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Sample records for ureter

  1. Ectopic Ureter

    MedlinePLUS

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

  2. 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. 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.

  4. Comprehensive data analysis of human ureter proteome.

    PubMed

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

    2016-03-01

    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

  5. Renal Pelvis and Ureter Cases - MP/H Rules

    Cancer.gov

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

  6. Fibroepithelial polyp of the ureter

    PubMed Central

    Sinha, Rajan Kumar; Jindal, Tarun; Kamal, Mir Reza; Karmakar, Dilip

    2013-01-01

    A 36-year-old woman presented with haematuria and a bladder mass on ultrasonogram. Cystoscopy revealed a tumour, cauliflower in shape with smooth stalk coming out from the ureteric orifice. Stalk of the polyp was identified in proximal ureter by ureteroscopy. The mass was excised endoscopically. PMID:24234435

  7. Fibroepithelial polyp of the ureter.

    PubMed

    Sinha, Rajan Kumar; Jindal, Tarun; Kamal, Mir Reza; Karmakar, Dilip

    2013-01-01

    A 36-year-old woman presented with haematuria and a bladder mass on ultrasonogram. Cystoscopy revealed a tumour, cauliflower in shape with smooth stalk coming out from the ureteric orifice. Stalk of the polyp was identified in proximal ureter by ureteroscopy. The mass was excised endoscopically. PMID:24234435

  8. Spontaneous rupture of the ureter

    PubMed Central

    Eken, Alper; Akbas, Tugana; Arpaci, Taner

    2015-01-01

    Spontaneous rupture of the ureter is a very rare condition and usually results from ureteral obstruction by a calculus. Only theoretical mechanisms have been proposed and no possible explanation has yet been reported in the literature. Intravenous contrast-enhanced computed tomography is the most informative study with high sensitivity. Treatment should be individualised, and depends on the state of the patient. Minimally invasive endourological procedures with double-J catheter placement and percutaneous drainage offer excellent results. Conservative management with analgesics and antibiotic coverage may be an alternative to surgery. Herein, we present a case of spontaneous rupture of the proximal ureter with no evidence of an underlying pathological condition. PMID:25715862

  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. Ectopic ureter draining into the uterus

    PubMed Central

    Ghosh, Bastab; Shridhar, Kartik; Pal, Dilip Kumar; Banerjee, Manju

    2016-01-01

    We report a rare case of a 13-year-old female child with a right-sided duplex system with the upper moiety draining into the uterus. Only one such case has been reported in scientific literature in English, of ectopic ureter draining into the uterus has been reported in literature. The patient was managed with laparoscopic end-to-side ureteroureterostomy into the normal ureter of the lower moiety. PMID:26834415

  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 ?s, and pulse rates of 150-500 Hz was delivered through a 100-?m-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 ?m. 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. [The ureters: findings at multidetector computed tomography].

    PubMed

    Lpez Amaya, J E; Meja Restrepo, J; Nicolau Molina, C; Zuluaga Santamara, A; Mazzaro, M

    2010-01-01

    Multidetector computed tomography (MDCT) and advances in CT urography techniques have enabled vast improvements in the depiction of the ureter. Studies of the ureter can find a wide variety of conditions including congenital defects and anatomic variants (anomalies in the origin, distribution, and distal insertion of the ureter) as well as all benign and malignant causes of focal and diffuse wall thickening (inflammatory and infectious processes, and neoplasms, as well as iatrogenic thickening and postsurgical changes). Other benign processes like ureteral kinking and stenosis due to extrinsic compression of the iliac vessels are also well characterized by MDCT. The aim of this article is to show the spectrum of ureteral variants and disease apart from common entities related to stones. PMID:20627329

  13. COMPASS-based ureter segmentation in CT urography (CTU)

    NASA Astrophysics Data System (ADS)

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

    2014-03-01

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

  14. Spectrum of ectopic ureters in children.

    PubMed

    Roy Choudhury, Subhasis; Chadha, Rajiv; Bagga, Deepak; Puri, Archana; Debnath, Pinaki Ranjan

    2008-07-01

    We reviewed the clinicopathological features, diagnosis, and surgical treatment of ectopic ureters (EU) in children in order to evaluate the anatomy, renal function, outcome, and the existence of any racial or regional difference in this abnormality. The records of 27 consecutive patients with 33 EU managed over a period of 7 years were analyzed. There were 25 female and two male patients. Their age ranged from 1 to 13 years, with an average of 4.5 years. The presenting features included history of continuous dribbling of urine with otherwise normal voiding in toilet-trained female patients, incontinence of urine, urinary tract infection, abdominal pain, and renal failure. The diagnostic work-up included ultrasonography (US) in all 27 patients, intravenous pyelography (IVP) in 23, micturating cystourethrogram (MCU) in 19, nuclear imaging (NI) in 16, and computed tomogram (CT) in five patients. All patients underwent examination under anesthesia (EUA) and cystourethrovaginoscopy immediately before the operation. Single-system ectopic ureter (SSEU) was present in 19 patients with 25 ureters (six bilateral), and duplex with ectopic ureter was present in eight cases. The left side was involved in 14 cases, the right side in seven, and the anomaly was bilateral in six cases. Abnormalities noted in the imaging studies were USG 23/27, IVP 23/23, MCU 11/19, NI 13/16, and CT 5/5 cases. EUA and cystourethrovaginocsopy helped in localization of the ectopic site and evaluation of the bladder. The surgical treatment included nephroureterectomy (NUT) for non-functioning kidney in 7 patients, heminephroureterectomy (HNUT) for non functioning upper pole of duplex kidney with EU in 6 patients, ureteric reimplantation (UTR) in 13 patients (19 ureters, 6 bilateral), and ureteropyelostomy (UTP) in one patient. In the follow-up period ranging from 1 to 5 years, 20 patients achieved continence; however, six cases with bilateral SSEU and one case of unilateral SSEU, who also had a patulous bladder neck, continued to dribble urine. SSEU was more common than duplex with ectopic ureter. A large number of functioning renal units associated with SSEU deserved preservation. The success of surgical treatment in terms of achievement of continence was high and depended on the integrity of the bladder neck. PMID:18463883

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

    PubMed Central

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

    2013-01-01

    Background and Purpose ?1-adrenoceptor (-AR) antagonists may facilitate ureter stone passage in humans. We aimed to study effects by the ?1A-AR selective antagonist silodosin (compared to tamsulosin and prazosin) on ureter pressures in a rat model of ureter obstruction, and on contractions of human and rat isolated ureters. Experimental Approach After ethical approval, ureters of male rats were cannulated beneath the kidney pelvis for in vivo ureteral intraluminal recording of autonomous peristaltic pressure waves. A partial ureter obstruction was applied to the distal ureter. Mean arterial blood pressure (MAP) was recorded. Approximate clinical and triple clinical doses of the ?1-AR antagonists were given intravenously. Effects by the ?1-AR antagonists on isolated human and rat ureters were studied in organ baths. Key Results Intravenous silodosin (0.10.3 mg kg?1) or prazosin (0.030.1 mg kg?1) reduced obstruction-induced increases in intraluminal ureter pressures by 2137% or 1840% respectively. Corresponding effects by tamsulosin (0.01 or 0.03 mg kg?1) were 920%. Silodosin, prazosin and tamsulosin reduced MAP by 1012%, 2526% (P < 0.05), or 1825% (P < 0.05) respectively. When effects by the ?1A-AR antagonists on obstruction-induced ureter pressures were expressed as a function of MAP, silodosin had six- to eightfold and 2.5- to eightfold better efficacy than tamsulosin or prazosin respectively. Silodosin effectively reduced contractions of both human and rat isolated ureters. Conclusions and Implications Silodosin inhibits contractions of the rat and human isolated ureters and has excellent functional selectivity in vivo to relieve pressure-load of the rat obstructed ureter. Silodosin as pharmacological ureter stone expulsive therapy should be clinically further explored. PMID:23373675

