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Sample records for ureter

  1. [Ureter drugs].

    PubMed

    Raynal, G; Bellan, J; Saint, F; Tillou, X; Petit, J

    2008-03-01

    Many improvements have been made recently in the field of the ureteral smooth muscle pharmacology. After a brief summary on physiological basis, we review what is known about effects on ureter of different drugs class. In a second part, we review clinical applications for renal colic analgesia, calculi expulsive medical therapy, ESWL adjuvant treatment and preoperative treatment before retrograde access. There are now sufficient data on NSAID and alpha-blockers. beta-agonists, especially for beta3 selective ones, and topical drugs before retrograde access are interesting and should be further evaluated. PMID:18472067

  2. Paraperitoneal Inguinal Hernia of Ureter

    PubMed Central

    Lu, Albert; Burstein, Jerome

    2012-01-01

    Inguinal herniation of ureter is an uncommon finding that can potentially lead to obstructive uropathy. We report a case of inguinal herniation of ureter discovered incidentally during workup for acute renal failure and ultrasound finding of hydronephrosis. PMID:23365714

  3. Ureter growth and differentiation.

    PubMed

    Bohnenpoll, Tobias; Kispert, Andreas

    2014-12-01

    The mammalian ureter is a slender tube that connects the renal pelvis with the bladder. It allows the unidirectional movement of urine by means of a peristaltically active smooth muscle layer that together with fibroelastic material ensheathes a water-impermeable multilayered urothelium. The ureteric urothelium as well as the outer mesenchymal coat arise from undifferentiated precursor tissues, the distal ureteric bud and its surrounding mesenchyme, respectively. Specification, growth and differentiation of these ureteric precursor tissues are tightly linked to each other, and are highly integrated with those of the adjacent rudiments of kidney and bladder. Here, we review the current knowledge on the cellular mechanisms as well as the molecular players that guide development of the tissue architecture of the ureter and its peristalsis. PMID:25087982

  4. Congenital malformations of the ureter: anatomical studies.

    PubMed

    Dorko, František; Tokarčík, Ján; Výborná, Eva

    2016-06-01

    The ureter is a derivate of the Wolffian mesonephric duct and undergoes complex changes during development. The most common developmental anomaly is complete duplication of the ureter. Duplication of the ureter may be complete or incomplete. Incomplete duplication of ureter is well known as bifid ureter. Presence of various anomalies of the ureter is associated with increased risk of urinary tract infections and many other clinical complications. PMID:26286110

  5. Ectopic Ureter Accompanied by Duplicated Ureter: Three Cases.

    PubMed

    Senel, Ufuk; Tanriverdi, Halil Ibrahim; Ozmen, Zafer; Sozubir, Selami

    2015-09-01

    We report cases of ectopic ureter accompanied by three types of ureteral duplication that had been diagnosed previously and treated for enuresis. Data from three female patients ranging in age from 1 to 10 years were evaluated. The ectopic ureter was observed on the left in one case, on the right in another and bilateral in the third case. Complete duplication was found in two cases, while the third had incomplete duplication. Ureteroneocystostomy was performed in one case and subtotal nephrectomy was carried out in the other two cases. Ureteroneocystostomy was performed for the ectopic ureter found in the opposite urinary system in one of the cases. Ectopic duplicated ureter should be considered in treatment-resistant enuresis and urinary tract infections and after a careful physical examination, imaging as well as function tests should be performed. PMID:26500949

  6. Cancer - renal pelvis or ureter

    MedlinePlus

    ... may include removing part of the bladder and tissues around it, or the lymph nodes. If the tumor is in the ureter, it may be possible to remove it while preserving the kidney. When the cancer has spread outside ...

  7. Cancer - renal pelvis or ureter

    MedlinePlus

    ... urine from the kidney to the bladder (ureter). Causes Cancer can grow in the urine collection system, but ... more common in people older than 65. The causes of this cancer are not completely known. Long-term (chronic) irritation ...

  8. Comprehensive data analysis of human ureter proteome

    PubMed Central

    Magdeldin, Sameh; Hirao, Yoshitoshi; El Guoshy, Amr; Xu, Bo; Zhang, Ying; Fujinaka, Hidehiko; Yamamoto, Keiko; Yates, John R.; Yamamoto, Tadashi

    2016-01-01

    Comprehensive human ureter proteome dataset was generated from OFFGel fractionated ureter samples. Our result showed that among 2217 non-redundant ureter proteins, 751 protein candidates (33.8%) were detected in urine as urinary protein/polypeptide or exosomal protein. On the other hand, comparing ureter protein hits (48) that are not shown in corresponding databases to urinary bladder and prostate human protein atlas databases pinpointed 21 proteins that might be unique to ureter tissue. In conclusion, this finding offers future perspectives for possible identification of ureter disease-associated biomarkers such as ureter carcinoma. In addition, Cytoscape GO annotation was examined on the final ureter dataset to better understand proteins molecular function, biological processes, and cellular component. The ureter proteomic dataset published in this article will provide a valuable resource for researchers working in the field of urology and urine biomarker discovery. PMID:26937461

  9. A proteomic glimpse into human ureter proteome

    PubMed Central

    Hirao, Yoshitoshi; Elguoshy, Amr; Xu, Bo; Zhang, Ying; Fujinaka, Hidehiko; Yamamoto, Keiko; Yates, John R.; Yamamoto, Tadashi

    2015-01-01

    Urine has evolved as one of the most important biofluids in clinical proteomics due to its noninvasive sampling and its stability. Yet, it is used in clinical diagnostics of several disorders by detecting changes in its components including urinary protein/polypeptide profile. Despite the fact that majority of proteins detected in urine are primarily originated from the urogenital (UG) tract, determining its precise source within the UG tract remains elusive. In this article, we performed a comprehensive analysis of ureter proteome to assemble the first unbiased ureter dataset. Next, we compared these data to urine, urinary exosome, and kidney mass spectrometric datasets. Our result concluded that among 2217 nonredundant ureter proteins, 751 protein candidates (33.8%) were detected in urine as urinary protein/polypeptide or exosomal protein. On the other hand, comparing ureter protein hits (48) that are not shown in corresponding databases to urinary bladder and prostate human protein atlas databases pinpointed 21 proteins that might be unique to ureter tissue. In conclusion, this finding offers future perspectives for possible identification of ureter disease‐associated biomarkers such as ureter carcinoma. In addition, the ureter proteomic dataset published in this article will provide a valuable resource for researchers working in the field of urology and urine biomarker discovery. All MS data have been deposited in the ProteomeXchange with identifier PXD002620 (http://proteomecentral.proteomexchange.org/dataset/PXD002620). PMID:26442468

  10. Minimally Invasive Approach of a Retrocaval Ureter

    PubMed Central

    Pinheiro, Hugo; Ferronha, Frederico; Morales, Jorge; Campos Pinheiro, Luís

    2016-01-01

    The retrocaval ureter is a rare congenital entity, classically managed with open pyeloplasty techniques. The experience obtained with the laparoscopic approach of other more frequent causes of ureteropelvic junction (UPJ) obstruction has opened the method for the minimally invasive approach of the retrocaval ureter. In our paper, we describe a clinical case of a right retrocaval ureter managed successfully with laparoscopic dismembered pyeloplasty. The main standpoints of the procedure are described. Our results were similar to others published by other urologic centers, which demonstrates the safety and feasibility of the procedure for this condition.

  11. Thulium fiber laser damage to the ureter

    NASA Astrophysics Data System (ADS)

    Wilson, Christopher R.; Hardy, Luke A.; Irby, Pierce B.; Fried, Nathaniel M.

    2015-07-01

    Our laboratory is studying experimental thulium fiber laser (TFL) as a potential alternative lithotripter to the clinical gold standard Holmium:YAG laser. Safety studies characterizing undesirable Holmium laser-induced damage to ureter tissue have been previously reported. Similarly, this study characterizes TFL induced ureter and stone basket damage. A TFL beam with pulse energy of 35 mJ, pulse duration of 500 μs, and pulse rates of 150-500 Hz was delivered through a 100-μm-core, low-OH, silica optical fiber to the porcine ureter wall, in vitro. Ureter perforation times were measured and gross, histological, and optical coherence tomography images of the ablation zone were acquired. TFL operation at 150, 300, and 500 Hz produced mean ureter perforation times of 7.9, 3.8, and 1.8 s, respectively. Collateral damage averaged 510, 370, and 310 μm. TFL mean perforation time exceeded 1 s at each setting, which is a greater safety margin than previously reported during Holmium laser ureter perforation studies.

  12. Indocyanine green for intraoperative localization of ureter.

    PubMed

    Siddighi, Sam; Yune, Junchan Joshua; Hardesty, Jeffrey

    2014-10-01

    Intraurethral injection of indocyanine green (ICG; Akorn, Lake Forest, IL) and visualization under near-infrared (NIR) light allows for real-time delineation of the ureter. This technology can be helpful to prevent iatrogenic ureteral injury during pelvic surgery. Patients were scheduled to undergo robot-assisted laparoscopic sacrocolpopexy. Before the robotic surgery started, the tip of a 6-F ureteral catheter was inserted into the ureteral orifice. Twenty-five milligrams of ICG was dissolved in 10-mL of sterile water and injected through the open catheter. The same procedure was repeated on the opposite side. The ICG reversibly stained the inside lining of the ureter by binding to proteins on urothelial layer. During the course of robotic surgery, the NIR laser on the da Vinci Si surgical robot (Intuitive Surgical, Inc, Sunnyvale, CA) was used to excite ICG molecules, and infrared emission was captured by the da Vinci filtered lens system and electronically converted to green color. Thus, the ureter fluoresced green, which allowed its definitive identification throughout the entire case. In all cases of >10 patients, we were able to visualize bilateral ureters with this technology, even though there was some variation in brightness that depended on the depth of the ureter from the peritoneal surface. For example, in a morbidly obese patient, the ureters were not as bright green. There were no intraoperative or postoperative adverse effects attributable to ICG administration for up to 2 months of observation. In our experience, this novel method of intraurethral ICG injection was helpful to identify the entire course of ureter and allowed a safe approach to tissues that were adjacent to the urinary tract. The advantage of our technique is that it requires the insertion of just the tip of ureteral catheter. Despite our limited cohort of patients, our findings are consistent with previous reports of the excellent safety profile of intravenous and intrabiliary ICG

  13. Vascularization of the ureter after experimental ureterolysis in rabbits.

    PubMed

    Sirca, A; Dekleva, A; Kordas, I

    1978-03-01

    The left ureter was isolated and its nutritive arteries interrupted in 43 rabbits. The blood flow in the isolated and in the control ureters was estimated intravitally by measuring the temperature in the wall of the ureters, and postmortally by counting the capillaries injected with India ink. The vascularization of the isolated ureter was lowered at 3 days after surgery and returned to normal values at 14 days. PMID:640805

  14. [An ectopic ureter which drained into the perianal area].

    PubMed

    Delgado Chanis, G

    1992-05-01

    The author reviews the clinical record of a 6-year-old boy, who had urinary incontinence with wetting of his underwear in the posterior part. IVP, Cystoscopy, Cystogram, Left Retrograde Pyelogram and Surgery showed a double distal ureter on the left side. The normal ureter drained in the bladder in the orthotopic ureteral orifice. The medial dilated ectopic ureter, in the form of an H, was connected to the normal ureter and drained in the perianal area. The incontinence stopped after the resection of the ectopic ureter. PMID:1620895

  15. Understanding the Ureter: Challenges and Opportunities.

    PubMed

    Park, Alyssa; Venkatesh, Ramakrishna

    2016-05-01

    The ureter is possibly the least studied and most poorly understood organ of the urinary tract. The pathophysiologic basis underlying the use of α-blockers to improve ureteral stone passage or to treat ureteral stent symptoms is poorly understood. This, in part, may explain why clinical studies of medical expulsive therapy for ureteral stone passage are fraught with conflicting data. Methods to study human ureter in vivo are few and challenging. The findings of many of the ureteral studies are from observational in vitro studies and were evaluated in other animal species that may not be applicable in human beings. There are few mechanistic studies evaluating the underlying molecular pathophysiologic mechanisms of human ureter. This is critical to our understanding and treatment of stent symptoms, including the development of a patient friendly ureteral stent and for the pharmacologic modulation of ureteral activity. The following is an overview of some of the observational and mechanistic ureteral studies evaluating the pharmacologic and stent effects, including potential areas for further research. PMID:26864852

  16. Bilateral complete duplication of the ureters, with calculi simultaneously obstructing the four ureters

    PubMed Central

    Alsayyad, Ahmed Jalal

    2016-01-01

    Bilateral complete duplication of the ureters is a rare condition. We report a case of an adult male patient with bilateral complete duplication of the ureters, with a single stone simultaneously obstructing each of the four ureteral limbs. Multiple bilateral renal stones were awlso demonstrated in the imaging studies. The ureteral stones ranged from 7 to 23 mm in length and 5–11 mm in width. Ureteroscopy and holmium laser lithotripsy for the ureteral stones were done sequentially in the four ureteral limbs, in a single session. Four double-J stents were inserted after removal of all ureteric stones, one in each ureter. The patient passed uneventful postoperative course. The patient has received extracorporeal shock wave lithotripsy sessions for the bilateral renal stones. The double-J stents were removed under local anesthesia after clearance of all stones. To the best of our knowledge, there are no data in the literature representing an identical case. PMID:27141198

  17. Bilateral complete duplication of the ureters, with calculi simultaneously obstructing the four ureters.

    PubMed

    Alsayyad, Ahmed Jalal

    2016-01-01

    Bilateral complete duplication of the ureters is a rare condition. We report a case of an adult male patient with bilateral complete duplication of the ureters, with a single stone simultaneously obstructing each of the four ureteral limbs. Multiple bilateral renal stones were awlso demonstrated in the imaging studies. The ureteral stones ranged from 7 to 23 mm in length and 5-11 mm in width. Ureteroscopy and holmium laser lithotripsy for the ureteral stones were done sequentially in the four ureteral limbs, in a single session. Four double-J stents were inserted after removal of all ureteric stones, one in each ureter. The patient passed uneventful postoperative course. The patient has received extracorporeal shock wave lithotripsy sessions for the bilateral renal stones. The double-J stents were removed under local anesthesia after clearance of all stones. To the best of our knowledge, there are no data in the literature representing an identical case. PMID:27141198

  18. Ureter tracking and segmentation in CT urography (CTU) using COMPASS

    SciTech Connect

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

    2014-12-15

    Purpose: The authors are developing a computerized system for automated segmentation of ureters in 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. Methods: COMPASS consists of three stages: (1) rule-based adaptive thresholding and region growing, (2) path-finding and propagation, and (3) edge profile extraction and feature analysis. With institutional review board approval, 79 CTU scans performed with intravenous (IV) contrast material enhancement were collected retrospectively from 79 patient files. One hundred twenty-four ureters were selected from the 79 CTU volumes. On average, the ureters spanned 283 computed tomography slices (range: 116–399, 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 124 ureters was identified manually to initialize the tracking by COMPASS. In addition, the centerline of each ureter was manually marked and used as reference standard for evaluation of tracking performance. The performance of COMPASS was quantitatively assessed by estimating the percentage of the length that was successfully tracked and segmented for each ureter and by estimating the average distance and the average maximum distance between the computer and the manually tracked centerlines. Results: Of the 124 ureters, 120 (97%) were segmented completely (100%), 121 (98%) were segmented through at least 70%, and 123 (99%) were segmented through at least 50% of its length. In comparison, using our previous method, 85 (69%) ureters were segmented completely (100%), 100 (81%) were segmented through at least 70%, and 107 (86%) were segmented at least 50% of its length. With COMPASS, the average distance between the computer and the manually generated centerlines is 0.54 mm, and the average maximum distance is 2

  19. Ureter Regeneration–The Proper Scaffold Has to Be Defined

    PubMed Central

    Kowalczyk, Tomasz; Nowacki, Maciej; Bodnar, Magdalena; Marszałek, Andrzej; Pokrywczyńska, Marta; Frontczak-Baniewicz, Małgorzata; Kowalewski, Tomasz A.; Chłosta, Piotr; Drewa, Tomasz

    2014-01-01

    The aim of this study was to compare two different acellular scaffolds: natural and synthetic, for urinary conduit construction and ureter segment reconstruction. Acellular aortic arch (AAM) and poly(L-lactide-co-caprolactone) (PLCL) were used in 24 rats for ureter reconstruction in both tested groups. Follow-up period was 4 weeks. Intravenous pyelography, histological and immunohistochemical analysis were performed. All animals survived surgical procedures. Patent uretero-conduit junction was observed only in one case using PLCL. In case of ureter segment reconstruction ureters were patent in one case using AAM and in four cases using PLCL scaffolds. Regeneration of urothelium layer and focal regeneration of smooth muscle layer was observed on both tested scaffolds. Obtained results indicates that synthetic acellular PLCL scaffolds showed better properties for ureter reconstruction than naturally derived acellular aortic arch. PMID:25162415

  20. Violent injuries to the upper ureter.

    PubMed

    Evans, R A; Smith, M J

    1976-07-01

    Frequently traumatic injury to the renal pelvis or upper ureter is overshadowed by multiple associated injuries. The diagnosis may be particularly difficult, due to the lack of hematuria and absence of pathognomonic findings. All too frequently the delayed manifestations of urinary wound drainage, retroperitoneal mass, or urinary ascites and sepsis first draw attention to the ureteral injury. A review of the problem and our experience with 16 such injuries is presented. As with other infrequent injuries the single and most important diagnostic factor is the prepared mind of the examiner. We feel all patients who have penetrating abdominal trauma, have fractured lumbar processes, or are involved in accidents where deceleration or extension occur should have infusion pyelography even in the absence of hematuria. PMID:948098

  1. GLI3 repressor controls functional development of the mouse ureter.

    PubMed

    Cain, Jason E; Islam, Epshita; Haxho, Fiona; Blake, Joshua; Rosenblum, Norman D

    2011-03-01

    Obstructive and nonobstructive forms of hydronephrosis (increased diameter of the renal pelvis and calyces) and hydroureter (dilatation of the ureter) are the most frequently detected antenatal abnormalities, yet the underlying molecular mechanisms are largely undefined. Hedgehog (Hh) proteins control tissue patterning and cell differentiation by promoting GLI-dependent transcriptional activation and by inhibiting the processing of GLI3 to a transcriptional repressor. Genetic mutations that generate a truncated GLI3 protein similar in size to the repressor in humans with Pallister-Hall syndrome (PHS; a disorder whose characteristics include renal abnormalities) and hydroureter implicate Hh-dependent signaling in ureter morphogenesis and function. Here, we determined that Hh signaling controls 2 cell populations required for the initiation and transmission of coordinated ureter contractions. Tissue-specific inactivation of the Hh cell surface effector Smoothened (Smo) in the renal pelvic and upper ureteric mesenchyme resulted in nonobstructive hydronephrosis and hydroureter characterized by ureter dyskinesia. Mutant mice had reduced expression of markers of cell populations implicated in the coordination of unidirectional ureter peristalsis (specifically, Kit and hyperpolarization-activation cation-3 channel [Hcn3]), but exhibited normal epithelial and smooth muscle cell differentiation. Kit deficiency in a mouse model of PHS suggested a pathogenic role for GLI3 repressor in Smo-deficient embryos; indeed, genetic inactivation of Gli3 in Smo-deficient mice rescued their hydronephrosis, hydroureter, Kit and Hcn3 expression, and ureter peristalsis. Together, these data demonstrate that Hh signaling controls Kit and Hcn3 expression and ureter peristalsis. PMID:21339645

  2. GLI3 repressor controls functional development of the mouse ureter

    PubMed Central

    Cain, Jason E.; Islam, Epshita; Haxho, Fiona; Blake, Joshua; Rosenblum, Norman D.

    2011-01-01

    Obstructive and nonobstructive forms of hydronephrosis (increased diameter of the renal pelvis and calyces) and hydroureter (dilatation of the ureter) are the most frequently detected antenatal abnormalities, yet the underlying molecular mechanisms are largely undefined. Hedgehog (Hh) proteins control tissue patterning and cell differentiation by promoting GLI-dependent transcriptional activation and by inhibiting the processing of GLI3 to a transcriptional repressor. Genetic mutations that generate a truncated GLI3 protein similar in size to the repressor in humans with Pallister-Hall syndrome (PHS; a disorder whose characteristics include renal abnormalities) and hydroureter implicate Hh-dependent signaling in ureter morphogenesis and function. Here, we determined that Hh signaling controls 2 cell populations required for the initiation and transmission of coordinated ureter contractions. Tissue-specific inactivation of the Hh cell surface effector Smoothened (Smo) in the renal pelvic and upper ureteric mesenchyme resulted in nonobstructive hydronephrosis and hydroureter characterized by ureter dyskinesia. Mutant mice had reduced expression of markers of cell populations implicated in the coordination of unidirectional ureter peristalsis (specifically, Kit and hyperpolarization-activation cation–3 channel [Hcn3]), but exhibited normal epithelial and smooth muscle cell differentiation. Kit deficiency in a mouse model of PHS suggested a pathogenic role for GLI3 repressor in Smo-deficient embryos; indeed, genetic inactivation of Gli3 in Smo-deficient mice rescued their hydronephrosis, hydroureter, Kit and Hcn3 expression, and ureter peristalsis. Together, these data demonstrate that Hh signaling controls Kit and Hcn3 expression and ureter peristalsis. PMID:21339645

  3. Beyond ureterolithiasis: gamut of abnormalities affecting the ureter.

    PubMed

    Moosavi, Bardia; Fasih, Najla; Virmani, Vivek; Kielar, Ania

    2016-01-01

    Nephrolithiasis is the most common condition involving the ureters. However, various other entities can affect the ureters, albeit less frequently. Imaging plays a crucial role in diagnosis, management, and follow-up of ureteral pathology. In the past decade, computed tomography urography has replaced traditional methods of ureteral imaging due to its high spatial resolution, multiplanar imaging, and rapid acquisition time. More recently, magnetic resonance urography has also been explored in evaluating ureteral abnormalities. In this review, we briefly discuss current imaging techniques used in assessment of the ureters and present a diverse group of diseases affecting the ureters. We begin with primary and secondary ureteral malignancies, followed by uncommon infectious/inflammatory diseases that can involve the ureters including tuberculosis, xanthogranulomatous pyelonephritis, and graft-versus-host disease. We then discuss the imaging characteristics of endometriosis and retroperitoneal fibrosis as two important examples of pelvic and retroperitoneal processes that occasionally obstruct the ureters and present with clinical symptoms similar to that of renal stones. We end with a brief discussion of miscellaneous conditions that affect the ureters, including ureteral hemorrhage, ureteral intussusception, ureteral pseudodiverticulosis, Malacoplakia, and ureteritis cystica. Knowledge of these entities and their characteristic imaging manifestations along with patient's clinical presentation allows accurate diagnosis and timely patient management. PMID:27317212

  4. Evidence for Alpha Receptors in the Human Ureter

    NASA Astrophysics Data System (ADS)

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

    2007-04-01

    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

  5. Improved radiographic visualization of calculus in distal ureter.

    PubMed

    Amar, A D

    1979-10-01

    Roentgenographic visualization of a calculus in the distal ureter is often made difficult by gas or bowel contents in the region of the pelvis. Filling the bladder with sterile water raises the bladder dome and displaces the bowel upward. Any calculus in the lower 4 to 5 cm. of the distal ureter is then clearly demonstrated on roentgenograms taken against the water-filled bladder instead of against the bowel filled with gas and feces. This maneuver also aids in differentiation of a calculus in the distal ureter from a phlebolith in the bladder wall, and has improved visualization of distal ureteral calculus in 50 patients during the last six years. PMID:494477

  6. Brg1 Determines Urothelial Cell Fate during Ureter Development

    PubMed Central

    Weiss, Robert M.; Guo, Songshan; Shan, Alan; Shi, Hongmei; Romano, Rose-Anne; Sinha, Satrajit; Cantley, Lloyd G.

    2013-01-01

    Developing and adult ureters express the epigenetic regulator Brg1, but the role of Brg1 in ureter development is not well understood. We conditionally ablated Brg1 in the developing ureter using Hoxb7-Cre and found that Brg1 expression is upstream of p63, Pparγ, and sonic hedgehog (Shh) expression in the ureteral epithelium. In addition, epithelial stratification in the basal cells required Brg1-dependent p63 expression, whereas terminal differentiation of the umbrella cells required Brg1-dependent Pparγ expression. Furthermore, the loss of ureteric Brg1 resulted in failure of Shh expression, which correlated with reduced smooth muscle cell development and hydroureter. Taken together, we conclude that Brg1 expression unifies three aspects of ureter development: maintenance of the basal cell population, guidance for terminal differentiation of urothelial cells, and proper investment of ureteral smooth muscle cells. PMID:23449535

  7. Renal Agenesis with Full Length Ipsilateral Refluxing Ureter.

    PubMed

    Pal, Dilip Kumar; Chandra, Vipin; Banerjee, Manju

    2016-01-01

    Unilateral renal agenesis with vesicoureteral reflux in the ipsilateral full length ureter is a rare phenomenon. Herein we report a case of 10-year old boy who presented with recurrent urinary tract infections. No renal tissue was identified on left side in various imaging studies. Micturating cystourethrogram (MCUG) showed left sided refluxing and blind ending ureter. Left ureterectomy was done because of recurrent UTI in the refluxing system. PMID:27170916

  8. Renal Agenesis with Full Length Ipsilateral Refluxing Ureter

    PubMed Central

    Chandra, Vipin; Banerjee, Manju

    2016-01-01

    Unilateral renal agenesis with vesicoureteral reflux in the ipsilateral full length ureter is a rare phenomenon. Herein we report a case of 10-year old boy who presented with recurrent urinary tract infections. No renal tissue was identified on left side in various imaging studies. Micturating cystourethrogram (MCUG) showed left sided refluxing and blind ending ureter. Left ureterectomy was done because of recurrent UTI in the refluxing system. PMID:27170916

  9. A quantitative histological analysis of the dilated ureter of childhood.

    PubMed

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

    1992-11-01

    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

  10. Electrical propagation in the renal pelvis, ureter and bladder.

    PubMed

    Hammad, F T

    2015-02-01

    Under normal conditions, following the passage of urine from the collecting duct, the urine is stored briefly in the renal pelvis before being transported through the ureter to the bladder where the urine is stored for a longer time (hours) before being voided through the urethra. The transport of urine from the renal pelvis to the bladder occurs spontaneously due to contractions of the muscles in the wall of the pelvis and ureter. Spontaneous contractions also occur in the detrusor muscle and are responsible for maintaining the bladder shape during the filling phase. These muscle contractions occur as result of electrical impulses, which are generated and propagated through different parts of the urinary tract. The renal pelvis and the ureter differ from the bladder in relation to the origin, characteristics and propagation of these electrical impulses. In the ureter, the electrical impulses originate mainly at the proximal region of the renal pelvis and are transmitted antegradely down the length of the ureter. The electrical impulses in the bladder, on the other hand, originate at any location in the bladder wall and can be transmitted in different directions with the axial direction being the prominent one. In this manuscript, an overview of the current state of research on the origin and propagation characteristics of these electrical impulses in the normal and pathological conditions is provided. PMID:25204732

  11. Fstl1 Antagonizes BMP Signaling and Regulates Ureter Development

    PubMed Central

    Gong, Jianfeng; Yu, Mingyan; Zhang, Fangxiong; Sha, Haibo; Gao, Xiang

    2012-01-01

    Bone morphogenetic protein (BMP) signaling pathway plays important roles in urinary tract development although the detailed regulation of its activity in this process remains unclear. Here we report that follistatin-like 1 (Fstl1), encoding a secreted extracellular glycoprotein, is expressed in developing ureter and antagonizes BMP signaling activity. Mouse embryos carrying disrupted Fstl1 gene displayed prominent hydroureter arising from proximal segment and ureterovesical junction defects. These defects were associated with significant reduction in ureteric epithelial cell proliferation at E15.5 and E16.5 as well as absence of subepithelial ureteral mesenchymal cells in the urinary tract at E16.5 and E18.5. At the molecular level, increased BMP signaling was found in Fstl1 deficient ureters, indicated by elevated pSmad1/5/8 activity. In vitro study also indicated that Fstl1 can directly bind to ALK6 which is specifically expressed in ureteric epithelial cells in developing ureter. Furthermore, Sonic hedgehog (SHH) signaling, which is crucial for differentiation of ureteral subepithelial cell proliferation, was also impaired in Fstl1-/- ureter. Altogether, our data suggest that Fstl1 is essential in maintaining normal ureter development by antagonizing BMP signaling. PMID:22485132

  12. Fluid Structural Analysis of Urine Flow in a Stented Ureter

    PubMed Central

    Gómez-Blanco, J. Carlos; Martínez-Reina, F. Javier; Cruz, Domingo; Pagador, J. Blas; Sánchez-Margallo, Francisco M.; Soria, Federico

    2016-01-01

    Many urologists are currently studying new designs of ureteral stents to improve the quality of their operations and the subsequent recovery of the patient. In order to help during this design process, many computational models have been developed to simulate the behaviour of different biological tissues and provide a realistic computational environment to evaluate the stents. However, due to the high complexity of the involved tissues, they usually introduce simplifications to make these models less computationally demanding. In this study, the interaction between urine flow and a double-J stented ureter with a simplified geometry has been analysed. The Fluid-Structure Interaction (FSI) of urine and the ureteral wall was studied using three models for the solid domain: Mooney-Rivlin, Yeoh, and Ogden. The ureter was assumed to be quasi-incompressible and isotropic. Data obtained in previous studies from ex vivo and in vivo mechanical characterization of different ureters were used to fit the mentioned models. The results show that the interaction between the stented ureter and urine is negligible. Therefore, we can conclude that this type of models does not need to include the FSI and could be solved quite accurately assuming that the ureter is a rigid body and, thus, using the more simple Computational Fluid Dynamics (CFD) approach. PMID:27127535

  13. Fstl1 antagonizes BMP signaling and regulates ureter development.

    PubMed

    Xu, Jingyue; Qi, Xin; Gong, Jianfeng; Yu, Mingyan; Zhang, Fangxiong; Sha, Haibo; Gao, Xiang

    2012-01-01

    Bone morphogenetic protein (BMP) signaling pathway plays important roles in urinary tract development although the detailed regulation of its activity in this process remains unclear. Here we report that follistatin-like 1 (Fstl1), encoding a secreted extracellular glycoprotein, is expressed in developing ureter and antagonizes BMP signaling activity. Mouse embryos carrying disrupted Fstl1 gene displayed prominent hydroureter arising from proximal segment and ureterovesical junction defects. These defects were associated with significant reduction in ureteric epithelial cell proliferation at E15.5 and E16.5 as well as absence of subepithelial ureteral mesenchymal cells in the urinary tract at E16.5 and E18.5. At the molecular level, increased BMP signaling was found in Fstl1 deficient ureters, indicated by elevated pSmad1/5/8 activity. In vitro study also indicated that Fstl1 can directly bind to ALK6 which is specifically expressed in ureteric epithelial cells in developing ureter. Furthermore, Sonic hedgehog (SHH) signaling, which is crucial for differentiation of ureteral subepithelial cell proliferation, was also impaired in Fstl1(-/-) ureter. Altogether, our data suggest that Fstl1 is essential in maintaining normal ureter development by antagonizing BMP signaling. PMID:22485132

  14. Primary adenocarcinoma of ureter: A rare histopathological variant

    PubMed Central

    Chaudhary, Prekshi; Agarwal, Rashi; Srinivasan, Shashank; Singh, Dinesh

    2016-01-01

    Primary carcinoma of ureter is an uncommon malignancy. Of which, mostly are transitional cell carcinomas followed by squamous cell carcinomas and adenocarcinomas being the rarest histopathology encountered. We report a case of adenocarcinoma ureter in a middle-aged male along with its clinical scenario. A 62-year-old male, presented with complaints of lower urinary tract symptoms. Computerized tomography urogram showed a soft tissue lesion at the right ureterovesical junction. Cystoscopic biopsy reported villous adenoma. Diethylene triamine pentaacetic acid scan reported nonfunctioning right kidney. He underwent laparoscopic right nephroureterectomy, and histopathology reported adenocarcinoma of the right lower third of ureter, with positive distal and close radial margins. The patient received external beam radiation to the postoperative bed and lymph nodes, and he is disease-free till date. PMID:27453661

  15. [Ectopic ureter as cause of pyonephrosis and urinary incontinence].

