava filter.  

PubMed

Inferior vena cava (IVC) filters are widely used to decrease the risk of pulmonary embolism in patients with contraindications to anticoagulation. Complications include local hematoma, access site deep venous thrombosis (DVT), filter migration and embolization, leg penetration through the IVC wall, IVC occlusion, and filter fracture with embolization. Other rare complications include leg penetration into adjacent organs including duodenum and ureter. Lumbar artery pseudoaneurysms are rare and may be spontaneous, iatrogenic, or traumatic. To date, there have been 3 case reports of lumbar artery pseudoaneurysms caused by IVC filters. We present an additional case of a lumbar artery pseudoaneurysm caused by a Gunther Tulip IVC filter treated successfully with selective embolization. PMID:22262118

Skeik, Nedaa; McEachen, James C; Stockland, Andrew H; Wennberg, Paul W; Shepherd, Roger F J; Shields, Raymond C; Andrews, James C

2011-11-01

331

Pseudoxanthoma elasticum and nephrocalcinosis: Incidental finding or an infrequent manifestation?  

PubMed

Pseudoxanthoma elasticum (PXE) is an inherited disorder characterized by generalized fragmentation and progressive calcification of elastic tissue. We report two sporadic cases of PXE, both of whom presented with asymptomatic yellowish papules over the flexural sites for cosmetic reasons. Histopathological findings on hematoxylin and eosin and Verhoeff-Van Gieson (VVG) staining were classical of PXE. In addition to this, renal calcification was documented on plain radiography of kidneys, ureters, and bladder (KUB) in both the cases. Paucity of literature describing the association of nephrocalcinosis with PXE prompted the present report. PMID:24860756

Gayen, Tirthankar; Das, Anupam; Roy, Sudipta; Biswas, Shamick; Shome, Kaushik; Chowdhury, Satyendra N

2014-04-01

332

Untitled  

Cancer.gov

Salivary glands Nasopharynx Other oral cavity and pharynx Esophagus Stomach Colon Rectum Liver, gallbladder, and other biliary tract Liver Gallbladder Other biliary tract Pancreas Nose, nasal cavity, and sinuses Larynx Lung, trachea, bronchus, and pleura Bones and joints Connective tissue Melanoma of skin Other skin Breast1 Bladder Kidney, renal pelvis, and ureter Eye Brain and other nervous system Thyroid gland Other endocrine glands Hodgkin's disease Non-Hodgkin's lymphoma Multiple myeloma Leukemia Other and unspecified cancers 0.1 1 10 20 49 Figure 1b.

333

Ureteric obstruction due to fungus-ball in a chronically immunosuppressed patient  

PubMed Central

Candida albicans is a fungus that can cause opportunistic urinary tract infections in immunocompromised patients. Disseminated fungaemia secondary to Candida albicans is associated with considerable mortality and therefore merits aggressive treatment. Diagnostic investigations for urosepsis and disseminated fungaemaia secondary to Candida albicans include positive urine and blood cultures. Herein, we describe an extremely unusual case of disseminated fungaemia associated with an obstructive fungus-ball in the distal ureter of an immunosuppressed patient. We also describe a novel application of an established endourological technique for managing this clinical scenario and discuss appropriate perioperative management strategies.

Davis, Niall F.; Smyth, Lisa G.; Mulcahy, Elizabeth; Scanlon, Tim; Casserly, Liam; Flood, Hugh D.

2013-01-01

334

Ureteral Extension In Wilms Tumor: A Report from the National Wilms Tumor Study Group (NWTSG)  

PubMed Central

Background Extension of Wilms tumor into the ureter is a rare event. We reviewed the National Wilms Tumor Study Group (NWTSG) database to define the clinical presentation, associated pathologic features and clinical outcome of these patients. Methods Records of children identified to have ureteral extension of Wilms tumor enrolled in NWTS-3, -4, and -5 were reviewed. Presenting symptoms, diagnostic studies, histopathology, operation performed, and outcome were recorded. The NWTS-5 data was prospectively collected. Results 45 children were identified with ureteral extension. For NWTS-5, the incidence of ureteral extension was 2%. Clinical presentations were gross hematuria in 22 patients, two had passage of tissue per urethra and one child had a urethral mass. The remainder had nonspecific presentations. Ureteral extension was seen on preoperative imaging in 14 patients, intraoperatively in 22, and on pathologic examination in nine patients. Hydronephrosis was noted in 12 patients and there was non function of the kidney in another 8. Laterality of the tumor was right side in 26 and left in 19. Cystoscopy was performed in 12 children. Findings included tumor seen at the ureteral orifice in six patients and bleeding from the orifice in one child. All patients had radical nephrectomy including partial ureterectomy. The ureteral margin was positive in three patients, including two of the seven with separate removal of the ureteral extension. The clinical stage was: stage I – 10, stage II – 18, stage III – 14, and stage IV - 3. The tumor extended into the proximal ureter in 23 patients, distal ureter in 13, seven had extension into the bladder, and one had urethral involvement. The level of ureteral extension was not clearly noted in the 45th child. The median follow-up was 96 months. Overall, 41 of 45 patients were alive at last contact. There were three deaths due to tumor in patients with unfavorable histology tumors, and one due to treatment toxicity in a child with favorable histology. Conclusions Ureteral extension occurs in approximately 2% of patients with Wilms tumor. The diagnosis should be suspected in patients with gross hematuria, hydronephrosis or nonfunctioning kidney. Cystoscopy with retrograde ureterogram may aid in preoperative diagnosis in these patients. Preoperative diagnosis is important since complete resection of the involved portion of ureter at the time of nephrectomy can avoid residual disease and the need for second surgery or radiation therapy.

Ritchey, Michael; Daley, Shane; Shamberger, Robert C.; Ehrlich, Peter; Hamilton, Thomas; Haase, Gerald; Sawin, Robert

2010-01-01

335

Jejunal serosal onlay flap for repair of large common bile duct defect in Mirizzi's syndrome.  

PubMed

Reconstruction of the common bile duct (CBD) has been performed using a variety of materials, ranging from synthetic i.e. teflon, to autogenous tissues such as veins, arteries, appendix, ureter, gallbladder, duodenum, etc. The onlay jejunal serosal patch has been commonly used to cover defects because of duodenal ulcer perforations and injuries. To the best of our knowledge, the use of this technique for choledochoplasty in Mirrizi syndrome has not been reported. We present a case of Mirrizi syndrome type III, in whom nearly three fourths of the CBD was eaten away by a large gallstone and the repair was done using an onlay serosal patch of the jejunum. PMID:11681115

Kaushik, R; Sharma, R

2001-01-01

336

Menouria due to congenital vesicovaginal fistula associated with complex genitourinary malformation.  

PubMed

Background: Congenital vesicovaginal fistula (VVF) is a very uncommon condition rarely suspected at initial presentation. It is usually seen in association with complex malformations of the genitourinary tract. Case: A bifid insertion of the solitary ureter causing an uretero-VVF was associated with an obstructing transverse vaginal septum manifesting as menouria. Also seen were solitary crossed renal ectopia, bicornuate uterus and skeletal anomalies. Conclusion: In women with menouria without vaginal menstruation, pre-operative evaluation to detect an obstructive vaginal anomaly and unusual uretero-vesicovaginal fistulous communications is necessary before surgical intervention. PMID:19955683

Rajamaheshwari, N; Seethalakshmi, K; Varghese, Lilly

2009-01-01

337

Pseudoxanthoma elasticum and nephrocalcinosis: Incidental finding or an infrequent manifestation?  

PubMed Central

Pseudoxanthoma elasticum (PXE) is an inherited disorder characterized by generalized fragmentation and progressive calcification of elastic tissue. We report two sporadic cases of PXE, both of whom presented with asymptomatic yellowish papules over the flexural sites for cosmetic reasons. Histopathological findings on hematoxylin and eosin and Verhoeff-Van Gieson (VVG) staining were classical of PXE. In addition to this, renal calcification was documented on plain radiography of kidneys, ureters, and bladder (KUB) in both the cases. Paucity of literature describing the association of nephrocalcinosis with PXE prompted the present report.

Gayen, Tirthankar; Das, Anupam; Roy, Sudipta; Biswas, Shamick; Shome, Kaushik; Chowdhury, Satyendra N.

2014-01-01

338

Mixed epithelial and stromal tumor of the kidney (MEST) simulating an upper tract TCC  

PubMed Central

We present a rare and interesting case of a mixed epithelial and stromal tumour (MEST) of the kidney. The case is unique as it involves a male patient with no history of hormonal therapy presenting with a filling defect in the renal collecting system and positive urine cytology. The patient was diagnosed with transitional cell carcinoma of the renal pelvis and subjected to nephroureterectomy, which revealed a solid tumour arising from the lower calyces and extending into the renal pelvis and upper ureter. Pathology revealed a MEST. The patient was disease-free at the 6-month follow-up.

Sountoulides, Petros; Koptsis, Michail; Metaxa, Linda; Theodosiou, Alexandros; Kikidakis, Dimitrios; Filintatzi, Chrysa; Paschalidis, Konstantinos

2012-01-01

339

Mixed epithelial and stromal tumor of the kidney (MEST) simulating an upper tract TCC.  

PubMed

We present a rare and interesting case of a mixed epithelial and stromal tumour (MEST) of the kidney. The case is unique as it involves a male patient with no history of hormonal therapy presenting with a filling defect in the renal collecting system and positive urine cytology. The patient was diagnosed with transitional cell carcinoma of the renal pelvis and subjected to nephroureterectomy, which revealed a solid tumour arising from the lower calyces and extending into the renal pelvis and upper ureter. Pathology revealed a MEST. The patient was disease-free at the 6-month follow-up. PMID:22396379

Sountoulides, Petros; Koptsis, Michail; Metaxa, Linda; Theodosiou, Alexandros; Kikidakis, Dimitrios; Filintatzi, Chrysa; Paschalidis, Konstantinos

2012-02-01

340

[Ureteral triplication, an unusual isolated presentation].  

PubMed

We report the case of a 26 years old female who presented, as a casual finding, a right complete ureteral triplicity (probably Campbell's tipe I) with no other associated abnormalities. Despite ureteral duplication is a frequent urological anomaly, the presence of three ureters occurring in the same side, in a complete or incomplete form, is a true rarity, with less than 100 cases publicated up to date. The present case is singular, not only because of its exceptional presentation but also because no other urological or extraurological anomalies were associated and no clinical manifestations were present. The most relevant literature is reviewed. PMID:15666520

Villanueva Peña, A; De Diego Rodríguez, E

2004-01-01

341

Fibroepithelial ureteral polyps presenting as ureteropelvic obstruction.  

PubMed

A 57-year-old woman presented with bilateral abdominal pain and flank discomfort. Imaging studies, consisting of CT scan, diethylene triamine pentaacetic acid renal scan with Lasix and a retrograde pyelogram, indicated an obstruction at the uteropelvic junction (UPJ), possibly due to fibroepithelial polyps within the ureter. A robotic pyeloplasty revealed a ureteral diverticulum and a thin, still-attached fibroepithelial polyp of approximately 2 cm in length. The patient tolerated the procedure well and was discharged one day postpyeloplasty with no reported complications. This rare clinical scenario should be considered when formulating a diagnosis for a UPJ obstruction. PMID:24759168

Cusano, Antonio; Abarzua-Cabezas, Fernando; Kesler, Stuart

2014-01-01

342

Modélisation du champ des vitesses de l'urine dans un bolus urétéral  

NASA Astrophysics Data System (ADS)

Urine transport is made from the kidney to the bladder through the ureter by isolated pockets called bolus. To determine the urine flow in a bolus, we use an adherence condition on the interface urine/wall. It gives us an infinite linear system verified by a set of parameters. An iterative and convergent algorithm allows us to solve this system and to determine analytically the components of the velocity vector in the bolus. To cite this article: A. Vogel et al., C. R. Mecanique 332 (2004).

Vogel, Alexandre; Elmabsout, Badaoui; Gintz, Daniel

2004-09-01

343

Obturator hernia with ureteral entrapment.  

PubMed

Obturator hernia of the ureter is uncommon. Computed tomography of a 77-year-old woman with sudden-onset lower left abdominal pain and urinary symptoms showed an obturator hernia with ureteral entrapment. Obturator hernia is a diagnostic challenge because the hernial mass is very insidious. It should be suspected in emaciated, multiparous, elderly women presenting with unexplained pain in the groin, hip, thigh or knee. High levels of clinical suspicion of high-risk patients and recourse to investigation by computed tomography are important, as delay in diagnosis and treatment is associated with increased morbidity and mortality. PMID:24926229

Izzo, Matteo; Regusci, Luca; Fasolini, Fabrizio

2014-05-01

344

An unusual presentation of bilateral Hutch diverticula.  

PubMed

Summary Hutch diverticula are rare congenital diverticula. The general consensus is that they occur secondary to a congenital failure of normal muscle development around the ureteral orifice where Waldeyer sheath anatomically covers the space between the intravesical ureter and muscular layer of the bladder. Our case highlights the radiological appearance of Hutch diverticula and the need for contrast-enhanced imaging to enable accurate evaluation and diagnosis. It illustrates how the presence of periureteric diverticula can contribute to ureteric obstruction and calculus formation; complicate the interpretation of renal tract imaging and the subsequent management of renal calculi. PMID:24859560

Fanning, Deirdre Mary; Morrin, Martina; Power, Richard

2014-01-01

345

Percutaneous radiofrequency ablation of a small renal mass complicated by appendiceal perforation.  

PubMed

Percutaneous radiofrequency ablation (RFA) has gained wide acceptance as nephron-sparing therapy for small renal masses in select patients. Generally, it is a safe procedure with minor morbidity and acceptable short-term oncologic outcome. However, as a result of the close proximity of vital structures, such as the bowel, ureter, and large vessels, to the ablative field, complications regarding these structures may occur. This is the first article describing appendiceal perforation as a complication of computed tomography-guided RFA despite hydrodissection. When performing this innovative and promising procedure one should be aware of the possibility of particular minor and even major complications. PMID:22011782

Boone, Judith; Bex, Axel; Prevoo, Warner

2012-06-01

346

[Ureteroscopy. Experience and results].  

PubMed

Ureteroscopy is an Endo-urological procedure which has been practiced around the world in all teaching centers of Urology. It presents obvious advantages. Our experience has been satisfactory, not only due to the coordinated and joint work, but for the results obtained in behalf of our patients who went back to their regular activities shortly after. As all the new procedures, it has a learning curve which is given after the initial training has been acquired but its performance will give expertise, same as radiologic technology and the development of new instruments with smaller diameter and accessories which allow the easier access to ureter and lithotripsy. PMID:1767038

Delgado, G; Alvarado, A; de Solanilla, E C

1991-09-01

347

Pathology Case Study: Bladder Mass in a 73-Year-Old Male  

NSDL National Science Digital Library

This case study, from the University of Pittsburgh School of Medicine's Department of Pathology, presents information about a 73-year-old male patient. According to the patient's history, he has a "history of invasive papillary transitional cell carcinoma with excessive muscular invasion and angiolymphatic invasion." Both gross and microscopic images of the prostate, bladder, pelvic lymph nodes, and the right and left pelvic ureter are provided in this case. Using these images and the provided patient history, students can test their knowledge of pathology and compare their diagnostic findings with the official findings in the "Final Diagnosis" section.

Hakam, Ardeshir

2007-07-26

348

An investigation into the mechanism whereby pH affects tension in guinea-pig ureteric smooth muscle.  