  16. Double obstruction of ureter: A diagnostic challenge

    PubMed Central

    Halder, Pankaj; Shukla, Ram Mohan; Mandal, Kartik Chandra; Mukhopadhyay, Biswanath; Barman, Shibsankar

    2014-01-01

    Introduction: Isolated obstruction of the ureteropelvic junction and the vesico-ureteric junction are the two most common causes of hydronephrosis in a pediatric population.[1] They do not pose diagnostic difficulties when are present alone but when together can be difficult to diagnose. Here, we discuss the problems we faced when we encountered these two anomalies in the same ureter and the way in which we managed them. Aim: To assess the difficulties in diagnosis of pediatric patients who present with both ureteropelvic junction obstruction (UPJO) and vesico-ureteric junction obstruction (VUJO) in the ipsilateral ureter and their management protocol. Materials and Methods: This is a retrospective study. The study period is from 1 January 2004 to 31 December 2011. Out of 254 children who were diagnosed to have hydronephrosis due to UPJO in our institute, 5 patients (in the age range of 5 to 10 years) had both UPJO and VUJO in the ipsilateral ureter. The problems we faced in diagnosing the two conditions are mentioned with a literature review. Results: Operative intervention was used in four out of five patients; none of the patients had an accurate diagnosis before surgery. All patients were suspected of having double obstruction during pyeloplasty when appropriate size double J stent could not be negotiated through the vesicoureteric junction into the bladder. Postoperative nephrostogram confirmed the diagnosis in all patients. Conclusion: Children with double obstruction of the ipsilateral ureter present as a diagnostic dilemma. Because of the rarity of this condition it can escape the eye of even an astute clinician. Early diagnosis can be made if this condition is kept in mind while treating any hydronephrosis due to UPJO or UVJO. PMID:25197188

  17. Duplicated Renal System with H Shaped Ureter: An Extraordinary Anomaly.

    PubMed

    Akbulut, Fatih; Savun, Metin; Ucpinar, Burak; Sahan, Murat; Arslan, Burak; Ozgor, Faruk; Simsek, Abdulmuttalip; Berberoglu, Ahmet Yalcın; Baykal, Murat; Binbay, Murat

    2016-01-01

    Duplex collecting systems are the most commonly encountered anomaly of the urinary system. Complete duplex system with an H shaped ureter is a very rare situation. There are only two reported H ureter cases in the literature. Herein, we aimed to present an H shaped ureter case, which was identified while performing ureterorenoscopy to a 48-year-old female patient due to a right distal ureteral stone. PMID:26942033

  18. Duplicated Renal System with H Shaped Ureter: An Extraordinary Anomaly

    PubMed Central

    Akbulut, Fatih; Savun, Metin; Ucpinar, Burak; Sahan, Murat; Arslan, Burak; Ozgor, Faruk; Simsek, Abdulmuttalip; Berberoglu, Ahmet Yalcın; Baykal, Murat; Binbay, Murat

    2016-01-01

    Duplex collecting systems are the most commonly encountered anomaly of the urinary system. Complete duplex system with an H shaped ureter is a very rare situation. There are only two reported H ureter cases in the literature. Herein, we aimed to present an H shaped ureter case, which was identified while performing ureterorenoscopy to a 48-year-old female patient due to a right distal ureteral stone. PMID:26942033

  19. Persistent Urinary Incontinence: A Case Series of Missed Ectopic Ureters

    PubMed Central

    Wang, Ming-Hsien

    2015-01-01

    Ectopic ureter is a rare cause of urinary incontinence in children. Symptomatic cases are unlikely to resolve spontaneously, and incontinence are often associated with significant psychological impact on these children. This case series of 2 older children with missed ectopic ureters by the urologic community outline workup for persistent urinary incontinence, with emphasis on history, physical, embryology review, and radiographic evaluations. PMID:26793560

  20. 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: 116399, 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 2.02 mm. With our previous method, the average distance between the centerlines was 0.80 mm, and the average maximum distance was 3.38 mm. The improvements in the ureteral tracking length and both distance measures were statistically significant (p < 0.0001). Conclusions: COMPASS improved significantly the ureter tracking, including regions across ureter lesions, wall thickening, and the narrowing of the lumen.

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

    PubMed Central

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

    2014-01-01

    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: 116399, 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 2.02 mm. With our previous method, the average distance between the centerlines was 0.80 mm, and the average maximum distance was 3.38 mm. The improvements in the ureteral tracking length and both distance measures were statistically significant (p < 0.0001). Conclusions: COMPASS improved significantly the ureter tracking, including regions across ureter lesions, wall thickening, and the narrowing of the lumen. PMID:25471966

  2. Ureter RegenerationThe Proper Scaffold Has to Be Defined

    PubMed Central

    Kowalczyk, Tomasz; Nowacki, Maciej; Bodnar, Magdalena; Marsza?ek, Andrzej; Pokrywczy?ska, Marta; Frontczak-Baniewicz, Ma?gorzata; Kowalewski, Tomasz A.; Ch?osta, 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

  3. Inguinoscrotal herniation of the ureter: Description of five cases

    PubMed Central

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

    2015-01-01

    INTRODUCTION Descent of the ureter into the inguinal canal or scrotum is rare but undoubtedly underreported. Most known cases were recognized at the time of surgery for hernia repair. We encountered five cases recently. PRESENTATION OF CASE We reviewed the records and CT images of five patients with inguinal hernias containing a segment of the ureter. All of our cases, like most reported cases, featured obese adult males. Our cases had different outcomes, ranging from inadvertent injury of the displaced ureter to correction of the anomaly at the time of hernia repair. DISCUSSION In all of our cases, the affected ureter was displaced anteriorly from the psoas muscle by greater than 1cm at the level of the L4 vertebra on abdominal CT. This association has not been previously described. CONCLUSION Pre-operative diagnosis by CT can prevent injury to the ureter. We hypothesize that anterior displacement of the ureter at the level of L4 as seen on CT may be predictive of inguinoscrotal herniation of the ureter. PMID:26280912

  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 immunohistochemistry and molecular techniques. These findings may lend support to the preliminary studies of the effectiveness of alpha-receptor blockade on ureteral colic and stone passage.