    PubMed

    Martín, Martín S; García-Ripoll, Torrecilla J R; Ruíz, Sanz A; Rodríguez, Gonzalo V; Ferro, Rivera J; del Busto, Fernández E

    2008-02-01

    Ectopic ureter accounts with an incidence of 1 in 2000 newborns. When present, ectopic ureter can be associated with duplex kidneys in an 85 % of the cases. Clinical manifestations of this malformation include incontinence and urinary tract infections. Ectopic ureter frequently occurs in association with a dysplastic upper pole renal moiety. When a poorly functioning upper pole segment is present, a standard surgical treatment is upper pole heminephrectomy. A 23-years old woman presented with left renal colic pain, fever and urinary leak. Ultrasound, intravenous pyelogram and antegrade pyelogram revealed a partial duplex right kidney and a complete duplex left kidney with hydronephrosis and ectopic insertion into the urethra of the left upper pole moiety. Following diagnosis upper pole heminephrectomy and partial ureterectomy was performed. PMID:18409479

  16. Retained Urethral Catheter Secondary to Placement in Proximal Ureter

    PubMed Central

    Sharda, Rajan

    2016-01-01

    We present an unusual complication secondary to indwelling urethral catheter placement. Routine catheter placement by the obstetrics team in a postpartum female leads to retention of the catheter and inability of its removal by both the obstetrics and urology teams. Although a retained urinary catheter is relatively common, inability to remove a catheter secondary to placement inadvertently into a ureter is extremely rare. In this paper we will discuss the options in removing a retained catheter and present our case of a retained catheter secondary to placement within the right proximal ureter. PMID:27144050

  17. Herlyn-Weber-Wunderlich syndrome with ectopic ureter in prepubertal female

    PubMed Central

    Garge, Saurabh; Bagga, Deepak; Acharya, Sameer Kant; Yadav, Devendra Kumar; Khan, Tanvir Roshan; Kumar, Ram; Kumar, Vinod; Kumar, Srinivas; Gupta, Divya; Prasad, Ashish

    2014-01-01

    We report a rare case of uterovaginal duplication in a prepubertal female. The patient also had a permeable ureter (ureter with urine passing through it) subtending a poorly functioning kidney with ectopic insertion in the obstructed hemivagina. PMID:24741215

  18. The Endoscopic Removal of Eroded Foreign Bodies in the Ureter.

    PubMed

    Kurz, David Anthony; Mucksavage, Phillip

    2016-01-01

    A complication of using foreign materials in surgery is potential erosion into nearby tissues. The endoscopic removal of foreign bodies that have eroded into the urinary tract is a safe and minimally invasive option that has previously been described, most commonly in the bladder and urethra. We present the case of a patient who had a remote history of a pyeloplasty and was found to have different foreign bodies eroding into the ureter causing symptoms. To our knowledge, this is the first case where a patient presented with two different types of ureteral foreign body erosions that were each effectively treated endoscopically. PMID:27579409

  19. Primary Neuroendocrine Tumors of the Ureter: A Short Review.

    PubMed

    Acosta, Andres M; Kajdacsy-Balla, Andre

    2016-07-01

    Neuroendocrine tumors represent 0.05% of urinary tract malignancies, and most originate in the bladder. Their pathogenesis is debated, since ureters are thought to lack neuroendocrine cells. Morphologically, most ureteral neuroendocrine tumors demonstrate the typical small cell neuroendocrine appearance, are immunohistochemically positive for synaptophysin/chromogranin A/CD56, and show electron-dense granules by electron microscopy. Clinical presentation is similar to that of other more common ureteral neoplasms. Prognosis is usually dismal, but a multimodal treatment approach including platinum-based adjuvant or neoadjuvant chemotherapy seems to be beneficial. PMID:27362572

  20. The Endoscopic Removal of Eroded Foreign Bodies in the Ureter

    PubMed Central

    Mucksavage, Phillip

    2016-01-01

    Abstract A complication of using foreign materials in surgery is potential erosion into nearby tissues. The endoscopic removal of foreign bodies that have eroded into the urinary tract is a safe and minimally invasive option that has previously been described, most commonly in the bladder and urethra. We present the case of a patient who had a remote history of a pyeloplasty and was found to have different foreign bodies eroding into the ureter causing symptoms. To our knowledge, this is the first case where a patient presented with two different types of ureteral foreign body erosions that were each effectively treated endoscopically. PMID:27579409

  1. Penetrating Trauma to the Ureter, Bladder, and Urethra

    PubMed Central

    Zaid, Uwais B.; Bayne, David B.; Harris, Catherine R.; Alwaal, Amjad; McAninch, Jack W.; Breyer, Benjamin N.

    2015-01-01

    We describe the epidemiology, diagnosis, and management of adult civilian penetrating trauma to the ureter, bladder, and urethra. Trauma is a significant source of death and morbidity. Genitourinary injuries are present in 10% of penetrating trauma cases. Prompt recognition and appropriate management of genitourinary injuries, which are often masked or overlooked due to concomitant injuries, is essential to minimize morbidity. Penetrating trauma most commonly results from gunshot wounds or stab wounds. Compared to blunt trauma, these typically require surgical exploration. An understanding of anatomy and a high index of suspicion are necessary for prompt recognition of genitourinary injuries. PMID:26623247

  2. Robotic uretero-ureterostomy of the retrocaval ureter without excision of the retrocaval segment

    PubMed Central

    Alkhudair, Waleed K.; Seyam, Raouf; Al Zahrani, Hassan M.; Al Otaibi, Mohammed F.; Taweel, Waleed Al

    2012-01-01

    Robotic reconstruction of the retrocaval ureter is gaining momentum as the method of choice for surgically treating this rare condition. Maintaining the retrocaval ureteric segment further facilitates the procedure. We report a case of a 23-year-old man who underwent intraperitoneal robotic resection anastomosis and repositioning of the retrocaval ureter. We also discuss the advantages of this technique. PMID:22511429

  3. A very unusual anatomical variation and complication of common iliac artery and ureter in retroperitonoscopic ureterolithotomy

    PubMed Central

    Huri, Emre; Akgül, Turgay; Karakan, Tolga; Sargon, Mustafa; Germiyanoğlu, Cankon

    2011-01-01

    Anatomical localization of theureter comes along psoas major muscle and crosses over common iliac artery bifurcation. Common iliac artery aneurysm and impacted atherosclerosis are a rare condition that should be differed from the impacted ureter stone to avoid from undesirable complication. In this case, we present a very unusual anatomical variation and complication of common iliac artery and ureter in retroperitonoscopic ureterolithotomy. PMID:21523238

  4. [The operative cystoscope with joystick control mechanism of flexible tools inserted into the urinary bladder and the ureter].

    PubMed

    Komiakov, B K; Topuzov, M É; Zubarev, V A; Stetsik, O V

    2014-01-01

    The authors developed an operative cystoscope with joystick control mechanism of ureter catheters and other flexible tools. This construction allowed control of flexible tools inserted into the bladder and the ureter in various directions, thus providing a necessary observation of the operative field at endoscopic operations on the bladder and ureter. This was one of the factors, which determined the operation success. PMID:25055539

  5. US and MDCT findings in a caudal blind ending bifid ureter with calculi

    PubMed Central

    Ustuner, Evren; Atman, Ebru Dusunceli; Yagci, Cemil; Tokatli, Zafer Nida; Uzun, Caglar

    2011-01-01

    Herein we present a rare ureteric duplication anomaly; blind ending bifid ureter with calculi which is asymptomatic unless complicated by infection, reflux, calculi or malignancy. The diagnosis is often missed at intravenous urography (IVU) and US because the ipsilateral ureter and kidney are grossly normal. In this case the diagnosis was established with ultrasound (US) and mainly with multidetector computerized tomography (MDCT) imaging using multiplanar reformats and 3-D reconstructions which were unique to this case. MDCT scans not only revealed the exact diagnosis and anatomic relationships but also ruled out other pathologies included in the differential diagnosis as well, such as ureter and bladder diverticula. PMID:24765338

  6. Laparoscopic Single Site Surgery for Repair of Retrocaval Ureter in a Morbidly Obese Patient

    PubMed Central

    Abdel-Karim, Aly M.; Yahia, Elsayed; Hassouna, M.; Missiry, M.

    2015-01-01

    This is to describe a case of a morbidly obese (BMI = 40) female with retrocaval ureter treated with laparoendoscopic single-site surgery. A JJ stent was positioned. A 2 cm umbilical access was created. A single port platform was positioned. The entire ureter was mobilized posterior to the vena cava and transected where the dilated portion ended. The distal ureter was repositioned lateral to the inferior vena cava. Anastomosis was done. A 3 mm trocar was used to assist suturing. At 4-month follow-up, CT revealed no evidence of obstruction of the right kidney and the patient was symptomless. Although challenging, in a morbidly obese patient, LESS repair for retrocaval ureter is feasible. PMID:26793585

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

    PubMed Central

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

    2013-01-01

    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

  8. General Information about Transitional Cell Cancer of the Renal Pelvis and Ureter

    MedlinePlus

    ... Pelvis and Ureter Treatment (PDQ®)–Patient Version General Information About Transitional Cell Cancer of the Renal Pelvis ... the PDQ Adult Treatment Editorial Board . Clinical Trial Information A clinical trial is a study to answer ...

  9. A case of an ectopic ureter with vaginal insertion diagnosed in adulthood.

    PubMed

    Demir, Mehmet; Çiftçi, Halil; Kılıçarslan, Nihat; Gümüş, Kemal; Oğur, Mehmet; Gülüm, Mehmet; Yeni, Ercan

    2015-03-01

    Ectopic ureter which is one of the causes of urinary incontinence in adults is a rarely seen entity. In this case, diagnosis and treatment of urinary incontinence in a female patient thought to originate from an ectopic ureter will be evaluated. On magnetic resonance (MR) urograms double collecting system in both kidneys and also grade 3 hydroureteronephrosis in the collecting system which drained the upper pole of the right kidney were seen. The ureter draining the upper pole of the right kidney was seen to open into a 24 mm-wide cystic pouch inside the right lateral wall of the vaginal cuff. During vaginal examination an orifice of 3 mm was observed on the right wall of the vagina. Right ureteroneocystostomy was performed. Ureters with ectopic orifices are very rarely seen causes of urinary incontinence. To establish the diagnosis, this pathology must be recognized, should be kept in mind, and appropriate diagnostic methods must be used. PMID:26328201

  10. Initial Series of Four-Arm Robotic Completely Intracorporeal Ileal Ureter.

    PubMed

    Chopra, Sameer; Metcalfe, Charles; Satkunasivam, Raj; Nagaraj, Shalini; Becker, Carlee; de Castro Abreu, Andre Luis; Azhar, Raed A; Gill, Inderbir; Desai, Mihir; Aron, Monish; Berger, Andre

    2016-04-01

    Ileal ureter formation has been found to be a suitable treatment option for long, chronic ureteral strictures not amendable to less invasive forms of repair. Minimally invasive surgical techniques for this condition have been investigated. We report the first series of robotic completely intracorporeal ileal ureter using a four-arm robotic technique. Three patients underwent this procedure, including one patient with a solitary kidney. All procedures were performed effectively with a median operative time of 450 minutes (range: 420-540) and median estimated blood loss of 100 mL (range: 50-200). Postoperatively, one patient suffered volvulus and subsequent necrosis of small bowel and ileal ureter, which required re-operation and small bowel resection, including the ileal ureter. The other two patients report no surgical complications to date. This early series represents preliminary technical procedure feasibility. Further experience is necessary. PMID:26859439

  11. Bleeding Ureter: Endometriosis Mascarading as a Ureteral Malignancy - A Case Report

    PubMed Central

    Sandeep, Puvvada; Pathade, Amey; Nagaraj, H K

    2014-01-01

    Ureteral endometriosis is a serious localization of disease burden that can lead to urinary tract obstruction, with subsequent hydroureter, hydronephrosis, and potential kidney loss. As the diagnosis is elusive, a heavy clinical suspicion is necessary. Surgical technique to treatment varies, but the goal is to salvage renal function and decrease disease burden. Here, we are presenting a rare case of bleeding ureter in a young lady who had endometriosis of the ureter. PMID:25478397

  12. Intravesical and transperitoneal laparoscopy in the management of tumor in the residual ureter.

    PubMed

    Branco, Anibal Wood; Stunitz, Luciano; Nichele, Sandro; Douat, Paulo Henrique; Luiz, Murilo; Tha Nassif, Lucas

    2013-01-01

    The occurrence of tumor in the residual ureter after an incomplete nephroureterectomy required by a tumor of renal collecting system is an uncommon but a well described situation. The recommended treatment in this situation is the radical excision of the remaining ureter, being the open technique the most used approach. The aim of this video is to demonstrate a new approach using intravesical and transperitoneal laparoscopy to remove the residual ureter following the oncological concepts. A 67 year-old male patient underwent an incomplete open right radical nephroureterectomy for a transitional cell carcinoma of the renal collecting system. After 16 months, the cystoscopy diagnostic revealed a recurrence of it in the residual ureter. An intravesical approach followed by a transperitoneal laparoscopy has removed the remaining ureter. Operative time was 110 minutes, blood loss 100 mL, the patient was discharged on the first postoperative day and the Foley catheter was removed on the seventh one. Pathological examination revealed low grade transitional cell carcinoma and free surgical margins, no recurrence was observed after six months. To our knowledge, this is the first treatment description of a tumor in the residual ureter with these techniques. This approach can be a minimal invasive alternative in this unusual situation. PMID:23683677

  13. Primary congenital bladder diverticula: Where does the ureter drain?

    PubMed Central

    Macedo, Antonio; Garrone, Gilmar; Ottoni, Sérgio Leite; Oliveira, Diego Estevam; do Rosário Souza, Geórgia Rubiane Meira; da Cruz, Marcela Leal

    2015-01-01

    Background: Primary congenital bladder diverticulum (PCBD) is related to a deficient detrusor layer allowing out-pouching of the bladder mucosa through the inadequate muscularis wall. We aimed to review our experience with symptomatic PCBD in order to correlate clinical findings with anatomical aspects and to present late outcome. Materials and Methods: We reviewed all patients operated in our institution since 2004. We evaluated the charts for complaints, radiological exams, method of treatment, complications and length of follow-up. Results: We treated 10 cases (11 renal units - [RU]), predominantly males (9/10), mean age at surgery of 5.3 years. All patients had significant urological complaints presenting either with antenatal hydronephrosis (4) or febrile urinary tract infection (5) and urinary retention in one. The ureter was found implanted inside the diverticulum in 8/11 RU. An extravesical psoas-hitch ureteroneocystostomy and diverticulum resection was performed in 10/11 cases, whereas 1 case was treated intravesically based on surgeon's preference without performing cystoscopy. Mean follow-up was 34.1 months (1-120) without complications. Conclusions: PCBD is an uncommon diagnosis and has a high probability of drainage inside the diverticulum (72.7%). We recommend the extravesical approach associated with diverticulectomy and ureteroneocystostomy as the preferred technique to treat this abnormality. PMID:26712296

  14. The impact of method of distal ureter management during radical nephroureterectomy on tumour recurrence

    PubMed Central

    Kapoor, Anil; Dason, Shawn; Allard, Christopher B.; Shayegan, Bobby; Lacombe, Louis; Rendon, Ricardo; Jacobsen, Niels-Erik; Fairey, Adrian; Izawa, Jonathan; Black, Peter; Tanguay, Simon; Chin, Joseph; So, Alan; Lattouf, Jean-Baptiste; Bell, David; Saad, Fred; Drachenberg, Darrell; Cagiannos, Ilias; Fradet, Yves; Alamri, Abdulaziz; Kassouf, Wassim

    2014-01-01

    Introducton: Radical nephroureterectomy for upper tract urothelial carcinoma (UTUC) must include some form of distal ureter management to avoid high rates of tumour recurrence. It is uncertain which distal ureter management technique has the best oncologic outcomes. To determine which distal ureter management technique resulted in the lowest tumour recurrence rate, we analyzed a multi-institutional Canadian radical nephroureterectomy database. Methods: We retrospectively analyzed patients who underwent radical nephroureterectomy with distal ureter management for UTUC between January 1990 and June 2010 at 10 Canadian tertiary hospitals. Distal ureter management approaches were divided into 3 categories: (1) extravesical tenting for ureteric excision without cystotomy (EXTRAVESICAL); (2) open cystotomy with intravesical bladder cuff excision (INTRAVESICAL); and (3) extravesical excision with endoscopic management of ureteric orifice (ENDOSCOPIC). Data available for each patient included demographic details, distal ureter management approach, pathology and operative details, as well as the presence and location of local or distant recurrence. Clinical outcomes included overall recurrence-free survival and intravesical recurrence-free survival. Survival analysis was performed with the Kaplan-Meier method. Multivariable Cox regression analysis was also performed. Results: A total of 820 patients underwent radical nephroureterectomy with a specified distal ureter management approach at 10 Canadian academic institutions. The mean patient age was 69.6 years and the median follow-up was 24.6 months. Of the 820 patients, 406 (49.5%) underwent INTRAVESICAL, 316 (38.5%) underwent EXTRAVESICAL, and 98 (11.9%) underwent ENDOSOPIC distal ureter management. Groups differed significantly in their proportion of females, proportion of laparoscopic cases, presence of carcinoma in situ and pathological tumour stage (p < 0.05). Recurrence-free survival at 5 years was 46.3%, 35.6%, and

  15. First-ever Reported Obstructing Ureteral Nephrogenic Adenoma in a Child and Subsequent Robotic-assisted Laparoscopic Ileal Ureter.

    PubMed

    Koenig, Joel F; Rensing, Adam; Austin, Paul F; Vricella, Gino

    2016-08-01

    To report the first known case of a completely intracorporeal robotic-assisted laparoscopic ileal ureter in the pediatric population, a 12-year-old boy with near-complete replacement of his right ureter with nephrogenic adenoma and resulting debilitating renal colic. Intracorporeal robotic-assisted laparoscopic ileal ureter was performed without complication. A detailed description of our surgical technique is included. The patient had improvement in hydronephrosis and complete resolution of renal colic symptoms with minimal incisional length compared to traditional laparotomy. Intracorporeal robotic-assisted laparoscopic ileal ureter provides the benefits of minimally invasive surgery when complete ureteral replacement is needed. PMID:27001506

  16. Real-Time Near-Infrared Fluorescence-Guided Identification of the Ureters using Methylene Blue

    PubMed Central

    Matsui, Aya; Tanaka, Eiichi; Choi, Hak Soo; Kianzad, Vida; Gioux, Sylvain; Lomnes, Stephen J.; Frangioni, John V.

    2009-01-01

    Background The aim of this study was to determine whether the invisible near-infrared (NIR) fluorescence properties of methylene blue (MB), a dye already FDA-approved for other indications, could be exploited for real-time, intraoperative identification of the ureters. Methods The optical properties of MB were quantified in vitro. Open surgery and laparoscopic NIR fluorescence imaging systems were employed. Yorkshire pigs were injected intravenously with: 0.1 mg/kg MB (n = 8), 10 mg furosemide followed by 0.1 mg/kg MB (n = 6), or 0.5 mg/kg MB (n = 6). The contrast-to-background ratio (CBR) of the kidney and ureters, and MB concentration in urine, were quantified. Results Peak MB absorbance, emission, and intensity in urine occurred at 668 nm, 688 nm, and 20 μM, respectively. After intravenous injection, doses as low as 0.1 mg/kg MB provided prolonged imaging of the ureters, and a dose of 0.5 mg/kg provided statistically significant improvement of CBR. Pre-injection of furosemide increased urine volume but did not improve CBR. Laparoscopic identification of the ureter using MB NIR fluorescence was demonstrated. Conclusions Ureteral imaging using MB NIR fluorescence provides sensitive, real-time, intraoperative identification of the ureters during open and laparoscopic surgeries. PMID:20117811

  17. Thulium fiber laser lithotripsy in an in vitro ureter model

    NASA Astrophysics Data System (ADS)

    Hardy, Luke A.; Wilson, Christopher R.; Irby, Pierce B.; Fried, Nathaniel M.

    2014-12-01

    Using a validated in vitro ureter model for laser lithotripsy, the performance of an experimental thulium fiber laser (TFL) was studied and compared to the clinical gold standard holmium:YAG laser. The holmium laser (λ=2120 nm) was operated with standard parameters of 600 mJ, 350 μs, 6 Hz, and 270-μm-core optical fiber. The TFL (λ=1908 nm) was operated with 35 mJ, 500 μs, 150 to 500 Hz, and a 100-μm-core fiber. Urinary stones (60% calcium oxalate monohydrate/40% calcium phosphate) of uniform mass and diameter (4 to 5 mm) were laser ablated with fibers through a flexible video-ureteroscope under saline irrigation with flow rates of 22.7 and 13.7 ml/min for the TFL and holmium laser, respectively. The temperature 3 mm from the tube's center and 1 mm above the mesh sieve was measured by a thermocouple and recorded throughout each experiment for both lasers. Total laser and operation times were recorded once all stone fragments passed through a 1.5-mm sieve. The holmium laser time measured 167±41 s (n=12). TFL times measured 111±49, 39±11, and 23±4 s, for pulse rates of 150, 300, and 500 Hz, respectively (n=12 each). Mean peak saline irrigation temperatures reached 24±1°C for holmium, and 33±3°C, 33±7°C, and 39±6°C, for TFL at pulse rates of 150, 300, and 500 Hz, respectively. To avoid thermal buildup and provide a sufficient safety margin, TFL lithotripsy should be performed with pulse rates below 500 Hz and/or increased saline irrigation rates. The TFL rapidly fragmented kidney stones due in part to its high pulse rate, high power density, high average power, and observation of reduced stone retropulsion and may provide a clinical alternative to the conventional holmium laser for lithotripsy.

  18. Thulium fiber laser lithotripsy in an in vitro ureter model.

    PubMed

    Hardy, Luke A; Wilson, Christopher R; Irby, Pierce B; Fried, Nathaniel M

    2014-12-01

    Using a validated in vitro ureter model for laser lithotripsy, the performance of an experimental thulium fiber laser (TFL) was studied and compared to the clinical gold standard holmium:YAG laser. The holmium laser (λ = 2120 nm) was operated with standard parameters of 600 mJ, 350 μs, 6 Hz, and 270-μm-core optical fiber. The TFL (λ=1908 nm) was operated with 35 mJ, 500 μs, 150 to 500 Hz, and a 100-μm-core fiber. Urinary stones (60% calcium oxalate monohydrate/40% calcium phosphate) of uniform mass and diameter (4 to 5 mm) were laser ablated with fibers through a flexible video-ureteroscope under saline irrigation with flow rates of 22.7 and 13.7 ml/ min for the TFL and holmium laser, respectively. The temperature 3 mm from the tube's center and 1 mm above the mesh sieve was measured by a thermocouple and recorded throughout each experiment for both lasers. Total laser and operation times were recorded once all stone fragments passed through a 1.5-mm sieve. The holmium laser time measured 167±41 s (n=12). TFL times measured 111±49, 39±11, and 23±4 s, for pulse rates of 150, 300, and 500 Hz, respectively (n=12 each). Mean peak saline irrigation temperatures reached 24±1°C for holmium, and 33±3°C, 33±7°C, and 39±6°C, for TFL at pulse rates of 150, 300, and 500 Hz, respectively. To avoid thermal buildup and provide a sufficient safety margin, TFL lithotripsy should be performed with pulse rates below 500 Hz and/or increased saline irrigation rates. The TFL rapidly fragmented kidney stones due in part to its high pulse rate, high power density, high average power, and observation of reduced stone retropulsion and may provide a clinical alternative to the conventional holmium laser for lithotripsy. PMID:25518001

  19. Fused ureters in patient with horseshoe kidney and aortic abdominal aneurysm.

    PubMed

    Obidike, Stephen; Woha, Akeh; Aftab, Fuad

    2014-01-01

    Horseshoe kidney (HSK) is a very common developmental abnormality in the kidney. They are associated with abnormalities like multiple renal arteries, abnormal position of the ureter in the renal pelvis and highly placed ureteropelvic junction. These can result in urological complications. However, the ureters run their separate course and empty individually into the urinary bladder. Surprisingly, anatomical anomalies do occur and can lead to unexpected findings on investigation or surgical treatment. Such anomalies can present diagnostic and management challenges to unsuspecting clinicians. This report deals with one of such anomalies that seem not to have been reported before in the literature. This case is a rare finding of fused ureters over the renal isthmus in a patient with HSK who also has aortic abdominal aneurysm (AAA). Simultaneous occurrences of HSK and AAA have been reported severally in the past, and the authors are paying attention on the ureteral anomaly. PMID:25433080

  20. Urinary concentration in the papillary collecting duct of the rat. Role of the ureter.

    PubMed

    Oliver, R E; Roy, D R; Jamison, R L

    1982-01-01

    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 H(2)O(-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 H(2)O(-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 H(2)O(-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 H(2)O(-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. PMID:7054236

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

    SciTech Connect

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

    2008-05-15

    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.

  2. Retrocaval ureter and contra lateral renal agenesis - a case report and review of literature.

    PubMed

    Cardoza, Felix; Shambhulinga, C K; Rajeevan, A T

    2016-01-01

    Associated congenital anomalies are seen in 21% of retrocaval ureter patients; among them, associated contralateral renal agenesis is a very rare entity. We report one such case of right circumcaval ureter with left renal agenesis, diagnosed after febrile UTI. Surgical correction with uretero-ureterostomy was successful. In literature very few such cases are reported and only one case with renal failure was reported. Unilateral renal agenesis cases complicated by associated such anomalies need definitive management and lifelong clinical monitoring to diagnose and prevent chronic kidney disease. PMID:27564299

  3. Single system ectopic ureter to rectum subtending solitary kidney and bladder agenesis in newborn male.

    PubMed

    Weight, Christopher J; Chand, Deepa; Ross, Jonathan H

    2006-12-01

    We report a case of a single system solitary ectopic ureter to the rectum with bladder agenesis in a viable newborn male. Only 2 cases of ectopic ureter to the rectum and 18 cases of bladder agenesis have been reported in viable newborns. To our knowledge, this case constitutes the first reported combination of these defects in a living neonate. Associated anomalies also included renal dysplasia, anal stenosis, and urethral-rectal fistula. Nephrectomy is often necessary to prevent infection or hypertension. PMID:17169660

  4. Retrocaval ureter and contra lateral renal agenesis – a case report and review of literature

    PubMed Central

    Cardoza, Felix; Shambhulinga, C. K.; Rajeevan, A. T.