PubMed Central

1. We have altered intracellular (pHi) and extracellular pH (pHo) in the smooth muscle of guinea-pig ureter and determined the effects on evoked phasic contractions. In order to investigate the mechanisms underlying the effects of pH alteration, intracellular Ca2+ ([Ca2+]i), pHi, electrical activity and force were measured. 2. Intracellular acidification, produced by the weak acid butyrate, application of CO2 at constant pHo or removal of weak bases, greatly increased phasic contractions. Alkalinization with weak bases or by removal of CO2 inhibited contractions. The results were similar whether Hepes or CO2-HCO3-buffered the solutions. 3. Phasic contractions were preceded by intracellular Ca2+ transients in the ureter. Acidification of the cytoplasm led to an increase in the amplitude of the Ca2+ transient, and alkalinization decreased its magnitude. 4. In the ureter the action potential leads to Ca2+ influx, therefore electrophysiological recordings of its configuration were made during alteration of pHi. Acidification led to the action potential duration and amplitude being increased, whereas alkalinization shortened the action potential and reduced its amplitude. 5. As the effects of acidification on the action potential resembled the effects of blocking of K+ channels, we investigated whether pHi alteration was able to alter tension when K+ channels were blocked by tetraethylammonium. Acidification was unable to potentiate force under these conditions nor did alkalinization decrease force. 6. External pH over the range 6.8-8.0 had little or no effect on pHi, phasic contractions and [Ca2+]i. Tonic contractions were enhanced, however, when pHo was increased. 7. These data suggest that pHi alteration in the guinea-pig ureter modulates the action potential, probably by alteration of K+ currents. Subsequent changes in [Ca2+]i and contraction then occur. A potentiating effect of acidic pH on force is not common in muscle, but may be a characteristic of the smooth muscle of the urinary tract. Changes of pHo had little effect on phasic force or pHi, but modulated tonic contractions. The possible physiological significance of these results is discussed.

Burdyga, T V; Taggart, M J; Wray, S

1996-01-01

349

A case of McKusick-Kaufman Syndrome.  

PubMed

We are reporting a rare case of McKusick- Kaufman Syndrome in a ten-month old female infant from Addis Ababa with difficulty of urination often days duration. Clinical exam revealed supra-pubic mass with tenderness and had left hand postaxial polydactily. Ultrasound and CT scans showed the mass to be hydrometrocolpos posterior to the bladder. Intravenous urography revealed a lower abdomen-pelvic mass displacing and compressing the ureters with bilateral hydronephrosis. Further pelvic exam under anaesthesia revealed hydrometrocolpos with vaginal agenesis. This, to the best knowledge of the authors, is the first ever reported case of the syndrome in Ethiopia. PMID:21991762

Zewdneh, Daniel; Shewarega, Zelalem

2011-07-01

350

Menouria due to congenital vesicovaginal fistula associated with complex genitourinary malformation  

PubMed Central

Background: Congenital vesicovaginal fistula (VVF) is a very uncommon condition rarely suspected at initial presentation. It is usually seen in association with complex malformations of the genitourinary tract. Case: A bifid insertion of the solitary ureter causing an uretero–VVF was associated with an obstructing transverse vaginal septum manifesting as menouria. Also seen were solitary crossed renal ectopia, bicornuate uterus and skeletal anomalies. Conclusion: In women with menouria without vaginal menstruation, pre-operative evaluation to detect an obstructive vaginal anomaly and unusual uretero–vesicovaginal fistulous communications is necessary before surgical intervention.

Rajamaheshwari, N.; Seethalakshmi, K.; Varghese, Lily

2009-01-01

351

Use of reconstructed small intestine submucosa for urinary tract replacement.  

PubMed

We used reconstructed SIS (ReSIS), a photocrosslinked biomaterial, to create grafts in various shapes and sizes. Sheets of ReSIS were placed in 14 swine to repair bladder defects, and ReSIS tubes were placed in six swine to replace a segment of excised ureter. Histologic analysis of the bladder repair revealed transitional urothelial cells lining the ReSIS by 1 week. After 2 weeks, fibroblasts and mononuclear cells had infiltrated the ReSIS, neovascularization had occurred, and the urothelial lining was more complex, containing multiple cell layers. After 4 weeks, a definite submucosa was present and the ReSIS was starting to degrade. An initial muscular regeneration was demonstrated at 12 weeks. No foreign body reaction, calcification, or sedimentation was noted in any animal. The ureteral implants showed identical histologic changes, without obstruction or leakage of the replaced segment. The ReSIS allowed rapid urothelial regeneration, ingrowth of new blood vessels, and the orderly deposition and organization of new collagen. Our study demonstrates that the photocrosslinking technique used to create larger sheets and tubes of this biomaterial (ReSIS) does not detract from the positive attributes of the SIS and should improve its usefulness in accomplishing larger bladder augmentations and ureter replacements. PMID:10826734

Xie, H; Shaffer, B S; Wadia, Y; Gregory, K W

2000-01-01

352

Upper-urinary-tract urothelial tumors: conservative treatment by Nd:YAG laser  

NASA Astrophysics Data System (ADS)

Upper urinary malignancies are rare tumors whose diagnosis sometimes represents a difficult dilemma. In selected cases, it is possible to treat the tumor with laser irradiation. This approach is reserved to low-stage low-grade tumors, a tumor in a solitary kidney, bilateral syncroneous disease or patients with deterioration of renal function. Thirty one patients suspected to have malignancies, as they presented upper tract filling defects at IVP, underwent uretero-pyeloscopy to confirm the diagnosis. Twenty patients with upper urinary tract urothelial tumors were treated with Nd:YAG laser irradiation. Before the procedure, the ureter and the pelvis were accessed by 0.038 inch guide-wire or 4 French ureteral catheter. A power of 25 - 30 watts/3 seconds was carried out for the laser irradiation of the tumor and of the base. Sometime after the procedure a ureter single J catheter was left indwelling for 48 hours. In the follow-up the patients had endoscopic surveillance every three months. Actually 12 patients are tumor-free after 3 - 36 months. Eight patients had a recurrence after the first treatment and they underwent new laser irradiation. All the recurrences were in other sites of the upper urinary tract and seemed to be related to tumor grade. In conclusion, conservative endourological ureteropyeloscopy coupled with Nd:YAG laser irradiation should be considered a useful treatment in selected patients.

Gaboardi, Franco; Bozzola, Andrea; Melodia, Tommaso; Gulfi, Gildo M.; Galli, Stefano

1993-05-01

353

Escherichia coli–Mediated Impairment of Ureteric Contractility Is Uropathogenic E. coli Specific  

PubMed Central

Background.?Ureters are fundamental for keeping kidneys free from uropathogenic Escherichia coli (UPEC), but we have shown that 2 strains (J96 and 536) can subvert this role and reduce ureteric contractility. To determine whether this is (1) a widespread feature of UPEC, (2) exhibited only by UPEC, and (3) dependent upon type 1 fimbriae, we analyzed strains representing epidemiologically important multilocus sequence types ST131, ST73, and ST95 and non-UPEC E. coli. Methods.?Contractility and calcium transients in intact rat ureters were compared between strains. Mannose and fim mutants were used to investigate the role of type 1 fimbriae. Results.?Non-UPEC had no significant effect on contractility, with a mean decrease after 8 hours of 8.8%, compared with 8.8% in controls. UPEC effects on contractility were strain specific, with decreases from 9.47% to 96.7%. Mannose inhibited the effects of the most potent strains (CFT073 and UTI89) but had variable effects among other UPEC strains. Mutation and complementation studies showed that the effects of the UTI89 cystitis isolate were fimH dependent. Conclusions.?We find that (1) non-UPEC do not affect ureteric contractility, (2) impairment of contractility is a common feature of UPEC, and (3) the mechanism varies between strains, but for the most potent UPEC type 1 fimbriae are involved.

Floyd, Rachel V.; Upton, Mathew; Hultgren, Scott J.; Wray, Susan; Burdyga, Theodor V.; Winstanley, Craig

2012-01-01

354

Urological complications of renal transplantation: the impact of double J ureteric stents.  

PubMed Central

In a 10 year series of 350 consecutive renal transplant operations, the overall urological complication rate was 7.7%. During this period double J stents were introduced and were used either in the treatment of actual urological complications or as a prophylactic measure to protect ureters which had been damaged at retrieval. A total of 34 double J stents were used in 33 patients. The indications were: ureteric obstruction (n = 13), urinary leak (n = 5), short transplant ureter anastomosed using an extravesical ureteroneocystostomy (n = 10) and ureteric injury at the time of organ retrieval (n = 6). Thirty-two double J stents were inserted at open operation and two were inserted by an antegrade method after percutaneous nephrostomy. Improvement in renal function occurred in 16 out of the 18 cases of urological complications. No kidneys were lost and there were no deaths as a direct result of these complications. In a number of cases the insertion of a double J stent was the only treatment, thus eliminating the need for more complex surgery. All 16 patients who had a ureteric stent inserted as a prophylactic measure at the time of transplantation made uncomplicated postoperative recoveries. Urinary tract infection was relatively common (27%) after double J stent insertion, but other complications were rare. In conclusion, double J stents have proved to be a useful adjunct in the management of renal transplant related urological complications.

Nicholson, M. L.; Veitch, P. S.; Donnelly, P. K.; Bell, P. R.

1991-01-01

355

[Fragmentation of urinary calculi using the Lithoclast EMS. Technique and results].  

PubMed

The Lithoclast is an endoscopic lithotriptor which uses the ballistic energy produced by a small hand-held apparatus, by the movement of a small metal part (the projectile) driven by a jet of compressed air. The energy is transmitted to a metal rod whose diameter is selected according to the application: 0.8 or 1 mm in the ureter; 2 mm in the bladder and kidney. We have used this apparatus to treat 40 stones in 39 patients (25 ureteric stones, 11 renal stones, 4 bladder stones). Satisfactory fragmentation was obtained for 39 of the 40 stones (97.5%). The apparatus is very easy to use in the kidney and bladder (the risk of urinary tract perforation is very low at this level). The risk of perforation of the ureteric wall by 0.8 mm or 1 mm rods is considerable (12% of cases), but these punctate lesions heal rapidly over a double J stent. Special techniques should be used in the ureter to limit the risk of pushing the stone towards the renal pelvis. PMID:8305936

Abbar, M; Sousa Castello, A; Gelet, A; Martin, X; Marechal, J M; Dubernard, J M

1993-12-01

356

Management of iatrogenic ureteral injury  

PubMed Central

Iatrogenic injury to the ureter is a potentially devastating complication of modern surgery. The ureters are most often injured in gynecologic, colorectal, and vascular pelvic surgery. There is also potential for considerable ureteral injury during endoscopic procedures for ureteric pathology such as tumor or lithiasis. While maneuvers such as perioperative stenting have been touted as a means to avoid ureteral injury, these techniques have not been adopted universally, and the available literature does not make a case for their routine use. Distal ureteral injuries are best managed with ureteroneocystostomy with or without a vesico-psoas hitch. Mid-ureteral and proximal ureteral injuries can potentially be managed with ureteroureterostomy. If the distal segment is unsuitable for anastomosis then a number of techniques are available for repair including a Boari tubularized bladder flap, transureteroureterostomy, or renal autotransplantation. In rare cases renal autotransplantation or ureteral substitution with gastrointestinal segments may be warranted to re-establish urinary tract continuity. Laparoscopic and minimally invasive techniques have been employed to remedy iatrogenic ureteral injuries.

Burks, Frank N.

2014-01-01

357

[Marked efficacy of multimodality therapy for ureteral cancer producing granulocyte colony-stmimulating factor].  

PubMed

A 69-year-old man was admitted with the chief complaint of macroscopic hematuria. Computerized tomography (CT) and ureteroscopy showed right ureter cancer. Right nephroureterectomy and partial cystectomy were performed. Histological examination revealed urothelial carcinoma of ureter (Grade3, pT3, INFbeta, ly1). The patient underwent two courses of adjuvant chemotherapy with gemcitabine and cisplatin. Three months later, abdominal CT showed a mass in his right obturatorius area. The patient's white blood cell count was 34,140 cells/microl. Additionally serum analysis revealed high value of granulocyte colony stimulating factor (G-CSF), 596 pg/ml with no obvious focus. After being diagnosed with recurrent ureteral cancer producing G-CSF, the patient underwent secondary chemotherapy with gemcitabine and docetaxel. After three courses of chemotherapy, CT revealed a marked decrease in tumor size, and the value of G-CSF declined at 31 pg/nl. Subsequently, radiotherapy (60 Gy) was administered. The patient has been alive for 16 months. PMID:24908815

Nomura, Shunichiro; Nemoto, Kaoru; Shioji, Go; Miura, Takafumi; Tsuboi, Narumi; Abe, Hiroyuki; Kondo, Yukihiro

2014-04-01

358

Supra-vesical urinary diversion and ureteric re-implantation for malignant disease.  

PubMed

Supra-vesical diversion or ureteric reconstruction is indicated for fistulae from the bladder or ureter, urinary incontinence, painful frequency and for end-stage renal failure due to obstructive uropathy. In a palliative setting, conservative measures, such as an indwelling catheter or ureteric stents, should be tried first. Open or laparoscopic surgery should be considered if these measures fail. For a patient who is leaking urine or has a very painful bladder, such surgery may well be justified, even very close to the end of life, as the symptoms are so unpleasant. When the problem is of end-stage renal failure that may be symptomless, the decision is more difficult; the patient may only gain a few months of life with no change in symptoms in return for the major surgery. The options available include cutaneous diversion either by ureterostomy or conduit and reconstruction either by re-implanting a ureter into the bladder or transuretero-ureterostomy. A laparoscopic approach may be possible in many cases. PMID:20739151

Woodhouse, C R J

2010-11-01

359

Pseudotumoral tuberculous ureteritis: a case report  

PubMed Central

Introduction Tuberculosis is still endemic in Morocco and the urogenital form is common. This form is characterized by clinical polymorphism. However, the isolated ureteric form is very rare. The differential diagnosis might be raised in tumoral cases while undertaking surgical excision which is the realistic choice. Hence, we report an isolated ureteric tuberculosis case, and we discuss the clinical, imaging, diagnostic and therapeutical features. Case presentation A 30-year-old Moroccan man consulted us for left back pain associated with urinary frequency and a few macroscopic episodes of hematuria for the past six months. A computed tomography urography revealed a left hydronephrosis and hydroureter secondary to focal wall thickening of the left lumbar ureter. Hence, we had diagnosed a ureteral tumor. However, a clinical examination showed irritative voiding symptoms and epididymal disorders associated with prostate infection suggesting a Koch’s bacillus assessment of the patient’s urine of which the results proved strongly positive. The treatment consisted of establishing a double-J ureteric stent to drain the left kidney, followed by antituberculous antibiotics. Conclusion Urogenital tuberculosis is common in endemic countries, however isolated ureter affection is rare. It is important to consider a ureteral tuberculosis diagnosis whenever ureteral thickening is revealed in a patient living in a country in which tuberculosis is endemic.

2013-01-01

360

Options in the management of tuberculous ureteric stricture  

PubMed Central

Ureteric stricture is a feared manifestation of genitourinary tuberculosis (TB) with the commonest site being the lower ureter. The purpose of this review is to discuss the management options for this condition. Literature search was done using PubMed and all articles on TB and ureteric stricture were reviewed published between 1990 till September 2007. The exact site and length of stricture must be defined with radioimaging (intravenous urography, retrograde, or antegrade pyelography) and renal function be quantified. The treatment of stricture mostly requires some kind of intervention after a brief period of antituberculous medicines with or without steroids. For uncomplicated/simple strictures (short segment, passable, with renal function >25%, good bladder capacity) endourologic option should be used which usually means double-J stenting with or without balloon dilatation. For complicated/complex strictures (long segment, dense fibrosis, with renal function <20%, small bladder capacity) regular surgical options should be considered which usually means ureteroureterostomy or ureteropyelostomy for upper ureteric strictures, intubated ureterostomy, or transureteroureterostomy for midureteric strictures, psoas hitch/Boari flap for lower ureteric strictures or ileal ureter/autotransplantation for whole length/multiple strictures.

Goel, Apul; Dalela, D.