  5. 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, Ppar?, 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 Ppar? 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

  6. Unusual anatomic variation of bilateral ectopic ureters in a dog.

    PubMed

    Hosgood, G; Salisbury, K; Blevins, W E; Widmer, W R

    1989-12-01

    An unusual anatomic variation of bilateral ectopic ureters was diagnosed in a 6-week-old female Siberian Husky with urinary incontinence. Assessment during surgery revealed bilateral ectopic ureters with a common opening in the proximal portion of the urethra. Ureteroneocystostomy was performed bilaterally. After surgery, intermittent urinary incontinence continued, but was less severe. After resection of a persistent hymen in the 6-month-old dog, incontinence appeared to resolve, but then recurred, and has been controlled by phenylpropanolamine administration. PMID:2599944

  7. Synchronous endoscopic management of bilateral kidney and ureter fungal bezoar.

    PubMed

    Modi, Pranjal; Goel, Rajiv

    2007-01-01

    Candidiasis of the lower urinary tract is common in immunocompromised patients. Diabetes and chronic indwelling catheter are two common risk factors for such opportunistic infections. However, upper urinary candidiasis is rare. Further, bilateral synchronous involvement of kidneys and ureter is extremely rare. Treatment usually requires relief of obstruction by percutaneous drainage of the kidney and systemic infusion or local irrigation of antifungal agents. When these measures fail, percutaneous surgical debulking of the fungal bezoar is indicated. We present a case of obstructive anuria due to fungal bezoar in both the pelvicalyceal system and ureter managed by bilateral synchronous endoscopic removal of fungal bezoar. PMID:17495501

  8. [CHARACTERISTICS OF THE URETER CONTRACTIONS IN CHILDREN WITH CHRONIC PYELONEPHRITIS].

    PubMed

    Goremykin, V I; Usanov, D A; Rytik, A P; Prosova, E E

    2015-01-01

    The article presents results of electrophysiological study of the function of the ureter in the frequency range of 0.6-35 Hz, conducted in 100 children aged 5 to 13 years with chronic pyelonephritis. Data of 35 healthy people were used as a control. It was shown that the features of ureter contractions were significantly different in the two groups. Marked decrease of amplitudes of signal harmonics was found at a frequency of 1.4 Hz in patients with pyelonephritis compared to controls. Myostimulation in pyelonephritis group has led to an approximation of harmonic amplitudes to the values of the control group. PMID:26390566

  9. [An unusual cause of acute pyelonephritis: the retrocaval ureter].

    PubMed

    Rossi, Luigi; Lisi, Piero; Vigo, Valentina; Lomonte, Carlo; Basile, Carlo

    2015-01-01

    Retrocaval ureter is a rare congenital malformation in which the proximal right ureter courses toward the midline on the posterior aspect of the inferior vena cava before emerging medial and anterior to this structure and then descending into the pelvis. This anatomical anomaly may be asymptomatic or manifest clinically, usually starting from the fourth decade of life, with flank pain, pyelonephritis, gross hematuria or other rarer signs. We describe the case of a young woman being hospitalized because of acute pyelonephritis; she had previously complained of flank pain associated with episodes of high fever. Computed tomography of the abdomen identified the malformation. The patient underwent surgical correction by laparoscopy and, at one year of follow-up, did not show any further clinical problem. PMID:26252261

  10. Extraperitoneal inguinoscrotal herniation of the ureter: a rare case of recurrence after hernia repair.

    PubMed

    Golgor, E; Stroszczynski, C; Froehner, M

    2009-01-01

    Inguinoscrotal herniation of the ureter is a rare finding with the potential for serious surgical complications. Two anatomic forms are defined. In the more common paraperitoneal variant, the herniating peritoneal sac drags the ureter and sometimes other abdominal structures with it. The uncommon variant--extraperitoneal inguinal herniais without a peritoneal sac and consists of the ureter and fat tissue. We report a case of extraperitoneal inguinoscrotal hernia possibly due to a prior inguinal hernia repair. PMID:19641370

  11. Interaction of mid-infrared laser radiation with soft ureter tissue

    NASA Astrophysics Data System (ADS)

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

    2004-09-01

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

  12. Inguinal Herniation of a Transplant Ureter: Lessons Learned From a Case of "Water Over the Bridge".

    PubMed

    Hakeem, Abdul R; Gopalakrishnan, Palanivel; Dooldeniya, Mohantha D; Irving, Henry C; Ahmad, Niaz

    2016-02-01

    Inguinal herniation of the transplant ureter is rare, and there is a paucity of reports in the literature. Herniation is usually secondary to implanting a long redundant ureter and may be precipitated by its course over the spermatic cord. Most often, there is loss of the allograft owing to delayed presentation and chronic ureteric obstruction. Here, we report a case of inguinal herniation of a transplant ureter with obstruction and graft dysfunction. A 72-year-old man presented 9 years after deceased-donor kidney transplant, with progressive graft dysfunction and a symptomatic right inguinal hernia. A nephrostogram and subsequent surgery confirmed herniation of a loop of transplant ureter into the inguinal canal with a proximal dilated ureter and hydronephrosis. A long and redundant ureter had been anastomosed "over" the spermatic cord to the bladder during the original operation. The ureter was shortened by excising the distal segment, and the proximal dilated ureter was anastomosed to the bladder passing it "underneath" the spermatic cord. We used a Vicryl (polyglactin 910) mesh to repair the hernia. The graft function improved to baseline levels after the nephrostomy and remained stable after the surgery. This case emphasizes the need to keep the ureter short, and the importance of passing it underneath the spermatic cord before anastomosing to the bladder. Transplant and general surgeons should be aware of such presentations of graft dysfunction with inguinal hernia to avoid delayed diagnosis and graft loss. PMID:26114341

  13. Effect of tetracyclines and 4-epiderivatives on the ureter.

    PubMed

    Arrigoni, E; Benzi, G; Ferrara, A

    1972-04-01

    1. The effect of tetracyclines on the isolated dog ureter is dependent on: (a) the tetracyclines used-mepicycline and doxycycline antagonizing, and tetracycline and rolitetracycline increasing the contractor action of barium chloride; (b) the percentage of 4-epiderivatives in the tetracyclines used-the higher the epiderivative concentration, the smaller the effect of mepicycline or doxycycline, and the greater the action of tetracycline or rolitetracycline.2. In vivo the addition of the antibiotics into the renal pelvis shows no significant differences between the various tetracyclines or different 4-epiderivative concentrations on the intra-ureteral flow of the dog or guinea-pig.3. Intravenous injection of mepicycline or doxycycline does not induce a significant change in the intra-ureteral flow, while intravenous administration of tetracycline or rolitetracycline produces a triphasic response: (a) a marked decrease of the intra-ureteral flow for a few minutes; (b) a return to the control condition for 30-60 min; and (c) a lesser but persistent decrease in flow for 60-120 minutes. In the first phase the ureteral smooth muscle is directly affected by the antibiotics circulating in the blood, while in the third phase the tetracyclines act via the intra-ureteral mucosa.4. Neurogenic effects on the ureter-bladder junction in vivo are not affected by the tetracyclines tested. PMID:4625269

  14. Ureter segmentation in CT urography (CTU) by COMPASS with multiscale Hessian enhancement

    NASA Astrophysics Data System (ADS)

    Fairbanks, Duncan; Hadjiiski, Lubomir; Zhou, Chuan; Chan, Heang-Ping; Cohan, Richard H.; Caoili, Elaine M.; Cha, Kenny