    2016-01-01

    ABSTRACT Associated congenital anomalies are seen in 21% of retrocaval ureter patients; among them, associated contralateral renal agenesis is a very rare entity. We report one such case of right circumcaval ureter with left renal agenesis, diagnosed after febrile UTI. Surgical correction with uretero-ureterostomy was successful. In literature very few such cases are reported and only one case with renal failure was reported. Unilateral renal agenesis cases complicated by associated such anomalies need definitive management and lifelong clinical monitoring to diagnose and prevent chronic kidney disease. PMID:27564299

  5. [Carcinoma of the ureter after long-term use of analgesic [phenacetin derivative]--report of the two cases (spouses)].

    PubMed

    Miyauchi, T; Marouka, M; Nagayama, T; Wakatsuki, S

    1990-12-01

    Two cases (spouses) of carcinoma of the ureter possibly induced by long-term use of analgesic were presented. Case 1: A 66-year-old female with hematuria was diagnosed as a carcinoma of the ureter in January, 1985 and underwent resection of the left kidney and the ureter with partial resection of the urinary bladder. In December, 1988 she died due to recurrent cancer. Case 2: A 70-year-old male (a husband of case 1 patient) with hematuria was diagnosed as a carcinoma of the ureter in August, 1987 and underwent resection of the kidney and the ureter of the left side. In October, 1988 he died due to recurrent cancer. These two patients had used routinely phenacetin because of persistent headache for about 20 and 15 years, respectively and the presumed total dose was amounted to 4 and 2.5 kg, respectively. PMID:2292826

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

    PubMed Central

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

    2012-01-01

    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. PMID:23049475

  7. Lithiasis inside a blind-ending branch of a trifid ureter.

    PubMed

    Baró, P R; Juliá, C L

    1989-01-01

    A case of lithiasis inside a blind-ending branch of a trifid ureter is presented. This is a very uncommon anomaly and its association with lithiasis is not previously reported. The diagnosis was made by means of excretory urography followed by computed tomography (CT). The embryology, classification, and clinical aspects of such malformation are discussed. PMID:2734973

  8. Transperitoneal Laparoscopic Pyelopyelostomy for Retrocaval Ureter without Excision of the Retrocaval Segment: Experience on Three Cases

    PubMed Central

    Ghoundale, O.; Kasmaoui, E. H.; Touiti, D.

    2016-01-01

    Introduction. Retrocaval ureter is a rare congenital anomaly. Open surgery was the classic treatment for this condition. Laparoscopy is currently an admitted procedure to treat many urological diseases. The objective of our study is to present our experience and discuss the safety and the feasibility of transperitoneal laparoscopic pyelopyelostomy for treatment of retrocaval ureter (RCU). Materials and Methods. Three symptomatic patients underwent laparoscopic repair for RCU in our department. The diagnosis was suspected on the computed tomography scan (CT) and confirmed on ascending pyelography. After placement of a JJ stent, and, using the transperitoneal approach, the retro peritoneum was exposed; the ureter was identified in both sides of the vena cava. The retrocaval segment was entirely mobilized and pulled from behind of the vena cava after section of renal pelvis. A pyelopyelostomy was done in a normal anatomic position. Results. All operations were achieved laparoscopically without conversion to open surgery. The mean operative time was 140 minutes (110–190). No intraoperative complication occurred. Blood loss was less than 50 mL in all patients. The mean hospital stay was 5 days (4–6 days). All patients were symptom-free after surgery and had reduction of hydronephrosis in control imagery. Conclusion. Laparoscopy seems safe, feasible, and reproducible in managing retrocaval ureter. PMID:27403160

  9. Transperitoneal Laparoscopic Pyelopyelostomy for Retrocaval Ureter without Excision of the Retrocaval Segment: Experience on Three Cases.

    PubMed

    El Harrech, Y; Ghoundale, O; Kasmaoui, E H; Touiti, D

    2016-01-01

    Introduction. Retrocaval ureter is a rare congenital anomaly. Open surgery was the classic treatment for this condition. Laparoscopy is currently an admitted procedure to treat many urological diseases. The objective of our study is to present our experience and discuss the safety and the feasibility of transperitoneal laparoscopic pyelopyelostomy for treatment of retrocaval ureter (RCU). Materials and Methods. Three symptomatic patients underwent laparoscopic repair for RCU in our department. The diagnosis was suspected on the computed tomography scan (CT) and confirmed on ascending pyelography. After placement of a JJ stent, and, using the transperitoneal approach, the retro peritoneum was exposed; the ureter was identified in both sides of the vena cava. The retrocaval segment was entirely mobilized and pulled from behind of the vena cava after section of renal pelvis. A pyelopyelostomy was done in a normal anatomic position. Results. All operations were achieved laparoscopically without conversion to open surgery. The mean operative time was 140 minutes (110-190). No intraoperative complication occurred. Blood loss was less than 50 mL in all patients. The mean hospital stay was 5 days (4-6 days). All patients were symptom-free after surgery and had reduction of hydronephrosis in control imagery. Conclusion. Laparoscopy seems safe, feasible, and reproducible in managing retrocaval ureter. PMID:27403160

  10. Massive inguinoscrotal herniation of the bladder with ureter: incidental demonstration on bone scan.

    PubMed

    Ilgan, Seyfettin; Ozguven, Mehmet; Emer, Mustafa O; Karacalioglu, Alper O

    2007-08-01

    Inguinoscrotal herniation of the bladder is a rare clinical entity. The condition is often diagnosed incidentally or during the course of surgical repair of inguinal hernias. In a smaller number of cases, bladder hernia can be seen during nuclear medicine studies. We report a rare case of massive inguinoscrotal bladder herniation with ureter, causing urinary stasis on bone scintigraphy. PMID:17705019

  11. Concomitant Vesicouterine Rupture with Avulsion of Ureter: A Rare Complication of Vaginal Birth after Cesarean Section

    PubMed Central

    Thiek, J Lalnunnem; Sialo, Stephen; Ahanthem, Santa Singh

    2016-01-01

    Uterine rupture is the most serious and life threatening complication and occurs in 0.7-0.9% of vaginal birth after lower segment caesarean section. Cases of bladder rupture along with uterine rupture have been rarely reported and avulsion of ureter, required ureteric implantation is even rarer. This case report describe a very rare case of vesicouterine rupture with avulsion of ureter following vacuum assisted delivery in a grandmulti with previous lower segment cesarean section (LSCS). Haematuria is the most common presentation of bladder rupture. Antenatal counseling regarding this entity is recommended if woman opted for vaginal birth after cesarean section. Intrapartum and postpartum high index of suspicion are important in clinching the diagnosis. PMID:27134952

  12. Neuroendocrine carcinoma of the ureter: A case report and literature review

    PubMed Central

    WANG, WEI; LIU, GUANGMING; LI, YANMIN; SIRIWARDANE, UDESHIKA; MA, HONGSHUN

    2016-01-01

    Primary neuroendocrine carcinoma (NEC) of the ureter is a rare entity, with few cases reported in the literature. These tumors are usually locally aggressive and are associated with a poor prognosis due to the thin walls of the ureter. This is the case report of a 69-year-old male patient who presented with left flank pain and gross hematuria. Following diagnosis of ureteral carcinoma, nephroureterectomy was performed. Postoperatively, the patient refused chemotherapy and radiotherapy, and succumbed to extensive metastases after 12 months of follow-up. The aim of the present study was to provide a literature review of NEC and its clinical and pathological characteristics, diagnostic methods and latest modifications in therapy. PMID:26870199

  13. Primary diffuse large B-cell lymphoma of the left ureter: A case report

    PubMed Central

    Chen, Ping; Jiang, Maoqing; Lin, Yuanwei; Ye, Xianwang; Ruan, Xinzhong; Huang, Qiuli

    2016-01-01

    Diffuse large B-cell lymphoma (DLBCL) is a subtype of non-Hodgkin lymphoma occurring in various sites, but rarely involving the ureters. Primary DLBCL is a rare entity. Imaging studies in a 82-year-old male patient revealed left hydronephrosis and an area of nodular soft tissue density in the upper ureteral wall. On enhanced computed tomography scans, the lesion exhibited early enhancement. As the lesion was considered to be malignant, a left nephroureterectomy was performed for the purpose of pathological diagnosis. Histological analysis and immunohistochemistry revealed DLBCL. Since the surgery, the patient has survived for 16 months without evidence of a relapse. Thus, in cases with ureteral stenosis or obstruction for which the cause is uncertain, the possibility of primary lymphoma of the ureter should be considered and further histopathological examination of bioptic samples should be performed as soon as possible. PMID:27588189

  14. Primary follicular non-Hodgkin's lymphoma of the ureter: A case report and literature review

    PubMed Central

    DAI, ZHIHONG; LIU, ZHIYU; GAO, YUREN; WANG, LIANG

    2016-01-01

    Ureteral cancer is a rare type of neoplasm, with the most prevalent forms including squamous cell carcinoma, transitional cell carcinoma and adenocarcinoma. Ureteral lymphoma is particularly uncommon, and forming a pre-operative diagnosis of the disease is often difficult. The current study describes the case of a 31-year-old man presenting with a space-occupying lesion located in the left lower ureter. Follicular non-Hodgkin's lymphoma was diagnosed via intraoperative frozen section and post-operative pathological analysis. The affected ureteric segment was excised, and the ureter was repaired by end-to-end anastomosis with insertion of a double-J tube for internal drainage. The patient was followed up for 10 months and presented with no signs of recurrence. The current study affirms the importance of pathological examination in the differential diagnosis of ureteral neoplasms and the selection of an appropriate treatment. PMID:27313721

  15. Three-Dimensional Numerical Simulations of Peristaltic Contractions in Obstructed Ureter Flows.

    PubMed

    Najafi, Zahra; Gautam, Prashanta; Schwartz, Bradley F; Chandy, Abhilash J; Mahajan, Ajay M

    2016-10-01

    Ureteral peristalsis can be considered as a series of waves on the ureteral wall, which transfers the urine along the ureter toward the bladder. The stones that form in the kidney and migrate to the ureter can create a substantial health problem due to the pain caused by interaction of the ureteral walls and stones during the peristaltic motion. Three-dimensional (3D) computational fluid dynamics (CFD) simulations were carried out using the commercial code ansys fluent to solve for the peristaltic movement of the ureter, with and without stones. The effect of stone size was considered through the investigation of varying obstructions of 5%, 15%, and 35% for fixed spherical stone shape. Also, an understanding of the effect of stone shape was obtained through separate CFD calculations of the peristaltic ureter with three different types of stones, a sphere, a cube, and a star, all at a fixed obstruction percentage of 15%. Velocity vectors, mass flow rates, pressure gradients, and wall shear stresses were analyzed along one bolus of urine during peristalsis of the ureteral wall to study the various effects. It was found that the increase in obstruction increased the backflow, pressure gradients, and wall shear stresses proximal to the stone. On the other hand, with regard to the stone shape study, while the cube-shaped stones resulted in the largest backflow, the star-shaped stone showed highest pressure gradient magnitudes. Interestingly, the change in stone shape did not have a significant effect on the wall shear stress at the obstruction level studied here. PMID:27464354

  16. [Endoscopic ureterolithotomy in large concrements of the upper third of the ureter].

    PubMed

    Martov, A G; Teodorovich, O V; Galliamov, É A; Lutsevich, O É; Zabrodina, N B; Gordienko, A Iu; Parkhonin, D I

    2011-01-01

    Endoscopic ureterolithotomy was made in 38 patients who had concrements in the upper third of the ureter more than 1 cm in size. Operations were retroperitoneoscopic and laparoscopic in 20 and 18 cases, respectively. Five patients had recurrent stones, 7 patients had prior extracorporeal shock-wave lithotripsy, 2 patients failed contact ureterolithotripsy. In the rest cases endoscopic ureterolithotomy was a first-line treatment. A complete elimination of the stone was achieved in all the cases. Mean time of the operation in a retroperitoneoscopic approach was 149 min, in laparoscopic - 125 min. Mean blood loss was the same. Conversion was performed in one case in the group of retroperitoneal approach. Postoperative stay in hospital in retroperitoneo- and laparoscopic ureterolithotomy was 3 - 16 days. Laparoscopic ureterolithotomy produced a complication in one case - an insignificant injury of the colon. Urinous infiltration and pneumonia developed after retroperitoneoscopic ureterolithotomy in one and one case, respectively. Thus, endoscopic ureterolithotomy in large stones of the upper third of the ureter via retroperitoneal and transperitoneal approach is a safe, low-invasive and effective operation which provides complete stones elimination. Endoscopic ureterolithotomy should be done in uneffective first-line treatment. It is a leading method in the treatment of large and long-standing stones of the upper third of the ureter. PMID:22279788

  17. Invasive urothelial carcinoma with chordoid features of the ureter: a rare entity and review of literature

    PubMed Central

    Wei, Jianguo; Yue, Zhenying; Song, Dianhang; Wang, Qiang; Teng, Xiaodong

    2015-01-01

    Invasive urothelial carcinoma (UC) is characterized by some histologic variants that can sometimes lead to diagnostic difficulty. In addition to those described by the World Health Organization. Recently invasive urothelial carcinoma with chordoid features (UCC) has been described as a distinct entity and there are relatively few reported cases in the English-language literature. To date 13 cases of UCC have been reported in 2 case series, respectively in 2009 and 2015. We report the 14th case in an 80-year-old female, and to the best of our knowledge this is the second case report of UCC in the ureter. She was admitted to our hospital with macroscopic haematuria and unspecific left lower abdominal pain. Computed tomography scan revealed a soft tissue nodule in the middle of the left ureter. The left nephroureterectomy was performed. Morphologically, 85% areas had acellular myxoid stroma was associated with the neoplastic cells. The neoplastic cells had scant eosinophilic cytoplasm and were arranged into cords closely mimicking chordoma or extraskeletal myxoid chondrosarcoma. 15% areas was typical invasive urothelial carcinoma, and focal areas had transition phenomenon between them. Immunohistochemically, the tumor cells were positive for CK, 34βE12 and p63, but were negative for S100, AFP, CD34, Syn and CgA. The final histopathological diagnosis was UCC of the ureter. PMID:26823892

  18. IDENTIFICATION AND THE RELATIONSHIP OF DIFFERENT TYPES OF SPONTANEOUS ACTIVITY IN THE RAT URINARY TRACT: URETER, URINARY BLADDER.

    PubMed

    Kazaryan, K V; Simonyan, L G; Chibukhchyan, R G

    2015-04-01

    Simultaneous recording of spontaneous electrical activity was conducted from the ending areas of the ureter (the zone bordered with pyeloureteral anastomosis and bladder, respectively), as well as of the proximal part of the bladder. Normally the activity of the distal ureter zone is a propagating from the perirenal area action potentials with increased amplitude (100 microV). In these conditions from the bladder were recorded action potentials with relatively lower values of amplitude and frequency rhythm (31.9 microV and 17 min(-1), respectively). Isolation of investigating ureter areas from each other and from the bladder leads to the emergence of spike activity in the peribladder area different from that in norm: in the background of oscillating waves arises the action potential. Isolation of the ureter from the bladder also affects the nature of the initial activity. Of all analyzed parameters of activity change (decrease) only the amplitude and the frequency of action potentials reaching respectively 24.5 microV and 14.2 min(-1). The results indicate the presence of different types of autonomous spontaneous activity in the extreme zones of the ureter and bladder. The adjustment of these activity parameters in the areas can be provided by their relationship with each other. PMID:26336741

  19. Feasibility of Catheter-Directed Intraluminal Irreversible Electroporation of Porcine Ureter and Acute Outcomes in Response to Increasing Energy Delivery

    PubMed Central

    Srimathveeravalli, Govindarajan; Silk, Mikhail; Wimmer, Thomas; Monette, Sebastien; Kimm, Simon; Maybody, Majid; Solomon, Stephen B.; Coleman, Jonathan; Durack, Jeremy C.

    2015-01-01

    Purpose To evaluate the feasibility of focal intraluminal irreversible electroporation (IRE) in the ureter with a novel electrode catheter and to study the treatment effects in response to increasing pulse strength. Material and Methods Five IRE treatment settings were each evaluated twice for the ablation of normal ureter in five Yorkshire pigs (1–4 ablations/animal, total of 10 ablations) using a prototype device under ultrasound and fluoroscopic guidance. Animals received either unilateral or bilateral treatment, limited to a maximum of two ablations in any one ureter. Treatment was delivered with increasing pulse strength (1000V–3000V; increments of 500V) while keeping the pulse duration (100 µseconds) and number of pulses (90) constant. Ureter patency was assessed immediately following treatment with an antegrade ureteropyelography. Animals were sacrificed within 4 hours following treatment, and treated urinary tract was harvested for histopathologic analysis using hematoxylin and eosin (H&E) and Masson’s Trichrome (MT) stains. Results IRE was successfully performed in all animals without evidence of ureteral perforation. H&E analysis of IRE treatments demonstrated full thickness ablation at higher field strengths (mucosa to the adventitia). MT stains showed preservation of connective tissue at all field strengths. Conclusion Intraluminal catheter directed IRE ablation is feasible and produces full thickness ablation of normal ureters. There was no evidence of lumen perforation even at the maximum voltages evaluated in the study. PMID:25769212

  20. Hernia of the bladder through the broad ligament with renal agenesis and ipsilateral ureter blind ending.

    PubMed

    El Madi, Aziz; Khattala, Khalid; Rami, Mohammed; Bouabdallah, Youssef

    2014-01-01

    Hernia through a defect of the broad ligament is extremely rare in children. These defects can result from a developmental defect or a spontaneous rupture of cystic formations remnants of mesonephric ducts or Müller. Genital anomalies associated with unilateral renal agenesis are more common in females. We report the case of a 13 months girl allowed for assessment of recurrent urinary tract infection; abdominal examination did not objectified palpable mass, the external genitalia were without abnormalities. Abdominal ultrasound revealed a left renal space is empty with a retrovesical cyst. Cystography was requested that objectified a large pelvic cystic mass retrovesical communicating with the bladder, there was also a left vesicoureteral reflux. Uro- MRI showed a cystic formation retrovesical communicating with the bladder, the right pelvic kidney; uterus is normal size for age. DMSA scintigraphy confirmed the absence of the left kidney with the right kidney that ensures 100% of total renal function. To surgical exploration we found a hernia of the bladder through the left broad ligament, the uterus was dislocated on the right side; left ovary was hypoplasic; the ipsilateral ureter was blind with renal agenesis, we performed by reduction of the bladder then closing the hernial orifice, dissection of the ureter with its ligation and section at the vesical stoma. The postoperative course was uneventful. Evolution is favorable. This observation illustrates a hernia of the bladder through the broad ligament associated with ovarian hypoplasia, renal agenesis and ipsilateral ureter blind ending; this association was not described to our knowledge in the literature. PMID:25422693

  1. Decellularized ureter for tissue-engineered small-caliber vascular graft.

    PubMed

    Narita, Yuji; Kagami, Hideaki; Matsunuma, Hiroshi; Murase, Yosuke; Ueda, Minoru; Ueda, Yuichi

    2008-01-01

    Previous attempts to create small-caliber vascular prostheses have been limited. The aim of this study was to generate tissue-engineered small-diameter vascular grafts using decellularized ureters (DUs). Canine ureters were decellularized using one of four different chemical agents [Triton-X 100 (Tx), deoxycholate (DCA), trypsin, or sodium dodecyl sulfate (SDS)] and the histology, residual DNA contents, and immunogenicity of the resulting DUs were compared. The mechanical properties of the DUs were evaluated in terms of water permeability, burst strength, tensile strength, and compliance. Cultured canine endothelial cells (ECs) and myofibroblasts were seeded onto DUs and evaluated histologically. Canine carotid arteries were replaced with the EC-seeded DUs (n = 4). As controls, nonseeded DUs (n = 5) and PTFE prostheses (n = 4) were also used to replace carotid arteries. The degree of decellularization and the maintenance of the matrix were best in the Tx-treated DUs. Tx-treated and DCA-treated DUs had lower remnant DNA contents and immunogenicity than the others. The burst strength of the DUs was more than 500 mmHg and the maximum tensile strength of the DUs was not different to that of native ureters. DU compliance was similar to that of native carotid artery. The cell seeding test resulted in monolayered ECs and multilayered alpha-smooth muscle actin-positive cells on the DUs. The animal implantation model showed that the EC-seeded DUs were patent for at least 6 months after the operation, whereas the nonseeded DUs and PTFE grafts become occluded within a week. These results suggest that tissue-engineered DUs may be a potential alternative conduit for bypass surgery. PMID:18604613

  2. Hydrogen Sulfide Plays a Key Role in the Inhibitory Neurotransmission to the Pig Intravesical Ureter

    PubMed Central

    Fernandes, Vítor S.; Ribeiro, Ana S. F.; Martínez, Pilar; López-Oliva, María Elvira; Barahona, María Victoria; Orensanz, Luis M.; Martínez-Sáenz, Ana; Recio, Paz; Benedito, Sara; Bustamante, Salvador; García-Sacristán, Albino; Prieto, Dolores; Hernández, Medardo

    2014-01-01

    According to previous observations nitric oxide (NO), as well as an unknown nature mediator are involved in the inhibitory neurotransmission to the intravesical ureter. This study investigates the hydrogen sulfide (H2S) role in the neurogenic relaxation of the pig intravesical ureter. We have performed western blot and immunohistochemistry to study the expression of the H2S synthesis enzymes cystathionine γ-lyase (CSE) and cystathionine β-synthase (CBS), measurement of enzymatic production of H2S and myographic studies for isometric force recording. Immunohistochemical assays showed a high CSE expression in the intravesical ureter muscular layer, as well as a strong CSE-immunoreactivity within nerve fibres distributed along smooth muscle bundles. CBS expression, however, was not consistently observed. On ureteral strips precontracted with thromboxane A2 analogue U46619, electrical field stimulation (EFS) and the H2S donor P-(4-methoxyphenyl)-P-4-morpholinylphosphinodithioic acid (GYY4137) evoked frequency- and concentration-dependent relaxations. CSE inhibition with DL-propargylglycine (PPG) reduced EFS-elicited responses and a combined blockade of both CSE and NO synthase (NOS) with, respectively, PPG and NG-nitro-L-arginine (L-NOARG), greatly reduced such relaxations. Endogenous H2S production rate was reduced by PPG, rescued by addition of GYY4137 and was not changed by L-NOARG. EFS and GYY4137 relaxations were also reduced by capsaicin-sensitive primary afferents (CSPA) desensitization with capsaicin and blockade of ATP-dependent K+ (KATP) channels, transient receptor potential A1 (TRPA1), transient receptor potential vanilloid 1 (TRPV1), vasoactive intestinal peptide/pituitary adenylyl cyclase-activating polypeptide (VIP/PACAP) and calcitonin gene-related peptide (CGRP) receptors with glibenclamide, HC030031, AMG9810, PACAP6–38 and CGRP8–37, respectively. These results suggest that H2S, synthesized by CSE, is involved in the inhibitory neurotransmission

  3. Investigating the flow dynamics in the obstructed and stented ureter by means of a biomimetic artificial model.

    PubMed

    Clavica, Francesco; Zhao, Xuefeng; ElMahdy, Motaz; Drake, Marcus J; Zhang, Xunli; Carugo, Dario

    2014-01-01

    Double-J stenting is the most common clinical method employed to restore the upper urinary tract drainage, in the presence of a ureteric obstruction. After implant, stents provide an immediate pain relief by decreasing the pressure in the renal pelvis (P). However, their long-term usage can cause infections and encrustations, due to bacterial colonization and crystal deposition on the stent surface, respectively. The performance of double-J stents - and in general of all ureteric stents - is thought to depend significantly on urine flow field within the stented ureter. However very little fundamental research about the role played by fluid dynamic parameters on stent functionality has been conducted so far. These parameters are often difficult to assess in-vivo, requiring the implementation of laborious and expensive experimental protocols. The aim of the present work was therefore to develop an artificial model of the ureter (i.e. ureter model, UM) to mimic the fluid dynamic environment in a stented ureter. The UM was designed to reflect the geometry of pig ureters, and to investigate the values of fluid dynamic viscosity (μ), volumetric flow rate (Q) and severity of ureteric obstruction (OB%) which may cause critical pressures in the renal pelvis. The distributed obstruction derived by the sole stent insertion was also quantified. In addition, flow visualisation experiments and computational simulations were performed in order to further characterise the flow field in the UM. Unique characteristics of the flow dynamics in the obstructed and stented ureter have been revealed with using the developed UM. PMID:24498322

  4. Laparoscopic management of distal ureteric stones in a bilharzial ureter: Results of a single-centre prospective study

    PubMed Central

    Nour, Hani H.; Elgobashy, Samir E.; Elkholy, Amr; Kamal, Ahmad M.; Roshdy, Mamdouh A.; Elbaz, Ahmad G.; Riad, Essam

    2015-01-01

    Objective To determine the efficacy and safety of the laparoscopic management of an impacted distal ureteric stone in a bilharzial ureter, as bilharzial ureters are complicated by distal stricture caused by the precipitation of bilharzial ova in the distal ureter. These cases are associated with poorly functioning and grossly hydronephrotic kidneys that hinder the endoscopic manipulation of the coexistent distal high burden of, and long-standing, impacted stones. Patients and methods We used laparoscopic ureterolithotomy, with four trocars, to manage 51 bilharzial patients (33 men and 18 women; mean age 40.13 years) with distal ureteric stones. The ureter was opened directly over the stone and the stone was extracted. A JJ stent was inserted into the ureter, which was then closed with a 4–0 polyglactin running suture. Results The mean stone size was 2.73 cm. Conversion to open surgery was required in only one patient. The mean operative duration was 92 min, the postoperative pain score was 20–60, the mean (range) number of analgesic requests after surgery was 1.72 (1–3), comprising once in 21 patients, twice in 23 and thrice in seven. The mean hospital stay was 2.74 days, and the total duration of follow-up was 7–12 months. The stone recurred in four patients and a ureteric stricture was reported in two. All patients were rendered stone-free. Conclusion Laparoscopy is a safe and effective minimally invasive procedure for distal ureteric stones in a bilharzial ureter with hydronephrosis. PMID:26413344

  5. The Accordion Sign in the Transplant Ureter: Ramifications During Balloon Dilation of Strictures

    SciTech Connect

    Kriegshauser, J. Scott Naidu, Sailen G.; Chang, Yu-Hui H.; Huettl, Eric A.

    2015-04-15

    PurposeThis study was designed to demonstrate the accordion sign within the transplant ureter and evaluate its ramifications during balloon dilation of strictures.MethodsA retrospective electronic chart and imaging review included demographic characteristics, procedure reports, and complications of 28 renal transplant patients having ureteral strictures treated with percutaneous balloon dilation reported in our transplant nephrology database during an 8-year period. The accordion sign was deemed present or absent on the basis of an imaging review and was defined as present when a tortuous ureter became kinked and irregular when foreshortened after placement of a wire or a catheter. Procedure-related urine leaks were categorized as occurring at the stricture if within 2 cm; otherwise, they were considered away from the stricture.ResultsThe accordion sign was associated with a significantly greater occurrence of leaks away from the stricture (P = 0.001) but not at the stricture (P = 0.34).ConclusionsThe accordion sign is an important consideration when performing balloon dilation procedures on transplant ureteral strictures, given the increased risk of leak away from the stricture. Its presence should prompt additional care during wire and catheter manipulations.

  6. Normal functioning single system ectopic ureter draining into a Gartner’s cyst: laparoscopic management

    PubMed Central

    Prakash, Jai; Singh, Bhupendra Pal; Sankhwar, Satyanarayan; Goel, Apul

    2013-01-01

    Association of single system ectopic ureter with normal functioning bilateral kidney and absence of congenital anomalies is very rarely reported in the literature. We are reporting for the first time a case of this type of anomaly in which uretral ectopia was draining into a Gartner's cyst and was managed by laparoscopy. A 16 year girl presented with normal voiding with continuous dribbling since birth. Voiding cystourethrogram, intravenous urogram, cystovaginoscopy and retrograde contrast study confirmed the diagnosis. Ultrasound of the whole abdomen and physical examination ruled out any associated congenital anomalies. Transperitoneal laparoscopic ureteric reimplantation was performed and distal stump was ligated. On follow-up at 3 months she was completely dry; her vaginoscopy showed disappearance of cystic bulge and her voiding cystourethrogram showed normal study without any reflux. When single system ectopic ureter opens into small-to-moderate size wide opened mouth vaginal Gartner's cyst, laparoscopic ureteric reimplantation and ligation of distal stump is an appropriate procedure. PMID:23737579

  7. Complete Transperitoneal Laparoscopic Nephroureterectomy in Circumcaval Ureter with Upper Tract TCC: Initial Case Report

    PubMed Central

    Chhabra, Jaspreet Singh; Mishra, Shashikant; Sudharsan, S.B.; Ganpule, Arvind P.; Sabnis, Ravindra B.

    2015-01-01

    Abstract Transitional-cell carcinoma (TCC) of the upper tract in a case of circumcaval ureter (CCU) is a rare entity. Laparoscopic transperitoneal nephroureterectomy in such case represents a unique challenge in the era of minimally invasive surgery. We report a case of complete transperitoneal laparoscopic nephroureterectomy with bladder cuff excision done for TCC in a case of CCU. This case report describes the first point of technique of the procedure done for this rare entity. A 38-year-old male patient underwent the procedure for high-grade TCC of right lower calix. The essential tenets of the procedure included performance of the technique in a manner contrary to the conventional nephroureterectomy. The case report describes the procedure in the following steps: management of lower ureter and bladder cuff followed upper tract procedure after transposition of bladder cuff posterior to inferior vena cava. The procedure was accomplished utilizing four ports and a 6 cm Pfannenstiel incision with operative time of 220 minutes and blood loss of 50 mL.

  8. Transrectal ultrasonographic characterization of the accessory sex glands, pelvic urethra, and ureters in normal geldings.