2008-01-01

361

Combined endoscopic surgery in the prone-split leg position for successful single-session removal of an encrusted ureteral stent: a case report  

PubMed Central

Introduction Although encrusted stents may lead to some unwanted complications including urinary tract obstruction, urinary sepsis, and potential loss of kidney function, there is currently no consensus on the most efficient method for managing stents that are intentionally left in situ. This is the first report describing the management of an encrusted stent using combined endoscopic surgery in the prone split-leg position in a single session. Case presentation A 47-year-old Asian man presented with left flank pain and macrohematuria. The patient had undergone left ureteral stenting three years previously for the treatment of left ureteral stones and hydronephrosis; however, he was lost to follow-up before the treatment for the ureter stones was completed. Therefore, the ureteral stent and stones were not removed. An abdominal radiograph and a noncontrast computed tomography scan showed encrustation along the retained stent with stone burdens in the kidney and ureter. The ureteral stent could not be removed by cystoscopy after shock wave lithotripsy of the left ureteral stones. Therefore, endoscopic lithotripsy combined with flexible ureteroscopy and miniature nephroscopy was performed with the patient in the prone split-leg position. All the stones and the encrusted ureteral stent were successfully removed in a single session. Conclusions In this case, percutaneous nephrolithomy in addition to flexible ureteroscopy was preferred because severe encrustation of the proximal stent and ureteral stones complicated the therapeutic strategy. Combined endoscopic techniques in the prone split-leg position can achieve successful and safe management of encrusted stents.

2014-01-01

362

Anodized 20 nm diameter nanotubular titanium for improved bladder stent applications  

PubMed Central

Materials currently used for bladder applications often suffer from incomplete coverage by urothelial cells (cells that line the interior of the bladder and ureter) which leads to the continuous exposure of the underlying materials aggravating an immune response. In particular, a ureteral (or sometimes called an ureteric or bladder) stent is a thin tube inserted into the ureter to prevent or treat obstruction of urine flow from the kidney. The main complications with ureteral stents are infection and blockage by encrustation, which can be avoided by promoting the formation of a monolayer of urothelial cells on the surface of the stent. Nanotechnology (or the use of nanomaterials) may aid in urothelialization of bladder stents since nanomaterials have been shown to have unique surface energetics to promote the adsorption of proteins important for urothelial cell adhesion and proliferation. Since many bladder stents are composed of titanium, this study investigated the attachment and spreading of human urothelial cells on different nanotextured titanium surfaces. An inexpensive and effective scaled up anodization process was used to create equally distributed nanotubular surfaces of different diameter sizes from 20–80 nm on titanium with lengths approximately 500 nm. Results showed that compared to untreated titanium stents and 80 nm diameter nanotubular titanium, 20 nm diameter nanotubular titanium stents enhanced human urothelial cell adhesion and growth up to 3 days in culture. In this manner, this study suggests that titanium anodized to possess nanotubular surface features should be further explored for bladder stent applications.

Alpaslan, Ece; Ercan, Batur; Webster, Thomas J

2011-01-01

363

Ureteral extracorporeal shock wave lithotripsy utilizing Dornier MFL 5000.  

PubMed

Early reports indicated that stones in the upper ureter that have been manipulated back into the kidney have a higher success rate with SWL than those treated in situ. Difficulties in detecting stones in the mid and lower ureter with lithotripters using ultrasonographic localization also limit in situ SWL of ureteral calculi. We treated 254 patients with ureteral calculi (85 upper, 72 mid, and 97 lower) using in situ SWL on the Dornier MFL 5000. The mean stone volume was 1.4 cm2. Approximately one third of the patients required more than one session. The mean number of shock waves was 2010 (range 1400-3000) with a mean voltage of 20 kV (range 14-30 kV). Fragmentation was achieved in 92.6% of the patients. Only 0.4% of the sessions involved general anesthesia. At 3-month follow-up, available in 75% of the patients, the stone-free rate was 82.6%. Ureteral calculi can be treated effectively in situ by means of SWL. PMID:8186776

Ilker, N Y; Alican, Y; Sim?ek, F; Türkeri, L N; Akda?, A

1994-02-01

364

[Extracorporeal shock wave lithotripsy with EDAP LT-01 lithotriptor].  

PubMed

Extracorporeal shock wave lithotripsy (ESWL) by EDAP LT-01 was used to treat 77 patients with upper urinary tract stones. A total of 218 sessions were performed for 111 stones in 52 kidney units and 41 stones in 37 upper ureter units, and 77% of the 52 kidney stone units and 62% of the 37 ureter units were completely disintegrated. The success of fragmentation of kidney stones differed with the size of the stone, 96% of the stones less than 21 mm and 63% of the 8 stones between 21 and 30 mm were successfully fragmented. The success of fragmentation of ureteral stones differed auxiliary manipulation. Eighty-one percent of the 21 ureteral stones moved into the kidney, were successfully disintegrated, but 40% of the 20 stones unmoved could be disintegrated with retrograde manipulation. Of the 62 successful units, 89% became stone free within 3 months. Complications were subcapsular renal hematoma in 3 patients and obstruction in 5 patients. The initial 25 patients were treated under epidural anesthesia and 52 patients were treated without anesthesia. The results show that the indication of ESWL with LT-01 is better for the stones smaller than 30 mm and the indication should be determined after a couple of sessions for stones greater than 30 mm. ESWL with LT-01 can be performed on an out-patient basis without anesthesia in many cases. PMID:3400543

Araki, T; Takamoto, H; Hata, K

1988-04-01

365

[Evaluation of the results of extracorporeal shock-wave lithotripsy (ESWL) for solitary upper urinary tract stone].  

PubMed

We performed extracorporeal shock-wave lithotripsy (ESWL) on 1,701 patients in a total of 2,438 sessions using the Dornier kidney lithotriptor Model HM III from July 1985 to the end of June 1990. Among the patients with a solitary stone, 1,200 cases were available for the follow-up study in which the results of ESWL were analyzed according to the location and size of the stone. ESWL performed against stones at pelvis and calyces gave the best results. The results obtained on stones less than 20 mm in diameter were especially favorable with a success rate of 84%. ESWL performed against ureter stones showed poor results with a success rate of 62% for the stones smaller than 20 mm in diameter. We further studied the results of ESWL performed against ureter stones by dividing the patients into three groups: the patients treated in situ, the patients with ureteral stents and the patients with D-J stents. The results for stones larger than 10 mm in diameter were significantly better in the patients with D-J stents than in the patients treated in situ or the patients with ureteral stents. Among the patients treated in situ, the results were significantly worse for impacted stones than for non-impacted stones when the stone size was 10-20 mm in diameter. PMID:1785386

Wada, S; Kishimoto, T; Ameno, Y; Harima, M; Kamizuru, M; Iimori, H; Kanazawa, T; Maekawa, T; Asakawa, M; Yoshihara, H

1991-12-01

366

[The effect of remote-controlled shock-wave lithotripsy on kidney function].  

PubMed

Leucine arylamidase (LAA) excretion in circadian urine of 79 patients suffering from nephroureterolithiasis was measured before and after the session of remote impulse lithotripsy (RIL) to investigate the effect of the impulse on renal function. The stones were localized in the calyces, pelvis and upper third of the ureter. The patients were divided into 2 groups: 43 patients with noncomplicated nephroureterolithiasis (group 1) and 36 patients with complicated one including 12 subjects exposed to the second RIL (group 2). The enzyme excretion was significantly reduced in group 1 patients. Its activity recovered in group 1 within 6-7 days, in group 2 for 10-14 days. After the second RIL procedure LAA activity in the urine enhanced more rapidly, especially in group 2 patients. In calyceal, intrarenal pelvic and fused kidney location of the stone, LAA activity got more elevated than in the extrarenal pelvis or in the upper third of the ureter. It is demonstrated that RIL exhibits a short-term effect on the kidneys which depends on the presence of inflammation, the number of sessions, stones location and the number of impulses. PMID:8160315

Stepanov, V N; Perel'man, V M; Istratov, V G; Kadyrov, Z A; Badr

1993-01-01

367

Microsurgery of ureteral strictures using pulsed mid-IR lasers  

NASA Astrophysics Data System (ADS)

Efficiency and precision of intraluminal laser incisions of soft tissue were investigated particularly for reopening ureteral strictures. We used mid-IR laser radiation and an application system which nearly tangentially performed the contact incision via a low-OH quartz fiber to achieve a longitudinal cut through the whole ureter wall up to the periureteral fat tissue. With pulsed Holmium and Thulium laser radiation we investigated in vitro (using the model of pig ureters) the cutting efficiency and coagulation zone with respect to laser power, pulse length, cutting speed and fiber diameter. The thermo-mechanical mechanism of tissue ablation was evaluated by fast flash photography showing a growing influence of the cavitation bubble towards shorter pulse lengths. In a first clinical study 14 patients underwent the laser therapy. We used the Holmium laser in the free running mode at a pulse repetition rate of 10 Hz and with an average power of 3 W at the end of a 300 micrometers fiber. The reopening of the stenoses took about 19 min. with an average laser energy of 819 J applied. The whole procedure was observed by videoscopy. No bleeding could be seen and no complications during the laser treatment occurred.

Brinkmann, Ralf E.; Knipper, Ansgar; Droege, Gerit; Miller, Ado; Gromoll, Bernd; Birngruber, Reginald

1995-01-01

368

The Role of Ureteral Relaxation in the Promotion of Stone Passage  

NASA Astrophysics Data System (ADS)

In order to promote stone passage in renal colic, we must first understand normal ureteral activity and how this is affected by the presence of a stone. Measuring normal ureteral activity in humans is difficult without the use of invasive methods or techniques which in themselves may affect peristalsis. Monitoring the activity during confirmed renal colic is even more difficult and virtually impossible. Both animal and human studies have therefore been used in an attempt to understand the physiology of the ureter and how this is affected by the presence of a stone. Using this knowledge, drugs can be used to alter the behavior of the ureter in an attempt to promote stone passage. Peristalsis has always been thought to be essential to allow stone passage and therefore it has been necessary to determine whether stone passage occurs by promotion of ureteral activity or by smooth muscle relaxation. Research indicates that drugs which allow continued peristalsis whilst preventing the increased uncoordinated activity seen in renal colic would be the most advantageous. The alpha-1A-adrenoceptor antagonists are the most effective drugs to date.

Davenport, Kim; Timoney, Anthony G.; Keeley, Francis X.

2007-04-01

369

Laparoscopic nephrectomy in children for benign conditions: indications and outcome  

PubMed Central

Aim: To analyze the indications and outcome of laparoscopic nephrectomy for benign non-functioning kidneys in children. Materials and Methods: The data of all patients operated over a 10 year period was retrospectively analyzed. Results: There were 56 children, aged 4 months to 12 years with a male: female ratio of 2.3:1. The most common presentation in boys and girls was urinary tract infection (UTI) (61.5% and 47.05% respectively). Incontinence due to ectopic ureter was a close second in girls (41.17%). The most common underlying conditions were vesico-ureteric reflux (42.85%) and multicystic dysplastic kidney (23.2%). There were 6 nephrectomies, 4 heminephroureterectomies and the remaining nephroureterectomies. All children tolerated the surgery well. One patient underwent a concomitant cholecystectomy. The post-operative problems encountered were UTI (1), urine retention (1), pyonephrosis in the opposite kidney and development of contra-lateral reflux (1). All others had resolution of pre-operative symptoms with good cosmesis. Conclusions: As per available literature, this appears to be the largest Indian series of pediatric laparoscopic nephrectomies for benign non-functioning kidneys. Laparoscopic approach gives excellent results provided pre-operative investigations rule out other causes for the symptoms with which the patient presents. Often it is not the kidney but the dilated dysplastic ureter which is the seat of stasis and infection or pain and therefore should be completely removed.

Menon, Prema; Handu, Abhilasha T; Rao, Katragadda Lakshmi Narasimha; Arora, Suman

2014-01-01

370

Long-Term Urinary Bladder Function Following Unilateral Refluxing Low Loop Cutaneous Ureterostomy  

PubMed Central

Purpose Unilateral low loop cutaneous ureterostomy (LLCU) has been offered as the preferred method of temporary urinary diversion in cases of massively dilated and refluxing ureters. We sought to explore whether LLCU is effective in preserving urinary bladder function in the long term. Materials and Methods The charts of all patients who had undergone temporary unilateral LLCU as newborns in the presence of massive vesico-ureteric reflux were retrospectively reviewed. Demographic data, follow-up length, and presence of incontinence were recorded. Patients were interviewed regarding lower urinary tract symptoms (LUTS), and their urination patterns were recorded by using uroflow and post-void residual (PVR) measurements. Results Between 1972 and 2003, a total of 24 patients underwent unilateral LLCU in the presence of massively refluxing ureters. Eight patients were included in the final analysis. The median age at diversion was 12 days, the median time to closure was 22.5 months, and the median follow-up was 12.5 years. Urinary bladders showed normal contour, normal capacities, and minimal PVRs in most cases. None of the patients required augmentation cystoplasty. One patient suffered from urinary leakage and few demonstrated minimal LUTS. Conclusions Unilateral refluxing LLCU is an effective method of urinary diversion that preserves urinary bladder function for the long term. Larger studies are required to confirm this finding.

Golomb, Jacob; Kitrey, Noam D; Inbar, Yael; Heyman, Zehava; Kleinnbaum, Yeruham; Mor, Yoram

2012-01-01

371

Ultrasonography of the urinary tract in 29 female Saanen goats.  

PubMed

The left and right kidneys, ureters, urinary bladder and urethra of 29 female clinically healthy Saanen goats were examined via transcutaneous and transrectal ultrasonography. In order to establish reference values the examinations were performed using a 5.0 MHz linear transducer to scan the right caudal costal part of the abdominal wall, right and left dorsal flanks and right and left inguinal regions of standing goats. A 5.0 MHz intracavity probe was used for transrectal ultrasonographic examination of the urinary bladder and urethra. The kidneys were examined in longitudinal and cross section and assessed subjectively. They could usually be seen from the 12th intercostal space on the right side and dorsal right flank. The right kidney was 8.0 ± 0.67 cm long and the left was 8.4 ± 0.64 cm long. The ureters could not be visualized in any of the goats. The length of the urinary bladder was 5.1 ± 1.38 cm, and its largest cross-sectional diameter was 2.6 ± 1.01 cm. The urethra was seen in 23 goats and appeared as echogenic lines with no visible lumen. The transition from the neck of the bladder to the internal urethral orifice extended beyond the brim of the pelvis in only one goat. PMID:22287138

Steininger, K; Braun, U

2012-02-01

372

Purinergic signalling in the urinary tract in health and disease.  

PubMed

Purinergic signalling is involved in a number of physiological and pathophysiological activities in the lower urinary tract. In the bladder of laboratory animals there is parasympathetic excitatory cotransmission with the purinergic and cholinergic components being approximately equal, acting via P2X1 and muscarinic receptors, respectively. Purinergic mechanosensory transduction occurs where ATP, released from urothelial cells during distension of bladder and ureter, acts on P2X3 and P2X2/3 receptors on suburothelial sensory nerves to initiate the voiding reflex, via low threshold fibres, and nociception, via high threshold fibres. In human bladder the purinergic component of parasympathetic cotransmission is less than 3 %, but in pathological conditions, such as interstitial cystitis, obstructed and neuropathic bladder, the purinergic component is increased to 40 %. Other pathological conditions of the bladder have been shown to involve purinoceptor-mediated activities, including multiple sclerosis, ischaemia, diabetes, cancer and bacterial infections. In the ureter, P2X7 receptors have been implicated in inflammation and fibrosis. Purinergic therapeutic strategies are being explored that hopefully will be developed and bring benefit and relief to many patients with urinary tract disorders. PMID:24265069

Burnstock, Geoffrey

2014-03-01

373

Abdominal Hysterectomy: A New Approach for Conventional Procedure  

PubMed Central

Objective: The present comparative study helps in developing a new approach to conventional hysterectomy procedure so as prevent intra-operative and Post-operative complications during the procedure. Methods: Ligation of uterine and ovarian arteries was performed, prior to abdominal hysterectomy procedures, in Group A (n-1000) and conventional method of abdominal hysterectomy in Group B (n-450) from January 2000 to December 2009. It was a prospective study. Results: In Group A it was noted that traumatic injury to (L) uterine vessel was present in 4 (0.4%) cases and (R) uterine vessel in 3 (0.3%) cases without any noticeable injury to the ovarian vessels, ureters or bladder as compared to in Group B where injury to (L) uterine was noted in 11 (2.4%) cases, ureters in 1 (0.1%) case, bladder in 6(1.5%) cases, hematoma in 10 (2.2%). Post-operative complications were found to be uneventful in Group A. Conclusion: The Present study concludes that ligation of uterine and ovarian arteries, prior to conventional abdominal hysterectomy procedures is found to be extremely safe procedure thereby reducing the risk of intra-operative and post- operative complications.