    2015-03-01

    We are developing an automated method for the segmentation of ureters in CTU, referred to as COmbined Modelguided Path-finding Analysis and Segmentation System (COMPASS). Ureter segmentation is a critical component for computer-aided detection of ureter cancer. A challenge for ureter segmentation is inconsistent opacification of the region of interest, which makes it difficult to be distinguished from other tissue in the surrounding area. COMPASS consists of four stages: (1) region finding and adaptive thresholding, (2) segmentation accuracy analysis, (3) potential backtracking and branching, and (4) edge profile extraction and feature analysis. In this study, we evaluated a new method in which CTU images were pre-processed with 3D multiscale Hessian filtering that enhances tubular structures. Our goal is to compare the performance of COMPASS with and without multiscale Hessian enhancement. With IRB approval, 79 cases with 124 ureters and 10 cases with 18 ureters were collected retrospectively from patient files as training and test sets, respectively. On average, the ureters spanned 289 CT slices (range: 115-405, median: 302). The segmentation performance was quantitatively assessed as the percentage of length of each ureter that was successfully tracked relative to manually tracking. COMPASS alone segmented, on average, 99.16% and 98.74% of each ureter in the training and test sets, respectively. COMPASS with Hessian enhancement segmented, on average, 97.89% and 99.63% of each ureter in the training and test sets, respectively. Although the difference did not reach statistical significance in this small test set, Hessian-enhanced tracking shows promise for overcoming certain types of difficult cases.

  15. Metastatic Renal Cell Carcinoma to the Contralateral Ureter: A Rare Phenomenon.

    PubMed

    Dixon, Ashley; Tretiakova, Maria; Gore, John; Voelzke, Bryan B

    2016-01-01

    Metastatic renal cell carcinoma (RCC) to the contralateral ureter is a rare phenomenon. We report a metastatic RCC to the contralateral ureter 5 months after right radical nephrectomy for Fuhrman grade 3/4 clear cell adenocarcinoma with pathologic T3 staging. The distal ureter was excised followed by partial ileal ureteral substitution. Pathology confirmed metastatic clear cell RCC Fuhrman grade 2/4. Ileal ureteral substitution has been shown to provide good long-term functional outcomes and should be considered as a possible option for surgical treatment of ureteral metastasis. PMID:26793575

  16. Metastatic Renal Cell Carcinoma to the Contralateral Ureter: A Rare Phenomenon

    PubMed Central

    Dixon, Ashley; Tretiakova, Maria; Gore, John; Voelzke, Bryan B.

    2015-01-01

    Metastatic renal cell carcinoma (RCC) to the contralateral ureter is a rare phenomenon. We report a metastatic RCC to the contralateral ureter 5 months after right radical nephrectomy for Fuhrman grade 3/4 clear cell adenocarcinoma with pathologic T3 staging. The distal ureter was excised followed by partial ileal ureteral substitution. Pathology confirmed metastatic clear cell RCC Fuhrman grade 2/4. Ileal ureteral substitution has been shown to provide good long-term functional outcomes and should be considered as a possible option for surgical treatment of ureteral metastasis. PMID:26793575

  17. 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

  18. Ectopic ureter in the horse: Three cases and a review of the literature

    PubMed Central

    Pringle, John K.; Ducharme, Normand G.; Baird, John D.

    1990-01-01

    Ureterovesicular anastomosis resulted in resolution of the clinical signs of urinary incontinence in three horses with unilateral ectopic ureter. Follow-up of two of the horses ten months and three years later indicated no further urinary tract problems; the third horse died four days after surgery from intestinal infarction. Diagnosis can be readily confirmed by antegrade or retrograde ureterography, or endoscopic visualization of the ectopic ureteral openings. Nephrectomy appears indicated in cases of unilateral ectopic ureter with associated ipsilateral urinary tract infection or hydronephrosis, providing the contralateral kidney has normal function. Ureterovesicular anastomosis appears to be indicated in the management of unilateral ectopic ureters in the absence of ascending urinary tract infection or hydronephrosis, and in cases of bilateral ectopic ureters. ImagesFigure 1. PMID:17423490

  19. Metastasis to the proximal ureter from prostatic adenocarcinoma: A rare metastatic pattern.

    PubMed

    Zhang, Tao; Wang, Qi; Min, Jie; Yu, Dexin; Xie, Dongdong; Wang, Yi; Ding, Demao; Chen, Lei; Zou, Ci; Zhang, Zhiqiang; Wang, Daming

    2014-11-01

    Prostate cancer is one of the most common male malignancies, but it rarely metastasizes to the proximal ureter. We report a case of a 76-year-old man who presented with flank pain and lower urinary tract symptoms. Abdominal computed tomography scan revealed multiple filling defects at the middle of the left ureter, enlarged retroperitoneal lymph nodes, and probable psoas invasion. The patient underwent nephroureterectomy with excision of a cuff of bladder, and was found to have an adhesion between the middle part of left ureter and psoas intraoperatively. The pathological examination displayed positive immunohistochemical staining with prostate-specific antigen and prostate acid phostate, supporting the diagnosis of metastatic ureteral tumour from prostate cancer. In this case, periureteral soft tissue and ureteral muscular layer were infiltrated by metastatic tumour, whereas the mucosa was spared. The periureteral lymphatic pathway played an important role in the metastatic procedure of prostate cancer to the proximal ureter. PMID:25485016

  20. 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

  1. A Case of Complete Renal Duplex with H-Shaped Ureter

    PubMed Central

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

    2012-01-01

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

  2. 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 (?=2120 nm) was operated with standard parameters of 600 mJ, 350 ?s, 6 Hz, and 270-?m-core optical fiber. The TFL (?=1908 nm) was operated with 35 mJ, 500 ?s, 150 to 500 Hz, and a 100-?m-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 16741 s (n=12). TFL times measured 11149, 3911, and 234 s, for pulse rates of 150, 300, and 500 Hz, respectively (n=12 each). Mean peak saline irrigation temperatures reached 241C for holmium, and 333C, 337C, and 396C, 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.

  3. Successful neoadjuvant chemotherapy for primary invasive small-cell carcinoma of the ureter

    PubMed Central

    Osaka, Kimito; Kobayashi, Kazuki; Sakai, Naoki; Noguchi, Sumio

    2015-01-01

    We report a case of invasive small-cell carcinoma (SCC) of the ureter successfully treated by neoadjuvant chemotherapy and laparoscopic nephroureterectomy. SCC of the ureter is an extremely rare condition characterized by aggressive behaviour. A 70-year-old male presented with left flank pain; he was diagnosed with SCC of the ureter, cT3N0M0, by ureteroscopic biopsy. The patient received 3 cycles of neoadjuvant chemotherapy with cisplatin and irinotecan (IP) and underwent laparoscopic nephroureterectomy. The pathological diagnosis was urothelial carcinoma, high grade, without a small-cell component. The pathological stage was down-staged to pT2N0M0. Adjuvant chemotherapy was not performed. The patient has been free of local recurrence or distant metastasis for 38 months postoperatively. This is the first reported case of primary invasive SCC of the upper urinary tract treated by neoadjuvant chemotherapy followed by nephroureterectomy. PMID:26225186

  4. Successful neoadjuvant chemotherapy for primary invasive small-cell carcinoma of the ureter.

    PubMed

    Osaka, Kimito; Kobayashi, Kazuki; Sakai, Naoki; Noguchi, Sumio

    2015-01-01

    We report a case of invasive small-cell carcinoma (SCC) of the ureter successfully treated by neoadjuvant chemotherapy and laparoscopic nephroureterectomy. SCC of the ureter is an extremely rare condition characterized by aggressive behaviour. A 70-year-old male presented with left flank pain; he was diagnosed with SCC of the ureter, cT3N0M0, by ureteroscopic biopsy. The patient received 3 cycles of neoadjuvant chemotherapy with cisplatin and irinotecan (IP) and underwent laparoscopic nephroureterectomy. The pathological diagnosis was urothelial carcinoma, high grade, without a small-cell component. The pathological stage was down-staged to pT2N0M0. Adjuvant chemotherapy was not performed. The patient has been free of local recurrence or distant metastasis for 38 months postoperatively. This is the first reported case of primary invasive SCC of the upper urinary tract treated by neoadjuvant chemotherapy followed by nephroureterectomy. PMID:26225186

  5. Laparoscopic Nephroureterectomy and Management of the Distal Ureter: A Review of Current Techniques and Outcomes

    PubMed Central

    Viprakasit, Davis P.; Macejko, Amanda M.; Nadler, Robert B.