    PubMed

    Schnobrich, Maria Raymond; Turner, Regina Orstaglio; Belcher, Carolyn Niles; Slack, JoAnn

    2016-01-15

    Transrectal ultrasound of the internal urogenital tract may be used to aid in the diagnosis of reproductive tract and urinary tract pathology in both stallions and geldings. Abnormalities of the accessory sex glands of geldings are uncommon, although prostatic masses have recently been described in adult geldings presenting with dysuria, stranguria, and/or hematuria. The purpose of this study was to describe the normal ultrasonographic features and sizes of the accessory sex glands, caudal ureters, and pelvic urethra in clinically normal geldings. Eleven healthy geldings with no history of urogenital tract pathology were evaluated by a single observer experienced in ultrasound of the stallion accessory sex glands. The ultrasonographic appearance, relative anatomic relationships and sizes of the accessory sex glands, caudal ureters, and pelvic urethra were investigated using both rectal linear array and microconvex array transducers. Summary statistics including mean, standard error, confidence intervals, and range were calculated for each structure. There were no statistically significant differences in measurements between the left and right sides of paired structures or between measurements obtained with different transducers. Fluid was present in the seminal vesicles of 7 of 9 subjects. Midline cysts of the urethra as well as bulbourethral gland and prostatic cysts were identified. The normal reference ranges defined in this study will be useful in the clinical evaluation of geldings with suspected internal urogenital tract pathology. PMID:26483314

  9. Comparison of Cajal-like cells in pelvis and proximal ureter of kidney with and without hydronephrosis

    PubMed Central

    Balikci, Ömer; Turunç, Tahsin; Bal, Nebil; Çelik, Hüseyin; Özkardeş, Hakan

    2015-01-01

    ABSTRACT Objectives: To evaluate effects of Cajal-like cells on human renal pelvis and proximal ureter on peristalsis. Materials and Methods: 63 patients submitted to nephrectomy due to atrophic non-functional kidney associated with hydroureteronephrosis were included as study group and 30 cases with nephrectomy due to other reasons were included as control group. Samples from renal pelvis and proximal ureters were obtained and sections of 5μ form paraffin blocks of these samples were prepared; layers of lamina propria and muscularis mucosa were examined by immune-histochemistry using CD117 in order to determine count and distribution of Cajal-like cells. Results: During immune-histochemical examinations of sections, obtained from renal pelvis and proximal ureter of hydronephrotic kidneys by CD117, Cajal-like cells number determined in lamina propria and muscularis propria was statistically significantly lower compared to control group (p<0.001). Distribution of Cajal-like cells in renal pelvis and proximal tubulus was similar under examination by light microscope, and also both groups were not different from each other regarding staining intensity of Cajal-like cells by c-kit. Conclusion: Significantly reduced number of Cajal-like cells in study group compared to control group, shows that these cells may have a key role in regulation of peristalsis at level of renal pelvis and proximal ureter in urinary system. PMID:26742978

  10. Regional differences of energetics, mechanics, and kinetics of myosin cross-bridge in human ureter smooth muscle

    PubMed Central

    Vargiu, Romina; Perinu, Anna; Tintrup, Frank; Broccia, Francesca; Lisa, Antonello De

    2015-01-01

    This study provides information about baseline mechanical properties of the entire muscle and the molecular contractile mechanism in human ureter smooth muscle and proposed to investigate if changes in mechanical motor performance in different regions of isolated human ureter are attributable to differences in myosin crossbridge interactions. Classic mechanical, contraction and energetic parameters derived from the tension-velocity relationship were studied in ureteral smooth muscle strips oriented longitudinally and circularly from abdominal and pelvic human ureter parts. By applying of Huxley’s mathematical model we calculated the total working crossbridge number per mm2 (Ψ), elementary force per single crossbridge (Π0), duration of maximum rate constant of crossbridge attachment 1/f1 and detachment 1/g2 and peak mechanical efficiency (Eff.max). Abdominal longitudinal smooth muscle strips exhibited significantly higher maximum isometric tension and faster maximum unloaded shortening velocity compared to pelvic ones. Contractile differences were associated with significantly higher crossbridge number per mm2. Abdominal longitudinal muscle strips showed a lower duration of maximum rate constant of crossbridge attachment and detachment and higher peak mechanical efficiency than pelvic ones. Such data suggest that the abdominal human ureter showed better mechanical motor performance mainly related to a higher crossbridge number and crossbridge kinetics differences. Such results were more evident in the longitudinal rather than in the circular layer. PMID:26069527

  11. Regional differences of energetics, mechanics, and kinetics of myosin cross-bridge in human ureter smooth muscle.

    PubMed

    Vargiu, Romina; Perinu, Anna; Tintrup, Frank; Broccia, Francesca; Lisa, Antonello De

    2015-01-01

    This study provides information about baseline mechanical properties of the entire muscle and the molecular contractile mechanism in human ureter smooth muscle and proposed to investigate if changes in mechanical motor performance in different regions of isolated human ureter are attributable to differences in myosin crossbridge interactions. Classic mechanical, contraction and energetic parameters derived from the tension-velocity relationship were studied in ureteral smooth muscle strips oriented longitudinally and circularly from abdominal and pelvic human ureter parts. By applying of Huxley's mathematical model we calculated the total working crossbridge number per mm(2) (Ψ), elementary force per single crossbridge (Π0), duration of maximum rate constant of crossbridge attachment 1/f1 and detachment 1/g2 and peak mechanical efficiency (Eff.max). Abdominal longitudinal smooth muscle strips exhibited significantly higher maximum isometric tension and faster maximum unloaded shortening velocity compared to pelvic ones. Contractile differences were associated with significantly higher crossbridge number per mm(2). Abdominal longitudinal muscle strips showed a lower duration of maximum rate constant of crossbridge attachment and detachment and higher peak mechanical efficiency than pelvic ones. Such data suggest that the abdominal human ureter showed better mechanical motor performance mainly related to a higher crossbridge number and crossbridge kinetics differences. Such results were more evident in the longitudinal rather than in the circular layer. PMID:26069527

  12. A rare pediatric case of grossly dilated ureter presenting as abdominal mass.

    PubMed

    Srivastava, Madhur Kumar; Govindarajan, Krishna Kumar; Chakkalakkoombil, Sunitha Vellathussery; Halanaik, Dhanapathi

    2016-01-01

    Renal masses account for 55% of cases presenting as palpable abdominal mass in children.[1] An eight year male presented with palpable abdominal mass and pain. The patient underwent renal dynamic scan, which raised possibility of left duplex kidney with non-functioning moiety, as the size of left kidney was smaller than seen on Ultrasonography (USG). Magnetic resonance (MR)urography confirmed the findings with patient undergoing left hemi-nephrectomy and is doing well. In case of discrepancy in size of kidney on USG and renal scan, duplex kidney should be considered as differential, other causes being, renal cyst, benign/malignant mass and renal calculi. Gross hydro-ureter presenting as palpable abdominal mass is very rare with few reported cases.[234]. PMID:26917905

  13. Stereotactic Body Radiotherapy for Localized Ureter Transitional Cell Carcinoma: Three Case Reports

    PubMed Central

    Maehata, Yoshiyasu; Kuriyama, Kengo; Aoki, Shinichi; Araya, Masayuki; Marino, Kan; Onishi, Hiroshi

    2015-01-01

    The gold standard management for ureter transitional cell carcinoma (UTCC) is radical nephroureterectomy with excision of the bladder cuff. However, some patients cannot undergo this procedure for several reasons. In the case reports described herein, we performed stereotactic body radiotherapy (SBRT) on three patients with inoperable or surgery-rejected localized UTCC. Two out of the three patients did not develop local recurrence or distant metastasis during the observation period. However, recurrence was detected in the bladder of one patient 22 months after the treatment. No acute or late adverse events occurred in any of the three patients. SBRT may become one of the treatment options for inoperable or surgery-rejected UTCC patients. PMID:26442166

  14. Expectant Management of Ureter Stones: Outcome and Clinical Factors of Spontaneous Passage in a Single Institution's Experience

    PubMed Central

    Tchey, Dong-Un; Ha, Yun Sok; Kim, Won Tae; Yun, Seok Joong; Kim, Wun Jae

    2011-01-01

    Purpose The aim of this study was to evaluate the outcome of ureter stones with expectant management and the clinical factors associated with stone passage in Koreans. Materials and Methods We reviewed the charts of patients who visited the emergency room or urological office of our institution with acute renal colic between 2001 and 2008. A total of 656 ureter stone formers were enrolled in this study who had decided to be treated by expectant management. Clinical data such as gender, age, size and location of the stone, body mass index, and previous stone history were analyzed to find the factors related to spontaneous passage of ureter stones. Results Of the 656 ureter stones, 566 stones (86.3%) were spontaneously expelled. Mean duration of follow-up was 17.5 days (range, 1 to 100 days). Mean time to stone passage was 6.8 days for stones less than 2 mm in size, 12.6 days for stones 2 to 4 mm, 14.8 days for stones 4 to 6 mm, and 21.8 days for stones 6 to 8 mm (p<0.001). The cumulative spontaneous passage rate was 55.3% in 7 days, 73.7% in 14 days, 88.5% in 28 days, and 97.7% in 60 days after the first attack. A total of 90 patients (13.7%) required interventions because of symptom relapse or renal deterioration that was related to the location and size of the stone (each, p<0.001). The more proximal the location and the larger the stone was than 6 mm, the less the chance of spontaneous passage (each, p<0.001). Conclusions Size and location of ureter stones are the most important factors for predicting the spontaneous passage of the stone. If a patient has a distal ureter stone of less than 6 mm in size, it is acceptable for the urologist to observe for spontaneous passage for 2 months. PMID:22216398

  15. Intraoperative Management of an Incidentally Identified Ectopic Ureter Inserting Into the Prostate of a Patient Undergoing Radical Prostatectomy for Prostate Cancer: A Case Report.

    PubMed

    Singhal, Udit; Dauw, Casey A; Li, Amy Y; Miller, David C; Wolf, J Stuart; Morgan, Todd M

    2015-08-01

    Congenital variations in urinary tract anatomy present unique surgical challenges when they present without prior knowledge. Ectopic ureters occur as a rare anatomic variation of the urinary tract and are often associated with duplicated renal collecting systems. While the condition is uncommon, even more atypical is its discovery and subsequent diagnosis during surgical intervention for treatment of localized prostate cancer.We describe the intraoperative management of a unique case of bilateral ectopic ureters, with a right-sided ureter inserting into the prostate of a 54-year-old male undergoing robotic-assisted radical prostatectomy. While unknown at the time of surgery, this right-sided ureter was associated with a nonfunctioning right upper renal moiety of a duplex renal collecting system. This aberration was discovered intraoperatively and confirmed with imaging, and a robotic-assisted radical prostatectomy with right distal ureterectomy was performed. PMID:26266359

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

    PubMed Central

    Hernández, Medardo; Barahona, María Victoria; Simonsen, Ulf; Recio, Paz; Rivera, Luis; Martínez, Ana Cristina; García-Sacristán, Albino; Orensanz, Luis M; Prieto, Dolores

    2003-01-01

    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 μM) concentration-dependently increased the tone of intravesical ureteral strips, whereas the increases in phasic contractions were concentration-independent. The 5-HT2 receptor agonist α-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 μM), 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 μM) and spiperone (0.2 μM), respectively. However, 5-HT contraction was not antagonized by cyanopindolol (2 μM), SDZ–SER 082 (1 μM), Y-25130 (1 μM) and GR 113808 (0.1 μM), 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, α-adrenergic receptors and adrenergic neurotransmission with tetrodotoxin (1 μM), phentolamine (0.3 μM) and guanethidine (10 μM), respectively, reduced the contractions to 5-HT. However, physostigmine (1 μM), atropine (0.1 μM) and suramin (30 μM), 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. PMID:12522083

  17. [NEW OPTIONS OF ENDOSCOPIC TREATMENT FOR KIDNEY AND URETER STONES IN OBESE PATIENTS].

    PubMed

    Martov, A G; Dutov, S V; Andronov, A S; Kil'chukov, Z I; Tahaev, R A

    2015-01-01

    Effective urolithiasis treatment, especially in overweight patients has a considerable medical and social implication. Extracorporeal shock wave lithotripsy (ESWL) and percutaneous nephrolithotripsy (PCNL) in prone position of the patient are standard treatment options for kidney and ureter stones. These interventions are not always effective in patients with concomitant obesity and are associated with technical difficulties and an increased risk of complications. The study included 175 patients with obesity. The first group consisted of 96 (54.8%) patients treated with transurethral contact lithotripsy. The 2nd group consisted of 54 (30.9%) patients who underwent PCNL in the supine position. The third group comprised 25 (14.3%) patients with multiple stones of kidney and ureter, who underwent combined transurethral and percutaneous intervention in the supine position. The 1st and 3rd group had a higher prevalence of patients with II degree of obesity, in the 2nd group--with I degree of obesity. The mean duration of surgery in 1st group was 43.4 min, in the 2nd--70.3 min and in the third--84.6 min. Method of kidney drainage depended mainly on the presence, location and size of residual stone fragments. The average duration of the kidney drainage stent in patients of the 1st group was 39 days (ureteral catheter--1.3 days). In all patients of the 2nd and 3rd groups, at the final stage of the operation a nephrostomy tube was placed for an average of 2.7 days. The average postoperative hospital stay was 2.9 days in the 1st group, 4.1 days in the 2nd group and 4.5 days in the third group. In the 1st group, the stone-free status was achieved in 81 (84.4%) patients. Another 10 (10.4%) patients later needed ESWL for the complete disposal of the stones. In the 2nd group, the complete clearance of kidney stones was achieved in 49 (90.7%) patients. Another 3 (5.6%) patients required added ESWL to achieve the stone-free status. In the third group of patients stone free status

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

    PubMed Central

    Ahlawat, Rajesh K.; Gautam, Gagan

    2011-01-01

    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. PMID:21814308

  19. A novel type of ureteral stents in the treatment of a bilateral iatrogenic transaction of the ureters.

    PubMed

    Mazza, Ernesto; Mondaini, Francesco; Abdulcadir, Dalmar; Raspanti, Claudio; Citone, Michele; Lapini, Alberto

    2013-01-01

    This report illustrates the case of a patient who suffered an iatrogenic complete injury of both ureters after a complex surgical procedure to remove a large sacral chordoma. Ureteral recanalization was achieved with two removable, autoexpandable, and polytetrafluoroethylene covered nitinol stents. To our knowledge, we describe the first application of this type of stents to treat a bilateral ureteral transection. Despite the bad general conditions of the patient, the ureteral stents successfully restored and maintained the bilateral ureteral continuity. PMID:23984172

  20. Fibroproliferative response to urothelial failure obliterates the ureter lumen in a mouse model of prenatal congenital obstructive nephropathy

    PubMed Central

    Lee, Amanda J.; Polgar, Noemi; Napoli, Josephine A.; Lui, Vanessa H.; Tamashiro, Kadee-Kalia; Fujimoto, Brent A.; Thompson, Karen S.; Fogelgren, Ben

    2016-01-01

    Congenital obstructive nephropathy (CON) is the most prevalent cause of pediatric chronic kidney disease and end-stage renal disease. The ureteropelvic junction (UPJ) region, where the renal pelvis transitions to the ureter, is the most commonly obstructed site in CON. The underlying causes of congenital UPJ obstructions remain poorly understood, especially when they occur in utero, in part due to the lack of genetic animal models. We previously showed that conditional inactivation of Sec10, a central subunit of the exocyst complex, in the epithelial cells of the ureter and renal collecting system resulted in late gestational bilateral UPJ obstructions with neonatal anuria and death. In this study, we show that without Sec10, the urothelial progenitor cells that line the ureter fail to differentiate into superficial cells, which are responsible for producing uroplakin plaques on the luminal surface. These Sec10-knockout urothelial cells undergo cell death by E17.5 and the urothelial barrier becomes leaky to luminal fluid. Also at E17.5, we measured increased expression of TGFβ1 and genes associated with myofibroblast activation, with evidence of stromal remodeling. Our findings support the model that a defective urothelial barrier allows urine to induce a fibrotic wound healing mechanism, which may contribute to human prenatal UPJ obstructions. PMID:27511831

  1. Primary adenocarcinoma of the renal pelvis, ureter and the urinary bladder: A case report and review of the literature

    PubMed Central

    XIONG, XING; JIA, LINGHUA; WANG, JINGEN

    2016-01-01

    Primary adenocarcinoma is a rare type of urological neoplasm. The present study reports the case of a 55-year-old man with multifocal adenocarcinoma of the renal pelvis, ureter and urinary bladder that occurred in association with a large cystic calculus and perinephric abscess. The patient had suffered from gross hematuria for 2 years and right flank pain for 2 months. Following a series of investigations, a large cystic calculus with multiple tumors in the renal pelvis and ureter was identified. Multifocal tumors and a large calculus were located in the bladder using a cystoscope. The pathological report of 3 individual biopsies revealed a moderately differentiated tubular adenocarcinoma. Right nephrectomy, ureterectomy, radical cystectomy and left ureterocutaneostomy were performed. The pathological investigation revealed a moderately differentiated adenocarcinoma of the renal pelvis, ureter and urinary bladder. No additional treatment was administered and the patient remains alive at follow-up without disease recurrence or metastasis. Although uncommon, the development of a tumor is possible in patients that possess long-standing urolithiasis, particularly when accompanied by hydronephrosis or infection. PMID:26998081

  2. Fibroproliferative response to urothelial failure obliterates the ureter lumen in a mouse model of prenatal congenital obstructive nephropathy.

    PubMed

    Lee, Amanda J; Polgar, Noemi; Napoli, Josephine A; Lui, Vanessa H; Tamashiro, Kadee-Kalia; Fujimoto, Brent A; Thompson, Karen S; Fogelgren, Ben

    2016-01-01

    Congenital obstructive nephropathy (CON) is the most prevalent cause of pediatric chronic kidney disease and end-stage renal disease. The ureteropelvic junction (UPJ) region, where the renal pelvis transitions to the ureter, is the most commonly obstructed site in CON. The underlying causes of congenital UPJ obstructions remain poorly understood, especially when they occur in utero, in part due to the lack of genetic animal models. We previously showed that conditional inactivation of Sec10, a central subunit of the exocyst complex, in the epithelial cells of the ureter and renal collecting system resulted in late gestational bilateral UPJ obstructions with neonatal anuria and death. In this study, we show that without Sec10, the urothelial progenitor cells that line the ureter fail to differentiate into superficial cells, which are responsible for producing uroplakin plaques on the luminal surface. These Sec10-knockout urothelial cells undergo cell death by E17.5 and the urothelial barrier becomes leaky to luminal fluid. Also at E17.5, we measured increased expression of TGFβ1 and genes associated with myofibroblast activation, with evidence of stromal remodeling. Our findings support the model that a defective urothelial barrier allows urine to induce a fibrotic wound healing mechanism, which may contribute to human prenatal UPJ obstructions. PMID:27511831

  3. Mutations in TBX18 Cause Dominant Urinary Tract Malformations via Transcriptional Dysregulation of Ureter Development

    PubMed Central

    Vivante, Asaf; Kleppa, Marc-Jens; Schulz, Julian; Kohl, Stefan; Sharma, Amita; Chen, Jing; Shril, Shirlee; Hwang, Daw-Yang; Weiss, Anna-Carina; Kaminski, Michael M.; Shukrun, Rachel; Kemper, Markus J.; Lehnhardt, Anja; Beetz, Rolf; Sanna-Cherchi, Simone; Verbitsky, Miguel; Gharavi, Ali G.; Stuart, Helen M.; Feather, Sally A.; Goodship, Judith A.; Goodship, Timothy H.J.; Woolf, Adrian S.; Westra, Sjirk J.; Doody, Daniel P.; Bauer, Stuart B.; Lee, Richard S.; Adam, Rosalyn M.; Lu, Weining; Reutter, Heiko M.; Kehinde, Elijah O.; Mancini, Erika J.; Lifton, Richard P.; Tasic, Velibor; Lienkamp, Soeren S.; Jüppner, Harald; Kispert, Andreas; Hildebrandt, Friedhelm

    2015-01-01

    Congenital anomalies of the kidneys and urinary tract (CAKUT) are the most common cause of chronic kidney disease in the first three decades of life. Identification of single-gene mutations that cause CAKUT permits the first insights into related disease mechanisms. However, for most cases the underlying defect remains elusive. We identified a kindred with an autosomal-dominant form of CAKUT with predominant ureteropelvic junction obstruction. By whole exome sequencing, we identified a heterozygous truncating mutation (c.1010delG) of T-Box transcription factor 18 (TBX18) in seven affected members of the large kindred. A screen of additional families with CAKUT identified three families harboring two heterozygous TBX18 mutations (c.1570C>T and c.487A>G). TBX18 is essential for developmental specification of the ureteric mesenchyme and ureteric smooth muscle cells. We found that all three TBX18 altered proteins still dimerized with the wild-type protein but had prolonged protein half life and exhibited reduced transcriptional repression activity compared to wild-type TBX18. The p.Lys163Glu substitution altered an amino acid residue critical for TBX18-DNA interaction, resulting in impaired TBX18-DNA binding. These data indicate that dominant-negative TBX18 mutations cause human CAKUT by interference with TBX18 transcriptional repression, thus implicating ureter smooth muscle cell development in the pathogenesis of human CAKUT. PMID:26235987

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

    NASA Astrophysics Data System (ADS)

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

    2009-04-01

    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.

  5. Memokath Metallic Stent in the Treatment of Transplant Kidney Ureter Stenosis or Occlusion

    SciTech Connect

    Boyvat, Fatih E-mail: boyvatf@yahoo.com; Aytekin, Cuneyt; Colak, Turan; Firat, Ali; Karakayali, Hamdi; Haberal, Mehmet

    2005-04-15

    Purpose. To determine the efficacy of the Memokath 051 stent (Engineers and Doctors, Hornbaek, Denmark) in the treatment of recurrent ureteral stenosis or occlusion in transplant kidneys. Methods. From October 1985 through January 2004, 1,131 renal transplantations were performed at our center. Four patients who developed recurrent renal transplant ureter obstruction had nephrostomy catheters placed. Antegrade pyelography showed ureteral stenosis in three cases and complete occlusion in one patient. In each case, a Memokath 051 stent was inserted via an antegrade approach. Mean follow-up was 20 months (range 18-21 months). Creatinine levels were measured and ultrasonography was performed during follow-up. Results. All stent procedures were technically successful. During follow-up, one stent migrated within 10 days after stent insertion and was removed cystoscopically. Another stent had to be removed in the 14th month due to resistant infection, and was replaced with a new Memokath 051 stent which remained patent for another 8 months. The other two stents were fully patent at the 18th and 21st month of follow-up, respectively. Conclusion. Placement of a Memokath 051 stent appears to be a promising treatment alternative to balloon dilation, double-J stents and open surgical intervention for ureteral stenosis or occlusion in kidney transplant recipients. Further study of larger series is necessary.

  6. [Free peritoneal patch grafts in surgery on renal pelvis and ureter (author's transl)].

    PubMed

    Stadie, G; Schneider, H J; Brundig, P

    1981-09-01

    36 operations of the renal pelvis or ureter were carried out in 35 patients. In all these cases a split stenosis or a tissue defect were covered by free peritoneal patches. Urographic controls of 30 patients showed 29 good or very good results. The following statements can be made: 1. In cases of a secondary scarred stenosis, of renal pelvic or ureteral wall defects, plastic operations of intrarenal pelvis of transsinus operations of staghorn calculi the splitting with splinting and covering by autologous tissue seems to represent a suitable operation. -- 2. As material the renal capsule, the venous wall and the peritoneum are suitable. -- 3. In cases of severe ureteral stenoses, which have to be resected, especially in cases of considerable differences of the ureteral lumen, the semicircular suture with covering should be preferred to the circular suture. -- 4. The covering of the defects by patches of autologous material reduces the time of the postoperative urinary diversion with all its dangers and the period of hospitalization. -- 5. In cases of a short covered stenoses (up to 4 cm) postoperative disturbance of the transport or urine was observed only once. The results of stenoses, longer than 4 cm, cannot yet be evaluated. PMID:7197416

  7. Mutations in TBX18 Cause Dominant Urinary Tract Malformations via Transcriptional Dysregulation of Ureter Development.

    PubMed

    Vivante, Asaf; Kleppa, Marc-Jens; Schulz, Julian; Kohl, Stefan; Sharma, Amita; Chen, Jing; Shril, Shirlee; Hwang, Daw-Yang; Weiss, Anna-Carina; Kaminski, Michael M; Shukrun, Rachel; Kemper, Markus J; Lehnhardt, Anja; Beetz, Rolf; Sanna-Cherchi, Simone; Verbitsky, Miguel; Gharavi, Ali G; Stuart, Helen M; Feather, Sally A; Goodship, Judith A; Goodship, Timothy H J; Woolf, Adrian S; Westra, Sjirk J; Doody, Daniel P; Bauer, Stuart B; Lee, Richard S; Adam, Rosalyn M; Lu, Weining; Reutter, Heiko M; Kehinde, Elijah O; Mancini, Erika J; Lifton, Richard P; Tasic, Velibor; Lienkamp, Soeren S; Jüppner, Harald; Kispert, Andreas; Hildebrandt, Friedhelm

    2015-08-01

    Congenital anomalies of the kidneys and urinary tract (CAKUT) are the most common cause of chronic kidney disease in the first three decades of life. Identification of single-gene mutations that cause CAKUT permits the first insights into related disease mechanisms. However, for most cases the underlying defect remains elusive. We identified a kindred with an autosomal-dominant form of CAKUT with predominant ureteropelvic junction obstruction. By whole exome sequencing, we identified a heterozygous truncating mutation (c.1010delG) of T-Box transcription factor 18 (TBX18) in seven affected members of the large kindred. A screen of additional families with CAKUT identified three families harboring two heterozygous TBX18 mutations (c.1570C>T and c.487A>G). TBX18 is essential for developmental specification of the ureteric mesenchyme and ureteric smooth muscle cells. We found that all three TBX18 altered proteins still dimerized with the wild-type protein but had prolonged protein half life and exhibited reduced transcriptional repression activity compared to wild-type TBX18. The p.Lys163Glu substitution altered an amino acid residue critical for TBX18-DNA interaction, resulting in impaired TBX18-DNA binding. These data indicate that dominant-negative TBX18 mutations cause human CAKUT by interference with TBX18 transcriptional repression, thus implicating ureter smooth muscle cell development in the pathogenesis of human CAKUT. PMID:26235987

  8. Overexpression of Heme Oxygenase-1 Prevents Renal Interstitial Inflammation and Fibrosis Induced by Unilateral Ureter Obstruction

    PubMed Central

    Li, Jian-Si; Zhang, Qing-Fang; Wang, Yu-Xiao; Zhao, Shi-Lei; Yu, Jing; Wang, Chang; Qin, Ying; Wei, Qiu-Ju; Lv, Gui-Xiang; Li, Bing

    2016-01-01

    Renal fibrosis plays an important role in the onset and progression of chronic kidney diseases. Many studies have demonstrated that heme oxygenase-1 (HO-1) is involved in diverse biological processes as a cytoprotective molecule, including anti-inflammatory, anti-oxidant, anti-apoptotic, antiproliferative, and immunomodulatory effects. However, the mechanisms of HO-1 prevention in renal interstitial fibrosis remain unknown. In this study, HO-1 transgenic (TG) mice were employed to investigate the effect of HO-1 on renal fibrosis using a unilateral ureter obstruction (UUO) model and to explore the potential mechanisms. We found that HO-1 was adaptively upregulated in kidneys of both TG and wild type (WT) mice after UUO. The levels of HO-1 mRNA and protein were increased in TG mice compared with WT mice under normal conditions. HO-1 expression was further enhanced after UUO and remained high during the entire experimental process. Renal interstitial fibrosis in the TG group was significantly attenuated compared with that in the WT group after UUO. Moreover, overexpression of HO-1 inhibited the loss of peritubular capillaries. In addition, UUO-induced activation and proliferation of myofibroblasts were suppressed by HO-1 overexpression. Furthermore, HO-1 restrained tubulointerstitial infiltration of macrophages and regulated the secretion of inflammatory cytokines in UUO mice. We also found that high expression of HO-1 inhibited reactivation of Wnt/β-catenin signaling, which could play a crucial role in attenuating renal fibrosis. In conclusion, these data suggest that HO-1 prevents renal tubulointerstitial fibrosis possibly by regulating the inflammatory response and Wnt/β-catenin signaling. This study provides evidence that augmentation of HO-1 levels may be a therapeutic strategy against renal interstitial fibrosis. PMID:26765329

  9. Anterior Hip Fracture Dislocation with Intrapelvic Retention of the Femoral Head and Ureter Fistula

    PubMed Central

    Patrascanu, Calin; Cibu, Dan

    2014-01-01

    Introduction: The anterior dislocation of the hip represents only a small percentage of all hip dislocations: 85% are posterior. Most commonly associated with this dislocation is a fracture of the femoral head and, in rare cases, a femoral neck fracture. We have found in literature no report of an anterior dislocation of the hip associated with femoral neck fracture, pelvic retention of the head and ureteral fistula. We report such a case of a 68 year old male. Case Report: A 68 year old male was presented to our attention, following a severe injury of the hip when falling from a high bridge, with severe pain in the hip and a clinical aspect of femoral neck fracture. The X-ray confirmed the femoral neck fracture but following an anterior dislocation with the head retained into the pelvis. The patient also had hematuria. An Austin Moore prosthesis was implanted for the femoral neck fracture and the head was extracted by the urologist by a new abdominal incision. Urological evaluation revealed a fistula of the ureter, treated by an internal drainage for three months. One month later the Moore prosthesis was extracted and the patient had a Girldestone hip for 5 months. Revision with a Muller cemented prosthesis had a normal evolution. Conclusion: The anterior fracture dislocation of the hip with pelvic retention of the femoral head and ureteral fistula is a rare condition resulting from high energy trauma. A multidisciplinary team is necessary to diagnose and treat fracture and soft tissue lesions. Early diagnosis and treatment is necessary to avoid septic complications. PMID:27298980

  10. The Effect of Terpene Combination on Ureter Calculus Expulsion After Extracorporeal Shock Wave Lithotripsy

    PubMed Central

    Kim, Dai Hee; Goh, Hyeok Jun; Lee, Ho Won; Kim, Kyu Shik; Kim, Yong Tae; Moon, Hong Sang; Lee, Seung Wook

    2014-01-01

    Purpose Terpene combination (Rowatinex) is known to help with the expulsion of urinary stones. The aim of this study was to determine how Rowatinex affects the expulsion of remnant stones after shock wave lithotripsy (SWL). Materials and Methods Clinical data were collected retrospectively from 499 patients with a diagnosis of ureteral stones who underwent SWL from January 2009 to August 2012. Ureteral stones were diagnosed in all patients by kidney, ureter, and bladder x-ray and abdominal computed tomography (CT). The progress of patients was documented every 2 weeks to confirm remnant stones after SWL. The patients with remnant stones underwent SWL again. Group 1 consisted of patients who were prescribed an analgesic, Tamsulosin 0.2 mg, and Rowatinex. Group 2 consisted of patients who were prescribed only an analgesic and Tamsulosin 0.2 mg. The expulsion rate of urinary stones was compared between groups. Results The expulsion rate of urinary stones was not significantly different between the two groups after 2 weeks. However, after 4 weeks, group 1 had a significantly higher expulsion rate (72.2% compared with 61.1%, p=0.022). Fifteen patients (10.2%) in group 1 and 40 (11.4%) in group 2 had to undergo ureteroscopic removal of the stone (p=0.756). Acute pyelonephritis occurred in one patient (0.7%) in group 1 and in one patient (0.3%) in group 2 (p=0.503). Conclusions The long-term administration of Rowatinex for 4 weeks increased the expulsion rate of urinary stones after SWL. PMID:24466395

  11. Buckshot colic: utilizing holmium:yag laser for ureteroscopic removal of a bullet fragment within the proximal ureter.