Dutta, Indranil

2014-01-01

374

Percutaneous Ureteral Elevation in Laparoendoscopic Single-Site Radical Nephrectomy  

PubMed Central

Background and Objectives: To describe our technique of suture-assisted ureteral retraction during Laparoendoscopic Single-Site (LESS) radical nephrectomy. Materials and Methods: A healthy, 39-year-old woman with an incidental 5-cm enhancing left renal mass elected to undergo radical nephrectomy. A 2-cm skin incision was made in the left upper quadrant of the abdomen, and a Covidien SILS port was introduced using standard Hasson techniques. Straight and angled laparoscopic instruments were used to mobilize the kidney outside of Gerota's fascia. To place the renal vessels on stretch and facilitate hilar dissection, the ureter and lower pole attachments were encircled with a 0-Vicryl suture inserted percutaneously via a disposable fascial closure device. The kidney was bagged and removed intact. Results: The procedure was performed without complication with a total operative time of 265 minutes. EBL was minimal at 25mL. The patient was discharged home on postoperative day 1, and final pathology revealed stage pT1b chromophobe renal cell carcinoma with negative surgical margins. Conclusion: LESS radical nephrectomy is feasible in select patients. Suture-assisted retraction of the ureter and lower pole attachments using a fascial closure device facilitates safe dissection and control of the renal hilum.

Ming, Jessica M.; Mirza, Moben; Smith, Anthony Y.

2010-01-01

375

Considerations in Minimally Invasive Surgery for Renal and Ureteric Calculi: A Bicenter Quality Control Study  

PubMed Central

Background The use of minimally invasive surgery is increasing. Evaluating the quality of care brings new sights in the optimization of operating techniques. Methods We included all procedures performed in two hospitals during 2010 and 2011. A total of 264 patients were included in the ureterorenoscopy (URS) group and 77 patients in the percutaneous nephrolitholapaxy (PCNL) group. Data were gathered by retrospectively reviewing medical records. Results Mean stone diameter in the URS group was 9 mm. Patients suffered from a single stone in 79% of the cases. Calculi in the distal ureter, defined as the part of the ureter below the lower border of the sacroiliac joint, were most likely to be removed. A stone-free status was reached in 69% of the cases using URS. Mean stone diameter in the PCNL group was 23 mm. PCNL was successful in 70% of the cases in Haga Hospital versus 53% in Medisch Centrum Haaglanden. Incidence of complications was comparable between the hospitals (p = 0.5). Outcome and quality of both PCNL and URS was not influenced by sex, age or body mass index. Conclusion The clinical results were comparable with results in the literature. Further improvement can be made by optimization of technical aspects and centralization of treatment by urologists experienced in minimally invasive techniques.

Weltings, Saskia; Roshani, Hossain; Leenarts, Joost; Pelger, Rob

2013-01-01

376

A case of gross haematuria due to an ureteric-iliac artery fistula.  

PubMed

A case of gross haematuria due to an ureteric-iliac artery fistula We report a case of a 75-year-old man presented with gross haematuria and left hydronephrosis due to an ureteric iliac- artery fistula . Medical history included a previous positioning of aorto-bisiliac graft and an iliac artery stent placed to exclude an hypogastric aneurysm. A retrograde pyelography revealed a compression of the middle ureter and an extravasation of contrast at that level, for this reason a double J stent was inserted. Contrast-enhanced computed tomography showed the presence of a fistula between the left ureter and the internal iliac. The patient underwent endovascular treatment using a stent-graft with the subsequent patient's recovery. Ureteric iliac-artery fistula is a rare condition and it generally manifests with life threatening gross bleeding. We suggest a multidisciplinary clinical approach in order to achieve the best results for the patient and to avoid severe complications. Endovascular techniques have been demonstrated to be effective and rapid in the treatment of this emergency condition; ureteral stenting is also recommended. PMID:24395028

Madonia, Massimo; Russo, Giorgio Ivan; Trignano, Emilio; Paliogiannis, Panagiotis; Cimino, Sebastiano; Corbu, Carlo; Morgia, Giuseppe

2013-12-01

377

Morphological analysis of rat ureteric terminal arterioles in situ.  

PubMed

Confocal imaging of Fluo-4, Propidium iodide, and di-8-Anepps loaded ureter were used to study the morphology of terminal arterioles with an inner diameter <50 ?m in intact rat ureter. Optical sectioning showed that the muscle coat of the terminal arterioles consisted of a monolayer of highly curved smooth muscle cells which run circumferentially around the endothelium. This technique allowed not only to measure the inner diameter of the terminal arterioles but also to define the orientation and number of revolutions an individual smooth muscle cell made around the endothelium. We measured thickness, width, length, and morphological profile of the myocytes and endothelial cells. Propidium iodide staining showed nuclei of individual cells by continuous imaging at high resolution in serial optical sections. Conventional haematoxylin-eosin, Masson's tri-chrome staining, and transmission electron microscopy were also used in this study to compare the measurements obtained from live confocal imaging with histological standard methods. Parameters obtained from live imaging were significantly different. This technique of live staining allowed measuring the cellular and nuclear dimensions of the terminal arterioles in their natural environment which are important in studying the effects of vascular disease or aging on vascular structure. PMID:23450700

Mumtaz, Sadaf

2013-06-01

378

Survey of surgical experience during training in obstetrics and gynaecology in the UK.  

PubMed

The 2002 RCOG survey of training reported that the percentage of obstetric and gynaecology trainees who class their operative training as good or very good has declined from 45% in 1995, to 39% in 2002; reduction in years of training and number of working hours may have further impact on the surgical experience. In this study, we have attempted to assess the level of surgical confidence reported by senior and recently accredited trainees in obstetrics and gynaecology in the UK via an anonymised postal questionnaire. A total of 103 replies were received from 202 questionnaires. Some 99% of the respondents said they felt competent to carry out a simple total abdominal hysterectomy; 61.2% could confidently dissect the ureter and 55.3% could repair major damage to the bladder. However, when managing major obstetric haemorrhage, only 44.6% of respondents felt confident to perform a caesarean hysterectomy; 27.1% could dissect the ureter and 41.7% could apply a B-Lynch suture to the uterus. The level of competence increased with seniority and also with additional time spent in research, subspecialty training or other specialties. There appears to be an appropriate level of confidence in carrying out gynaecological surgical procedures by senior trainees and new consultants. However, surprisingly few respondents were confident in performing any surgical procedure necessary in the management of major obstetric haemorrhage. This may have serious implications in the provision of out of hours senior cover for maternity units in the future. PMID:16753675

Ghaem-Maghami, S; Brockbank, E; Bridges, J

2006-05-01

379

OCT-aided anastomosis platform study in the rodent model  

NASA Astrophysics Data System (ADS)

Anastomosis is one of the most commonly performed procedure in the clinical environment that involves tubular structures, such as blood vessel, lymphatic vessel, seminal duct and ureter. Suture based anastomosis is still the foundation for most basic surgical training and clinical operation, although alternate techniques have been developed and under development. For those tubular-structure-anastomosis, immediate real-time post-operative evaluation of the surgical outcome is critical to the success of surgery. Previously evaluation is mostly based on surgeons' experience. Fourier-domain optical coherence tomography is high-speed, high-resolution noninvasive 3D imaging modality that has been widely used in the biomedical research and clinical study. In this study we used Fourier-domain optical coherence tomography as an evaluation tool for anastomosis of lymphatic vessels, ureter and seminal duct in rodent model. Immediate post-operative and long term surgical site data were collected and analyzed. Critical clinical parameters such as lumen patency, anastomosed site narrowing and suture error detection are provided to surgeons.

Huang, Yong; Tong, Dedi; Zhu, Shan; Wu, Lehao; Ibrahim, Zuhaib; Lee, WP Andrew; Brandacher, Gerald; Kang, Jin U.

2014-02-01

380

Long-term effects of pediatric extracorporeal shockwave lithotripsy on renal function  

PubMed Central

Introduction Extracorporeal shock wave lithotripsy (ESWL) is a well-known and successful treatment modality. In addition, it can be used in premature infants. ESWL is used to treat kidney and ureter stones in children. However, although it is a preferred noninvasive treatment in that setting, there is debate about its long-term effects on growing kidneys in children. Objectives To investigate the long-term effects of pediatric ESWL on renal function in light of updated literature. Methods PubMed and Medline were searched for studies on ESWL in a pediatric population with keywords including efficacy, child, kidney calculi, ureter calculi, lithotripsy, injury, vascular trauma, and shock waves. The research was limited to the English literature during a period from 1980 to 2014. In total, 3,000 articles were evaluated, but only 151 papers were considered. Only the manuscripts directly related to the reviewed subjects were included in the current study. Results However, the acute effects of ESWL in kidney are well-described. Although there are limited studies on the long-term effects of ESWL in children, there is a widespread opinion that ESWL is not affecting renal functions in the long-term. Conclusion ESWL is a safe, effective, and noninvasive treatment option in children. Although ESWL can cause some acute effects in the kidney, there is no long-term effect on the growing kidneys of children.

Akin, Yigit; Yucel, Selcuk

2014-01-01

381

Marked hydronephrosis and hydroureter after distigmine therapy in an adult male patient with paraplegia due to spinal cord injury: a case report  

PubMed Central

Introduction Distigmine, a long-acting anti-cholinesterase, is associated with side effects such as Parkinsonism, cholinergic crisis, and rhabdomyolysis. We report a spinal cord injury patient, who developed marked hydronephrosis and hydroureter after distigmine therapy, which led to a series of complications over subsequent years. Case presentation A 38-year-old male developed T-9 paraplegia in 1989. Intravenous urography, performed in 1989, showed normal kidneys, ureters and bladder. He was prescribed distigmine bromide orally and was allowed to pass urine spontaneously. In 1992, intravenous urography showed bilateral marked hydronephrosis and hydroureter. Distigmine was discontinued. He continued to pass urine spontaneously. In 2006, intravenous urography showed moderate dilatation of both pelvicalyceal systems and ureters down to the level of urinary bladder. This patient was performing self-catheterisation only once a day. He was advised to do catheterisations at least three times a day. In December 2008, this patient developed haematuriawhich lasted for nearly four months.. He received trimethoprim, then cephalexin, followed by Macrodantin, amoxicillin and ciprofloxacin. In February 2009, intravenous urography showed calculus at the lower pole of left kidney. Both kidneys were moderately hydronephrotic. Ureters were dilated down to the bladder. Dilute contrast was seen in the bladder due to residual urine. This patient was advised to perform six catheterisations a day, and take propiverine hydrochloride 15 mg, three times a day. Microbiology of urine showed Klebsiella oxytoca, Pseudomonas aeruginosa, and Enterococcus faecalis. Cystoscopy revealed papillary lesions in bladder neck and trigone. Transurethral resection was performed. Histology showed marked chronic cystitis including follicular cystitis and papillary/polypoid cystitis. There was no evidence of malignancy. Conclusion Distigmine therapy resulted in marked bilateral hydronephrosis and hydroureter. Persistence of hydronephrosis after omitting distigmine, and presence of residual urine in bladder over many years probably predisposed to formation of polypoid cystitis and follicular cystitis, and contributed to prolonged haematuria, which occurred after an episode of urine infection. This case illustrates the dangers of prescribing distigmine to promote spontaneous voiding in spinal cord injury patients. Instead of using distigmine, spinal cord injury patients should be advised to consider intermittent catheterisation together with oxybutynin or propiverine to achieve complete, low-pressure emptying of urinary bladder.

Mansour, Paul; Soni, Bakul M; Hughes, Peter L; Singh, Gurpreet; Oo, Tun

2009-01-01

382

Renin dependence of captopril-induced drinking after ureteric ligation in the rat.  

PubMed Central

In experiments lasting 8 h, low (0.5 mg kg-1) or medium (5 mg kg-1) subcutaneous doses of the angiotensin-converting enzyme inhibitor captopril were mildly dipsogenic in sham-operated rats, much more so in rats subjected to bilateral ureteric ligation and not at all in bilaterally nephrectomized rats. Rats with ligated ureters drank enough water to gain weight during the experiments. All other groups lost weight. The enhanced responsiveness of rats with ligated ureters, despite fluid retention, shows that captopril-induced drinking was not secondary to increased renal fluid loss. Ureteric ligation alone which caused some increase in renin secretion was mildly dipsogenic compared with sham operation. Captopril caused further increases in plasma renin concentration and more drinking suggesting that the captopril response is renin-dependent. The failure of the nephrectomized rat to drink after captopril also shows that the response is renin-dependent. The highest dose (50 mg kg-1) of captopril did not at first stimulate drinking, though water intake increased later. Slowness to drink was not the result of general depression of behaviour since drinking in response to subcutaneous hypertonic NaCl or intracranial angiotensin II was not inhibited by the highest dose. Slowness to drink after the highest dose was attributable to blockade of converting enzyme centrally as well as peripherally. This meant that the increased circulating angiotensin I resulting from peripheral blockade of converting enzyme was only slowly converted to angiotensin II in the brain. When cerebral conversion of angiotensin I was prevented by a single intracranial injection of 25 micrograms captopril, drinking in response to the lower doses of captopril was also inhibited in normal rats and in rats with ligated ureters. The same intracranial dose of captopril also inhibited drinking in response to intracranial injections of renin or angiotensin I, but not angiotensin II. The time course of inhibition of renin-induced drinking was similar to that of inhibition of subcutaneous captopril-induced drinking. In conclusion, subcutaneous captopril causes increased water intake through activation of the renal renin-angiotensin system, an effect that is enhanced when the system has already been partly activated by ureteric ligation. Increased circulating angiotensin I resulting from blockade of peripheral converting enzyme must be converted to angiotensin II in the brain in order to stimulate drinking. Drinking is not the consequence of increased fluid loss.

Elfont, R M; Fitzsimons, J T

1983-01-01

383

Immunoglobulin G4-Related Retroperitoneal Fibrosis Treated with Hochuekkito, a Kampo Medicine, following Steroid Treatment  

PubMed Central

We report a case of immunoglobulin G4 (IgG4)-related retroperitoneal fibrosis (RF) with complete remission and no relapses after therapy with steroids and Hochuekkito, a Kampo (i.e. traditional Japanese herbal) medicine. A 62-year-old Japanese man was admitted to our hospital for treatment of a retroperitoneal mass detected by computed tomography. The mass had a maximum diameter of 11.0 cm; it involved the left ureter and was associated with left hydronephrosis. After inserting a ureteral stent, we performed a biopsy by laparotomy. Histopathology revealed IgG4-related RF. The lesion disappeared after 7 months of steroid therapy. We subsequently used Hochuekkito as an alternative maintenance treatment because of steroid-related complications. The patient has not relapsed in the 3 years since starting the medication. To the best of our knowledge, this is the first case of IgG4-related RF treated with Hochuekkito as a maintenance treatment.

Fukuchi, Minoru; Sakurai, Shinji; Kogure, Toshiaki; Naitoh, Hiroshi; Kuwano, Hiroyuki

2014-01-01

384

Uretero-Internal Pudendal Artery Fistula with Longterm Indwelling of Ureteral Stent: A Case Report  

PubMed Central

A 74-year-old woman presenting with bilateral ureteral stricture was referred to our hospital. She had undergone radical hysterectomy and adjuvant irradiation therapy for cervical cancer in 2000. Double-J stents were inserted in both the ureters and replaced at regular intervals. Eighteen months after ureteral stenting, she complained of gross hematuria and was managed with hemostatic agents. During a routine replacement of the right double-J stent, massive bleeding was observed from the urethra which continued intermittently. The source of bleeding was not identified on computed tomography and angiography. We kept her at rest, which reduced the bleeding. However, she required intermittent transfusions. Angiography was performed at the time of bleeding on March 5, 2011. A uretero-internal pudendal artery fistula was found, and coil embolization was performed. Thereafter, hematuria did not recur up to the last followup in July 2011.