    2009-01-01

    Laparoscopic nephroureterectomy (LNU) is becoming an increasingly common alternative treatment for transitional cell carcinoma (TCC) of the renal pelvis and ureter due to decreased perioperative morbidity, shorter hospitalization, and comparable oncologic control with open nephroureterectomy (ONU). Mobilization of the kidney and proximal ureter may be performed through a transperitoneal, retroperitoneal, or hand-assisted approach. Each technique is associated with its own benefits and limitations, and the optimal approach is often dictated by surgeon preference. Our analysis of the literature reflects equivalent cancer control between LPN and OPN at intermediate follow-up with significantly improved perioperative morbidity following LPN. Several methods for bladder cuff excision have been advocated, however, no individual technique for management of the distal ureter proved superior. Overall, complete en-bloc resection with minimal disruption of the urinary tract should be optimized to maintain oncologic outcomes. Longer follow-up and prospective studies are needed to fully evaluate these techniques. PMID:19148293

  6. Intra operative lesion of the pelvic ureter solved in a minimally invasive manner

    PubMed Central

    Stoica, RA; Enache, T; Iordache, N

    2014-01-01

    Abstract Ureteral lesions during open hysterectomy, vaginal hysterectomy or laparoscopic hysterectomy have a rate of 0.2% up to 6%. Multiple complications may occur if the lesion is not recognised intra operatively: hydronephrosis, anuria (bilateral lesion), ureterovaginal fistula, ileus, peritonitis. The rate of recognition of an intra operative ureter lesion is 30% and it could rise up to 90% when cystoscopy with ureteroscopy is used at the end of the intervention. The article presents the case of a 46-year-old patient with uterine fibromatosis, whose pelvic ureter was sectioned during surgery. The lesion was recognised during surgery because, at the end of each intervention, the diuresis was stimulated by injecting Furosemide in order to detect the lesions of the ureters and urinary bladder. PMID:25408763

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

    PubMed Central

    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

  8. 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

  9. 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.

  10. Effects of exteriorization of the ureters on the water metabolism of the domestic fowl

    PubMed Central

    Dicker, S. E.; Haslam, J.

    1972-01-01

    1. Six domestic fowls were operated for exteriorization of the ureters. 2. Three weeks after the operation their food and water intake was compared with that of six unoperated control fowls of similar weight. 3. Water intake was calculated from the amount of water drunk, the metabolic water and the water content of the food eaten; while water loss was estimated from the water content of urine and faeces excreted and from evaporation. 4. Fowls with exteriorized ureters drank more than the control birds. The excess of water drunk by these birds approximated the amount of water lost in the urine. PMID:5071927

  11. Laparoscopic Nephroureterectomy: Oncologic Outcomes and Management of Distal Ureter; Review of the Literature

    PubMed Central

    Berger, Andre; Fergany, Amr

    2009-01-01

    Introduction. Laparoscopic radical nephroureterectomy (LNU) is being increasingly performed at several centers across the world. We review oncologic outcomes after LNU procedure and the techniques for the management of distal ureter. Materials and Methods. A comprehensive review of the literature was performed on the oncological outcomes and management of distal ureter associated with LNU for upper tract transitional cell carcinoma (TCC). Results and Discussion. LNU for upper tract TCC is performed pure laparoscopically (LNU) or hand-assisted (HALNU). The management of the distal ureter is still debated. LNU appears to have superior perioperative outcomes when compared to open surgery. Intermediate term oncologic outcomes after LNU are comparable to open nephroureterectomy (ONU). Conclusions. Excision of the distal ureter and bladder cuff during nephroureterectomy remains controversial. Intermediate term oncologic outcomes for LNU compare well with ONU. Initial long-term oncologic outcomes are encouraging. Prospective randomized comparison between LNU and open surgery is needed to define the role of these modalities in the current context. PMID:19020656

  12. 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

  13. IgG4-related Kidney Disease Mimicking Malignant Ureter Tumor: Case Report and Literature Review.

    PubMed

    Lei, Wen-Hui; Xin, Jun; Shao, Chu-Xiao; Mao, Ming-Feng; Zhu, Chao-Yong; Wu, Chui-Fen; Jin, Lie

    2016-01-01

    Immunoglobulin G4-related disease is a recently recognized systemic disease that can affect any organ or tissue in the body, including the kidneys. IgG4-related kidney disease (IgG4-RKD) is an important part of immunoglobulin G4-related disease. The most common renal manifestation of IgG4-RKD is tubulointerstitial nephritis and glomerular lesions. There, however, is few case of IgG4-RKD mimicking malignant ureter tumor leading to severe hydronephrosis. We herein report an unusual case of IgG4-RKD mimicking malignancy.A 66-year-old Asian man presented to the nephrologist with soreness of loins, anorexia, and acute kidney injury in 2010. His renal function spontaneously improved after 2 weeks' hemodialysis without systemic steroid therapy. Four years later, he presented to the urologist with severe left hydronephrosis because of marked thickness of the left ureter wall. As a ureteral malignancy could not be ruled out, laparoscopic nephroureterectomy was performed.IgG4-related kidney disease was confirmed by the histologic examination. Then, repeat laboratory test showed almost complete recovery of renal function after initiation of steroidal therapy.This case highlights the rare possibility of IgG4-RKD mimicking malignant ureter tumor. Nephrologist and pathologists should be aware of the possibility that hydronephrosis with ureter obstruction may be involved in IgG4-RKD. PMID:26817905

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

    PubMed Central

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

    2009-01-01

    Congenital anomalies affecting the ureter-bladder junction are frequent in newborns and are often associated with other developmental defects. However, the molecular and morphological processes underlying these malformations are still poorly defined. In this study, we identified the leukocyte antigenrelated (LAR) family protein tyrosine phosphatase, receptor type, S and F (Ptprs and Ptprf [also known as Lar], respectively), as crucially important for distal ureter maturation and craniofacial morphogenesis in the mouse. Embryos lacking both Ptprs and Ptprf displayed severe urogenital malformations, characterized by hydroureter and ureterocele, and craniofacial defects such as cleft palate, micrognathia, and exencephaly. The detailed analysis of distal ureter maturation, the process by which the ureter is displaced toward its final position in the bladder wall, leads us to propose a revised model of ureter maturation in normal embryos. This process was deficient in embryos lacking Ptprs and Ptprf as a result of a marked reduction in intrinsic programmed cell death, thereby causing urogenital system malformations. In cell culture, Ptprs bound and negatively regulated the phosphorylation and signaling of the Ret receptor tyrosine kinase, whereas Ptprs-induced apoptosis was inhibited by Ret expression. Together, these results suggest that ureter positioning is controlled by the opposing actions of Ret and LAR family phosphatases regulating apoptosis-mediated tissue morphogenesis. PMID:19273906

  15. 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, 34?E12 and p63, but were negative for S100, AFP, CD34, Syn and CgA. The final histopathological diagnosis was UCC of the ureter.