    PubMed

    Ziegelmann, Matthew; Carrasco, Alonso; Knoedler, John; Krambeck, Amy E

    2016-06-01

    Buckshot colic is a rare phenomenon, presenting as firearm-induced urinary tract obstruction. We present a case of gunshot-induced ureteral obstruction in a 49-year-old male, treated endoscopically with the holmium:YAG (holmium) laser. CT revealed a 1 cm bullet fragment within the left proximal ureter. A percutaneous nephrolithotomy was performed utilizing the holmium laser to fragment the metal into basket-retrievable pieces. At 4 month follow up the patient is without evidence of stricture. To our knowledge, this is the first reported utilization of the holmium laser to treat "buckshot colic". Endoscopy with holmium laser appears a feasible and safe treatment option. PMID:27347630

  12. A rare cause of ureteral injuries; simultaneous common iliac artery and ureter injury during posterior lumbar disc surgery

    PubMed Central

    Başer, Aykut; Alkış, Okan; Toktaş, Cihan; Zümrütbaş, Ali Ersin

    2016-01-01

    Major vascular injuries during lumbar disc surgery are rare but well-recognized complications. However, vascular injuries of the branches of the aorta and ureteral injuries are very rare. Although its incidence is not known definitely, it is estimated to be 1/1000. Ureteral injuries comprise less than 1% of all genitourinary traumas. In this article, we report clinical progress of a patient who had simultaneous internal iliac artery and ureteral injury during lumbar discectomy. The patient was managed with primary ureteroureterostomy. To our knowledge, this is the first case reported with simultaneous ureter and iliac artery trauma during lumbar disc surgery. PMID:27274898

  13. Partial substitution of the ureter using a double short segments of the ileum following the monti procedure

    PubMed Central

    Lahyani, Mounir; Jakhlal, Nabil; Bakloul, Fouad; Karmouni, Tarik; Elkhader, Khalid; Koutani, Abdellatif; Andaloussi, Ahmed Ibn Attya; Bezza, Ismail; Elouazni, Mohamed; Ifrine, Lhssan; Belkouchi, Abdelkader

    2015-01-01

    The partial substitution of the ureter using a pediculated double short segments of the ileum is a technique used to re-establish ureteral transit and preserve the renal unit, following the resection of extensive ureteral lesions. Standard surgical procedure for an ileoureteroplasty consists of isolating an ileal duct of equal or greater length than the ureteral defect and interposing it in the urinary tract in an isoperistaltic direction. Monti described a surgical technique that allows for the creation of catheterizable stomas in continent urinary diversions, using the Mitrofanoff principle. These passageways were created from one or several 2.5 cm long ileal sections by means of their detubulization and transverse retubulization. PMID:26161193

  14. Retroperitoneal laparoendoscopic single-site ureterolithotomy and ureteroureterostomy for retrocaval ureter with ureteral calculus: first case report.

    PubMed

    Chen, Zhi; Chen, Xiang; Luo, Yan-Cheng; He, Yao; Li, Nan-Nan; Xie, Chao-Qun; Lai, Chen; Fang, Xiao-Long

    2012-12-01

    A 53-year-old man presented with a 6-month history of intermittent right flank pain. Radiological imaging confirmed the diagnosis of retrocaval ureter (RCU) and ureteral calculus. Retroperitoneal laparoendoscopic single-site surgery (LESS) ureterolithotomy and ureteroureterostomy was successfully performed. The operative time was 185 min and the blood loss was approximately 20 ml. The patient's postoperative course was uneventful. Postoperative analgesia was not needed. The patient was discharged on the third postoperative day. The drain and double-J stent were respectively removed at 1 and 8 weeks postoperatively. At the 3-month follow-up, nuclear scan showed no evidence of obstruction of the right kidney and the patient also remained symptom free. It may be concluded that retroperitoneal LESS repair for RCU is a feasible and safe procedure, which can be considered as a option for the management of RCU even if it is complicated by the presence of a ureteral calculus. PMID:22624948

  15. Partial substitution of the ureter using a double short segments of the ileum following the Monti procedure.

    PubMed

    Lahyani, Mounir; Jakhlal, Nabil; Bakloul, Fouad; Karmouni, Tarik; Elkhader, Khalid; Koutani, Abdellatif; Andaloussi, Ahmed Ibn Attya; Bezza, Ismail; Elouazni, Mohamed; Ifrine, Lhssan; Belkouchi, Abdelkader

    2015-01-01

    The partial substitution of the ureter using a pediculated double short segments of the ileum is a technique used to re-establish ureteral transit and preserve the renal unit, following the resection of extensive ureteral lesions. Standard surgical procedure for an ileoureteroplasty consists of isolating an ileal duct of equal or greater length than the ureteral defect and interposing it in the urinary tract in an isoperistaltic direction. Monti described a surgical technique that allows for the creation of catheterizable stomas in continent urinary diversions, using the Mitrofanoff principle. These passageways were created from one or several 2.5 cm long ileal sections by means of their detubulization and transverse retubulization. PMID:26161193

  16. Laparoscopic nephroureterectomy with transvesical single-port distal ureter and bladder cuff dissection: points of technique and initial surgical outcomes with five patients

    PubMed Central

    Markuszewski, Marcin; Kłącz, Jakub; Sieczkowski, Marcin; Połom, Wojciech; Piaskowski, Wojciech; Krajka, Kazimierz; Matuszewski, Marcin

    2014-01-01

    Although a variety of techniques have been used to manage the distal ureter during laparoscopic radical nephroureterectomy (LNU), a consensus has not yet been established. Recently, some authors have used a single-port transvesical approach to excise the distal ureter and bladder cuff following LNU. The aim of the study was to present our initial experience in „en bloc” dissection of the distal ureter and bladder cuff during LNU, using a transvesical single-port approach (T-LESS) and standard laparoscopic instruments. From April to October 2012, 5 patients aged 45 to 73 years with upper urinary tract urothelial tumors were subjected to LNU/T-LESS. After a standard LNU was performed, a TriPort+® device was introduced into the bladder and the pneumovesicum was established. A bladder cuff with a distal ureter was dissected and put in the paravesical tissue. The bladder wall defect was closed with the V-loc® 3/0 suture. The LNU was then completed in the flank position. All procedures were completed successfully. No significant blood loss or complications were observed. The mean operative time was 250 min (range: 200–370) for a total procedure and 59 min (range: 42–80) for the T-LESS stage. The postoperative hospital stay was 5.2 days (range: 4–9). Pathologic examination revealed no positive margin in any of the cases. The LNU/T-LESS approach is an efficient and safe procedure. A well-visualized dissection of the distal ureter, closing the defect of the bladder, the use of standard laparoscopic instruments and a good cosmesis are advantages of the method. PMID:25097698

  17. Standards of the Polish Ultrasound Society – update. Ultrasound examination of the kidneys, ureters and urinary bladder

    PubMed Central

    Woźniak, Magdalena Maria; Wieczorek, Andrzej Paweł

    2013-01-01

    The paper presents the principles of performing proper ultrasound examinations of the urinary tract. The following are discussed: preparation of patients, type of optimal apparatus, technique of examination and conditions which its description should fulfill. Urinary track examination in adults and in children constitutes an integral part of each abdominal examination. Such examinations should be performed with fasting patients or several hours after the last meal, with filled urinary bladder. Apparatus Ultrasound examinations in children and infants are performed using transducers with the frequency of 5.0–9.0 MHz and in adults – with the frequency of 2.0–6.0 MHz. Doppler options are desirable since they improve diagnostic capacity of sonography in terms of differentiation between renal focal lesions. Scanning technique Renal examinations are performed with the patients in the supine position. The right kidney is examined in the right hypochondriac region using the liver as the ultrasound “window.” The left kidney is examined in the left hypochondriac region, preferably in the posterior axillary line. Ultrasound examinations of the upper segment of the ureters are performed after renal examination when the pelvicalyceal system is dilated. A condition necessary for a proper examination of the perivesical portion of the ureter is full urinary bladder. The scans of the urinary bladder are performed in transverse, longitudinal and oblique planes when the bladder is filled. Description of the examination The description should include patient's personal details, details of the referring unit, of the unit in which the examination is performed, examining physician's details, type of ultrasound apparatus and transducers as well as the description proper. PMID:26673083

  18. Effect of aminoglycoside antibiotics on the electrical stimulation-induced contractile response of the guinea-pig ureter.

    PubMed

    Yoshida, M; Koeda, T

    1989-06-01

    Using electrical stimulation, we first investigated whether the movement of ureteral smooth muscle of the guinea-pig was myogenic in its control, or neurogenic. We then investigated the effects of aminoglycoside antibiotics (kanamycin, bekanamycin and ribostamycin) on the movement of ureteral smooth muscle induced by electrical stimulation. In these investigations, each ureter removed from the animal was cut into three approximately equal-sized segments, which are an upper segment (kidney side), a middle segment and a lower segment (urinary bladder side). Each segment was mounted in an organ bath filled with Krebs solution and the mechanical response induced by electrical stimulation of each segment was recorded isometrically. Each one of the upper, the middle and the lower segments was stimulated with rectangular pulses (50 volt, 0.1-3 msec durations, 40 Hz) for a period of 2 sec. Of all segments tested (ten in each group), none showed any response to the stimulation with pulses below 0.5 msec duration. While 2-3 segments out of ten of the upper, the middle and the lower ureteral segments showed a contractile response to stimulation with pulses of 1 msec duration, the rest of the segments showed no response to the same stimulation. This contractile response was not inhibited by tetrodotoxin which is known to block the nerve-mediated response. And also, all the ten samples of each upper, middle and lower segment never failed to show a contractile response to stimulation with pulses of 2 msec and 3 msec duration. Various drugs which are already known to block the nerve-mediated response (i.e., atropine, guanethidine, phentolamine, propranolol and tetrodotoxin) were tried, but none of them had an inhibitory effect on the contractile response. On the other hand, each one of kanamycin (KM), bekanamycin (AKM) and ribostamycin (RSM) in concentrations of 1 x 10(-5) g/ml-1 x 10(-3) g/ml produced a concentration-dependent decreasing effect in the magnitude of the electrical

  19. Philureter trigoniopsis, a new genus and species (Dactylogyridae, Ancyrocephalinae) from the ureters and urinary bladder of Galaxias maculatus (Osmeriformes: Galaxiidae) in Patagonia (Argentina).

    PubMed

    Viozzi, G P; Gutiérrez, P A

    2001-04-01

    The monotypic Philureter n. gen. (Ancyrocephalinae; Dactylogyridae) is proposed to accommodate Philureter trigoniopsis n. sp. with the following features: presence of a cuplike ventral haptor armed with 14 hooks and 2 anchor/bar complexes; dorsal pair of anchors poorly defined and variable in shape, 1 frequently absent; tandem, intercecal gonads, testis bilaterally lobulated. Philureter trigoniopsis n. sp. is described from the ureters and urinary bladder of Galaxias maculatus (Jenyns, 1842) (Osmeriformes) in Patagonian Andean lakes, Argentina. PMID:11318570

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

    SciTech Connect

    Wang, K.-L.; Yang, Y.-C.; Chao, K. S. Clifford Wu, M.-H.; Tai, H.-C.; Chen, T.-C.; Huang, M.-C.; Chen, J.-R.; Su, T.-H.; Chen, Y.-J.

    2007-10-01

    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)

  1. Optimal Skin-to-Stone Distance Is a Positive Predictor for Successful Outcomes in Upper Ureter Calculi following Extracorporeal Shock Wave Lithotripsy: A Bayesian Model Averaging Approach

    PubMed Central

    Cho, Kang Su; Jung, Hae Do; Ham, Won Sik; Chung, Doo Yong; Kang, Yong Jin; Jang, Won Sik; Kwon, Jong Kyou; Choi, Young Deuk; Lee, Joo Yong

    2015-01-01

    Objectives To investigate whether skin-to-stone distance (SSD), which remains controversial in patients with ureter stones, can be a predicting factor for one session success following extracorporeal shock wave lithotripsy (ESWL) in patients with upper ureter stones. Patients and Methods We retrospectively reviewed the medical records of 1,519 patients who underwent their first ESWL between January 2005 and December 2013. Among these patients, 492 had upper ureter stones that measured 4–20 mm and were eligible for our analyses. Maximal stone length, mean stone density (HU), and SSD were determined on pretreatment non-contrast computed tomography (NCCT). For subgroup analyses, patients were divided into four groups. Group 1 consisted of patients with SSD<25th percentile, group 2 consisted of patients with SSD in the 25th to 50th percentile, group 3 patients had SSD in the 50th to 75th percentile, and group 4 patients had SSD≥75th percentile. Results In analyses of group 2 patients versus others, there were no statistical differences in mean age, stone length and density. However, the one session success rate in group 2 was higher than other groups (77.9% vs. 67.0%; P = 0.032). The multivariate logistic regression model revealed that shorter stone length, lower stone density, and the group 2 SSD were positive predictors for successful outcomes in ESWL. Using the Bayesian model-averaging approach, longer stone length, lower stone density, and group 2 SSD can be also positive predictors for successful outcomes following ESWL. Conclusions Our data indicate that a group 2 SSD of approximately 10 cm is a positive predictor for success following ESWL. PMID:26659086

  2. AB178. Holmium laser resection of the distal ureter and bladder cuff during radical nephroureterectomy for patients with pelvis or ureteral cancer

    PubMed Central

    Ge, Yongchao

    2016-01-01

    Objective To explore the feasibility of transurethral resection for the distal ureter and bladder cuff in radical nephroureterectomy for the treatment of upper urinary tract urothelial carcinoma (UUT-UC). Methods A total of 76 patients with renal pelvic carcinoma or upper tract urothelial carcinoma during July 2003 to December 2011 were retrospective analyzed. All patients were divided into two groups according to doctor’s suggestion and their wishes. Thirty-six patients of them received excision of the distal ureter and bladder cuff by transurethral Holmium laser (cystoscopy group) combined with open nephroureterectomy, and 40 patients of them underwent open surgery (open surgery group).The operation time, postoperative activity time, and postoperative hospital stay in the two groups were compared. Results All operations were completed successfully in both groups. Compared with Open Surgery Group, the operation time [(177.2±36.9) vs. (229.6±28.1) min, t=−7.004, P=0.000], postoperative activity time [(2.7±0.7) vs. (4.1±1.0) d, t=−6.802, P=0.000] and hospital stay [(6.9±1.0) vs. (8.6±1.5) d, t=−5.448, P=0.000] of cystoscopy group were shorter. No recurrence or metastasis was observed from a follow-up of 6–120 months (median=32 months) in the two groups. Conclusions Transurethral surgery is superior to traditional open surgery in trauma degree and postoperative recovery time. Transurethral Holmium laser resection of the distal ureter and bladder cuff is a minimally invasive and safety technique in the nephroureterectomy for the treatment of UTUC.

  3. Does diabetes affect the distribution and number of interstitial cells and neuronal tissue in the ureter, bladder, prostate, and urethra of humans?

    PubMed Central

    Dogan, Hayriye; Kandemir, Olcay; Atmaca, Ali Fuat; Akbulut, Ziya; Balbay, Mevlana Derya

    2014-01-01

    Introduction The aim of this study was to investigate and compare the distribution and number of interstitial cells (ICs) and neuronal tissue in the ureter, bladder, prostate, and urethra of human patients with and without diabetes. Material and methods Human tissue was obtained from patients who had undergone radical cystectomy for bladder cancer (10 diabetic and 11 non–diabetic males). Interstitial cells were stained immunohistochemically with anti–human CD117 (c–kit) rabbit polyclonal antibody, Vimentin, and Connexin–43. Neural tissue was stained with synaptophysin. The number of ICs and neurons was evaluated and compared between the groups (diabetic versus non–diabetic). Results The mean number of c–kit (+) ICs in bladder lamina propria was significantly decreased in diabetics (32.40 ±12.96 versus 57.18 ±25.37, p = 0.036). The mean number of ICs in the detrusor muscle was significantly decreased in diabetics (40.50 ±16.79 versus 64.55 ±22.08, p = 0.013). Between the groups, no significant differences were detected regarding the number of ICs at the level of the ureter, urethra, and prostate. No significant differences were detected regarding the number of nerves in the ureter, bladder, prostate, and urethra of both groups. Conclusions The number of ICs may be decreased in the lamina propria and detrusor muscle of the human bladder in diabetes. This can be an underlying cause of lower urinary tract (LUT) dysfunction in diabetics. Research into the development of drugs targeting or stimulating IC function in order to prevent diabetic LUT dysfunction is warranted. PMID:25667756

  4. Clinical and Prognostic Factors for Renal Parenchymal, Pelvis, and Ureter Cancers in SEER Registries: Collaborative Stage Data Collection System, Version 2

    PubMed Central

    Altekruse, Sean F.; Dickie, Lois; Wu, Xiao-Cheng; Hsieh, Mei-Chin; Wu, Manxia; Lee, Richard; Delacroix, Scott

    2015-01-01

    BACKGROUND The American Joint Committee on Cancer’s (AJCC) 7th edition cancer staging manual reflects recent changes in cancer care practices. This report assesses changes from the AJCC 6th to the AJCC 7th edition stage distributions and the quality of site-specific factors (SSFs). METHODS Incidence data for renal parenchyma and pelvis and ureter cancers from 18 Surveillance, Epidemiology, and End Results (SEER) registries were examined, including staging trends during 2004–2010, stage distribution changes between the AJCC 6th and 7th editions, and SSF completeness for cases diagnosed in 2010. RESULTS From 2004 to 2010, the percentage of stage I renal parenchyma cancers increased from 50% to 58%, whereas stage IV and unknown stage cases decreased (18% to 15%, and 10% to 6%, respectively). During this period, the percentage of stage 0a renal pelvis and ureter cancers increased from 21% to 25%, and stage IV and unknown stage tumors decreased (20% to 18%, and 7% to 5%, respectively). Stage distributions under the AJCC 6th and 7th editions were about the same. For renal parenchymal cancers, 71%–90% of cases had known values for 6 required SSFs. For renal pelvis and ureter cancers, 74% of cases were coded as known for SSF1 (WHO/ISUP grade) and 47% as known for SSF2 (depth of renal parenchymal invasion). SSF values were known for larger proportions of cases with reported resections. CONCLUSIONS Stage distributions between the AJCC 6th and 7th editions were similar. SSFs were known for more than two-thirds of cases, providing more detail in the SEER database relevant to prognosis. PMID:25412394

  5. Injury - kidney and ureter

    MedlinePlus

    ... toxic substances such as lead, cleaning products, solvents, fuels, or long-term use of high-dose pain ... work and play. Use cleaning products, solvents, and fuels as directed. Make sure the area is well- ...

  6. 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 Eliminating medicines or exposure to substances ...

  7. Transcatheter Arterial Embolization Therapy for a Hypoplastic Pelvic Kidney with a Single Vaginal Ectopic Ureter to Control Incontinence: The Usefulness of Three-Dimensional CT Angiography Using Multidetector-Row Helical CT

    SciTech Connect

    Kudoh, Kouichi Kadota, Masataka; Nakayama, Yoshiharu; Imuta, Masanori; Yasuda, Tsuyoshi; Yamashita, Yasuyuki; Inadome, Akito; Yoshida, Masaki; Ueda, Shouichi

    2003-09-15

    A girl with continuous urinary incontinence was successfully treated by angiographic embolization of a hypoplastic pelvic kidney with a single unilateral vaginal ectopic opening of the ureter. For this intervention, CT angiography was useful for detecting the corresponding renal artery of the hypoplastic kidney.

  8. Results of a Seven-Year, Single-Centre Experience of the Long-Term Outcomes of Bovine Ureter Grafts Used as Novel Conduits for Haemodialysis Fistulas

    SciTech Connect

    Das, Neelan Bratby, Mark J.; Shrivastava, Vivek; Cornall, Alison J.; Darby, Christopher R.; Boardman, Philip; Anthony, Susan; Uberoi, Raman

    2011-10-15

    Purpose: To report the long-term outcomes of bovine ureter grafts as novel conduits for haemodialysis fistulas. Materials and Methods: Thirty-five patients underwent placement of a total of 40 SynerGraft 100 (SG100; CryoLife Europa{sup Registered-Sign}, Guildford, UK) bovine ureter grafts between April 2002 and February 2009. Prospective data were collected on all patients, including active surveillance with blood flow studies and 6-monthly duplex ultrasound studies. Main outcome measures were primary and secondary patency rates. Results: Mean follow-up time was 97 weeks (range 4-270). Thirteen patients died from unrelated causes during the study period; 12 of these patients had a functioning graft at the time of death. Five patients underwent transplantation, and all had a functioning graft at transplantation. Twelve patients had a functioning graft at the end of the study period. One hundred and ten stenoses were detected, and 97 venoplasty procedures were performed. Of the stenoses, 41.8% were located at the venous anastomosis, 12.7% within the graft, 17.3% in the outflow veins, and 28.1% in central veins. No arterial stenoses were detected. Primary patency rates were 53% at 6 months and 14% at 1 year. Secondary patency rates were 81% at 6 months, 75% at 1 year, and 56% at 2 years. Conclusions: Active surveillance and intervention was able to achieve satisfactory long-term secondary patency for these novel conduits compared with those made of PTFE seen in other studies.

  9. A2B adenosine receptors mediate relaxation of the pig intravesical ureter: adenosine modulation of non adrenergic non cholinergic excitatory neurotransmission

    PubMed Central

    Hernández, Medardo; Barahona, María Victoria; Bustamante, Salvador; García-Sacristán, Albino; Orensanz, Luis M

    1999-01-01

    The present study was designed to characterize the adenosine receptors involved in the relaxation of the pig intravesical ureter, and to investigate the action of adenosine on the non adrenergic non cholinergic (NANC) excitatory ureteral neurotransmission. In U46619 (10−7  M)-contracted strips treated with the adenosine uptake inhibitor, nitrobenzylthioinosine (NBTI, 10−6  M), adenosine and related analogues induced relaxations with the following potency order: 5′-N-ethylcarboxamidoadenosine (NECA)=5′-(N-cyclopropyl)-carboxamidoadenosine (CPCA)=2-chloroadenosine (2-CA)>adenosine>cyclopentyladenosine (CPA)=N6-(3-iodobenzyl)-adenosine-5′-N-methylcarboxamide (IB-MECA)=2-[p-(carboxyethyl)-phenylethylamino]-5′-N-ethylcarboxamidoadenosine (CGS21680). Epithelium removal or incubation with indomethacin (3×10−6  M) and L-NG-nitroarginine (L-NOARG, 3×10−5  M), inhibitors of prostanoids and nitric oxide (NO) synthase, respectively, failed to modify the relaxations to adenosine. 1,3-dipropyl-8-cyclopentylxanthine (DPCPX, 10−8 M) and 4-(2-[7-amino-2-(2-furyl) [1,2,4]-triazolo[2,3-a][1,3,5]triazin-5-ylamino]ethyl)phenol (ZM 241385, 3×10−8  M and 10−7  M), A1 and A2A receptor selective antagonists, respectively, did not modify the relaxations to adenosine or NECA. 8-phenyltheophylline (8-PT, 10−5  M) and DPCPX (10−6  M), which block A1/A2-receptors, reduced such relaxations. In strips treated with guanethidine (10−5  M), atropine (10−7  M), L-NOARG (3×10−5  M) and indomethacin (3×10−6  M), both electrical field stimulation (EFS, 5 Hz) and exogenous ATP (10−4  M) induced contractions of preparations. 8-PT (10−5  M) increased both contractions. DPCPX (10−8  M), NECA (10−4  M), CPCA, (10−4  M) and 2-CA (10−4  M) did not alter the contractions to EFS. The present results suggest that adenosine relaxes the pig intravesical ureter, independently of prostanoids

  10. Impact of Colic Pain as a Significant Factor for Predicting the Stone Free Rate of One-Session Shock Wave Lithotripsy for Treating Ureter Stones: A Bayesian Logistic Regression Model Analysis

    PubMed Central

    Chung, Doo Yong; Cho, Kang Su; Lee, Dae Hun; Han, Jang Hee; Kang, Dong Hyuk; Jung, Hae Do; Kown, Jong Kyou; Ham, Won Sik; Choi, Young Deuk; Lee, Joo Yong

    2015-01-01

    Purpose This study was conducted to evaluate colic pain as a prognostic pretreatment factor that can influence ureter stone clearance and to estimate the probability of stone-free status in shock wave lithotripsy (SWL) patients with a ureter stone. Materials and Methods We retrospectively reviewed the medical records of 1,418 patients who underwent their first SWL between 2005 and 2013. Among these patients, 551 had a ureter stone measuring 4–20 mm and were thus eligible for our analyses. The colic pain as the chief complaint was defined as either subjective flank pain during history taking and physical examination. Propensity-scores for established for colic pain was calculated for each patient using multivariate logistic regression based upon the following covariates: age, maximal stone length (MSL), and mean stone density (MSD). Each factor was evaluated as predictor for stone-free status by Bayesian and non-Bayesian logistic regression model. Results After propensity-score matching, 217 patients were extracted in each group from the total patient cohort. There were no statistical differences in variables used in propensity- score matching. One-session success and stone-free rate were also higher in the painful group (73.7% and 71.0%, respectively) than in the painless group (63.6% and 60.4%, respectively). In multivariate non-Bayesian and Bayesian logistic regression models, a painful stone, shorter MSL, and lower MSD were significant factors for one-session stone-free status in patients who underwent SWL. Conclusions Colic pain in patients with ureter calculi was one of the significant predicting factors including MSL and MSD for one-session stone-free status of SWL. PMID:25902059

  11. Conditional Knockout of Src Homology 2 Domain-containing Protein Tyrosine Phosphatase-2 in Myeloid Cells Attenuates Renal Fibrosis after Unilateral Ureter Obstruction

    PubMed Central

    Teng, Jing-Fei; Wang, Kai; Li, Yao; Qu, Fa-Jun; Yuan, Qing; Cui, Xin-Gang; Wang, Quan-Xing; Xu, Dan-Feng

    2015-01-01

    Background: Src homology 2 domain-containing protein tyrosine phosphatase-2 (SHP-2) is a kind of intracellular protein tyrosine phosphatase. Studies have revealed its roles in various disease, however, whether SHP-2 involves in renal fibrosis remains unclear. The aim of this study was to explore the roles of myeloid cells SHP-2 in renal interstitial fibrosis. Methods: Myeloid cells SHP-2 gene was conditionally knocked-out (CKO) in mice using loxP-Cre system, and renal interstitial fibrosis was induced by unilateral ureter obstruction (UUO). The total collagen deposition in the renal interstitium was assessed using picrosirius red stain. F4/80 immunostaing was used to evaluate macrophage infiltration in renal tubular interstitium. Quantitative real-time polymerase chain reaction and enzyme linked immunosorbent assay were used to analyze the production of cytokines in the kidney. Transferase-mediated dUTP nick-end labeling stain was used to assess the apoptotic renal tubular epithelial cells. Results: Src homology 2 domain-containing protein tyrosine phosphatase-2 gene CKO in myeloid cells significantly reduced collagen deposition in the renal interstitium after UUO. Macrophage infiltration was evidently decreased in renal tubular interstitium of SHP-2 CKO mice. Meanwhile, the production of pro-inflammatory cytokines was significantly suppressed in SHP-2 CKO mice. However, no significant difference was observed in the number of apoptotic renal tubular epithelial cells between wild-type and SHP-2 CKO mice. Conclusions: Our observations suggested that SHP-2 in myeloid cells plays a pivotal role in the pathogenesis of renal fibrosis, and that silencing of SHP-2 gene in myeloid cells may protect renal from inflammatory damage and prevent renal fibrosis after renal injury. PMID:25947403

  12. Serum Neutrophil Gelatinase Associated Lipocalin (NGAL) Outperforms Serum Creatinine in Detecting Sepsis-Induced Acute Kidney Injury, Experiments on Bilateral Nephrectomy and Bilateral Ureter Obstruction Mouse Models.