Yuki, Hideo; Takayama, Yasuhiro; Takuma, Masahisa; Takahashi, Mika; Ando, Tadasuke; Sumino, Yasuhiro; Nomura, Takeo; Sato, Fuminori; Mimata, Hiromitsu

2012-01-01

385

Ureteral Interventions  

PubMed Central

The pelvic course of the ureter with its close proximity to the iliac artery, pelvic viscera, and other structures predispose to fistula formation. Surgical management of lower urinary tract fistulas is difficult and often ineffective. Nonvascular lower urinary tract fistulas can be managed by urinary diversion with percutaneous nephrostomy to allow for fistula healing. If this fails, ureteral embolization can be very effective; however, this should be preceded by careful evaluation and discussion with the patient as this intervention results in irreversible ureteral occlusion necessitating a diverting nephrostomy catheter indefinitely. A ureteroarterial fistula is a distinct entity compared with nonvascular fistulas with a different approach to management; it can be managed by exclusion of the fistula by endovascular placement of a stent graft across the arterial component of the fistula.

Popuri, Radha; Zuckerman, Darryl A.

2011-01-01

386

Engineering tissues and organs.  

PubMed

Genitourinary tissues can be engineered in-vitro and in-vivo for reconstruction using selective cell transplantation in combination with acellular matrices. This technology involves an interdisciplinary approach combining techniques of cell biology and materials sciences towards the development of functional tissues or organs. Tissues and organs in urology, such as the bladder, clitoris, corpus cavermosum, kidney, testis, ureter and urethra have been created in the laboratory, with varying degrees of functionality. Cells have also been recently used in patients as bulking agents for the treatment of vesicoureteral reflux and urinary incontinence. As the science of tissue engineering evolves, one can expect a wider application of this technology to the armamentarium of urologic surgery. PMID:10668571

Atala, A

1999-11-01

387

[Ureteral jet in patients with benign prostatic hypertrophy: prognostic evaluation during single and combined therapy].  

PubMed

By color-Doppler ultrasound it's possible to visualize urine flow jet from ureter into the bladder. Aim of the study was to evaluate of ureteral jet in patients with benign prostatic hyperplasia before, during and after with one or two drugs medical therapy. Thirteen patients, aged 51-63 years, were studied; they were not affected by metabolic, hepatic, renal diseases and by prostate inflammation. Eco color Doppler p.w. (Toshiba SSA 270A) with a convex probe of 3.5 MHz was used. A transabdominal ultrasound study was performed, prostate volume measured and ureteral jet visualized before and along treatment (at six months interval) with Finasteride and at the end of treatment. Successively, in four patients, with relapse of prostatic synptomatology, a transabdominal ultrasound study was performed, before and along a treatment with Finasteride, 5 mg/die (Finastid, Neopharmed) and Terazosin hydrochloride, 5 mg/die (Teraprost, Malesci), and at the end of treatment. PMID:9162355

Sperandeo, M; Sperandeo, G; Carella, M; Bianco, G; Cera, A; Scarale, M G; Viola, M

1996-12-01

388

Nephroureterectomy for Transitional Cell Carcinoma - The Value of Pre-Operative Histology  

PubMed Central

INTRODUCTION Nephroureterectomy with excision of a cuff of bladder remains the standard for managing upper tract transitional cell carcinoma (TCC). Increasing use of diagnostic upper tract endoscopy has underlined the importance of obtaining a pre-operative histological diagnosis in order to avoid under-treating high-grade or multifocal disease and over-treating low-grade disease, which could, in selected cases, be managed conservatively. We review nephroureterectomy at our institution over a 10-year period with particular reference to a pre-operative histological diagnosis. PATIENTS AND METHODS Nephroureterectomy was performed in 113 patients from February 1994 to February 2004. Of these cases, 58 were for upper tract TCC and 50 of these 58 had intravenous urography (IVU): 9 had only IVU, 28 had an additional CT scan, 5 had an additional ultrasonography and 8 had additional CT + ultrasonography for pre-operative work-up. Thirty-four of the 58 cases had retrograde pyelography. Nineteen (32.7%) of the 58 cases had a pre-operative ureteroscopy (URS) and biopsy; 14 of these had rigid URS for tumours in the lower (11) and middle (3) thirds of the ureter and 5 had flexible URS for pelvicalyceal tumours by an experienced endourologist. Thirty-one (53%) of the 58 tumours were within the pelvicalyceal system and 27 within the ureter (upper, 5; middle, 3; lower, 19). Forty-eight patients underwent a total nephroureterectomy: 40 had a two incision approach and 8 had an endoscopic resection of the lower ureter. Five of the 58 cases had a sub-total nephroureterectomy and 5 a laparoscopic nephroureterectomy with open excision of lower ureter. RESULTS Nineteen (32.7%) of the 58 patients had a pre-operative histological diagnosis – 17 G2pTa, 1 G1pTa, and 1 G2pT1. Fourteen (74%) biopsies matched the final postoperative histology, but 1 was down-staged, 3 up-staged and 1 up-graded compared to the original histology. Five (12.8%) of 39 patients without pre-operative histology had no TCC in the final surgical specimen: 4 (10.25%) had benign pathology such as capillary haemangioma, urothelial cysts and reactive urothelial changes while one had renal cell carcinoma (RCC). CONCLUSIONS This study underlines the importance of obtaining a pre-operative histological diagnosis in cases with presumed upper tract TCC. Failure to do so can result in unnecessary ablative surgery for benign disease. Such an approach can also help identify multifocality and grade of disease so that treatment of upper tract TCC can be tailored more appropriately with ablative surgery for high-grade or multifocal disease and conservative (endoscopic) therapy for low-grade disease in selected cases. Patients with suspected TCC of the upper tract should be managed at centres where facilities for the comprehensive evaluation of such tumours exist.

Chitale, Sudhanshu; Mbakada, Rashidi; Irving, Stuart; Burgess, Neil

2008-01-01

389

Primary obstructive megaureter with a giant lower ureteral stone synchronous with ipsilateral staghorn kidney  

PubMed Central

INTRODUCTION Primary obstructive megaureter (POM) is uncommon in adults. Urolithiasis formation may uncover the underlying congenital abnormally of these patients. PRESENTATION OF CASE Herein, we present a 20-year-old man who was admitted with synchronous left renal staghorn and a lower giant ureteral stone. Radiologic evaluations revealed that POM is the underlying cause of the uncommon occurrence of synchronous left reno-ureteral stone formation. DISCUSSION Urinary tract stones are not uncommon in the POM. Although synchronous renal-ureteral unit stones are less common but staghorn-ureteral stones complex are very rare. In such conditions full radiologic work-up is recommended. Based on our literature review, this is the first reported case of staghorn-ureteral stones complex in the setting of adult POM. CONCLUSION In every case with dilated ureter concomitant with ureteral stone or renal stone, the POM should be included in the differential diagnosis.

Moslemi, Mohammad Kazem

2012-01-01

390

Don't get caught out! A rare case of a calcified urachal remnant mimicking a bladder calculus  

PubMed Central

Computer tomography through the kidneys, ureters and bladder (CT KUB) is the mainstay investigation of suspected renal tract calculi. However, several pathologies other than renal tract calculi can cause apparent urinary bladder calcification. We describe the case of a 45 year old man who presented with left sided renal colic. Prone CT KUB performed on admission revealed a calcified urachal remnant mimicking a urinary bladder calculus in the dependent portion of the urinary bladder, confirmed by reviewing the multi-planar reformatted images. This is the first reported case in the literature of this phenomenon. We discuss the importance of using multi-planar reformatted images (MPR) and maximum intensity projection images (MIP), as well as careful review of previous imaging, in making the correct diagnosis. We also discuss the differential diagnoses that should be considered when presented with urinary bladder calcification.

Rodrigues, Jonathan Carl Luis; Gandhi, Sanjay

2013-01-01

391

Complete genome sequence of a recombinant nephropathogenic infectious bronchitis virus strain in China.  

PubMed

Recently, nephropathogenic infectious bronchitis virus (IBV) outbreaks have occurred in commercial broiler flocks and have been associated with a high incidence and morbidity in China. The CK/CH/Zhejiang/06/10 strain (IBV-YX10) was isolated from a 12-day-old broiler chicken in a flock of chickens with swollen speckled kidneys and distended ureters filled with uric acid in China in 2010. Here we reported the complete genomic sequence of the IBV-YX10 which was a natural recombinant nephropathogenic infectious bronchitis virus strain. These findings will contribute additional insights into the molecular characteristics of evolving IBV genomes and the need for effective control of IBV in China. PMID:23166232

Xue, Yu; Xie, Qingmei; Yan, Zhuanqiang; Ji, Jun; Chen, Feng; Qin, Jianping; Sun, Baoli; Ma, Jingyun; Bi, Yingzuo

2012-12-01

392

[The kidney in shock. A new experimental method for the induction of controlled shock. I].  

PubMed

In this research we identify a new experimental model to study the shock-kidney, since this complication occurs with discreet frequency during high surgery operation. The model that better reproduce the surgical shock-kidney is the controlled hypovolemic shock. We used for this experiment five pigs of weight between 40 and 50 kg and were studied the following data: Ecg, arterial pressure, central venous pressure, diuresis (by incannulation of both ureters), renal arterial flow, levels of the renin in the renal vein. The measurements were made before, during and after the shock. The hypovolemic shock was induced by removing from carotid artery a sufficient quantity of blood to bring the pressure to 45-50 mmHg. This pressure level was kept constant for 120 min and then was reported to normal level by introducing the blood previously removed. During the experiment no kind of drugs were used. PMID:7032542

Colì, G; Frascaroli, G; Giubilei, G; Grillone, G; Nanni Costa, A; Piccinni, L; Pierangeli, A; Prandini, R

1981-10-15

393

Complete Genome Sequence of a Recombinant Nephropathogenic Infectious Bronchitis Virus Strain in China  

PubMed Central

Recently, nephropathogenic infectious bronchitis virus (IBV) outbreaks have occurred in commercial broiler flocks and have been associated with a high incidence and morbidity in China. The CK/CH/Zhejiang/06/10 strain (IBV-YX10) was isolated from a 12-day-old broiler chicken in a flock of chickens with swollen speckled kidneys and distended ureters filled with uric acid in China in 2010. Here we reported the complete genomic sequence of the IBV-YX10 which was a natural recombinant nephropathogenic infectious bronchitis virus strain. These findings will contribute additional insights into the molecular characteristics of evolving IBV genomes and the need for effective control of IBV in China.

Xue, Yu; Yan, Zhuanqiang; Ji, Jun; Chen, Feng; Qin, Jianping; Sun, Baoli; Ma, Jingyun; Bi, Yingzuo

2012-01-01

394

An Unusual Extremely Distant Noncommunicating Uterine Horn with Myoma and Adenomyosis Treated with Laparoscopic Hemihysterectomy  

PubMed Central

A 41-year-old woman referred to us with dysmenorrhea and severe pelvic pain although she was previously submitted to right laparotomic adnexectomy for ovarian endometrioma and to a subsequent operative laparoscopy for pelvic adhesions. After ultrasound examination, the patient underwent diagnostic hysteroscopy and operative laparoscopy which confirmed the clinic suspect of an unicornuate uterus. However, it was very unusual to see an extremely distanced right horn, without communication with uterus, without adnexa, and with a small myoma belonging to it. Moreover, omentum and bowel were attached to fundus of right horn and thick adhesions fixed it to rectum and right pelvic wall. Therefore, identification of anatomical structures was difficult, as it was extremely arduous to isolate the ureter, which was involved inside the adhesions surrounding the right uterine horn. Nevertheless, laparoscopic right hemihysterectomy was successfully performed and right horn was sent to our pathologist who recognized hypotrophic endometrium and adenomyosis.

Morelli, Michele; Mocciaro, Rita; Lico, Daniela; Zullo, Fulvio

2013-01-01

395

Laparoscopic Morcellation of Didelphic Uterus With Cervical and Renal Aplasia  

PubMed Central

This is a case report (and review of the literature) of a 12-year and 10-month-old girl with a rare congenital anomaly of uterus didelphys, unilateral cervix aplasia, and ipsilateral renal aplasia. She had severe dysmenorrhea from the first menses. In an effort to preserve fertility, a cervical fistula was made that closed over. A laparoscopic hemi-hysterectomy was done successfully and rapidly with laparoscopic morcellation. Because no ureter was present, it was not necessary to trace it. For this congenital anomaly, laparoscopic morcellation of the obstructed hemiuterus is the preferred treatment either as a primary procedure or as a secondary procedure following failure of a surgical cervical fistula for the young patient.

Brodman, Michael; Schlosshauer, Peter; Deligdisch, Liane

2009-01-01

396

Efficacy of expulsive therapy using nifedipine or tamsulosin, both associated with ketoprofene, after shock wave lithotripsy of ureteral stones.  

PubMed

Extracorporeal shock wave lithotripsy (ESWL) is currently considered one of the main treatments for ureteral stones. Some studies have reported the effectiveness of pharmacologic therapies (calcium antagonists or alpha-blockers) in facilitating ureteral stone expulsion after ESWL. We prospectively evaluated the efficacy, after ESWL, of nifedipine on upper-middle ureteral stones, and tamsulosin on lower ureteral stones, both associated to ketoprofene as anti-edema agent. From January 2003 to March 2005 we prospectively evaluated 113 patients affected by radiopaque or radiolucent ureteral stones. Average stone size was 10.16 +/- 2.00 mm (range 6-14 mm). Thirty-seven stones were located in the upper ureter, 27 in the middle ureter, and 49 in the lower ureter. All patients received a single session of ESWL (mean number of shock waves: 3,500) by means of a Dornier Lithotripter S (mean energy power for each treatment: 84%). Both ultrasound and X-ray were used for stone scanning. After treatment, 63 of 113 patients were submitted to medical therapy to aid stone expulsion: nifedipine 30 mg/day for 14 days administered to 35 patients with upper-middle ureteral stones (group A1) and tamsulosin 0.4 mg/day for 14 days administered to 28 patients with stones located in the distal ureter (group A2). The remaining 50 patients were used as a control group (29 upper-middle ureteral stones-B1-and 21 lower ureteral stones-B2-), receiving only pain-relieving therapy. No significant difference in stone size between the groups defined was observed. Stone clearance was assessed 1 and 2 months after ESWL by means of KUB, ultrasound scan and/or excretory urography. A stone-free condition was defined as complete stone clearance or the presence of residual fragments smaller than 3 mm in diameter. The stone-free rates in the expulsive medical therapy group were 85.7 and 82.1% for the nifedipine (A1) and tamsulosin (A2) groups respectively; stone-free rates in the control groups were 51.7 and 57.1% (B1 and B2, respectively). Five patients (14.3%) in group A1, 5 (17.8%) in group A2, 14 (48.3%) in group B1 and 9 (42.8%) in group B2 were not stone-free after a single ESWL session and required ESWL re-treatment or an endoscopic treatment. Medical therapy following ESWL to facilitate ureteral stone expulsion results in increased 1- and 2-month stone-free rates and in a lower percentage of those needing re-treatment. The efficacy of nifedipine for the upper-mid ureteral tract associated with ketoprofene makes expulsive medical therapy suitable for improving overall outcomes of ESWL treatment for ureteral stones. PMID:17396251

Micali, S; Grande, M; Sighinolfi, M C; De Stefani, S; Bianchi, G

2007-06-01

397

[Seminal vesicle cyst associated with ipsilateral renal dysplasia and vena cava malformation : a case report].  