  16. Transvesical Laparoendoscopic Single-Site Management of Distal Ureter During Laparoscopic Radical Nephroureterectomy.

    PubMed

    Nunez Bragayrac, Luciano A; Machuca, Victor; Saenz, Eric; Cabrera, Marino; de Andrade, Robert; Sotelo, Rene J

    2014-09-11

    Abstract Objective: To describe the management of the distal ureter during radical nephroureterectomy with the transvesical laparoendoscopic single-site surgery (T-LESS) approach. Methods: Between January 2010 and October 2013, five patients underwent laparoscopic radical nephroureterectomy for upper urinary tract carcinoma (UTUC) with the T-LESS approach. Patients were placed in the supine position. A 2.5-cm skin incision was made in the line between the pubis and the umbilicus. The bladder was identified and a multiport was inserted into the bladder. The patients were repositioned to a lateral decubitus position; pneumovesicum was established and the ureteral openings were identified. We marked the bladder cuff with electrocautery all the way through to the extravesical fat. The bladder defect was sealed with sutures. After checking for any leak or bleeding, the multiport was removed and the bladder was closed. At this point, we continued with nephrectomy by standard laparoscopy or LESS. A 18F Foley catheter was placed into the bladder. Results: The mean age was 70 years (range 58-81 years), the mean operative time was 198 minutes (range 115-390 minutes), the mean time for the management of the distal ureter was 35 minutes (range 27-45 minutes), the mean estimated blood loss was 234?mL (range 60-850?mL), and the mean hospital stay was 3.8 days (range 2-8 days). In all patients the bladder cuff was free of disease. Conclusion: The transvesical laparoendoscopic single-site approach to the distal ureter for UTUC appears safe and reproducible, with faster closure of the bladder defect and improved cosmesis. PMID:25211699

  17. [Ectopic insertions of single ureters in children. Apropos of 9 cases].

    PubMed

    Haffaf, Y; Fremond, B; Babut, J M; Guibert, L

    1986-01-01

    The authors present 9 cases of ectopic implantation of a single ureter in children. Ureteric ectopia is part of a congenital anomaly of the whole of the urinary tract, which explains the incidence of renal ectopia and associated dysplastic lesions of the renal parenchyma. The authors stress the importance of ultrasonography and, more recently, the CT scan for the localisation of the kidney homolateral to the ureteral ectopia. An analysis of the treatment and the results demonstrates the contrast between the unilateral forms which are easily treated and which have a good prognosis and the bilateral forms which are more difficult to treat and have a less favourable prognosis. PMID:3514641

  18. TCC in Transplant Ureter-When and When Not to Preserve the Transplant Kidney.

    PubMed

    Olsburgh, J; Zakri, R H; Horsfield, C; Collins, R; Fairweather, J; O'Donnell, P; Koffman, G

    2016-02-01

    We present four cases of transitional cell carcinoma of the transplant ureter (TCCtu). In three cases, localized tumor resection and a variety of reconstructive techniques were possible. Transplant nephrectomy with cystectomy was performed as a secondary treatment in one locally excised case. Transplant nephroureterectomy was performed as primary treatment in one case. The role of oncogenic viruses and genetic fingerprinting to determine the origin of TCCtu are described. Our cases and a systematic literature review illustrate the surgical, nephrological, and oncological challenges of this uncommon but important condition. PMID:26731492

  19. 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 40.13years) 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 40 polyglactin running suture. Results The mean stone size was 2.73cm. Conversion to open surgery was required in only one patient. The mean operative duration was 92min, the postoperative pain score was 2060, the mean (range) number of analgesic requests after surgery was 1.72 (13), comprising once in 21 patients, twice in 23 and thrice in seven. The mean hospital stay was 2.74days, and the total duration of follow-up was 712months. 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

  20. 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

  1. Preliminary results of laser tissue welding in extravesical reimplantation of the ureters

    NASA Astrophysics Data System (ADS)

    Kirsch, Andrew J.; Milton, Daniel T.; Dean, Gregory E.; Oz, Mehmet C.; Libutti, Steven K.; Treat, Michael R.; Nowygrod, Roman; Hensle, Terry W.

    1993-07-01

    One future use of laparoscopic technology is in extravesical reimplantation of the ureters. Technical difficulty arises, however, when intracorporal fine suturing is necessary. We have assessed the efficacy of laser-activated fibrinogen solder to close vesical muscle flaps over submucosal ureters (Lich-Gregoir technique) in a canine model. Four dogs were subjected to unilateral flap closures via a protein solder consisting of indocyanine green and fibrinogen applied to the serosal surface of the bladder and exposed to 808 nm continuous wave diode laser energy. Contralateral reimplantation was performed using 4 - 0 vicryl muscle flap closures and served as controls. Urinary drainage catheters were left in place for 24 hours postoperatively. At 7 (n equals 1), 14 (n equals 2), and 28 (n equals 1) days following reimplantation, intravenous pyelograms confirmed bilateral renal function and ureteral patency. Disruption of wound closures were considered the point of wound dehiscence, vesical diverticulum, or leakage. At intravesical pressures above 100 cm H2O there was no evidence of wound disruption in either of the groups. However, surrounding normal tissue was noted to disrupt. In conclusion, laser-welded vesical wound closures appear at least as strong as suture closures in the canine model.

  2. Sall1-dependent signals affect Wnt signaling and ureter tip fate to initiate kidney development

    PubMed Central

    Kiefer, Susan M.; Robbins, Lynn; Stumpff, Kelly M.; Lin, Congxing; Ma, Liang; Rauchman, Michael

    2010-01-01

    Development of the metanephric kidney depends on precise control of branching of the ureteric bud. Branching events represent terminal bifurcations that are thought to depend on unique patterns of gene expression in the tip compared with the stalk and are influenced by mesenchymal signals. The metanephric mesenchyme-derived signals that control gene expression at the ureteric bud tip are not well understood. In mouse Sall1 mutants, the ureteric bud grows out and invades the metanephric mesenchyme, but it fails to initiate branching despite tip-specific expression of Ret and Wnt11. The stalk-specific marker Wnt9b and the ?-catenin downstream target Axin2 are ectopically expressed in the mutant ureteric bud tips, suggesting that upregulated canonical Wnt signaling disrupts ureter branching in this mutant. In support of this hypothesis, ureter arrest is rescued by lowering ?-catenin levels in the Sall1 mutant and is phenocopied by ectopic expression of a stabilized ?-catenin in the ureteric bud. Furthermore, transgenic overexpression of Wnt9b in the ureteric bud causes reduced branching in multiple founder lines. These studies indicate that Sall1-dependent signals from the metanephric mesenchyme are required to modulate ureteric bud tip Wnt patterning in order to initiate branching. PMID:20702564

  3. [Transitional carcinoma of the ureter with osseous metaplasia of the stroma: a case report].