    PubMed

    Leelahavanichkul, Asada; Somparn, Poorichaya; Issara-Amphorn, Jiraphorn; Eiam-Ong, Somchai; Avihingsanon, Yingyos; Hirankarn, Nattiya; Srisawat, Nattachai

    2016-05-01

    Serum neutrophil gelatinase associated lipocalin (sNGAL), a promising acute kidney injury (AKI) biomarker produced by renal and non-renal tissues, might be affected by sepsis. We evaluated sNGAL in zero glomerular filtration rate models [bilateral ureter obstruction (BUO) and bilateral nephrectomy (BiNx)] with subsequent cecal ligation and puncture (CLP)-induced sepsis in 6 to 8-week-old ICR mice. We found that sNGAL increased earlier than serum creatinine (Scr) in BiNx/BUO with and without CLP. The earliest time-point of increased sNGAL in BiNx+CLP was 1 h after surgery. Scr, but not sNGAL, was lower at 18 h after BiNx/BUO+CLP compared with BiNx/BUO alone. Compared with BUO, BiNx had higher, and equal sNGAL at 1 to 18 h and 36 h, respectively. Additionally, similar NGAL expression in internal organs (heart, lung, liver, and spleen) and survival rates indicated the comparable severity of BiNx and BUO. Serum interleukin (IL)-6 was increased and correlated with sNGAL in BiNx/BUO with and without sepsis. In summary, we demonstrated: sNGAL is an early AKI biomarker, which is not affected by sepsis; sNGAL is mainly produced by extrarenal sources as demonstrated by the comparable sNGAL in BiNx and BUO; the saturation of renal NGAL re-absorption in BUO is demonstrated by lower sNGAL in BUO at 1 to 18 h, but not at 36 h when compared with BiNx; and a correlation of sNGAL and IL-6 implied sNGAL is a good sepsis prognostic biomarker. Therefore, sNGAL is a more beneficial sepsis-AKI biomarker than Scr. PMID:26863120

  13. MR urography (MRU) of non-dilated ureter with diuretic administration: Static fluid 2D FSE T2-weighted versus 3D gadolinium T1-weighted GE excretory MR

    PubMed Central

    Roy, C.; Ohana, M.; Host, Ph.; Alemann, G.; Labani, A.; Wattiez, A.; Lang, H.

    2014-01-01

    Objective The goal of this prospective study was to compare the efficiency of two types of MRU after diuretic administration to identify the non-dilated ureter. Methods MR pelvic examinations were performed in 126 patients after receiving furosemide. Each patient underwent in addition to their protocol for context, two types of MRU: 2D T2-weighted FSE (T2w-MRU) and 3D Gd T1-weighted GE (CE-MRU). Four segments were checked for each ureter. For the first part of the analysis, readers evaluated the whole image quality using a four points subjective scale and for the second part, they were asked to score separately each ureteral segment as present or absent. Results 1008 ureteral segments were checked. For the image quality, readers did not find any significant difference (3.8 ± 0.5 vs 3.6 ± 0.7, p value: 0.13) between MRU methods. The interobserver agreement was excellent with a κ correlation coefficient as high as 0.89 for T2w-MRU and 0.92 for CE-MRU, respectively. For the detection of the segments and considering the 9 rotations for the T2W MRU, there were no statistically significant differences between the two groups. Conclusion T2-weighted MRU with multiple orientations and diuretic is sufficient to identify the non-dilated ureter. It offers information on ureteral peristaltism. It can be suggested that this sequence is able to detect an initial obstruction before hydronephrosis occurs. PMID:26937423

  14. Ultrasound: Renal (Kidneys, Ureters, Bladder) (For Parents)

    MedlinePlus

    ... kidney area and images are recorded on a computer. The black-and-white images show the internal ... the images can be seen clearly on the computer screen. A technician (sonographer) trained in ultrasound imaging ...

  15. Tumors of the kidney, ureter, and bladder.

    PubMed Central

    See, W. A.; Williams, R. D.

    1992-01-01

    Neoplastic diseases of the kidneys and urinary collecting system are relatively common, but when detected early, they have an excellent prognosis. Because gross or microscopic hematuria may be an early harbinger of genitourinary pathology, the primary care physician and internist play an integral role in diagnosing these diseases. A high index of suspicion together with a thorough history, physical examination, and appropriate diagnostic studies will enable the correct diagnosis and improved patient management in most cases. Images PMID:1595278

  16. Left Inguinal Bladder Hernia that Causes Dilatation in the Ureter.

    PubMed

    Ugur, Mustafa; Atcı, Nesrin; Oruc, Cem; Akkucuk, Seckin; Aydogan, Akin

    2016-05-01

    The scrotal bladder hernia is a rare condition that may present as scrotal swelling and urinary system obstruction or infection symptoms. Diagnosis of this condition before the operation decreases the severe complications like bladder injury during operation. In this article, a 75-year-old man presented to our clinic with right inguinal swelling and lower urinary system infection. Inguinal bladder hernia was diagnosed after performing a computed tomography. The hernia was repaired without any complications. PMID:27179171

  17. Primary malignant melanoma of the urinary bladder and ureter.

    PubMed

    Khan, Munad; O'Kane, Dermot; Du Plessis, Justin; Hoag, Nathan; Lawrentschuk, Nathan

    2016-02-01

    Primary malignant melanoma of the urinary bladder is a rare lesion. We report the case of a 78-year-old male with no previous history of cutaneous melanoma who presented with hematuria. Further investigation with imaging and cystoscopy raised suspicion of a primary bladder and ureteric melanoma, which had subsequently metastasized. This was confirmed with histological assessment and a thorough search for alternative primary lesions. Unfortunately, our patient passed away prior to receiving any oncological treatment for his metastatic melanoma, underscoring both the high mortality of this lesion and the need for a consensus on definitive treatment. PMID:26892061

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

    PubMed Central

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

    2014-01-01

    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

  19. [Elective organ and function preservation in ureter and renal pelvis tumors].

    PubMed

    Rausch, S; Gakis, G; Bedke, J; Stenzl, A

    2014-09-01

    With the technical innovations of smaller, flexible ureteroscopes, color-filtered imaging, and endoscopic laser technology, organ-preserving treatment for upper urinary tract transitional cell carcinoma has become feasible. While in the past, radical nephroureterectomy was the sole gold standard approach for the treatment of upper urinary tract tumors, the endoscopic approach is no longer restricted to only patients with the imperative indication of kidney preservation. Initial clinical results have demonstrated oncologic efficacy of endoscopic management or segmental ureteral resection. However, careful preoperative risk-assessment and close endoscopic follow-up are mandatory. PMID:25148912

  20. [Intravesical Recurrence of Small Cell Carcinoma of the Ureter: A Case Report].

    PubMed

    Ueda, Norichika; Kobayashi, Yasuyuki; Arai, Hiroki; Honda, Masahito; Yoshida, Kyotaro

    2016-02-01

    A 63-year-old man who presented with asymptomatic gross hematuria was referred to our hospital. Left ureteral tumor (cT3N0M0) was diagnosed and left nephroureterectomy was performed. Pathological examination revealed urothelial carcinoma and small cell carcinoma with local invasion (pT3). The patient was treated with three cycles of adjuvant chemotherapy with gemcitabine and cisplatin. Three months after the chemotherapy, cystoscopy showed an intravesical recurrence of the tumor. Transurethral resection was performed and histopathological examination revealed small cell carcinoma (pT1). We recommended a cystectomy and neoadjuvant chemotherapy with etoposide and carboplatin according to the standard care of small cell carcinoma of bladder. However, the patient refused to undergo cystectomy and desired to preserve his bladder. Therefore, after two cycles of chemotherapy with etoposide and carboplatin, transurethral resection was performed to examine the presence of the residual tumor instead of immediate cystectomy. Because of no residual tumor, another two cycles of chemotherapy were added instead of a cystectomy. There is no evidence of recurrence seven months after the chemotherapy. PMID:27018413

  1. Congenital anatomic variants of the kidney and ureter: a pictorial essay.

    PubMed

    Srinivas, M R; Adarsh, K M; Jeeson, Riya; Ashwini, C; Nagaraj, B R

    2016-03-01

    Congenital renal parenchymal and pelvicalyceal abnormalities have a wide spectrum. Most of them are asymptomatic, like that of ectopia, cross fused kidney, horseshoe kidney, etc., while a few of them become complicated, leading to renal failure and death. It is very important for the radiologist to identify these anatomic variants and guide the clinicians for surgical and therapeutic procedures. Cross-sectional imaging with a volume rendered technique/maximum intensity projection has overcome ultrasonography and IVU for identification and interpretation of some of these variants. PMID:26747433

  2. Robotic-assisted laparoscopic approaches to the ureter: Pyeloplasty and ureteral reimplantation

    PubMed Central

    Samarasekera, Dinesh; Stein, Robert J.

    2014-01-01

    Introduction and Objectives: The benefits of robotic surgery when compared to standard laparoscopy have been well established, especially when it comes to reconstructive procedures. The application of robotic technology to laparoscopic pyeloplasty has reduced the steep learning curve associated with the procedure. Consequently, this has allowed surgeons who are less experienced with laparoscopy to offer this treatment to their patients, instead of referring them to centers of excellence. Robotic pyeloplasty has also proved useful for repairing secondary UPJO, a procedure which is considered extremely difficult using a conventional laparoscopic approach. Finally, the pursuit of scarless surgery has seen the development of laparoendoscopic single site (LESS) procedures. The application of robotics to LESS (R-LESS) has also reduced the difficulty in performing conventional LESS pyeloplasty. Herein we present a literature review with regards to robotic-assisted laparoscopic pyeloplasty. We also discuss the benefits of robotic surgery with regards to reconstruction of the lower urinary tract. Materials and Methods: A systematic literature review was performed using PubMed to identify relevant studies. There were no time restrictions applied to the search, but only studies in English were included. We utilized the following search terms: Ureteropelvic junction obstruction and laparoscopy; laparoscopic pyeloplasty; robotic pyeloplasty; robotic ureteric reimplantation; robotic ureteroneocystostomy; robotic boari flap; robotic psoas hitch. Results: There has been considerable experience in the literature with robotic pyeloplasty. Unfortunately, no prospective randomized studies have been conducted, however there are a number of meta analyses and systematic reviews. While there are no clear benefits when it comes to surgical and functional outcomes when compared to standard laparoscopic pyeloplasty, it is clear that robotics makes the operation easier to perform. There is also a benefit to the robotic approach when performing a redo-pyeloplasty. Robotic pyeloplasty has also been applied to the pediatric population, and there may be a benefit in older children while in very young patients, retroperitoneal open pyeloplasty is still the gold standard. In the field of single incision surgery R-LESS is technically easier to perform than conventional LESS. However, the design of the current robotic platform is not completely suited for this application, limiting its utility and often requiring a larger incision. Optimized R-LESS specific technology is awaited. What is clear, from a number of analyses, is that robotic pyeloplasty is considerably more expensive than the laparoscopic approach, largely due to costs of instrumentation and the capital expense of the robot. Until cheaper robotic technology is available, this technique will continue to be expensive, and a cost-benefit analysis must be undertaken by each hospital planning to undertake this surgery. Finally, the benefits of upper tract reconstruction apply equally to the lower tract although there is considerably less experience. However, there have been a number of studies demonstrating the technical feasibility of ureteral reimplantation. Conclusions: Robotic-assisted laparoscopic pyeloplasty is gaining popularity, likely due to the shorter learning curve, greater surgeon comfort, and easier intracorporeal suturing. This has allowed more surgeons to perform the procedure, improving accessibility. Robotic technology is also beneficial in the field of LESS. Nevertheless, the procedure still is not as cost-effective as the conventional laparoscopic approach, and until more affordable robotic technology is available, it will not be universally offered. PMID:25097316

  3. Case 230: Congenital Inguinal Herniation of the Left Ureter (Extraperitoneal Form).

    PubMed

    Di Nicolò, Pierpaolo; Aleo, Daniele; Riccioli, Emilio; Granata, Antonio

    2016-06-01

    History A 52-year-old man with a history of urinary tract infections and a previous clinical diagnosis of left inguinal hernia presented to the nephrologist with recent onset of dysuria and increasing swelling in the left inguinoscrotal region in the absence of fever or scrotal trauma. There was no relevant surgical or family history. The general physical examination findings were unremarkable, with a normal abdomen at both visual inspection and palpation; urogenital examination revealed a small left-sided palpable mass of the testis, compatible with an inguinal hernia or hydrocele. At first, gray-scale and color Doppler ultrasonographic (US) images of the testes and the inguinoscrotal region were obtained. Contrast material-enhanced computed tomographic (CT) images of the lower abdomen and pelvis were then obtained to further evaluate the urinary tract. PMID:27183410

  4. Unilateral hypoplastic kidney and ureter associated with diverse mesonephric remnant hyperplasia

    PubMed Central

    Xiao, Guang-Qian; Jerome, Jean-Gilles; Wu, Guan

    2015-01-01

    Mesonephric remnants have been rarely reported in the genitourinary system and sometimes impose a diagnostic challenge both clinically and pathologically. We reported a case of mesonephric remnant hyperplasia with mixed acinar/tubular and epididymis/vas deferens-like morphologies occurring in the renal parenchyma of a unilateral hypoplastic kidney, which has not been previously described. PMID:26309900

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

    PubMed Central

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

    2014-01-01

    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

  6. Primary hydatid cyst of the kidney and ureter with hydatiduria in a laboratory worker: a case report.

    PubMed

    Seetharam, Venkatesh; Khanna, Vinay; Jaiprakash, Padmapriya; Kosaraju, Kranthi; Thomas, Joseph; Mukhopadhayay, Chiranjay

    2012-01-01

    Hydatid disease is frequent in endemic regions and sheep farming areas. Most common localization of hydatid cyst occurs in liver followed by lungs. Renal hydatid cyst constitutes about 2-4% of all locations. We report a case of left renal hydatid from a laboratory technician admitted in a tertiary care hospital. There were few cases of renal hydatid disease reported in India among general population but to the best of our knowledge never reported from laboratory worker. The possibility of laboratory-acquired infection cannot be ruled out in this case due to lack of precautionary measures and containment facilities in resource-constrained setting. PMID:24555138

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

    PubMed

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

    2014-01-01

    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

  8. Gemcitabine Hydrochloride and Eribulin Mesylate in Treating Patients With Bladder Cancer That is Advanced or Cannot Be Removed by Surgery

    ClinicalTrials.gov

    2016-03-14

    Metastatic Ureteral Neoplasm; Metastatic Urethral Neoplasm; Stage III Bladder Urothelial Carcinoma; Stage III Ureter Cancer; Stage III Urethral Cancer; Stage IV Bladder Urothelial Carcinoma; Stage IV Ureter Cancer; Stage IV Urethral Cancer; Ureter Urothelial Carcinoma; Urethral Urothelial Carcinoma

  9. Initial Report of a Mycotic Aneurysm of the Common Iliac Artery With Compression of the Ipsilateral Ureter and Femoral Vein: A Literature Review and Case Report

    PubMed Central

    Lippoff, Orrin; Hoover, Eddie L.; Diaz, Carlos; Webb, Hueldine; Hsu, Hwei-Kang

    1986-01-01

    Iliac artery aneurysms are rare and the usual symptoms, pelvic pain and urological complaints, are nonspecific. We describe a patient with pelvic pain, intermittent urinary retention, and lower extremity edema. A right common iliac artery aneurysm was discovered during surgery after rupture had occurred. Pathologic examination revealed a mycotic process. This case demonstrates the obscure and unreported clinical features of iliac artery aneurysms. When this lesion is suspected, an angiogram should be performed promptly in an effort to prevent the predictable catastrophic consequences. (Texas Heart Institute Journal 1986; 13:321-324) Images PMID:15226863

  10. Stone heterogeneity index as the standard deviation of Hounsfield units: A novel predictor for shock-wave lithotripsy outcomes in ureter calculi.

    PubMed

    Lee, Joo Yong; Kim, Jae Heon; Kang, Dong Hyuk; Chung, Doo Yong; Lee, Dae Hun; Do Jung, Hae; Kwon, Jong Kyou; Cho, Kang Su

    2016-01-01

    We investigated whether stone heterogeneity index (SHI), which a proxy of such variations, was defined as the standard deviation of a Hounsfield unit (HU) on non-contrast computed tomography (NCCT), can be a novel predictor for shock-wave lithotripsy (SWL) outcomes in patients with ureteral stones. Medical records were obtained from the consecutive database of 1,519 patients who underwent the first session of SWL for urinary stones between 2005 and 2013. Ultimately, 604 patients with radiopaque ureteral stones were eligible for this study. Stone related variables including stone size, mean stone density (MSD), skin-to-stone distance, and SHI were obtained on NCCT. Patients were classified into the low and high SHI groups using mean SHI and compared. One-session success rate in the high SHI group was better than in the low SHI group (74.3% vs. 63.9%, P = 0.008). Multivariate logistic regression analyses revealed that smaller stone size (OR 0.889, 95% CI: 0.841-0.937, P < 0.001), lower MSD (OR 0.995, 95% CI: 0.994-0.996, P < 0.001), and higher SHI (OR 1.011, 95% CI: 1.008-1.014, P < 0.001) were independent predictors of one-session success. The radiologic heterogeneity of urinary stones or SHI was an independent predictor for SWL success in patients with ureteral calculi and a useful clinical parameter for stone fragility. PMID:27035621

  11. Stone heterogeneity index as the standard deviation of Hounsfield units: A novel predictor for shock-wave lithotripsy outcomes in ureter calculi

    PubMed Central

    Lee, Joo Yong; Kim, Jae Heon; Kang, Dong Hyuk; Chung, Doo Yong; Lee, Dae Hun; Do Jung, Hae; Kwon, Jong Kyou; Cho, Kang Su

    2016-01-01

    We investigated whether stone heterogeneity index (SHI), which a proxy of such variations, was defined as the standard deviation of a Hounsfield unit (HU) on non-contrast computed tomography (NCCT), can be a novel predictor for shock-wave lithotripsy (SWL) outcomes in patients with ureteral stones. Medical records were obtained from the consecutive database of 1,519 patients who underwent the first session of SWL for urinary stones between 2005 and 2013. Ultimately, 604 patients with radiopaque ureteral stones were eligible for this study. Stone related variables including stone size, mean stone density (MSD), skin-to-stone distance, and SHI were obtained on NCCT. Patients were classified into the low and high SHI groups using mean SHI and compared. One-session success rate in the high SHI group was better than in the low SHI group (74.3% vs. 63.9%, P = 0.008). Multivariate logistic regression analyses revealed that smaller stone size (OR 0.889, 95% CI: 0.841–0.937, P < 0.001), lower MSD (OR 0.995, 95% CI: 0.994–0.996, P < 0.001), and higher SHI (OR 1.011, 95% CI: 1.008–1.014, P < 0.001) were independent predictors of one-session success. The radiologic heterogeneity of urinary stones or SHI was an independent predictor for SWL success in patients with ureteral calculi and a useful clinical parameter for stone fragility. PMID:27035621

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

    ClinicalTrials.gov

    2015-01-28

    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

  13. Ureteroscopy

    MedlinePlus

    ... the ureters that have become narrow. Diagnose repeated urinary tract infections and other problems. Risks Risks of surgery and ... procedure include: Injury of the ureter or kidney Urinary tract infection Before the Procedure Tell your health care provider ...

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

    ClinicalTrials.gov

    2013-01-11

    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

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

    ClinicalTrials.gov

    2016-09-15

    Bladder Urothelial Carcinoma; Distal Urethral Carcinoma; Infiltrating Bladder Urothelial Carcinoma Associated With Urethral Carcinoma; Metastatic Urothelial Carcinoma of the Renal Pelvis and Ureter; Proximal Urethral Carcinoma; Recurrent Bladder Carcinoma; Recurrent Prostate Carcinoma; Recurrent Urethra Carcinoma; Recurrent Urothelial Carcinoma of the Renal Pelvis and Ureter; Regional Urothelial Carcinoma of the Renal Pelvis and Ureter; Stage IV Bladder Cancer; Stage IV Prostate Cancer; Stage IV Urethral Cancer; Ureter Carcinoma

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

    ClinicalTrials.gov

    2016-02-15

    Distal Urethral Carcinoma; Infiltrating Bladder Urothelial Carcinoma Associated With Urethral Carcinoma; Metastatic Urothelial Carcinoma of the Renal Pelvis and Ureter; Proximal Urethral Carcinoma; Recurrent Bladder Carcinoma; Recurrent Urethra Carcinoma; Recurrent Urothelial Carcinoma of the Renal Pelvis and Ureter; Regional Urothelial Carcinoma of the Renal Pelvis and Ureter; Stage III Bladder Cancer; Stage III Urethral Cancer; Stage IV Bladder Cancer; Stage IV Urethral Cancer; Ureter Carcinoma

  17. Gemcitabine, Paclitaxel, Doxorubicin in Metastatic or Unresectable Bladder Cancer With Decreased Kidney Function

    ClinicalTrials.gov

    2015-06-19

    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 Carcinoma of the Bladder; Urethral Cancer Associated With Invasive Bladder Cancer

  18. Pembrolizumab and Docetaxel or Gemcitabine Hydrochloride in Treating Patients Urothelial Cancer

    ClinicalTrials.gov

    2015-08-26

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

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

    ClinicalTrials.gov

    2014-01-27

    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

  20. Collecting and Studying Blood and Tissue Samples From Patients With Locally Recurrent or Metastatic Prostate or Bladder/Urothelial Cancer

    ClinicalTrials.gov

    2016-06-06

    Healthy Control; Localized Urothelial Carcinoma of the Renal Pelvis and Ureter; Metastatic Malignant Neoplasm in the Bone; Metastatic Malignant Neoplasm in the Soft Tissues; Metastatic Urothelial Carcinoma of the Renal Pelvis and Ureter; Recurrent Bladder Carcinoma; Recurrent Prostate Carcinoma; Recurrent Urothelial Carcinoma of the Renal Pelvis and Ureter; Stage IV Bladder Cancer; Stage IV Bladder Urothelial Carcinoma; Stage IV Prostate Cancer

  1. Evaluation and Treatment of a Ureterosciatic Hernia Causing Hydronephrosis and Renal Colic

    PubMed Central

    Salari, Keyan; Yura, Emily M.; Harisinghani, Mukesh

    2015-01-01

    Abstract An 87-year-old female presented with complaints of intermittent severe right renal colic. CT imaging demonstrated a ureterosciatic hernia and moderate hydronephrosis proximal to the portion of the ureter that was herniated through the sciatic foramen. A retrograde pyelogram demonstrated a transition point in the ureter at the location of the hernia. A ureteral stent was placed resulting in straightening of the ureter, resolution of hydronephrosis, and complete resolution of the patient's symptoms.

  2. Cabozantinib-s-malate and Nivolumab With or Without Ipilimumab in Treating Patients With Metastatic Genitourinary Tumors

    ClinicalTrials.gov

    2016-09-09

    Malignant Reproductive System Neoplasm; Malignant Urinary System Neoplasm; Metastatic Urethral Neoplasm; Metastatic Urothelial Carcinoma of the Renal Pelvis and Ureter; Progressive Neoplastic Disease; Recurrent Bladder Carcinoma; Recurrent Urethra Carcinoma; Recurrent Urothelial Carcinoma of the Renal Pelvis and Ureter; Regional Urothelial Carcinoma of the Renal Pelvis and Ureter; Solid Neoplasm; Stage III Bladder Urothelial Carcinoma; Stage III Urethral Cancer; Stage IV Bladder Urothelial Carcinoma; Stage IV Urethral Cancer; Urethral Urothelial Carcinoma

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

    ClinicalTrials.gov

    2013-08-23

    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

  4. Initial results with the Cohen cross-trigonal ureteroneocystotomy.

    PubMed

    Wacksman, J

    1983-06-01

    Between January 1976 and December 1980, 109 children with 157 ureters with reflux were seen in consultation. Of these ureters 52 were operated upon using the Cohen cross-trigonal technique, while 105 were followed conservatively. The operative procedure is a complete intravesical ureteral mobilization followed by the creation of a submucosal tunnel across the base of the bladder. Followup studies, including an excretory urogram and voiding cystourethrogram, showed minimal hydronephrosis in 1 ureter and persistent grade I reflux in 1 ureter. Evaluation of these initial results indicates that the Cohen cross-trigonal ureteroneocystotomy is a safe and effective antireflux procedure. PMID:6854798

  5. Recognition and Management of Ectopic Ureterocele During Robotic Assisted Laparoscopic Radical Prostatectomy.

    PubMed

    Li, Roger; Hu, Brian

    2016-09-01

    Ectopic ureter and ureterocele are rare congenital anomalies. As such, are seldom encountered incidentally during urologic surgery. We present a case illustrating an unforeseen encounter of an ectopic ureter with an associated ureterocele during a robotic assisted laparoscopic prostatectomy (RALP) and the surgical technique used to adapt to the anatomical variation. PMID:27313987

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

    ClinicalTrials.gov

    2013-05-01

    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

  7. Vesicoureteral Reflux (VUR)

    MedlinePlus

    ... shaped organs in the back that filter excess fluids and waste products from the blood and turn them into urine. The urine then flows out of the kidneys through the ureters, which are long, thin tubes. The ureters transfer urine to the bladder, a ...

  8. Peritoneal flap ureteropexy for idiopathic retroperitoneal fibrosis.

    PubMed

    Fowler, J W

    1987-07-01

    Eight patients had 13 ureters treated by peritoneal flap ureteropexy. There were no significant post-operative complications. Eleven ureters were functioning normally after an average follow-up of 28 months. The operation is suggested as a method of choice where omental wrapping is not possible. PMID:3620842

  9. Robot-Assisted Retroperitoneoscopic Surgery for Synchronous Contralateral Ureteral Metastasis of Renal-Cell Carcinoma

    PubMed Central

    Lai, Wei-Hong; Chiu, Allen Wen-Shien; Lu, Chih-Cheng; Huang, Steven Kuan-Hua

    2015-01-01

    Abstract Renal-cell carcinoma (RCC) with synchronous metastasis to contralateral ureter is extremely rare with only four cases reported in the literature. We report a case of synchronous metastatic RCC to the contralateral ureter with effective robot-assisted retroperitoneoscopic nephron-sparing surgery that leads to favorable oncologic and functional outcome. PMID:27579394

  10. Retrograde intra-vesical reconstructive surgery (RIVRS): A novel technique

    PubMed Central

    Laddha, Abhishek; Ganpule, Arvind; Mishra, Sahshikant; Sabnis, Ravindra; Desai, Mahesh

    2016-01-01

    Management of distal ureter by en block resection during radical nephrectomy for upper urinary tract transitional cell carcinoma (TCC) is considered as standard of care. In this report, we describe our technique for management of lower ureter which utilizes both the endoscopic and laparoscopic approach. The nephrectomy including the dissection of the lower ureter was completed laproscopically. The ureteral orifice was scored using a hook passed through a 24 Fr nephroscope and secured .Transurethral suturing of the defect with SewRight SR5 device passed through the working channel of the 24 Fr nephroscope was done. Our report highlights the fact that management of lower ureter in TCC pelvis can be done endoscopically/laproscopically without compromising the oncological principles. Our novel technique demonstrates feasibility of intra mural resection of the ureter and primary closure of the bladder endoscopically. PMID:27279408

  11. Retrograde intra-vesical reconstructive surgery (RIVRS): A novel technique.

    PubMed

    Laddha, Abhishek; Ganpule, Arvind; Mishra, Sahshikant; Sabnis, Ravindra; Desai, Mahesh

    2016-01-01

    Management of distal ureter by en block resection during radical nephrectomy for upper urinary tract transitional cell carcinoma (TCC) is considered as standard of care. In this report, we describe our technique for management of lower ureter which utilizes both the endoscopic and laparoscopic approach. The nephrectomy including the dissection of the lower ureter was completed laproscopically. The ureteral orifice was scored using a hook passed through a 24 Fr nephroscope and secured .Transurethral suturing of the defect with SewRight SR5 device passed through the working channel of the 24 Fr nephroscope was done. Our report highlights the fact that management of lower ureter in TCC pelvis can be done endoscopically/laproscopically without compromising the oncological principles. Our novel technique demonstrates feasibility of intra mural resection of the ureter and primary closure of the bladder endoscopically. PMID:27279408

  12. Ureteric Embolization for Lower Urinary Tract Fistulae: Use of Two Amplatzer Vascular Plugs and N-Butyl Cyanoacrylate Employing the 'Sandwich' Technique

    SciTech Connect

    Saad, Wael E. A. Kalagher, S.; Turba, U. C.; Sabri, S. S.; Park, A.-W.; Stone, J.; Angle, J. F.; Matsumoto, A. H.