PubMed

We report a rare case of seminal vesicle cyst associated with ipsilateral renal dysplasia and vena cava malformation. A 76-year-old man was hospitalized because of difficulty in urination. We diagnosed benign prostate hyperplasia with vesical diverticulum and administered medication that was found to improve urination. However, positron emission tomography-computed tomography showed a large mass in the pelvic region ; therefore, additional examinations were performed. Urethrocystography showed a filling defect in the bladder. Computed tomography revealed the absence of the right kidney and the presence of a double vena cava and a large seminal vesicle cyst on the same side. Magnetic resonance imaging showed a cystic ectopic ureter associated with the seminal vesicle cyst. Therefore, we diagnosed the patient with a seminal vesicle cyst associated with ipsilateral renal dysplasia and performed cyst puncture. The patient is currently free from urinary symptoms at 12 months after surgery. PMID:23070393

Fujita, Masahiro; Goto, Takayasu; Saiki, Shigeru

2012-09-01

398

Computed tomography manifestations of common inferior vena cava dysplasia and its clinical significance  

PubMed Central

This study aimed to review and analyse the computed tomography (CT) imaging results of frequently encountered developmental anomalies of the inferior vena cava (IVC). The underlying clinical significance was evaluated with reference to the relevant literature. CT images of patients who received abdominal or thoracic scanning between July 2009 and September 2011 were reviewed. Developmental anomalies observed in the IVC were identified and categorised. Images of the cases with typical anomalies were presented and their developmental mechanism, as well as clinical significance, was discussed. The most frequently encountered IVC developmental anomalies include the left vena cava, double vena cava, azygos continuation of the IVC, left circumaortic renal vein, left retroaortic renal vein and retrocaval ureter. The embryogenesis of the IVC is a complex process that results in various congenital anomalies. The developmental anomalies of the IVC are distinguished using a CT scan and have significant implications on clinical perspective.

QIAN, ZHEN-YU; YANG, MING-FENG; ZUO, KE-QIANG; CHENG, JIE; XIAO, HONG-BING; DING, WEI-XING

2013-01-01

399

Primary Pleomorphic Undifferentiated Sarcoma--a Rare Renal Localization: A Case Report  

PubMed Central

Undifferentiated pleomorphic sarcoma is known as a soft tissue sarcoma. Very few cases of this tumor originating from the renal parenchyma or renal capsule have been reported. We report a case of a 70-year-old patient admitted for enormous ureterohydronephrosis and pyelonephritis due to a pelvic ureter lithiasis. After draining by ureteral double J catheter, a nephroureterectomy was performed for nonfunctional kidney confirmed by scintigraphy. The histopathological study shows a pleomorphic undifferentiated sarcoma. The patient was sent to oncologists. Chemotherapy was proposed but the family decided to stop the treatment. The patient passed away 10 months later. Clinicians and pathologists should be aware of the very low occurrence of this renal tumor, which is extremely rare. Currently there is no consensus about its management. Our case extends the literature concerning this tumor.

Mellas, Soufiane; Bouchikhi, Ahmed Amine; Tazi, Mohamed-Fadl; Khallouk, Abdelhak; Elammari, Jallal-Eddin; El Fassi, Mohamed-Jamal; Mellas, Naoufal; Farih, Moulay Hassan

2012-01-01

400

Modern management of stone disease in patients with a solitary kidney  

PubMed Central

Analysing the data available in the literature, contemporary methods of treatment of nephrolithiasis are limited to the methods of minimally invasive percutaneous nephrolithotomy (PCNL) and ureterorenoscopic lithotripsy (URSL), not excluding their use in the presence of developmental abnormalities and kidney impairment only. Minimally invasive methods have become standard procedures. A complement to ineffective URSL and PCNL treatment is extracorporeal shock wave lithotripsy. This is confirmed by 30 years of observation in the only treatment of kidney calculi by Alken launched in 1981 and continued by Jones et al. Before the era of endoscopic procedures (PCNL and URSL) effectively removed the only deposits in the kidney in open operations. Minimally invasive treatments are recommended for patients with localized deposits in the pelvicalyceal system or solitary kidney ureter. They are recognized as safe and effective treatment in a solitary kidney in particular in patients who have already been operated on.

Tkocz, Michal; Ziaja, Damian

2011-01-01

401

Necropsy findings in a fetus with a 46,XY,dic t(X;21)(p11.1;p11.1).  

PubMed Central

We report the findings in a fetus terminated because of multiple abnormalities diagnosed on ultrasound, including asymmetry of the limbs, a hypoplastic diaphragm, unilateral duplex kidney with a double ureter, unilateral cystic kidney, and congenital heart disease including total pulmonary atresia. Cytogenetic studies showed an unbalanced translocation of the long arm of the X chromosome to chromosome 21, resulting in a 46,XY,dic t(X;21)(p11.1;p11.1) karyotype. The cytogenetics were confirmed by non-isotopic in situ hybridisation using probes specific to pericentric alphoid repeats. Parental chromosomes were normal indicating this to be a de novo translocation. It is suggested that the inactivation of the long arm of the X chromosome has resulted in an effective monosomy for chromosome 21. Images

Smith, N M; Fernandez, H; Chambers, H M; Callen, D F

1992-01-01

402

Canine distemper virus infection in fennec fox (Vulpes zerda).  

PubMed

Fifteen 8-month-old fennec foxes imported from Sudan showed fever, mucopurulent ocular discharge, diarrhea, severe emaciation, seizures, and generalized ataxia, and died. Three of the 15 animals were presented for diagnostic investigation. Severe dehydration, brain congestion, and gastric ulcers were observed in all animals. In one animal, the lungs had failed to collapse and were multifocally dark red in appearance. Histopathologically, there were lymphohistiocytic meningoencephalitis with malacia, mild interstitial pneumonia, lymphoid depletion of lymphoid tissues and organs, and intestinal villous atrophy with intralesional coccidia. There were many intracytoplasmic and/or intranuclear inclusion bodies in the epithelial cells of the medullary velum, lungs, liver, kidneys, trachea, pancreas, stomach, gall bladder, urinary bladder, and ureters, and in macrophages of malacia foci and lymphocytes and macrophages of lymphoid organs. Additionally, intestinal coccidia were confirmed to be Isospora species by a fecal test. To our knowledge, this is the first report of canine distemper with intestinal coccidiosis in fennec fox. PMID:20299771

Woo, Gye-Hyeong; Jho, Yeon-Sook; Bak, Eun-Jung

2010-08-01

403

Extra-Anatomic Stent (EAS) as a Salvage Procedure for Transplant Ureteric Stricture.  

PubMed

Ureteric stricture is the most common urological complication following renal transplantation. Management often involves endo-urological interventions and open surgery. The definitive treatment is surgical reconstruction to restore continuity. Where this is not possible or contra-indicated and a stent cannot be placed in the ureter, an extra-anatomic stent (EAS) could be used to bypass a complete ureteric obstruction. Using an existing nephrostomy tract, a percutaneous stent is placed in the kidney and is tunneled under the skin into the bladder establishing extra-anatomical urinary drainage. We report the use of a novel EAS system in a patient with transplant ureteric stricture when antegrade stent placement or surgical reconstruction was not possible. PMID:24984684

Tahir, W; Hakeem, A; White, A; Irving, H C; Lloyd, S N; Ahmad, N

2014-08-01

404

Botryoid Wilms' tumor: a case report and review of the literature  

PubMed Central

Here, we report a new case of botryoid Wilms’ tumor, a 4-year-old boy, who was referred to us with a chief complaint of dysuria and gross hematuria. The computed tomography and radical nephroureterectomy showed that a botryoid sarcoma-like appearance occupied the right renal pelvis and extended into the bladder. Histologic examination further confirmed this case was a mixed type of Wilms’ tumor. In a word, we demonstrated a rare case of botryoid Wilms’ tumor, which extended from the renal pelvis into the ureter and bladder, then some degenerative and necrotic tissue with calcification discharged from urethra. Postoperative adjuvant chemotherapy was executed. At 24-month follow-up, there was no evidence of recurrence.

2013-01-01

405

Unexpected urinary Schistosoma infection in a Belgian travel group returning from Malawi.  

PubMed

Urinary schistosomiasis, caused by Schistosoma haematobium, is a prevalent parasitic infection in certain areas of Africa and the Middle East. Humans can be infected by cercariae when they are in contact with contaminated freshwater. The adult worms reside in the veins of the vesical and pelvis plexuses. The urinary bladder, the seminal vesicles and the lower ends of the ureters are the most commonly affected organs. In this case report, we describe an unrecognised case of urinary schistosomiasis in a woman who was part of a Belgian travel group; two other patients out of eight were also infected. In Belgium, the number of reported cases of S. haematobium infection is limited. The aim of this report is to emphasize this parasitic infection should be suspected in patients who travel to endemic areas. PMID:24156230

Oyaert, M; Lagrange, W; Smet, G; De Feyter, K; Laffut, W

2013-01-01

406

Untitled  

Cancer.gov

Bladder9 181 188, 189.9 188, 189.3Ð.9 Kidney, renal pelvis, and ureter 180 189.0Ð.2 189.0Ð.2 Eye 192 190 190 Brain and other nervous system 193 191Ð2 191Ð2 Thyroid gland 194 193 193 Other endocrine glands 195 194 194, 164.0 HodgkinÕs disease 201 201 201 Non-HodgkinÕs lymphoma 200, 202, 205 200, 202 159.1, 200, 202, except 202.2Ð.6 Multiple myeloma 203 203 203 except 203.1 Leukemia 204 204Ð7 202.4, 203.1, 204Ð208 359 Appendix Table 3.

407

A huge bladder calculus causing acute renal failure.  

PubMed

We present a 39-year-old man with repeated urinary tract infection and lower abdominal pain. Kidney-ureter-bladder (KUB) and IVU film showed a huge 450-g elliptical pelvic calculus that was surgically removed with excellent results. Surgical intervention by cystolithotomy or endoscopic cystolithotripsy can achieve satisfactory results. Bladder outlet obstruction should be treated simultaneously. Bladder stone is a common disease, but it is rare for such a calculus to be so large as to cause bilateral hydronephrosis. Close follow-up, however, is mandatory because the recurrence of urolithiasis is high in those patients with voiding problems and recurrent urinary infection. To the best of our knowledge, this is the largest bladder stone in a human male. PMID:20033143

Wei, Wuran; Wang, Jia

2010-08-01

408

[Botryoid Wilms tumor extending into the duodenum].  

PubMed

We report on a rare case of botryoid Wilms tumor extending into the duodenum. This uncommon macroscopic form of nephroblastoma consists entirely of a polypoid renal intrapelvic mass. The main differential diagnosis of this unusual tumor is botryoid rhabdomyosarcoma. A 14-month-old boy presented with a painful abdominal mass. Radiology revealed a large heterogeneous mass in the renal calyx, protruding into the ureter. A right radical nephroureterectomy was carried out. The tumor was found to extend into the 2nd portion of the duodenum. The pathologic diagnosis was mixed type nephroblastoma, SIOP 2001 stage III. The patient was given a course of postoperative chemotherapy. No local recurrence or metastatic spread has been detected after 2 years. Only few such cases have been previously reported, some of them extending into the bladder. To our knowledge, botryoid nephroblastoma has not previously been described as extending into the digestive system. PMID:20943355

Lamalmi, N; Rouas, L; Cherradi, N; Malihy, A; Khattab, M; Alhamany, Z

2010-12-01

409

The first use of Resonance® metallic ureteric stent in a case of obstructed transplant kidney  

PubMed Central

INTRODUCTION To date, double JJ stent is the mainstay ureteric stent used in a transplant kidney. We herein report the first use of Resonance® metallic ureteric stent to manage ureteric obstruction in a transplant kidney. PRESENTATION OF CASE A 45-year-old lady underwent an uneventful living related donor renal transplantation. Due to post-operative pelvi-ureteric obstruction and recurrent obstruction following multiple distal stent migration and expulsion necessitated frequent nephrostomy insertion and antegrade stenting, she underwent challenging but successful retrograde insertion of a 12 centimetres long and size 6.0 French Cook Resonance® metallic ureteric stent which was performed under general anaesthesia. DISCUSSION Metallic ureteric stents are a fairly recent introduction to modern urology and they have been successfully used in the management of benign and malignant obstruction of ureter. CONCLUSION This is the first case of therapeutic metallic ureteric stent insertion in a transplant kidney.

Abdulmajed, Mohamed I.; Jones, Vaughan W.; Shergill, Iqbal S.

2014-01-01

410

Pulmonary Embolism with Abdominal Pain and ST Elevation: A Case Report  

PubMed Central

Pulmonary embolism is considered as a great masquerader due to its frequent nonspecific signs and symptoms. Typically pulmonary embolism is under-diagnosed or over-diagnosed. In this study a patient with pulmonary embolism is reported in which the patient exhibited two unusual manifestations namely; right upper quadrant abdominal pain and ST-T elevation in anterior precordial leads. Due to the fact that the patient did not display typical pulmonary embolism symptoms and its major risk factors, extensive workup to discern the cause was carried out. The examination included abdominal sonography, kidney ureter and bladder Computed Tomography scan (CT-scan) and coronary angiography. Eventually after a six-day delay, pulmonary embolism was diagnosed by spiral chest CT scan. This case and several other similar reports underlines the fact that while various other common causes may exist for right upper abdominal pain, one should always consider pulmonary embolism as a possible cause especially when backed up with ECG finding.

Fallahi, Mohammad Javad; Masoompour, Seyed Masoom; Mirzaee, Mehdi

2014-01-01

411

Laparotomic Myomectomy in the 16th Week of Pregnancy: A Case Report  

PubMed Central

Myomectomy is rarely performed during an ongoing pregnancy because of fear of miscarriage and the risk of an uncontrolled haemorrhage necessitating a hysterectomy. In cases where myomectomy is undertaken, most are performed at the time of cesarean section or with a laparoscopic approach. We report a case of a successful laparotomic myomectomy in the 16th week of pregnancy. A 35-year-old primigravida was admitted to our department with acute abdominal pain and hydronephrosis (serum creatinine 1.6?mg/dL). Imaging revealed a large implant myoma compressing the bladder, ureters, rectus, and gestational chamber and causing hydronephrosis. Laparotomic myomectomy was successfully performed and pregnancy continued uneventfully until the 38th week when a cesarean section was performed. Surgical management of myomas during pregnancy is worth evaluating in well-selected and highly symptomatic cases.

Di Donato, Violante; Gasparri, Maria Luisa; Lecce, Francesca; Caccetta, Jlenia; Panici, Pierluigi Benedetti

2014-01-01

412

[Retroperitoneoscopic ureterolithotomy].  

PubMed

Ureterolithotomy has an alternative which is much less invasive --retroperitoneoscopic ureterolithotomy (RU). Nineteen cases of RU are reported (15 males, 4 females). Thirteen patients have undergone RU as monotherapy, 5 patients--after ineffective sessions of extracorporeal shock wave lithotripsy, 1 patient--after contact ureterolithotripsy. Mean size of the stones was 12.8 (9.5-30) mm. All the stones were eliminated for one procedure. Duration of surgery in the first 5 operations was 1.5-2 hours, in subsequent ones--65-70 min. The number of bed-days varied from 2 to 10 days (4.2 days). One male had a postoperative attack of pyelonephritis which was treated with antibacterial drugs. RU is a safe and effective operation, it is justified when previous surgery was ineffective, in large, longstanding concrements of the upper and middle third of the ureter, monohydrate-oxalate concrements. PMID:17915444

Teodorovich, O V; Zabrodina, N B; Galliamov, E A; Kala?chev, O V

2007-01-01

413

Nd:YAG laser irradiation in the treatment of upper tract urothelial tumors  

NASA Astrophysics Data System (ADS)

Nineteen patients with upper tract filling defects were studied in order to determine their clinical diagnosis. In nine patients ureteropyeloscopy confirmed the presence of urothelial tumors of the upper urinary tract. In all the patients ureteroscopy and cold biopsy apparently localized low grade tumors. All the patients underwent Nd:YAG laser irradiation of the tumor and of the base utilizing 25-30 Watts for 3 sec. During the follow-up the patients had endoscopic surveillance every three months (average follow-up is 12 months). Ureteropyeloscopy seems to be an accurate form of evaluation and management of all upper urinary tract filling defects. It permits endoscopic access into ureter and renal pelvis, and coupled Nd:YAG laser it allows, in the same session, treatment of primarily low grade-low stage tumors by conservative approach and endoscopic means.