    PubMed

    Mege-Lechevallier, Florence; Cherasse, Arnaud; Ronze, Sbastien; Colombel, Marc; Scoazec, Jean-Yves

    2007-02-01

    Transitional cell carcinoma with osseous metaplasia of the stroma is a rare variant of urothelial carcinoma which must be distinguished from sarcomatoid carcinoma. We report here a further observation of this tumor variant, in a very unusual location, the ureter, in order to underline the radiological and pathological characteristics useful for the correct diagnosis, and to point out the problems of differential diagnosis. The diagnosis was made in an 85-year-old patient, presenting with chronic right lombalgias. Imaging studies showed a calcified thickening of the right ureter, associated with a major dilatation of the right excretory cavities and a parenchymal atrophy of the right kidney. A right nephro-ureterectomy was performed. Macroscopical examination showed an ossified, ill-limited tumor, measuring 4 cm in diameter, infiltrating the right ureteral wall. At histological examination, the lesion was identified as a high grade transitional cell carcinoma with extensive osseous metaplasia of the stroma. There was no evidence for a sarcomatous component (absence of mesenchymal cell proliferation, absence of mitosis in stromal cells). An early locoregional recurrence was observed three months after surgery. Our case report underlines the radiological and histological features of a rare variant of transitional cell carcinoma, which may be diagnosed by pre-operative imaging studies and which must be distinguished from a highly aggressive sarcomatoid carcinoma. PMID:17568360

  4. Analysis of 777 cases with obstruction of the ureter or extrahepatic bile duct by ultrasonography after normal saline retention enema

    PubMed Central

    2012-01-01

    Background Conventional transabdominal ultrasound usually fails to visualize parts of the ureter or extrahepatic bile duct covered by bowel gas. In this study, we propose a new method for gaining acoustic access to the ureters and extrahepatic bile duct to help determine the nature of obstruction to these structures when conventional transabdominal ultrasound fails. Methods The normal saline retention enema method, that is, using normal saline-filled colons to gain acoustic access to the bilateral ureters and extrahepatic bile duct and detecting the lesions with transabdominal ultrasonic diagnostic apparatus, was applied to 777 patients with obstructive lesions, including 603 with hydroureter and 174 with dilated common bile duct, which were not visualized by conventional ultrasonography. The follow-up data of all the patients were collected to verify the results obtained by this method. Results Of the 755 patients who successfully finished the examination after normal saline retention enema (the success rate of the enema is about 98%), the nature of obstruction in 718 patients was determined (the visualizing rate is approximately 95%), including 533 with ureteral calculus, 23 with ureteral stricture, 129 with extrahepatic bile duct calculus, and 33 with common bile duct tumor. Conclusions Colons filled fully with normal saline can surely give acoustic access to the bilateral ureters and extrahepatic bile duct so as to determine the nature of obstruction of these structures when conventional transabdominal ultrasound fails. PMID:22871226

  5. 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 Huxleys mathematical model we calculated the total working crossbridge number per mm2 (?), elementary force per single crossbridge (?0), 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

  6. 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

  7. 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

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

    PubMed Central

    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

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

    PubMed Central

    Wo?niak, Magdalena Maria; Wieczorek, Andrzej Pawe?

    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 5.09.0 MHz and in adults with the frequency of 2.06.0 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

  10. Lipid Cell and Micropapillary Variants of Urothelial Carcinoma of the Ureter

    PubMed Central

    Miyama, Yu; Morikawa, Teppei; Nakagawa, Tohru; Homma, Yukio; Fukayama, Masashi

    2015-01-01

    We report on a case of urothelial carcinoma (UC) with lipid cell and micropapillary variants in the ureter. A 64-year-old man presented with gross hematuria. Urinary cytology revealed the presence of atypical urothelial cells. Computed tomography and drip infusion/retrograde pyelography identified a mass-occupying lesion in the left mid-ureter, as well as left hydronephrosis. A clinical diagnosis of left ureteral cancer was given and the patient underwent left nephroureterectomy. Microscopically, the major component of the tumor was a conventional high-grade UC. In the invasive region, however, lipid cell and micropapillary variants of UC were also observed. Upon immunohistochemical analysis, all of the components were diffusely positive for cytokeratin 7 and p53. Intense membranous expression of human epidermal growth factor receptor 2 (HER2) was also observed in both the lipid cell and micropapillary variants of UC, whereas weak and incomplete staining was observed in most regions of the conventional UC. The pathological stage was pT3 N2. Multiple times, the patient experienced recurrence of the UC in the urinary bladder and urethra. Although the patient underwent total cystectomy and urethrectomy, 52 months following the initial surgery, signs of local recurrence developed, as well as multiple lymph node and bone metastases. The patient died 75 months following the initial surgery. To the best of our knowledge, this is the first reported case of a lipid cell variant of ureteral UC. The overexpression of HER2 may be associated with both the lipid cell and micropapillary variants of UC. PMID:26668574

  11. Intraoperative Management of an Incidentally Identified Ectopic Ureter Inserting Into the Prostate of a Patient Undergoing Radical Prostatectomy for Prostate Cancer

    PubMed Central

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

    2015-01-01

    Abstract 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

  12. Carcinosarcoma of the Ureter with a Small Cell Component: Report of a Rare Pathologic Entity and Potential for Diagnostic Error on Biopsy

    PubMed Central

    Newsom, Kent; Tojuola, Bayo; Al-Quran, Samer; Parekattil, Sijo; Hamilton, William; Vila Duckworth, Lizette

    2014-01-01

    Carcinosarcomas of the ureter are rare biphasic neoplasms, composed of both malignant epithelial (carcinomatous) and malignant mesenchymal (sarcomatous) components. Carcinosarcomas of the urinary tract are exceedingly rare. We report a unique case of a carcinosarcoma of the ureter with a chondrosarcoma and small cell tumor component arising in a 68-year-old male who presented with microscopic hematuria. CT intravenous pyelogram revealed right-sided hydroureter and hydronephrosis with thickening and narrowing of the right ureter. The patient underwent robot-assisted ureterectomy with bladder cuff excision and subsequent adjuvant chemotherapy. The patient is disease-free at 32 months after treatment. We provide a brief synoptic review of carcinosarcoma of the ureter and bladder with utilization of immunohistochemical (IHC) stains and potential diagnostic pitfalls. PMID:25587477

  13. Major difference between rat and guinea-pig ureter in the ability of agonists and caffeine to release Ca2+ and influence force.