    2013-08-01

    PurposeThis study describes and evaluated the effectiveness of occluding distal ureters in the clinical setting of urinary vaginal (vesicovaginal or enterovesicovaginal) fistulae utilizing a new technique which combines Amplatzer vascular plugs and N-butyl cyanoacrylate.MaterialsThis is a retrospective study (January 2007-December 2010) of patients with urinary-vaginal fistulae undergoing distal ureter embolization utilizing an Amplatzer- N-butyl cyanoacrylate-Amplatzer sandwich technique. An 8-12-mm type-I or type-II Amplatzer vascular plug was delivered using the sheath and deployed in the ureter distal to the pelvic brim. Instillation of 0.8-1.5 cc of N-butyl cyanoacrylate into ureter proximal to the Amplatzer plug was performed. This was followed by another set of 8-12-mm type-I or type-II Amplatzer vascular plugs in a technique referred to as the 'sandwich technique.'ResultsFive ureters in three patients were occluded utilizing the above-described technique during the 4-year study period. Mean maximum size Amplatzer used per ureter was 10.8 mm (range, 8-12). One ureter required three Amplatzer plugs and the rest required two. Two patients (3 ureters) were clinically successful with complete resolution of symptoms in 36-48 h. The third patient (2 ureters) was partly successful and required a second Amplatzer- N-butyl cyanoacrylate sandwich technique embolization. The mean clinical follow-up was 11.3 months (range, 1.7-29.2).ConclusionsThe Amplatzer- N-butyl cyanoacrylate-Amplatzer sandwich technique for occluding the distal ureter is safe and effective with a quick (probably due to the N-butyl cyanoacrylate) and durable (probably due to the Amplatzer plugs) clinical response.

  13. A sign on CT that predicts a hazardous ureteral anomaly

    PubMed Central

    Allam, E.S.; Johnson, D.Y.; Grewal, S.G.; Johnson, F.E.

    2016-01-01

    Introduction An aberrant course of the distal ureter can pose a risk of ureteral injury during surgery for inguinal hernia repair and other groin operations. In a recent case series of inguinoscrotal hernation of the ureter, we found that each affected ureter was markedly anterior to the psoas muscle at its mid-point on abdominal CT. We hypothesized that this abnormality in the abdominal course of the ureter would predict the potentially hazardous aberrant course of the distal ureter. Presentation of cases We reviewed all evaluable CT urograms performed at St. Louis University Hospital from June 2012 to July 2013 and measured the ureteral course at several anatomically fixed points. Discussion 93% (50/54) of ureters deviated by less than 1 cm from the psoas muscle in their mid-course (at the level of the L4 vertebra). Reasons for anterior deviation of the ureter in this study included morbid obesity with prominent retroperitoneal fat, congenital renal abnormality, and post-traumatic renal/retroperitoneal hematoma. We determined that the optimal level on abdominal CT to detect the displaced ureter was the mid-body of the L4 vertebra. Conclusion Anterior deviation of the ureter in its mid-course appears to predict inguinoscrotal herniation of the ureter. This finding is a sensitive predictor and should raise concern for this anomaly in the appropriate clinical setting. It is not entirely specific as morbid obesity and congenital anomalies may result in a similar imaging appearance. We believe that this association has not been reported previously. Awareness of this anomaly can have significant operative implications. PMID:27046105

  14. Distal ureterectomy techniques in laparoscopic and robot-assisted nephroureterectomy: Updated review

    PubMed Central

    Stravodimos, Konstantinos G.; Komninos, Christos; Kural, Ali Riza; Constantinides, Constantinos

    2015-01-01

    Controversies exist about the best method for managing the distal ureter during the laparoscopic (LNU) and robot-assisted nephroureterectomy (RANU). Therefore, PubMed, Scopus and Web of Science databases were searched in order to identify articles describing the management of distal ureter during LNU or RANU in patients suffering from upper urinary tract urothelial cell carcinoma. Forty seven articles were selected for their relevance to the subject of this review. The approaches that are usually performed regarding the distal ureter management are open excision, transurethral resection of ureteral orifice (Pluck Technique), ureteric intussusception and pure LNU or pure RANU. Pure LNU and RANU with complete laparoscopic dissection and suture reconstruction of ureter and bladder cuff seems to be better tolerated than open nephroureterectomy providing equal efficacy, without deteriorating the oncological outcome, however evidence is poor. Transurethral resection of the ureteric orifice and the bladder cuff after occlusion of the ureter with a balloon catheter seems to be an attractive alternative option for low stage, low grade tumors of the renal pelvis and the proximal ureter, while stapling technique is correlated with the increased risk of positive surgical margins. The open resection of the distal ureter in continuity with the bladder cuff is considered the most reliable approach, preferred in our practice as well, however the existing data are based on retrospective and non-randomized studies. PMID:25657536

  15. Appendicocalicostomy: A case of mistaken identity

    PubMed Central

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

    2014-01-01

    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

  16. Renographic Demonstration of Desmoid Tumor-Ureteral Fistula.

    PubMed

    Kim, David U; McQuinn, Garland; Lin, Eugene; Lee, Marie

    2016-01-01

    A 20-year-old woman with Gardner syndrome and intra-abdominal desmoid tumors presented with increasing abdominal pain. CT demonstrated a new area of central hypodensity in a presumed desmoid tumor, compressing the left ureter. Findings were suspicious for abscess or fistula to the ureter. Subsequent 99mTc-MAG3 renogram demonstrated persistent extraureteral radiotracer activity in the region of the tumor, confirming a desmoid tumor-ureteral fistula. Desmoid tumors are benign but locally aggressive fibrous neoplasms that can be sporadic or associated with familial adenomatous polyposis syndromes, specifically Gardner syndrome. Fistula formation to the ureter has been reported infrequently. PMID:26284772

  17. 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 ...

  18. Robot-Assisted Laparoscopic Extravesical Ureteral Reimplantation in Children: Top-Down Suturing Technique Without Stent Placement.

    PubMed

    Silay, Mesrur Selcuk; Baek, Minki; Koh, Chester J

    2015-08-01

    Extravesical robotic-assisted laparoscopic ureteral reimplantation in children is a challenging procedure. Our top-down suturing technique facilitates this reconstructive surgery. After mobilization of the ureter without the use of ureteral stent placement, the detrusor muscle is divided. Once adequate muscle flaps are raised, the ureter is placed into its new muscle tunnel. Unlike previously described techniques, the top-down suturing approach involves placement of the first detrusor stitch at the superior aspect. This allows the ureter to be elevated out of harm's way and in a tension-free manner. The rest of the detrusor reapproximation is performed in a top-down approach with interrupted sutures without the need for ureteral elevation or manipulation. This technique facilitates the suturing process and decreases trauma to the ureter with less instrument contact. This helps to prevent potential complications and improve success rates associated with this procedure. PMID:25674670

  19. Laser lithotripsy with a Q-switched alexandrite laser system

    NASA Astrophysics Data System (ADS)

    Uebelacker, Walter

    1992-06-01

    The laser lithotripsy of ureter stones with the Alexan Triptor was introduced into urology in 1989. Pulsenergy, pulsewidth, wavelength, fiber performance, and endoscope performance are important parameters for effective stone disintegration.

  20. Kidney stones

    MedlinePlus Videos and Cool Tools

    ... cortex to the inner medulla. The renal pelvis is the funnel through which urine exits the kidney ... a kidney stone (renal calculus). Usually the calculus is the size of a small pebble. But ureters ...

  1. Large bowel resection

    MedlinePlus

    ... bag outside your body. This is called an colostomy . The colostomy may be either short-term or permanent. Colectomy ... to the ureter or bladder Problems with the colostomy Scar tissue that forms in the belly and ...

  2. Nephrolithiasis (image)

    MedlinePlus

    Kidney stones result when urine becomes too concentrated and substances in the urine crystalize to form stones. Symptoms ... to move down the ureter causing intense pain. Kidney stones may form in the pelvis or calyces of ...

  3. Adult and pediatric urology

    SciTech Connect

    Gillenwater, J.Y.; Howards, S.S. ); Grayhack, J.T. ); Ducket, J.W. )

    1987-01-01

    This book contains 32 chapters. Come of the chapter titles are: Imaging; Urinary tract infections; Calculus formation; Perioperative care; Renal injuries; Kidney stone surgery; Trauma to the lower urinary tract; renel cystic disease; Bladder cancer; and The ureter.

  4. Kidney stones

    MedlinePlus

    ... kidney or ureter. It uses sound or shock waves to break up stones. Then, the stone fragments ... the urine. It is also called extracorporeal shock-wave lithotripsy or ESWL. Procedures performed by passing a ...

  5. Cervical Cancer Stage IIIB

    MedlinePlus

    ... Cancer Stage IIIB Description: Stage IIIB cervical cancer; drawing shows cancer in the cervix, the vagina, and ... that connect the kidneys to the bladder). The drawing shows the ureter on the right blocked by ...

  6. Cystinuria

    MedlinePlus

    ... rare condition in which stones made from an amino acid called cysteine form in the kidney, ureter, and ... Cystine is formed when two molecules of an amino acid called cysteine are bound together. The condition is ...

  7. Endometriosis

    MedlinePlus

    ... in the following places: • Peritoneum • Ovaries • Fallopian tubes • Outer surfaces of the uterus, bladder , ureters , intestines, and rectum • Cul-de-sac (the space behind the uterus) How does endometriosis cause problems? ...

  8. Kidney stones

    MedlinePlus Videos and Cool Tools

    ... urine exits the kidney and enters the ureter. As urine can become very concentrated as it passes through the kidneys. When the urine ... chemicals dissolved in the urine can crystallize, forming a kidney stone (renal calculus). Usually the calculus is ...

  9. Obstructive uropathy

    MedlinePlus

    ... enlarged prostate) Bladder or ureteral cancer Colon cancer Cervical cancer Uterine cancer Any cancer that spreads Scar tissue that occurs inside or outside of the ureters Problems with the nerves that supply the bladder Rarely, the problem occurs ...

  10. Blood in the Urine (Hematuria)

    MedlinePlus

    ... process starts in the kidneys , which remove excess fluids and waste from the blood and turn them into urine. The urine then flows through tubes called ureters into the bladder, where it's stored ...

  11. Novel application of an established technique for removing a knotted ureteric stent.

    PubMed

    Tempest, Heidi; Turney, Ben; Kumar, Sunil

    2011-01-01

    This report describes a case whereby a ureteric stent became knotted during removal and lodged within the upper ureter. The authors describe a novel minimally invasive technique to remove the knotted ureteric stent using the holmium laser. PMID:22701009

  12. Urinary Tract Infections (For Kids)

    MedlinePlus Videos and Cool Tools

    ... system made up of these main parts: two kidneys two ureters (say: yur -uh-turz) bladder urethra (say: yoo- ree -thruh) All day long, the kidneys clean waste products from your blood. The waste ...

  13. Cystinuria

    MedlinePlus

    ... rare condition in which stones made from an amino acid called cystine form in the kidney, ureter, and ... Cystinuria is caused by too much of an amino acid called cystine in the urine. Normally, most cystine ...

  14. Ureterocele

    MedlinePlus

    ... 2011:chap 130. Peters CA, Schlussel RN, Mendelsohn C. Ectopic ureter, ureterocele, and ureteral anomalies. In: Wein AJ, ed. Campbell-Walsh Urology . 10th ed. Philadelphia, PA: Elsevier Saunders; ...

  15. Management of full-length complete ureteral avulsion

    PubMed Central

    Tang, Kaifa; Sun, Fa; Tian, Yuan; Zhao, Yili

    2016-01-01

    ABSTRACT Introduction Complete ureteral avulsion is one of the most serious complications of ureteroscopy. The aim of this report was to look for a good solution to full-length complete ureteral avulsion. Case presentation A 40-year-old man underwent ureteroscopic management. Full-length complete avulsion of ureter occurred during ureteroscopy. Pyeloureterostomy plus greater omentum investment outside the avulsed ureter and ureterovesical anastomosis were performed 6 hours after ureteral avulsion. The patient was followed-up during 34 months. Double-J tube was removed at 3 months after operation. Twenty three months after the first operation, the patient developed hydronephrosis because of a new ureter upside stone, then rigid ureteroscopy and holmium laser lithotripsy were used successfully. Conclusion Pyeloureterostomy plus greater omentum investment outside the avulsed ureter and ureterovesical anastomosis may be a good choice for full-length complete ureteral avulsion. PMID:27136483

  16. 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

    2016-07-12

    Breast Carcinoma; Carcinoma of Unknown Primary Origin; Endometrial Carcinoma; Esophageal Carcinoma; Lung Carcinoma; Malignant Head and Neck Neoplasm; Melanoma; Ovarian Carcinoma; Renal Pelvis and Ureter Urothelial Carcinoma; Testicular Lymphoma

  17. Interstitial nephritis

    MedlinePlus

    ... kidney damage in older people. Possible Complications Metabolic acidosis can occur because the kidneys aren't able ... stage kidney disease Injury - kidney and ureter Metabolic acidosis Renal Urine output - decreased Update Date 9/22/ ...

  18. Renal scan

    MedlinePlus

    ... reduced kidney function. This may be due to: Acute or chronic kidney failure Chronic kidney infection (pyelonephritis) Complications of a kidney transplant Glomerulonephritis Hydronephrosis Injury of the kidney and ureter Narrowing or blockage ...

  19. Bladder cancer

    MedlinePlus

    ... Anemia Swelling of the ureters ( hydronephrosis ) Urethral stricture Urinary incontinence When to Contact a Medical Professional Call your ... More Anemia Hydronephrosis of one kidney Invasive Stress urinary incontinence Tumor Urethral stricture Urinary tract infection - adults Update ...

  20. 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 ...

  1. Muscles of the Head and Neck

    MedlinePlus

    ... Ureters Urinary Bladder Urethra Review Quiz Reproductive System Male Reproductive System Testes Duct System Accessory Glands Penis Male Sexual Response & Hormone Control Female Reproductive System Ovaries Genital Tract External Genitalia Female Sexual Response & ...

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

    PubMed

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

    2010-02-01

    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

  3. A Novel method of ensuring safe and accurate dilatation during percutaneous nephrolithotomy

    PubMed Central

    Javali, Tarun; Pathade, Amey; Nagaraj, H. K.

    2015-01-01

    ABSTRACT Objective: To report our technique that helps locate the guidewire into the ureter enabling safe dilatation during PCNL. Materials and Methods: Cases in which the guidewire failed to pass into the ureter following successful puncture of the desired calyx were subjected to this technique. A second guidewire was passed through the outer sheath of a 9 Fr. metallic dilator cannula, passed over the first guidewire. The cannula and outer sheath were removed, followed by percutaneous passage of a 6/7.5 Fr ureteroscope between the two guidewires, monitoring its progress through both the endoscopic and fluoroscopic monitors. Once the stone was visualized in the calyx a guidewire was passed through the working channel and maneuvered past the stone into the pelvis and ureter under direct endoscopic vision. This was followed by routine tract dilatation. Results: This technique was employed in 85 out of 675 cases of PCNL carried out at our institute between Jan 2010 to June 2014. The mean time required for our technique, calculated from the point of introduction of the ureteroscope untill the successful passage of the guidewire down into the ureter was 95 seconds. There were no intraoperative or postoperative complications as a result of this technique. Guidewire could be successfully passed into the ureter in 82 out of 85 cases. Conclusions: Use of the ureteroscope introduced percutaneously through the puncture site in PCNL, is a safe and effective technique that helps in maneuvering the guidewire down into the ureter, which subsequently enables safe dilatation. PMID:26689529

  4. A Laparoscopic Management Combined with a Flexible Ureteroscope for Ureteral Polyps of More Than 3 cm Length

    PubMed Central

    Ueda, Kousuke; Nishihara, Kiyoaki; Nakiri, Makoto; Suyama, Shunsuke; Chikui, Katsuaki; Hayashi, Shuichiro; Kurose, Hirofumi; Ogasawara, Naoyuki; Suekane, Shigetaka; Igawa, Tsukasa

    2016-01-01

    Abstract Ureteral polyps are benign tumors of the ureter, which are relatively rare. The etiology has proposed various hypotheses, involving chronic inflammation and congenital disease. Most of them are commonly diagnosed in the upper ureter including the ureteropelvic junction. Some studies have reported polypectomy using a holmium laser, but several studies presented laparoscopic ureteroureterostomy for patients in whom the mentioned procedure is difficult. We underwent laparoscopic ureteroureterostomy with a combination of flexible ureteroscope for ureteral polyps of more than 3 cm length. We used ureteroscopy with a laparoscopic approach to minimize the length of ureter resection. Using the light guide of ureteroscopy is useful to decide the exact and minimal excision range for ureteroureterostomy.

  5. Microureteroscopy in Children: Two First Cases

    PubMed Central

    Budia-Alba, Alberto; Galan-Llopis, Juan-Antonio; Montoya-Lirola, Maria-Dolores; García-Tabar, Pedro-José; Galiano-Baena, Juan-Francisco; Albertos-Mira-Marcelí, Nuria; Gonzalvez-Piñera, Jeronimo

    2016-01-01

    Abstract Background: Urinary stones disease is becoming more common not only in adults but also in children. Most cases are resolved with extracorporeal shock wave lithotripsy, but miniaturization of endoscopes has increased the use of ureteroscopy in resolving ureteral stones, most notably in children. Case Presentation: This presentation focuses on two cases of microureteroscopy. In both cases, the presence of lithiasis in the pelvic ureter was suspected to be the cause of ureter hydronephrosis, and a microureteroscopy was performed for treatment purposes. MicroPerc set 4.85F sheath was used to explore the pelvic ureter, thus avoiding the need to dilate the ureteral meatus or having to use the safety guide. Patients did not require a postoperative stent and were discharged within 24 hours of the procedure. Conclusion: Use of microureteroscopy proved satisfactory in the two cases of children and it allows diagnosis and treatment of ureteral pathology in pediatric patients. PMID:27579414

  6. An Everting Ureteral Access Sheath: Concepts and In Vitro Testing

    NASA Astrophysics Data System (ADS)

    Lee, Keith L.; Stoller, Marshall L.

    2007-04-01

    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.

  7. Arterioureteral fistula: an unusual clinical case.

    PubMed

    Coelho, Hugo; Freire, Maria José; Azinhais, Paulo; Temido, Paulo

    2016-01-01

    Arterioureteral fistulas (AUFs) are abnormal communications between a major artery and the mid to distal ureter. It is a rare but potentially life-threatening condition that is seldom recognised. We present a case of a 66-year-old man who was admitted to the surgical ward owing to infection of an aortic bifemoral bypass graft. During admission, the patient developed persistent haematuria with considerable loss of haemoglobin. He was submitted to urgent surgical exploration of the graft. An ascending pyelography performed at the beginning of the surgery clearly shows a communication between the left ureter and the vascular graft. Open surgical exploration was undertaken, the fistulised section of the ureter resected and an end-to-end ureteroplasty was performed. The vascular graft was removed and the patient later submitted to left supracondylar amputation. Urinary drainage remained intact. PMID:26969358

  8. Genetic Basis of Ureterocele.

    PubMed

    Schultza, Karin; Todab, Lia Yoneka

    2016-02-01

    Congenital anomalies of the kidney and urinary tract (CAKUT) form a group of heterogeneous disorders that affect the kidneys, ureters and bladder, with frequent asynchronous presentations and multiple CAKUT associations in the same individual. Urinary tract formation is a complex process, dependent of the interaction of multiple genes and their sub-product. The same genic alterations can lead to different molecular expressions and different morphological anomalies. The ureterocele is a cystic dilation of the distal intramural ureter, resulting in obstruction of urine flow, dilation of the ureter and renal pelvis and loss of renal function. Two key steps in the urinary tract ontogenesis may be related to ureterocele development: formation and migration of the ureteric bud and its incorporation in the bladder. This review aims to describe the morphological, cellular and biochemical steps, as well as the genes involved in the occurrence of this anomaly. PMID:27013924

  9. Genetic Basis of Ureterocele

    PubMed Central

    Schultza, Karin; Todab, Lia Yoneka

    2016-01-01

    Congenital anomalies of the kidney and urinary tract (CAKUT) form a group of heterogeneous disorders that affect the kidneys, ureters and bladder, with frequent asynchronous presentations and multiple CAKUT associations in the same individual. Urinary tract formation is a complex process, dependent of the interaction of multiple genes and their sub-product. The same genic alterations can lead to different molecular expressions and different morphological anomalies. The ureterocele is a cystic dilation of the distal intramural ureter, resulting in obstruction of urine flow, dilation of the ureter and renal pelvis and loss of renal function. Two key steps in the urinary tract ontogenesis may be related to ureterocele development: formation and migration of the ureteric bud and its incorporation in the bladder. This review aims to describe the morphological, cellular and biochemical steps, as well as the genes involved in the occurrence of this anomaly. PMID:27013924

  10. Tritium-bradykinin binding site localization in guinea pig urinary system

    SciTech Connect

    Manning, D.C.; Snyder, S.H.

    1986-01-01

    Bradykinin (BK) causes vasodilation and increases free water and sodium excretion in the kidney and stimulates smooth muscle contraction in the ureter and bladder. Several proposed sites of action for BK include the renal medullary collecting duct, renal blood vessels and the ureter and bladder smooth muscle. This study employs 3H-BK autoradiography to localize the sites of BK action. 3H-BK binding sites in the kidney are localized in the medullary interstitium where BK may produce prostaglandins which mediate its blood flow, natriuretic and diuretic effects. 3H-BK binding sites in the ureter and bladder are localized in the lamina propria below the basal epithelial layer and absent over the muscle layers suggesting an indirect action on urinary tract smooth muscle.

  11. Urolithiasis in primary obstructive megaureter: a management dilemma

    PubMed Central

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

    2014-01-01

    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

  12. MULTIDETECTOR-ROW COMPUTED TOMOGRAPHIC CHARACTERISTICS OF PRESUMED PREURETERAL VENA CAVA IN CATS.

    PubMed

    Pey, Pascaline; Marcon, Oriana; Drigo, Michele; Specchi, Swan; Bertolini, Giovanna

    2015-01-01

    Preureteral vena cava (circumcaval ureter, retrocaval ureter) occurs in a third of the feline population and has been associated with ureteral strictures in humans. The aim of this retrospective cross-sectional study was to describe the contrast-enhanced multidetector row computed tomographic (MDCT) characteristics of presumed preureteral vena cava in a group of cats. Medical records from two institutions located in different continents were searched from 2010-2013 for cases with complete contrast-enhanced MDCT examinations of the abdomen (i.e. included the entire course of the ureters and prerenal and renal segments of the caudal vena cava) and a diagnosis of preureteral caudal vena cava. For cases meeting inclusion criteria, CT scan data were retrieved and characteristics of the preureteral caudal vena cava were recorded. Presence of concomitant renal or ureteral diseases was also recorded. A total of 272 cats had contrast-enhanced abdominal CT scans during the study period and of these, 68 cats (22.43 ± 4.96%) had a diagnosis of presumed preureteral vena cava. In all affected cats, a "reverse-J ureter" was observed, i.e. a ureter running medially at the level of L4-5, passing dorsally to the caudal vena cava and then exiting ventrally between the caudal vena cava and aorta returning to its normal position. Having a preureteral vena cava resulted in an increased risk for concurrent urinary signs (OR = 3.00; CI: 95%; 1.28-6.99; P = 0.01). Findings supported the use of contrast-enhanced MDCT for characterizing morphology of preureteral vena cava and its relation with ureters in cats. PMID:25786990

  13. Molecular Pathology of Murine Ureteritis Causing Obstructive Uropathy with Hydronephrosis

    PubMed Central

    Ichii, Osamu; Otsuka, Saori; Namiki, Yuka; Hashimoto, Yoshiharu; Kon, Yasuhiro

    2011-01-01

    Primary causes of urinary tract obstruction that induces urine retention and results in hydronephrosis include uroliths, inflammation, and tumors. In this study, we analyzed the molecular pathology of ureteritis causing hydronephrosis in laboratory rodents. F2 progenies of C57BL/6 and DBA/2 mice were studied histopathologically and by comprehensive gene expression analysis of their ureters. Incidence of hydronephrosis was approximately 5% in F2 progenies. Histopathologically, this hydronephrosis was caused by stenosis of the proximal ureter, which showed fibrosis and papillary malformations of the proliferative epithelium with infiltrations of B-cell-dominated lymphocytes. Additionally, CD16-positive large granular leukocytes and eosinophils infiltrated from the ureteral mucosa to the muscular layer. Eosinophilic crystals were characteristically observed in the lumen of the ureter and the cytoplasm of large granular leukocytes, eosinophils, and transitional epithelial cells. Comprehensive gene profiling revealed remarkably elevated expression of genes associated with hyperimmune responses through activation of B cells in diseased ureters. Furthermore, diseased ureters showed dramatically higher gene expression of chitinase 3-like 3, known as Ym1, which is associated with formation both of adenomas in the transitional epithelium and of eosinophilic crystals in inflammatory conditions. The Ym1 protein was mainly localized to the cytoplasm of the transitional epithelium, infiltrated cells, and eosinophilic crystals in diseased ureters. We determined that the primary cause of hydronephrosis in F2 mice was ureteritis mediated by the local hyperimmune response with malformation of the transitional epithelium. Our data provide a novel molecular pathogenesis for elucidating causes of aseptic inflammation in human upper urinary tracts. PMID:22114694

  14. Possible pharmacological means of treating renal colic.

    PubMed

    Peters, H J; Eckstein, W

    1975-08-01

    The effects of various drugs on the partially obstructed ureter were investigated in a new model experiment which permitted the calculation of peripheral resistance. After the administration of noradrenaline, the local spasm of the ureter in the region of the obstruction was increased and the urinary flow fell. After administration of the alpha-blocker phentolamine and of the beta-receptor stimulant orciprenaline there was a reduction of the peripheral resistance and an increase in urinary flow due to spasmolysis. Because of its lower side-effect rate, phentolamine is worth investigating in further clinical studies. PMID:1162799

  15. Bilateral congenital midureteric strictures associated with multicystic dysplastic kidney and hydronephrosis: evaluation with MR urography.

    PubMed

    Grattan-Smith, J Damien; Jones, Richard A; Little, Stephen; Kirsch, Andrew J

    2011-01-01

    We report a case of bilateral congenital midureteric strictures diagnosed using MR urography. The severity of obstruction differed in the two ureters, resulting in a multicystic dysplastic kidney (MCDK) with an atretic ureter on one side and hydronephrosis that worsened over time due to progressive stenosis on the other. Although midureteric strictures are usually misdiagnosed as ureteropelvic junction (UPJ) or ureterovesical junction (UVJ) obstruction on conventional imaging, MR urography was able to clearly demonstrate both the anatomical and functional abnormalities. Additionally, because of the excellent anatomical resolution, similarities in the underlying pathological lesions could be contrasted with the severity of the pathophysiological impact upon each kidney. PMID:20714713

  16. Crossed Fused Renal Ectopia: Presentations on 99mTc-MAG3 Scan, 99mTc-DMSA SPECT, and Multidetector CT.

    PubMed

    Moon, Eun Ha; Kim, Min-Woo; Kim, Young Jun; Sun, In O

    2015-10-01

    Crossed renal ectopia is an uncommon developmental anomaly in which both kidneys are located on the same side of the body. The present case describes a 20-year-old man who underwent the military entrance physical examination. The ultrasound showed the right kidney in normal site with slightly increased size, but the left kidney was not identified. Tc-MAG3 scan showed a single kidney with 2 ureters, and the orifices of the ureters were connected at both sides of bladder. Tc-DMSA SPECT and contrast-enhanced multidetector CT were performed and revealed crossed fused renal ectopia. PMID:26252333

  17. Ureteral carcinoma presenting as a complex pelvic mass in a post menopausal patient.

    PubMed

    Farley, J H; Douglas, T H; Mcleod, D G; Harrison, C R

    1998-07-01

    This is a report of a low-grade ureteral carcinoma presenting as a pelvic mass in a postmenopausal woman with a prolonged history of lower back pain. A right complex adnexal mass and right hydroureter and hydronephrosis in an atrophic nonfunctioning right kidney was found during evaluation for the back pain. Operative evaluation revealed a normal uterus and ovaries; however, a 2 x 3-cm mass in the right ureter was found at the level of the uterine arteries. A total abdominal hysterectomy, bilateral salpingo-oophorectomy, and right nephroureterectomy were performed with pathology returning grade I papillary transitional cell carcinoma of the ureter. PMID:9698491

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

    ClinicalTrials.gov

    2013-07-01

    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

  19. Endoluminal release of ureteral ligature after hysterectomy.

    PubMed

    Wang, Chih-Jen; Lin, Victor Chia-Hsiang; Huang, Ching-Yu

    2016-01-01

    Iatrogenic ureteral injury is a well-recognized complication of abdominal total hysterectomy. We report a case of a 57-year-old female who underwent abdominal total hysterectomy for a uterine myoma and experienced severe right flank pain postoperatively. The imaging study displayed an obstruction of the right distal ureter. Under ureteroscopy, an extraluminal ligature was released with a holmium:yttrium-aluminum-garnet laser. The stenotic segment was immediately relieved. Two months later, the intravenous urogram illustrated patency of the distal ureter with regression of right hydronephrosis. There was no recurrent hydronephrosis during 1 year of follow-up. PMID:25241286

  20. Left-sided renal colic as a symptom of advanced stomach cancer – a case report

    PubMed Central

    Kuciel-Lisieska, Grażyna; Licznerska, Grażyna; Tenderenda, Michał

    2012-01-01

    The typical symptoms of advanced cancer of the stomach are well known in clinical practice. The presented case concerns a patient with symptoms of left-sided renal colic, caused by a malignant tumour involving the ureter, which was diagnosed with a CT scan. The multifocal process, involving the stomach, two parts of the colon, the left ovary and the side of the pelvis, was confirmed only during surgery. The resection or partial resection of the above-mentioned organs involved by the malignant process and reconstruction of the alimentary tract as well as the ureter were performed at time of this operation. The patient's recovery was without any complications. The histopathological findings support the diagnosis of this malignant process as disseminated stomach cancer. In the available literature only two cases of stomach cancer metastasis to the ureter have been described. In both cited examples resection of the ureter with nephrectomy was performed. The review of the literature supports the value of stomach palliative resection in prolonging life and improving quality of life. PMID:23788876

  1. Multiple endocrine neoplasia (MEN) II

    MedlinePlus

    ... neck Fever High blood pressure Rapid heart rate Thyroid nodules Imaging tests used to identify tumors may include: Abdominal CT scan Imaging of the kidneys or ureters MIBG scintiscan MRI of abdomen Thyroid scan Ultrasound of the thyroid Blood tests are ...