Gaboardi, Franco; Melodia, Tommaso; Bozzola, Andrea; Galli, Luigi

1991-07-01

414

Comparison of the pulsed dye and holmium lasers for stone fragmentation: in-vitro studies and clinical experience  

NASA Astrophysics Data System (ADS)

The pulsed dye laser used with a 1 microsecond pulse duration at 504 nm delivered via a 320 micron core fiber is designed specifically for ureteric calculi. The threshold for stone fragmentation is in the region of 40 to 50 mJ for the majority of stones. Fragmentation is efficient in the 60 to 70 mJ range but for some stones 100 mJ is required. The Candela MDL 2000 (Candela Corporation) is capable of delivering 140 mJ. This laser has minimal effect on tissue. The holmium laser delivers 300 microsecond pulses of 2.1 microns wavelength (Sunrise Technologies and Coherent Ltd). A maximum of 1 J per pulse at 5 Hz is usually recommended because of the significant action on tissue. Even using this regimen significant damage can be inflicted on the ureter. In this paper the action of these two laser regimens on stones is contrasted.

Watson, Graham M.; Smith, Neil

1993-05-01

415

Trans-urethral ultrasound (TUUS) imaging for visualization and analysis of the prostate and associated tissues  

NASA Astrophysics Data System (ADS)

Accurate assessment of pathological conditions in the prostate is difficult. Screening methods include palpation if the prostate gland, blood chemical testing, and diagnostic imaging. Trans-rectal Ultrasound (TRUS) is commonly used for the assessment of pathological conditions, however, TRUS is severely constrained by the relative distal location of the imaging probe. Trans-urethral Ultrasound (TUUS) may overcome some limitations of TRUS. A TUUS catheter was used to image the prostate, rectum, bladder, ureter, neuro-vascular bundles, arteries, and surrounding tissue. In addition, 360 degrees rotational scans were recorded for reconstruction into 3D volumes. Segmentation was challenging, however, new techniques such as active contour methods show potential. 3D visualizations, including both volume and surface rendering, were provided to clinicians off-line. On-line 3D visualization techniques are currently being developed. Potential applications of TUUS include: prostate cancer diagnosis and staging as well as image guided biopsy and therapy.

Holmes, David R.; Robb, Richard A.

2000-04-01

416

Sutureless end-to-end ureteral anastomosis using a new albumin stent and diode laser  

NASA Astrophysics Data System (ADS)

Sutureless end to end ureteral anastomoses was successfully constructed in acute and chronic experiments. A photothermal sensitive hydrolyzable (PSH) albumin stent played roles as solder and intraluminal supporter to adhesion and position the anastomosed ureter by end to end fashion. The anastomosis seam was lased with 810 nm diode laser energy supplied through hand- held 600 micrometers noncontact optical fiber. A continuous 1 watt wave of power was applied for laser anastomosis. Integrity, welding strength, bursting pressures of anastomosis and histological reaction, and radiological phenomena were compared to those of anastomoses constructed using a liquidity soldering technique. The acute results of two methods were equivalent at welding strengths, but the liquid soldering showed more energy consumption. At chronic study, the radiological and histological studies were performed to evaluate the complications of the anastomosis. Excellent heating and varied degrees of complications were observed. We conclude that PSH stent showed great promise for ureteral anastomosis using laser welding.

Xie, Hua; Shaffer, Brian S.; Prahl, Scott A.; Gregory, Kenton W.

1999-09-01

417

New tunable flashlamp-pumped solid state Ti:sapphire laser for laser lithotripsy  

NASA Astrophysics Data System (ADS)

Laser pulses from a flashlamp pumped, solid state Ti:sapphire laser (Vuman, free running untuned wavelength 792 nm, 2 microseconds pulse width and up to 240 mJ pulse energy) have been successfully and efficiently coupled into thin optical fibers. The coupling efficiency can be up to 67% for 300 micron and 43% for 200 micron core diameter optical fibers. With these two optical fibers in vitro laser lithotripsy has been performed successfully on various human calculi including gall bladder, kidney, ureter and salivary duct stones. The bright white flash of the induced plasma emission, strong shock waves, fiber recoil and stone propulsion and the splattering of the stone chips have been observed during the calculi fragmentation.

Jiang, Zhi X.; Giannetas, V.; Charlton, Andrew; King, Terence A.

1993-05-01

418

Laparoendoscopic Single-Site (LESS) Retroperitoneal Radical Nephrectomy in a Patient with Renal Cell Carcinoma Receiving Hemodialysis  

PubMed Central

We present here the patient undergoing laparoendoscopic single-site (LESS) retroperitoneal radical nephrectomy while receiving hemodialysis. An 81-year-old man under hemodialysis for 6 years was incidentally discovered to have two left renal masses with acquired cystic disease of the kidney (ACDK). A 4-cm flank incision for GelPort was made. Three trocars were inserted into the retroperitoneum through GelPort. After division of the renal vessels and ureter, the kidney was placed into the extraction bag and was retrieved through flank incision without any extra skin incision. There were no intraoperative and postoperative complications. This procedure offers an effective, minimally invasive therapeutic alternative to the standard laparoscopic technique in high-risk end-stage renal disease patients.

Nomura, Takeo; Sato, Fuminori; Takahashi, Mika; Sumino, Yasuhiro; Mimata, Hiromitsu

2011-01-01

419

[Application of rowatinex in the perioperative period in the extracorporeal shock wave lithotripsy].  

PubMed

Despite the high efficacy and safety of ESWL used to disintegrate stones in pyelocaliceal system and upper ureter, the issue of further reduction of the risk of complications of this procedure remains unresolved. The inclusion ofphytopreparations with anti-inflammatory and lithokinetic properties in the scheme of perioperative treatment is one of the ways for prevent complications of ESWL. The effect of the drug Rowatinex on the process of discharge of calculi fragments after ESWL is evaluated. The frequency and intensity of qualitative changes of urine after appointment this drug were assessed. It is concluded that Rowatinex has positive impact on the final result of ESWL in the case of its inclusion in the complex medical treatment, which manifests in terms of reducing the time of discharge of fragments, mitigation of subjective symptoms, as well as reducing the frequency of subclinical bacteriuria and severe complications. PMID:24956667

2014-01-01

420

Diagnosis and treatment of carcinosarcoma of the renal pelvis: A case report  

PubMed Central

Carcinosarcoma is a rare type of renal pelvis malignancy, the diagnosis of which requires the presence of malignant epithelial and mesenchymal components. The prognosis of this disease is extremely poor due to its rapid progression and widespread metastases. The present study describes a case of carcinosarcoma involving the right renal pelvis in a 73-year-old female who presented with intermittent hematuria and right-flank pain that had persisted for one month. Computed tomography revealed a 2.4×2.5 cm mass in the right renal pelvis, which was diagnosed as a right renal pelvic tumor. Laparoscopic radical resection of the right kidney and ureter was performed. Following surgery, immunohistochemical analysis showed positive reactions for epithelial and mesenchymal markers. Based on these findings, the patient was diagnosed with carcinosarcoma. Thus, immunohistochemical analysis is a critical method for the accurate diagnosis of carcinosarcoma.

DONG, BIAO; ZHANG, JIAN-JIAN; CHEN, CHAO; WANG, YUAN-TAO; ZHAI, XIU-YU; FU, YAO-WEN; ZHOU, HONG-LAN

2014-01-01

421

Impalement injury of the urinary bladder: a case report.  

PubMed

Impalement injury of the urinary bladder, especially secondary to rectal impalement, is extremely rare. In this case, a 31-year-old man sustained a steel pipe impalement injury through his perirectal region. He presented with gross hematuria, abdominal defense, and a penetrating wound. On the basis of the computed tomography findings and abdominal defense, we suspected a through-and-through bladder perforation from the rectal space to the intraperitoneum. Laparotomy revealed a through-and-through bladder perforation as well as damage to the right ureter, 3 distinct ileal injuries, and rectal anterior, anal, and right seminal vesicle injuries. Surgical repair of each damaged site was undertaken. The prompt diagnosis and surgical repair ensured good postoperative recovery. PMID:22741055

Morita, Jun; Naoe, Michio; Nakasato, Takehiko; Ogawa, Yoshio

2012-06-01

422

[Can bladder catheterization in pediatrics cause complications? The case of a urethral dysuria cystograph].  

PubMed

A urethral dysuria cystograph (CUMS (Cistografia Ureteral Miccional Seriada)) is the first diagnostic procedure, by means of x-rays, to evaluate bladder-urethral reflux. It consists of a bladder catheter to administer a radiopaque contrast dye through the ureter. To use the aforementioned technique without any asepsis measures and without knowledge about it can lead to possible complications. By means of a retrospective study using a sample of 181 patients, the authors have evaluated the incidence of possible complications and/or subsequent discomfort due to a urethral dysuria cystograph (CUMS). As final results, by means of an after test telephone call, the authors observed that 96.7% of the children who underwent this technique did not manifest any type of complication nor urinary discomfort. PMID:20014629

Alcázar García, A; Daviu Llorens, E; Daza Laguna, A; Durán Feliubadalo, C; Pons Torrents, X

2009-10-01

423

Embryonic Stem Cells Proliferate and Differentiate when Seeded into Kidney Scaffolds  

PubMed Central

The scarcity of transplant allografts for diseased organs has prompted efforts at tissue regeneration using seeded scaffolds, an approach hampered by the enormity of cell types and complex architectures. Our goal was to decellularize intact organs in a manner that retained the matrix signal for differentiating pluripotent cells. We decellularized intact rat kidneys in a manner that preserved the intricate architecture and seeded them with pluripotent murine embryonic stem cells antegrade through the artery or retrograde through the ureter. Primitive precursor cells populated and proliferated within the glomerular, vascular, and tubular structures. Cells lost their embryonic appearance and expressed immunohistochemical markers for differentiation. Cells not in contact with the basement membrane matrix became apoptotic, thereby forming lumens. These observations suggest that the extracellular matrix can direct regeneration of the kidney, and studies using seeded scaffolds may help define differentiation pathways.

Williams, Matthew J.; Hamazaki, Takashi; Terada, Naohiro; Clapp, William L.; Adin, Christopher; Ellison, Gary W.; Jorgensen, Marda; Batich, Christopher D.

2009-01-01

424

[Autotransplantation of the kidney 100 years after Imre Ullmann's pioneering operation].  

PubMed

The authors give an overview on renal autotransplantation on occasion of Emerich (Imre) Ullmann's pioneer operation 100 years ago. Ullmann was born in 1861 in Pécs, Hungary. After finishing the Vienna Medical School, he worked on the I. Surgical Clinic of the University of Vienna. In 1902, already as the chief of surgery of a Vienna hospital he successfully performed canine kidney autotransplantation, later also technically successful allo- and xenotransplantation. Human renal autotransplantations have been performed since the early 1960's mainly because of renovascular hypertension/aneurysm or ureter injuries or tumor. Rare indications are the loin pain-hematuria syndrome, echinococcosis of the kidney, the nutcracker syndrome, ureteroarterial fistula and there are reports about allograft autotransplantations also. Lately, laparoscopy gained place and nephrectomies are done more often minimally invasive. In Hungary twenty-four cases of kidney autotransplantation were performed. PMID:12858643

Langer, Robert; Perner, Ferenc

2003-06-01

425

Inflammatory variant of a well-differentiated retroperitoneal liposarcoma: case report of a rare giant variety.  

PubMed

Inflammatory liposarcoma is a rare variant of a well-differentiated liposarcoma (WDLPS). We present a case of a 37 years old male who had a giant variety of this inflammatory WDLPS. CT scan revealed a large abdomino-pelvic mass abutting the left kidney and pushing the IVC, Aorta and the left ureter across the midline. CT guided FNAC did not reveal any malignant cells. A large 9-kg fibro-fatty mass, which appeared irregular, congested and bosillated was excised. Microscopic picture revealed foci of fibrosis with mature adipose tissue. Lymphocyte and plasma cell infiltrate was abundant along with multi-nucleate giant cells and few lipoblasts. There are no case reports of a giant inflammatory variant of WD-LPS in world literature and this is the first of its kind from the Indian sub-continent. We present a case report of this rare giant variant of inflammatory WDLPS and discuss the review of literature. PMID:16763361

Mehrotra, Prateek K; Ramachandran, C S; Goel, Deep; Arora, Vijay

2006-01-01

426

[Vaginal hysterectomy leniens: intrafascial technique].  

PubMed

The appearance of a new intrafascial technique for vaginal hysterectomy serves to remind us that in spite of well-standardized techniques, gynecologists perform this less often than formerly. The described technique is an intrafascial variation of the extrafascial vaginal hysterectomy beginning at the fundus uteri. We mobilize the anterior vaginal wall using Strassmann's incision. The body of the uterus should be delivered through the anterior fornix. Then follows the ligation of the broad ligaments and careful dissection of the fibroareolar space of the posterior cervical wall. The cardinal ligament requires intrafascial clamping and ligation. This technique is simple and avoids injury to the ureters. If this operation is successfully performed, postoperative pain is minimal, and hospitalization could be greatly reduced. PMID:15459520

Tapia, Jorge E

2004-10-01

427

Anterior pelvic reconstruction with ileum after cancer treatment.  

PubMed Central

Ileum has been used to reconstruct the lower urinary tract in 15 patients (10 women, five men) after treatment for bladder or gynaecological cancer. Seven patients had previously received radical pelvic irradiation. Four methods were used: group 1 (five patients): bladder patch after partial cystectomy or bladder augmentation after clam cystotomy for bladder contracture; group 2 (four patients): bladder replacement after subtotal (supratrigonal) cystectomy; group 3 (two patients): ureteric replacement for lower ureteric obstruction or fistula, and group 4 (four patients): complete replacement of bladder and lower ureters after anterior pelvic exenteration, with creation of neovagina from caecum in the two female patients. Review of the results indicates that ileum provides a versatile and safe material for anterior pelvic reconstruction in cancer patients even after previous pelvic irradiation. Images Figure 1. Figure 2. Figure 4. Figure 5. Figure 6.

Hendry, W F; Christmas, T J; Shepherd, J H

1991-01-01

428

First experience using peptide receptor radionuclide therapy in a patient with urothelial carcinoma.  

PubMed

A 78-year-old man with urothelial carcinoma metastasis after surgical resection of the right kidney, part of the ureter, and urinary bladder in May 2003 and 3 cycles of chemotherapy with cisplatin-gemcitabine was referred for peptide receptor radionuclide therapy (PRRT). Somatostatin-receptor profile was assessed by 68Ga-labeled lanreotide PET, and PRRT was performed using 3738 MBq (101 mCi) of 90Y-DOTA-lanreotide. Because of adequate PRRT response confirmed with MRI and 18F-FDG PET, surgical resection of the solitary cervical metastasis was feasible. Treatment was well tolerated, and the patient remains in complete remission from his urothelial carcinoma. PMID:23579972

Putzer, Daniel; Gabriel, Michael; Prommegger, Rupert; Kendler, Dorota; Virgolini, Irene Johanna

2013-10-01

429

Multiple primary malignancies: a report of two cases.  