  2. Hematuria (Blood in the Urine)

    MedlinePlus

    ... tract is the body’s drainage system for removing wastes and extra water. The urinary tract includes two kidneys, two ureters, ... 1 to 2 quarts of urine, composed of wastes and extra water. The urine flows from the kidneys to the ...

  3. Horseshoe kidney transplantation

    PubMed Central

    Kanyári, Zsolt; Zádori, Gergely; Zsom, Lajos; Berhés, Mariann; Hamar, Mátyás; Kóbor, Krisztina; Péter, Antal

    2015-01-01

    Horseshoe kidney is a fusion anomaly found in approximately one in 400–600 people. Due to vascular and ureteral variations, transplantation with a horseshoe kidney presents a technical challenge. In our case, the isthmus connected the upper poles and contained parenchyma. It consisted of three renal arteries, five veins collected to the inferior vena cava, and two ureters and pyelons. It was implanted en bloc to the left side retroperitoneally. During the early period, cellular and humoral rejection was confirmed and treated. For a urine leak, double J catheters were implanted into both ureters. Later, the first catheter was removed. Subsequently, urinary sepsis developed, necessitating graftectomy. The uncommon anatomy of ureters and antibody-mediated rejection (AMR) may both be factors for a ureter tip necrosis led to an infected urinoma. After other Hungarian authors, we also report a horseshoe kidney transplantation that was technically successful. However, after an adequately treated but severe acute humoral rejection, the patient developed sepsis, and the kidney had to be removed. We conclude that transplantation with horseshoe kidney is technically feasible but may increase the risk for urinary complications and resultant infections. Careful consideration of risk and benefit is advised when a transplant professional is faced with this option. PMID:26120481

  4. Mesenteric desmoid-type fibromatosis causing secondary hypertension in a young woman

    PubMed Central

    Kim, Mi-Seon; Jung, Myung-Chul; Kim, Yong-Bong

    2014-01-01

    This report describes an 18-year-old woman presenting with abdominal distension, left flank pain, and hypertension. She had a huge abdominal mass, diagnosed as a mesenteric desmoid-type fibromatosis, causing compression of the left external iliac vessels and ureter, as well as elevated renin concentration and hypertension. After surgical removal of the mass, all signs improved including hypertension. PMID:25264535

  5. [Laparoscopic robot-assisted partial nephrectomy with total ureterectomy in a symptomatic complete duplicated system: advantages of transperitoneal approach].

    PubMed

    Tostivint, V; Doumerc, N; Roumiguie, M; Beauval, J-B; Rischmann, P; Soulie, M; Galinier, P; Bouali, O

    2014-10-01

    We report the case of a laparoscopic robot assisted left upper polar partial nephrectomy with total ureterectomy performed in a teenager. A 14 year-old girl was referred to our institution for stress urinary incontinence. The morphological assessment (ultrasound scan and uro-MRI) showed a double collecting system with a complete ureteral duplication complicated by a dysplasia of the upper moiety of the duplex left kidney and a mega ureter. The surgery started on a lateral decubitus position by the upper polar partial nephrectomy and the ureter section behind superior polar renal vessels. The patient was placed in a supine position and the mega ureter was released and sectioned at the level of the distal adynamic segment in the left uterine parameter. The transperitoneal route was chosen as it provides a large workspace and allows the dissection of the ureters into their pelvic portion by a simple repositioning of the robot ports without additional incision and without any modification of the operative field. No intraoperative and postoperative complication was noticed. Laparoscopic robotic assisted surgery in pediatric urology is increasing, and to our knowledge, we reported this technique and surgery for the first time in France and in children. In the reported case, we showed that the robotic minimally invasive surgery in children is an innovative and safe technique for the treatment of symptomatic upper urinary tract malformations. PMID:25176144

  6. 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. ...

  7. Ureteric sludge syndrome.

    PubMed Central

    Nicholson, R; Hewitt, I; Kam, A

    1991-01-01

    Four cases of a form of obstructive uropathy previously unreported in children are described. All presented with oligoanuria and either flank pain or fluid retention and had evidence of crystalline sludge in their lower ureters. Three cases had an underlying crystalluria. Images p344-a PMID:2025014

  8. Laparoscopic bypass pyeloureterostomy.

    PubMed

    Noh, Paul H; Shah, Anish K

    2013-02-01

    Minimally invasive surgery has been increasingly applied in paediatric urology, including the treatment of ureteropelvic junction obstruction. To the best of our knowledge, we describe the first laparoscopic bypass pyeloureterostomy in a 3-month-old male infant, with giant hydronephrosis and high insertion of the ureter into the renal pelvis. PMID:22889709

  9. Renal sparing treatment of upper tract malignant urothelial tumours using photodynamic therapy (PDT)-three case reports.

    PubMed

    Coombs, L M; Dixon, Kate

    2004-05-01

    Urothelial cancers of the upper urinary tract are usually treated by excision of the kidney, ureter and cuff of the bladder on the affected side. These three cases demonstrate the feasibility, safety and efficacy of photodynamic therapy as a renal sparing procedure for urothelial tumours. PMID:25048071

  10. Renal dysfunction due to hydronephrosis by SAPHO syndrome: a case report

    PubMed Central

    Kakoki, Katsura; Miyata, Yasuyoshi; Enokizono, Mikako; Uetani, Masataka; Sakai, Hideki

    2015-01-01

    Key Clinical Message Synovitis, Acne, Pustulosis, Hyperostosis, Osteitis (SAPHO) syndrome shows varied pathological symptoms. This is the first report of hydronephrosis due to the mechanical compression of bilateral ureters as a result of SAPHO syndrome. From our experience, MRI is the most useful imaging examination to check the upper urinary tract in SAPHO syndrome. PMID:26331013

  11. Urothelial carcinoma of the allograft kidney developed in a renal transplant patient

    PubMed Central

    Gökçe, Mehmet İlker; Kocaay, Akın Fırat; Aktürk, Serkan; Tüzüner, Acar

    2016-01-01

    Renal transplantation is the best option in the treatment of end-stage renal disease However these patients are under the risk of developing malignancies particularly due to effects of immune supression. These malignancies tend to be more agressive compared to the general population. Here, we present a case of urothelial carcinoma develoing in the ureter of allograft kidney.

  12. Postpartum vaginal cystic lesions: everyday practice or a differential diagnosis challenge?

    PubMed

    Machairiotis, Nikolaos; Tourountous, Ioannis; Karamperis, Alexandros; Zarogoulidis, Paul; Oikonomou, Anastasia; Theodoros, Rokkos; Palouki, Panagiota; Hohenforst-Schmidt, Wolfgang; Zissimopoulos, Athanasios; Machairiotis, Christodoulos

    2013-01-01

    Postpartum vaginal cystic lesions constitute a common situation that is caused either by inflammation or by accumulation of lymph. We report a case of a 33-year-old woman who had bilateral duplication of the pelvicalyceal system and ureter, and after the labor of her second child, she had one ureter prolapse into the vagina after initially appearing as a cystic lesion. Ureteral duplication is the most common renal abnormality, occurring in approximately 1% of the population and in 10% of children who are diagnosed with urinary tract infections. In our case we consider possible that this clinical situation was a result of a combination of postpartum pelvic floor trauma and prolapse of the ureter. There are only several of these cases in the literature where ureter prolapse is associated and complicated by pelvic floor trauma caused during or after labor. The clinical approach of the cystic lesions located in the vagina during the postpartum period should include a meticulous examination of the urinary system before any other medical practice. PMID:23803247

  13. Ureterorenoscopic treatment of ureteral stones – influence of operator’s experience and skill on the procedure outcome

    PubMed Central

    Librenjak, Davor; Šitum, Marijan; Gugić, Dijana; Milostić, Kazimir; Duvnjak, Mario

    2011-01-01

    Aim To observe the influence of operating urologist’s education and adopted skills on the outcome of ureterorenoscopy treatment of ureteral stones. Methods The study included 422 patients (234 men, 55.4%) who underwent ureterorenoscopy to treat ureteral stones at the Urology Department of Clinical Hospital Center Split, Croatia, between 2001 and 2009. All interventions were carried out with a semi-rigid Wolf ureteroscope and an electropneumatic generator used for lithotripsy. The operating specialists were divided into two groups. The first group included 4 urologists who had started learning and performing endoscopic procedures at the beginning of their specialization and the second group included 4 urologists who had started performing endoscopic procedures later in their careers, on average more than 5 years after specialization. Results Radiology tests confirmed that 87% (208/238) of stones were completely removed from the distal ureter, 54% (66/123) from the middle ureter, and 46% (28/61) from the proximal ureter. The first group of urologists completed significantly more procedures successfully, especially for the stones in the distal (95% vs 74%; P = 0.001) and middle ureter (66% vs 38%; P = 0.002), and their patients spent less time in the hospital postoperatively. Conclusion Urologists who started learning and performing endoscopic procedures at the beginning of their specialization are more successful in performing ureteroscopy. It is important that young specialists receive timely and systematic education and cooperate with more experienced colleagues. PMID:21328721

  14. Urolithiasis and cystotomy in the rabbit.

    PubMed

    Brown, Cyndi

    2011-03-01

    Cystotomy is a surgical incision into the urinary bladder, which may be required for removal of calculi, diagnosis of tumors or refractory urinary tract infections, or repair of ectopic ureters and ruptured bladders. This column describes the indications and techniques for cystotomy in the rabbit. PMID:21326187

  15. Iatrogenic ureteric injuries: approaches to etiology and management

    PubMed Central

    Watterson, James D.; Mahoney, John E.; Futter, Norman G.; Gaffield, Johanna

    1998-01-01

    Injury to the ureter is a risk of any pelvic or abdominal surgery, including laparoscopy and ureteroscopy. The morbidity associated with such injury may be serious, resulting in increased hospital stay, compromise of the original surgical outcome, secondary invasive interventions, reoperation, potential loss of renal function and deterioration of the patient’s quality of life. Management of ureteric injuries, in conjunction with frank and open dialogue with the patient, can lead to an optimal outcome. For ureteral ligation, removal of the suture and assessment of ureteral viability are recommended, with surgical correction if necessary. For partial transection primary closure is suggested over stent placement. For uncomplicated upper- and middle-third ureteral injury ureteroureterostomy is the procedure of choice. For injuries above the pelvic brim several procedures are available: ureteroureterostomy, ureteroileal interposition and nephrectomy. For injuries below the pelvic brim ureteroneocystostomy is recommended with a psoas hitch or Boari bladder flap. To decrease the incidence of iatrogenic ureteral injury, a sound knowledge of abdominal and pelvic anatomy is the best prevention. If the proposed operation is likely to be close to the ureter, the ureter should be identified at the pelvic brim. If the dissection is likely to be difficult, preoperative intravenous pyelography and placement of a ureteral catheter may help in identifying and protecting the ureter. PMID:9793505

  16. Ureteral fibropapilloma in a dog.

    PubMed

    Hattel, A L; Diters, R W; Snavely, D A

    1986-04-15

    A fibropapilloma was found to involve the left ureter in a 7-year-old castrated male Doberman Pinscher dog. Severe unilateral hydronephrosis and hydroureter were associated with the ureteral mass. Treatment consisted of unilateral nephrectomy and ureterectomy. This case represents an additional type of primary ureteral neoplasm found in the dog. PMID:3710881

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

    PubMed Central

    Biočíc, Mihovil; Todoríc, Jakov; Budimir, Dražen; Roíc, Andrea Cvitkovíc; Pogorelíc, Zenon; Juríc, Ivo; Šušnjar, Tomislav

    2012-01-01

    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. PMID:22854114

  18. Left renal vein compression syndrome ("nutcracker phenomenon").

    PubMed

    Stassen, C M; Weil, E H; Janevski, B K

    1989-06-01

    Four cases are presented with clinical diagnosis of scrotal varicocele on the left side, and one case with ureter varices and left-sided haematuria as a result of compression of the left renal vein between the aorta and superior mesenteric artery (SMA), also known as "nutcracker phenomenon". The clinical signs and the radiological diagnostic methods of the condition are discussed. PMID:2544950

  19. Multimodal Eph/Ephrin signaling controls several phases of urogenital development.

    PubMed

    Peuckert, Christiane; Aresh, Bejan; Holenya, Pavlo; Adams, Derek; Sreedharan, Smitha; Porthin, Annika; Andersson, Louise; Pettersson, Hanna; Wölfl, Stefan; Klein, Rüdiger; Oxburgh, Leif; Kullander, Klas

    2016-08-01

    A substantial portion of the human population is affected by urogenital birth defects resulting from a failure in ureter development. Although recent research suggests roles for several genes in facilitating the ureter/bladder connection, the underlying molecular mechanisms remain poorly understood. Signaling via Eph receptor tyrosine kinases is involved in several developmental processes. Here we report that impaired Eph/Ephrin signaling in genetically modified mice results in severe hydronephrosis caused by defective ureteric bud induction, ureter maturation, and translocation. Our data imply that ureter translocation requires apoptosis in the urogenital sinus and inhibition of proliferation in the common nephric duct. These processes were disturbed in EphA4/EphB2 compound knockout mice and were accompanied by decreased ERK-2 phosphorylation. Using a set of Eph, Ephrin, and signaling-deficient mutants, we found that during urogenital development, different modes of Eph/Ephrin signaling occur at several sites with EphrinB2 and EphrinA5 acting in concert. Thus, Eph/Ephrin signaling should be considered in the etiology of congenital kidney and urinary tract anomalies. PMID:27344203

  20. Nephric duct insertion is a crucial step in urinary tract maturation that is regulated by a Gata3-Raldh2-Ret molecular network in mice

    PubMed Central

    Chia, Ian; Grote, David; Marcotte, Michael; Batourina, Ekaterina; Mendelsohn, Cathy; Bouchard, Maxime

    2011-01-01

    Urinary tract development depends on a complex series of events in which the ureter moves from its initial branch point on the nephric duct (ND) to its final insertion site in the cloaca (the primitive bladder and urethra). Defects in this maturation process can result in malpositioned ureters and hydronephrosis, a common cause of renal disease in children. Here, we report that insertion of the ND into the cloaca is an unrecognized but crucial step that is required for proper positioning of the ureter and that depends on Ret signaling. Analysis of Ret mutant mice at birth reveals hydronephrosis and defective ureter maturation, abnormalities that our results suggest are caused, at least in part, by delayed insertion of the ND. We find a similar set of malformations in mutants lacking either Gata3 or Raldh2. We show that these factors act in parallel to regulate ND insertion via Ret. Morphological analysis of ND extension in wild-type embryos reveals elaborate cellular protrusions at ND tips that are not detected in Ret, Gata3 or Raldh2 mutant embryos, suggesting that these protrusions may normally be important for fusion with the cloaca. Together, our studies reveal a novel Ret-dependent event, ND insertion, that, when abnormal, can cause obstruction and hydronephrosis at birth; whether ND defects underlie similar types of urinary tract abnormalities in humans is an interesting possibility. PMID:21521737

  1. Continuous dual-wavelength, high-intensive Nd:YAG laser in operative urology

    NASA Astrophysics Data System (ADS)

    Reznikov, Leonid L.; Pupkova, Ludmila S.; Miroshnicov, B. I.; Snezhko, D. A.; Nikitichev, A. A.; Pokrovskiy, Vasiliy P.; Gomberg, Vladimir G.

    1994-05-01

    A ruby laser with a 0.694 mkm wavelength was used as a source of a new model of laser lithotriptor. The optical irradiation parameters selected included 1 mks duration pulse, frequency from 1 to 5 Hz, energy at an output of up to 120 mJ, transmitted via light guide quartz fiber of 400 kmk. The tip of the light guide was directed to the calculus through a catheterized cystoscope. Light guide position control was done by the presence of a specific acoustic signal accompanying plasma formation. Plasma is not formed by laser action on the ureter wall. In doubtful cases we used roentgenological examination. After lithotripsy and direct processing by irradiation, histological investigations of the ureter wall showed only slight submucosal hemorrhage or revealed no changes. Implantation of the calculus and fiber particles into the ureter wall was not observed. Twenty-nine patients were subjected to lithotripsy of calculus (oxalates, urates, phosphates) in the low and mid-ureter. Usually from 1000 to 3000 impulses were used to destroy the calculus. Calculus fragments passed without assistance (13 patients) or were removed by extractors (7 patients). The recovery of passing of urine and removal of renal colic were observed during lithotripsy if obturation had occurred (8 patients). Ureteral perforation, blood loss, and acute pyelonephritis did not occur.

  2. Robotic Proximal Ureteropyelostomy After Unsuccessful Endourologic Management of Complicated Proximal Ureteral Stone Disease

    PubMed Central

    Olvera-Posada, Daniel; Dion, Marie; Alenezi, Husain; Razvi, Hassan

    2015-01-01

    Abstract We present a clinical case of a 66-year-old female with a left ureteropelvic junction impacted renal calculi associated with a tortuous ureter. After a failed combined retrograde and antegrade endoscopic procedure, a robot-assisted laparoscopic ureteropyelostomy was successful.

  3. Ionizing radiation and kidney cancer among Japanese atomic bomb survivors.

    PubMed

    Richardson, David B; Hamra, Ghassan

    2010-06-01

    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

  4. First Case Report of Acute Renal Failure After Mesh-Plug Inguinal Hernia Repair in a Kidney Transplant Recipient

    PubMed Central

    Veroux, Massimiliano; Ardita, Vincenzo; Zerbo, Domenico; Caglià, Pietro; Palmucci, Stefano; Sinagra, Nunziata; Giaquinta, Alessia; Veroux, Pierfrancesco

    2016-01-01

    Abstract Acute renal failure due to ureter compression after a mesh-plug inguinal repair in a kidney transplant recipient has not been previously reported to our knowledge. A 62-year-old man, who successfully underwent kidney transplantation from a deceased donor 6 years earlier, was admitted for elective repair of a direct inguinal hernia. The patient underwent an open mesh-plug repair of the inguinal hernia with placement of a plug in the preperitoneal space. We did not observe the transplanted ureter and bladder during dissection of the inguinal canal. Immediately after surgery, the patient became anuric, and a graft sonography demonstrated massive hydronephrosis. The serum creatinine level increased rapidly, and the patient underwent an emergency reoperation 8 hours later. During surgery, we did not identify the ureter but, immediately after plug removal, urine output increased progressively. We completed the hernia repair using the standard technique, without plug interposition, and the postoperative course was uneventful with complete resolution of graft dysfunction 3 days later. Furthermore, we reviewed the clinical features of complications related to inguinal hernia surgery. An increased risk of urological complications was reported recently in patients with a previous prosthetic hernia repair undergoing kidney transplantation, mainly due to the mesh adhesion to surrounding structures, making the extraperitoneal dissection during the transplant surgery very challenging. Moreover, older male kidney transplant recipients undergoing an inguinal hernia repair may be at higher risk of graft dysfunction due to inguinal herniation of a transplanted ureter. Mesh-plug inguinal hernia repair is a safe surgical technique, but this unique case suggests that kidney transplant recipients with inguinal hernia may be at higher risk of serious urological complications. Surgeons must be aware of the graft and ureter position before proceeding with hernia repair. A prompt

  5. [SURGICAL TREATMENT OF PATIENTS WITH URETERAL RUPTURES].

    PubMed

    Komjakov, B K; Guliev, B G

    2015-01-01

    The aim of the study was to analyze the causes of ureteral ruptures and the types surgical procedures used for their management. Over the period from 2006 to 2014, 7 patients with ureteral ruptures underwent surgical treatment in the Mechnikov N-WSMU clinic. All of them were males aged 50 to 71 years. In all cases, the ureter was injured during ureteroscopy and contact lithotripsy. In two patients the right ureter was cut off at the border of the upper and middle third, in four--at 3-4 cm below pyeloureteral segment, one patient diagnosed with a complete separation of the ureter from the kidney pelvis. Patients, who have suffered a detachment of the ureter in other hospitals, previously underwent surgical exploration of the retroperitoneal space, drainage of the kidney by pyelonephrostomy (5) and ureterocutaneostomy (1). In a case of a patient with an injury that occurred in our clinic, laparoscopic nephrectomy with autologous renal transplantation was carried out. Five patients with extended ureter defects underwent ileo-ureteroplasty. The patient with left ureterocutaneostomy underwent nephrovesical bypass. Patency of the upper urinary tract and kidney function were restored in all patients, all of them were relieved from external drains. The duration of the intestinal plastic averaged 160 minutes, laparoscopic nephrectomy with autologous transplantation--210 min and nephrovesical bypass--110 min. Blood transfusion was required only in autologous graft patient. The ureteral rupture is a serious complication of ureteral endourological procedures in upper urinary tract. It requires such complicated reconstructive operations as autologous transplantation of the kidney or intestinal ureteroplasty. PMID:26390553

  6. [Urinary dribbling in girls: which investigations in 2012?].

    PubMed

    Grimaldi, C; Bourlière Najean, B; Guys, J-M; Petit, P

    2013-06-01

    Continuous urinary leakage, despite normal deliberate voiding, must suggest the diagnosis of ectopic ureter, more specifically in girls. Ectopic ureter is usually associated with duplex kidney and complete ureteral duplication. The strategy of investigations has changed over the past few years, due to MRI development in the analysis of urinary tract malformations. We report the case of a 4-year-old girl who presented with these symptoms and had a suspicion of left duplex kidney on the prenatal ultrasonography (US). Two US examinations during the first months of life were compatible with a left duplex kidney without any complication. Another US at the age of 4 years was reported as normal. We completed the investigation with MR urography, which revealed a left duplex kidney with a poorly functioning dysplastic upper pole, and the orifice of the ureter of this upper pole inserting in the vagina. The surgical treatment, realized by celioscopy, was partial nephrectomy of the upper pole, removing most of the ectopic ureter. US is the first exam to investigate urinary tract malformations. However, duplex kidney with small dysplastic pole and ectopic insertion of a nondilated ureter may be difficult to see, and a normal US should never end the investigations. Intravenous urography and renal scintigraphy used to be the reference complementary exams, but are now replaced by MR urography. Without using ionizing radiation, MR urography can visualize duplex kidney and ectopic ureteral insertion with high resolution, and evaluates renal function of each kidney and each pole. These morphological and functional data are essential to determine the surgical treatment. PMID:23639836

  7. TREATMENT EFFECTS OF WST11 VASCULAR TARGETED PHOTODYNAMIC THERAPY IN UROTHELIAL CELL CARCINOMA AND FEASIBILITY, SAFETY, AND LONG TERM OUTCOMES IN THE UPPER URINARY TRACT OF SWINE

    PubMed Central

    Murray, Katie S; Winter, Ashley G; Corradi, Renato Beluco; LaRosa, Stephen; Jebiwott, Sylvia; Somma, Alexander; Takaki, Haruyuki; Srimathveeravalli, Govindarajan; Lepherd, Michelle; Monette, Sebastien; Kim, Kwanghee; Scherz, Avigdor; Coleman, Jonathan A

    2016-01-01

    Purpose Surgical management of upper tract urothelial carcinoma requires removal of kidney and ureter, compromising renal function. Non-surgical alternatives have potentially prohibitive safety concerns. We examine the feasibility and safety of ablation of the ureter and renal pelvis using endoluminal vascular-targeted photodynamic therapy in a porcine model and report efficacy of WST11 vascular-targeted photodynamic therapy in a murine model. Materials and Methods Following approval, we performed 28 endoluminal ablations in the ureters and renal pelvis of 18 swine. Intravenous infusion of WST11 (4mg/kg) followed by laser illumination (10 minutes) was performed via percutaneous access or retrograde ureteroscopic approach. Animals were followed clinically with laboratory testing, imaging and histology was evaluated at several post-ablation time points. A murine xenograft was created with the 5637 human urothelial cell carcinoma line to determine sensitivity to this therapy. Results At 24 hours, 50 mW/cm laser fluence produced superficial necrosis of the ureter and deeper necrosis (penetrating the muscularis propria or adventitia) was produced by treatment with 200 mW/cm in the ureter and renal pelvis. At 4 weeks, superficial urothelium had regenerated over the treatment site. No symptomatic obstruction, clinically relevant hydronephrosis, or abnormality of lab testing was noted up to 4 weeks. In mice, 80% had no evidence of tumor at 19 days after WST11 vascular-targeted photodynamic therapy. Conclusions Urothelial cell carcinoma appears to be sensitive to WST11 vascular-targeted photodynamic therapy. Depth of WST11 vascular-targeted photodynamic therapy treatment effects can be modulated in a dose-dependent manner by titration of light intensity. Moreover, this treatment modality, applied to the porcine upper urinary tract, is feasible via antegrade and retrograde access. PMID:26860792

  8. Complete laparoscopic nephroureterectomy with intravesical lockable clip

    PubMed Central

    Eret, Viktor; Ürge, Tomáš; Klečka, Jiří; Trávníček, Ivan; Hes, Ondřej; Petersson, Fredrik; Stránský, Petr

    2012-01-01

    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. PMID:24578933

  9. Cell death serves as a single etiological cause of a wide spectrum of congenital urinary tract defects

    PubMed Central

    Guo, Qiusha; Tripathi, Piyush; Poyo, Edward; Wang, Yinqiu; Austin, Paul F.; Bates, Carlton M.; Chen, Feng

    2011-01-01

    Purpose We genetically disrupted the Wolffian duct (WD) in mice to study the affected organogenesis processes and to test the hypothesis that cell loss can be the developmental basis for a wide spectrum of congenital anomalies in the kidney and urinary tract. Materials and Methods We use Hoxb7-Cre transgenic lines (HC1 and HC2) to induce diphtheria toxin (DT) production from a ROSADTA allele, disrupting the wolffian duct and derivatives. Results The first set of mutants (HC1;ROSADTA/+) exhibited agenesis of the kidney, ureter, and reproductive tracts. The second set of mutants (HC2;ROSADTA/+) exhibited diverse defects, including renal agenesis/hypoplasia, hydronephrosis, hydroureter, ureter-vas deferens fistulas in males and ureter-oviduct/uterus fistulas in females. The phenotypic differences correspond to the degree of apoptosisinduced caudal truncation of the wolffian duct, which is less severe and more variable in HC2;ROSADTA/+ mice. Whenever the wolffian duct failed to reach the urogenital sinus, the ureter failed to separate from the wolffian duct, suggesting that ureteral migration along the common nephric duct to the cloaca and the subsequent common nephric duct degeneration constitute the only pathway for separating the ureter and WD derivatives. Conclusions The diverse and severe defects observed emphasize the central role of the wolffian duct in providing progenitors and signals for urogenital development. These results also indicate that the quantitative difference in cell deathinduced caudal truncation of the wolffian duct can lead to a wide range of qualitatively distinct defects, and that cell death can serve as a single etiological cause of a wide spectrum of congenital kidney and urinary tract defects. PMID:21511282

  10. Comparison of retrograde endo-pyelotomy and endo-balloon rupture of the ureteropelvic junction in a porcine model.

    PubMed

    Pearle, M S; Moon, Y T; Endicott, R C; Gardner, S M; Humphrey, P; Clayman, R V

    1994-12-01

    Excellent results and durable success have been achieved with antegrade and retrograde endo-pyelotomy for treating primary and secondary ureteropelvic junction obstruction. Recently, a 30F dilating balloon was used to rupture the ureteropelvic junction (ENDOBRST) with encouraging results. While balloon distention of the ureteropelvic junction is a technically simpler procedure than endo-pyelotomy, clinical and laboratory data comparing the 2 methods are lacking. In an acute and chronic animal study we compared endo-pyelotomy via a ureteral cutting balloon incision to balloon rupture (that is 30F) of the normal ureteropelvic junction in each of 20 female farm pigs. Eight pigs were harvested acutely after treatment, and a macroscopic and histological examination of the treated ureteropelvic junction was completed. In 11 chronic pigs after endo-pyelotomy a 7F double pigtail ureteral stent was placed bilaterally and then removed after 6 weeks. Evaluation in the chronic group consisted of a furosemide washout renogram and retrograde pyelogram immediately preoperatively and 6 weeks after stent removal. The animals were likewise harvested 6 weeks after stent removal. One control pig underwent passage of the balloon cutting catheter and balloon dilating catheters without activation or dilation, respectively. Ureteral stents were placed bilaterally for 6 weeks and the pig was otherwise treated similarly to the other chronic study animals. In the acute group all ureters after endo-pyelotomy demonstrated retroperitoneal extravasation of contrast material. At harvest the ureters had been cleanly incised along a length of 3 to 4 cm. through the adventitial layer. In contrast, the balloon treated ureters showed free retroperitoneal extravasation in only half of the animals. Among the balloon treated ureters 7 of 8 had a linear tear of varying length (1 to 5 cm.) involving all but a thin adventitial layer of tissue. Histologically, the endo-pyelotomy ureters demonstrated a clean