PubMed

The diagnosis of multiple primary malignancies (MPMs) in a patient has been reported rather frequently during the past decade. Here we present two cases with three synchronous primary malignant tumors. The first patient is a 66-year-old male with synchronous colorectal cancer, renal cell carcinoma (RCC) and non-small cell lung cancer (NSCLC). The second patient is a 64-year-old female with breast cancer, transitional cell carcinoma of the ureter and endometrial cancer. MPMs seem to be diagnosed in a higher incidence than that predicted only by the influence of hazard and, whenever found, they raise questions regarding not only possible common etiologic factors or same pathogenetic mechanisms but also they cause a lot of troubles to both clinicians and patients because the therapeutic options usually become limited. PMID:24826064

Sakellakis, Minas; Peroukides, Stavros; Iconomou, Gregoris; Boumpoucheropoulos, Sotirios; Kalofonos, Haralabos

2014-04-01

430

Impalement Injury of the Urinary Bladder: A Case Report  

PubMed Central

Impalement injury of the urinary bladder, especially secondary to rectal impalement, is extremely rare. In this case, a 31-year-old man sustained a steel pipe impalement injury through his perirectal region. He presented with gross hematuria, abdominal defense, and a penetrating wound. On the basis of the computed tomography findings and abdominal defense, we suspected a through-and-through bladder perforation from the rectal space to the intraperitoneum. Laparotomy revealed a through-and-through bladder perforation as well as damage to the right ureter, 3 distinct ileal injuries, and rectal anterior, anal, and right seminal vesicle injuries. Surgical repair of each damaged site was undertaken. The prompt diagnosis and surgical repair ensured good postoperative recovery.

Naoe, Michio; Nakasato, Takehiko; Ogawa, Yoshio

2012-01-01

431

Multiple primary malignancies: a report of two cases  

PubMed Central

The diagnosis of multiple primary malignancies (MPMs) in a patient has been reported rather frequently during the past decade. Here we present two cases with three synchronous primary malignant tumors. The first patient is a 66-year-old male with synchronous colorectal cancer, renal cell carcinoma (RCC) and non-small cell lung cancer (NSCLC). The second patient is a 64-year-old female with breast cancer, transitional cell carcinoma of the ureter and endometrial cancer. MPMs seem to be diagnosed in a higher incidence than that predicted only by the influence of hazard and, whenever found, they raise questions regarding not only possible common etiologic factors or same pathogenetic mechanisms but also they cause a lot of troubles to both clinicians and patients because the therapeutic options usually become limited.

Peroukides, Stavros; Iconomou, Gregoris; Boumpoucheropoulos, Sotirios; Kalofonos, Haralabos

2014-01-01

432

Congenital pouch colon syndrome in a Saudi Arabian neonate.  

PubMed

Congenital pouch colon syndrome is partial or complete replacement of the colon by a pouch-like structure and anorectal malformation. Commonly reported from northern India, we believe this is the first report of congenital pouch colon syndrome in a Saudi Arabian neonate. He was referred with an imperforate anus and diagnosed as having a high anorectal malformation. The patient underwent a sigmoid colostomy. Continued abdominal distension after the colostomy prompted sonography and computed tomography, which showed an air- and fluid-containing cystic structure in the abdomen. Exploration revealed a thick-walled cystic structure in continuity with the distal colostomy and with a blood supply mainly from the superior mesenteric artery. The ureters were dilated and tortuous and the pouch opened into the posterior vesical wall. The pouch was resected and an end colostomy fashioned. The etiopathogenesis classification and management of the congenital pouch colon syndrome are discussed. PMID:18206446

Donkol, Ragab H; Jetley, Nishith Kumar; Al Mazkary, Mufareh H

2008-01-01

433

Reflex anuria: a rare cause of acute kidney injury  

PubMed Central

Background Acute Kidney Injury results from pre renal, post renal or intrinsic renal causes. Reflex anuria is a very rare cause of renal impairment which happens due to irritation or trauma to one kidney or ureter, or severely painful stimuli to other nearby organs. Case Presentation Here we present a case of acute kidney injury secondary to reflex anuria in a patient who underwent extensive gynecological surgery along with ureteral manipulation which recovered spontaneously. Conclusion Reflex Anuria is a rare and often not considered as cause of acute kidney injury. This case illustrates that this should be kept as a differential in potential cause of acute kidney injury in patient undergoing urogenital or gynecological surgeries.

Adediran, Samuel; Dhakarwal, Pradeep

2014-01-01

434

Ileo-Pelvic Anastomosis and Augmentation Cystoplasty for Treatment of Encrusted Pyelitis in a Transplanted Kidney  

PubMed Central

Infection stones are more likely to form after urinary diversion as the result of urinary stasis. To prevent urinary stasis due to encrusted pyelitis in a transplanted kidney, we describe an alternative a surgical treatment: ileo-pelvic anastomosis. In our patient with a transplanted kidney, the ileal conduit had previously been anastomosed end-to-side owing to renal tuberculosis with an atrophied bladder; the transplanted ureter was anastomosed to the ileum in the left lower abdomen with an ileal conduit on the opposite side. Routine check-up revealed hydronephrosis with infected pyelitis and ureteritis in the transplanted kidney. We performed ileo-pelvic end-to-end anastomosis to prevent urinary stasis by lengthening the ileal conduit and performed augmentation cystoplasty to support the atrophied bladder following tuberculosis. We suggest that this approach may be useful in similar cases.

Chin, Chur; Chung, Jae Sung; Oh, Cheol Kyu; Kim, Seong Chul; Hong, Seong Woo

2013-01-01

435

Simplified laparoscopic technique for the treatment of long distal ureteral stenosis  

PubMed Central

Laparoscopic interventions with the application of vesico-psoas hitch and Boari flap methods for the reconstruction of pronounced ureter defects require considerable physical skill and competence. This case series aims to present our experience in the treatment of long, distal ureteral stenoses via simplified laparoscopic ureteroneocystostomy in 3 male patients in whom the stenoses ranged from 5 cm to 6 cm. Prior to each laparoscopic intervention, intravenous urography and pyelography via a nephrostomy tube were performed. The mean operation time was 157 min (120–180 min), and blood loss averaged 33 ml (20–50 ml). No intra-operative or post-operative complications were recorded. The post-operative hospital stay was ? 6 days. Follow-up imaging examinations revealed normal kidney-urinary bladder urine flow in all cases. In conclusion, we consider that simplified ureteral replantation facilitates laparoscopic treatment of long, distal ureteral stenoses.

Slojewski, Marcin; Sikorski, Andrzej

2013-01-01

436

Simplified laparoscopic technique for the treatment of long distal ureteral stenosis.  

PubMed

Laparoscopic interventions with the application of vesico-psoas hitch and Boari flap methods for the reconstruction of pronounced ureter defects require considerable physical skill and competence. This case series aims to present our experience in the treatment of long, distal ureteral stenoses via simplified laparoscopic ureteroneocystostomy in 3 male patients in whom the stenoses ranged from 5 cm to 6 cm. Prior to each laparoscopic intervention, intravenous urography and pyelography via a nephrostomy tube were performed. The mean operation time was 157 min (120-180 min), and blood loss averaged 33 ml (20-50 ml). No intra-operative or post-operative complications were recorded. The post-operative hospital stay was ? 6 days. Follow-up imaging examinations revealed normal kidney-urinary bladder urine flow in all cases. In conclusion, we consider that simplified ureteral replantation facilitates laparoscopic treatment of long, distal ureteral stenoses. PMID:24501606

Golab, Adam; Slojewski, Marcin; Sikorski, Andrzej

2013-12-01

437

Organotypic culture of the urogenital tract.  

PubMed

Organotypic culture is an invaluable technique that allows researchers with the tool to analyze a tissue development in an isolated and well-defined environment. This technique also permits one to study the roles of different signaling systems/signaling molecules and to take advantage of the modern real-time imaging techniques, including confocal microscopy. With great success, our lab has used organotypic culture of the urogenital tract (UGT) to study growth and extension of the mesonephric (Wolffian) duct and its cloaca connection, ureter maturation, and bladder urothelium development (Batourina et al. Nat Genet 32:109, 2002; Batourina et al. Nat Genet 37:1082, 2005; Mendelsohn Organogenesis 5:306, 2009). PMID:22639250

Batourina, Ekaterina; Gandhi, Devangini; Mendelsohn, Cathy L; Molotkov, Andrei

2012-01-01

438

MODERN USE OF URINARY ANTISEPTICS  

PubMed Central

It is not necessary to resort to complete study in most cases of urinary tract infection. However, if the lesion is chronic or recurrent, associated with mixed organisms, complicated by lower tract involvement, accompanied by low total renal function, with or without abnormalities in a kidney-ureter-bladder x-ray film or in an intravenous urogram, then complete retrograde study should be carried out. A Gram stain will substitute for culture in most simple urinary tract infections and a trial of the agent of choice will act as a test of bacterial sensitivity. If the infection persists, however, more adequate bacteriologic studies are required. For good chemotherapeutic practice, it is important to: (1) Withhold the drug until it has been determined that obstruction, stone or other such lesion is not present; (2) watch for side effects and toxicity; and (3) give the best drug in large enough dosage for an adequate period of time.

Hinman, Frank

1952-01-01

439

Morphology and putative function of the colon and cloaca of marine and freshwater snakes.  

PubMed

Among tetrapods, evidence for postrenal modification of the urine by the distal digestive tract (including the colon and cloaca) is highly variable. Birds and bladderless reptiles are of interest because the colon and cloaca represent the only sites from which water and ions can be reclaimed from the urine secreted by the kidney. For animals occupying desiccating environments (e.g., deserts and marine environments), postrenal modification of the urine may directly contribute to the maintenance of hypo-osmotic body fluids. We compared the morphology and distribution of key proteins in the colon, cloaca, and urogenital ducts of watersnakes from marine (Nerodia clarkii clarkii) and freshwater (Nerodia fasciata) habitats. Specifically, we examined the epithelia of each tissue for evidence of mucus production by examining the distribution of mucopolysaccharides, and for evidence of water/ion regulation by examining the distribution of Na(+) /K(+) -ATPase (NKA), Na(+) /K(+) /Cl(-) cotransporter (NKCC), and aquaporin 3 (AQP3). NKCC localized to the basolateral epithelium of the colon, urodeal sphincter, and proctodeum, consistent with a role in secretion of Na(+), Cl(-) , and K(+) from the tissue, but NKA was not detected in the colon or any compartment of the cloaca. Interestingly, NKA was detected in the basolateral epithelium of the ureters, suggesting the urothelium may play a role in active ion transport. AQP3 was detected in the ureters and coprodeal complex, consistent with a role in urinary and fecal dehydration or, potentially, in the production of the watery component of the mucus secreted by the coprodeal complex. Since no differences in general cloacal morphology, production of mucus, or the distribution of ion transporters/water channels were detected between the two species, cloacal osmoregulation may either be regulated by proteins not examined in this study or may not be responsible for the differential success of N. c. clarkii and N. fasciata in marine habitats. PMID:21935975

Babonis, Leslie S; Womack, Molly C; Evans, David H

2012-01-01

440

Ureteroscope-assisted double-J stenting following laparoscopic ureterolithotomy.  

PubMed

The aim of this study was to examine the feasibility of ureteroscope-assisted double-J stenting following laparoscopic ureterolithotomy and to evaluate the effects of retrograde ureteroscopic access exerted on the sutured ureterotomy site. From January 2002 to December 2011, 30 patients with proximal ureteral stone underwent ureteroscopic double-J stenting of the ureter following retroperitoneal laparoscopic ureterolithotomy. Patient demographics and perioperative parameters, including the degree of hydronephrosis, urine leakage, and drainage time, were retrospectively reviewed. These data were compared with those of 30 consecutive patients who received open ureterolithotomy and intracorporeal ureteral double-J stenting. In addition, a PubMed search was conducted and the related literature on the placement of a ureteral stent was reviewed. Twenty-eight patients successfully underwent ureteral double-J stenting with ureteroscopic access. No malposition of the ureteral stent was identified in the ureteroscopic group, but two patients in the intracorporeal group required postoperative adjustment of the stent. Residual stone fragments were found during stent placement in three patients in the ureteroscopic group and holmium:yttrium-aluminum-garnet laser lithotripsy was immediately performed. There was no significant difference in postoperative outcomes or complication rates between the two groups. Ureteroscope-assisted ureteral double-J stenting is a simple and safe alternative allowing intraluminal navigation along the entire ureter, correct stent placement, and prompt treatment of residual stone fragments, without radiation exposure. In addition, ureteral disruption and urinary extravasation may not be concerns for ureteroscopic access with continuous normal saline irrigation. PMID:24751387

Chen, I-Hsuan; Tsai, Jeng-Yu; Yu, Chia-Cheng; Wu, Tony; Huang, Jong-Khing; Lin, Jen-Tai

2014-05-01

441

In-Vitro Assessment of a New Portable Ballistic Lithotripter with Percutaneous and Ureteroscopic Models  

PubMed Central

Abstract Background and Purpose The EMS Swiss LithoBreaker is a new, portable, electrokinetic lithotripter. We compared its tip velocity and displacement characteristics with a handheld, pneumatic lithotripter LMA StoneBreaker.™ We also evaluated fragmentation efficiency using in vitro models of percutaneous and ureteroscopic stone fragmentation. Materials and Methods Displacement and velocity profiles were measured for 1-mm and 2-mm probes using a laser beam aimed at a photo detector. For the percutaneous model, 2-mm probes fragmented 10-mm spherical BegoStone phantoms until the fragments passed through a 4-mm mesh sieve. The ureteroscopic model used 1-mm probes and compared the pneumatic and electrokinetic devices to a 200-?m holmium laser fiber. Cylindrical (4-mm diameter, 4-mm length) BegoStone phantoms were placed into silicone tubing to simulate the ureter; fragmented stones passed through a narrowing in the tubing. Results For both 1-mm and 2-mm probes, the electrokinetic device had significantly higher tip displacement and slower tip velocity, P<0.01. In the percutaneous model, the electrokinetic device needed an average of 484 impulses over 430 seconds to fragment one BegoStone, while the pneumatic device needed 29 impulses over 122 seconds to fragment one stone. Both clearance times and number of impulses needed for percutaneous stone clearance were significantly different at P<0.01. Ureteroscopically, the mean clearance time was 97 seconds for the electrokinetic lithotripter, 145 seconds for the pneumatic lithotripter, and 304 seconds for the laser. Comparing the pneumatic device with the electrokinetic device ureteroscopically, there was no significant difference in clearance time, P=0.55. Both the pneumatic and electrokinetic lithotripters, however, demonstrated decreased clearance times compared with the laser, P=0.027. Conclusions The portable electrokinetic lithotripter may be better suited for ureteroscopy instead of percutaneous nephrolithotomy. It appears to be comparable to the portable pneumatic device in the ureter. Further clinical studies are needed to confirm these findings in vivo.

Wang, Agnes J.; Baldwin, Gregory T.; Gabriel, James C.; Cocks, F. Hadley; Goldsmith, Zachariah G.; Iqbal, Muhammad W.; Astroza, Gaston M.; Simmons, W. Neal; Zhong, Pei; Preminger, Glenn M.

2012-01-01

442

Chromosome 3 duplication q21 leads to qter deletion p25 leads to pter syndrome in children of carriers of a pericentric inversion inv(3) (p25q21).  

PubMed Central

Close phenotypic similarity between two cases carrying a rec(3) dup q,inv(3) (p25q21), 12 additional infants from the same inv (3)(p25q21) kindred who lived less than 1 year, and eight cases studied in other medical centers has led us to postulate the existence of a distinct chromosome 3 duplication-deletion syndrome. In the presence of trisomy for (3)q21 leads to qter and monosomy for (3)p25 leads to pter, the facial dysmorphy is unique: a distorted head shape due to irregular cranial sutures, thick low eyebrows, long eyelashes, persistent lanugo, distended veins on the scalp, hypertelorism, oblique palpebral fissures, a very short nose with a broad depressed bridge and anteverted nares, protruding maxilla, thin upper lip, micrognathia, low-set ears, and a short webbed neck. Port-wine stains, congenital glaucoma, cloudy corneas, cleft palate and harelip also occur frequently. Each infant has difficulty sucking and swallowing. Congenital anomalies of the cardiovascular system, of midgut rotation, and of the urogenital system are noted for the infants who died neonatally. Most frequent is a ventricular septal defect, f