    PubMed Central

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

    1995-01-01

    1. We have investigated the internal Ca2+ store and its ability to affect contraction by simultaneously measuring force and Ca2+ in the ureter from guinea-pig and rat. Both species responded in a similar manner to electrical stimulation and depolarization with high-K+, generating plateau-type action potentials and increasing intracellular calcium ([Ca2+]i) and force. 2. In the guinea-pig, carbachol had no effect on [Ca2+]i and force in the resting ureter. In contrast, resting rat ureter always responded with a large [Ca2+]i rise and maintained force to carbachol in Ca(2+)-containing solution, and in Ca(2+)-free solution it showed a transient increase in [Ca2+]i and force. This Ca2+ release and force development was also present in both polarized and high-K(+)-depolarized preparations and was insensitive to nifedipine, suggesting the presence of a receptor-coupled pathway of Ca2+ release in rat ureter. 3. Caffeine was able to produce a release of Ca2+ from the internal store of guinea-pig ureter and elicit contraction. However, rat ureter failed to respond to caffeine. In the presence of La3+, the caffeine response in the guinea-pig ureter and carbachol response in the rat ureter, elicited in Ca(2+)-free solutions, were always increased and prolonged and could be repeatedly evoked, suggesting similarity in Ca2+ uptake behaviour of the store in both species. 4. Ryanodine blocked the caffeine responses of the guinea-pig ureter elicited both in Ca(2+)-containing and Ca(2+)-free solutions, both in the absence and presence of La3+. However, ryanodine failed to prevent the rat ureter responding to carbachol, suggesting that carbachol was releasing Ca2+ from a ryanodine-insensitive channel in the sarcoplasmic reticulum (SR). 5. Cyclopiazonic acid, which inhibits the SR Ca(2+)-ATPase, abolished the effects of both caffeine and carbachol in Ca(2+)-free solutions in guinea-pig and rat, respectively. 6. We conclude that there is a major difference in the mechanisms of Ca2+ release in the internal Ca2+ store of smooth muscle from guinea-pig and rat ureter. The data suggest that the guinea-pig store is purely a calcium-induced calcium release (CICR)-type store and that the rat store is a pure receptor-operated Ca2+ store. PMID:8847629

  14. An unusual combination of extra-adrenal pheochromocytoma and arteriovenous malformation of the ureter in a young adult

    PubMed Central

    Khawaja, Ali; Aziz, Wajahat; Nazim, Syed Muhammad; Abbas, Farhat

    2013-01-01

    We present a case of a 24-year-old gentleman who presented with painless pan haematuria for 2?weeks. During the workup, he was diagnosed to have a retrocaval mass after a CT scan while cystoscopy revealed a polypoidal pulsating lesion in the left ureter. After surgical manipulation of the retrocaval mass, the blood pressure of the patient raised to 260/130?mm?Hg. It was completely resected and diagnosed as extra-adrenal pheochromocytoma (paraganglioma) after histopathology. The lesion in the ureter was completely excised and fulgurated and diagnosed as an arteriovenous malformation. To the best of our knowledge, this is the first patient to be presented in the literature with this unusual combination. PMID:23616332

  15. 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

  16. Fatal cardiac thromboembolism in a patient with a pacemaker during ureteroscopic lithotripsy for ureter stone: a case report

    PubMed Central

    Chung, Mee Young; Chae, Su Min

    2015-01-01

    Intracardiac thrombosis is an infrequent and fatal complication in patients with an inserted pacemaker. A patient with an inserted pacemaker scheduled for ureter stone removal experienced cardiac arrest and cardiopulmonary resuscitation under general anesthesia. Echocardiography showed multiple intracardiac thrombi. Preoperative diagnostic workup including echocardiography for the detection of pacemaker lead thrombus, and the need for anticoagulation should be considered in patients with an inserted pacemaker and high-risk factors for thrombosis. PMID:25664159

  17. A Novel Type of Ureteral Stents in the Treatment of a Bilateral Iatrogenic Transaction of the Ureters

    PubMed Central

    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

  18. 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.

  19. Errors in the ultrasound diagnosis of the kidneys, ureters and urinary bladder

    PubMed Central

    Wieczorek, Andrzej Pawe?; Tyloch, Janusz F.

    2013-01-01

    The article presents the most frequent errors made in the ultrasound diagnosis of the urinary system. They usually result from improper technique of ultrasound examination or its erroneous interpretation. Such errors are frequent effects of insufficient experience of the ultrasonographer, inadequate class of the scanner, insufficient knowledge of its operation as well as of wrong preparation of patients, their constitution, severe condition and the lack of cooperation during the examination. The reasons for misinterpretations of ultrasound images of the urinary system may lie in a large polymorphism of the kidney (defects and developmental variants) and may result from improper access to the organ as well as from the presence of artefacts. Errors may also result from the lack of knowledge concerning clinical and laboratory data. Moreover, mistakes in ultrasound diagnosis of the urinary system are frequently related to the lack of knowledge of the management algorithms and diagnostic possibilities of other imaging modalities. The paper lists errors in ultrasound diagnosis of the urinary system divided into: errors resulting from improper technique of examination, artefacts caused by incorrect preparation of patients for the examination or their constitution and errors resulting from misinterpretation of ultrasound images of the kidneys (such as their number, size, fluid spaces, pathological lesions and others), ureters and urinary bladder. Each physician performing kidney or bladder ultrasound examination should possess the knowledge of the most frequent errors and their causes which might help to avoid them. PMID:26674139

  20. 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; Jppner, 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

  1. Inhibition of human and pig ureter motility in vitro and in vivo by the K(+) channel openers PKF 217-744b and nicorandil.

    PubMed

    Weiss, Ruth; Mevissen, Meike; Hauser, Daniela S; Scholtysik, Gnter; Portier, Christopher J; Walter, Bernhard; Studer, Urs E; Danuser, Hansjrg

    2002-08-01

    The relaxing property of the K(+) channel opener and nitric oxide donor nicorandil and the new K(+) channel opener PKF 217-744b was investigated on isolated human ureteral tissue in vitro and in intact ureters of anesthetized pigs in vivo. In addition, nicorandil and its antagonists, glibenclamide and methylene blue, were tested on isolated pig ureter tissue in vitro. Nicorandil decreased the frequency of spontaneous contractions in isolated pig ureter rings. This effect was antagonized by glibenclamide and methylene blue suggesting that the nicorandil induced relaxation of the ureter is mediated by activation of ATP-sensitive K(+) channels and involvement of soluble guanylate cyclase. Moreover, nicorandil and PKF 217-744b reduced the amplitude of electrically induced contractions in isolated human ureter rings. Calculations of EC(50) values showed that PKF 217-744b [EC(50) = 4.83 x 10(-8) M] was more potent than nicorandil [EC(50) = 4.38 x 10(-5) M]. Both drugs reduced the contraction frequency of the pig ureter after intravenous and topical administration in vivo. Intravenous, but not topical, administration of nicorandil and PKF 217-744b significantly decreased arterial blood pressure but did not affect the heart rate. The in vitro findings suggest that K(+) channel opening and nitric oxide release mediate the effect of nicorandil. Our in vivo results indicate that PKF 217-744b and nicorandil are promising drugs for clinical application in patients with acute stone colic to relieve obstruction and facilitate stone passage or to relax the ureter before ureteroscopy. PMID:12130728

  2. 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

  3. 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

  4. Alleviation of Kidney Damage Induced by Unilateral Ureter Obstruction in Rats by Rhodiola rosea

    PubMed Central

    Terzi, E. Hakan; Kemahli, Eray; Gucuk, Adnan; Tosun, Mehmet; etinkaya, Ayhan

    2013-01-01

    Abstract Purpose To evaluate the efficacy of Rhodiola rosea extract in terms of alleviating the renal damage induced by unilateral ureter obstruction (UUO) in rats. Material and Methods Thirty Wistar albino male rats were divided into five groups: (I) Control, (II) UUO 7 days, (III) UUO 7 days+extract,(IV) UUO 14 days, and (V) UUO 14 days+extract. Seven or 14 days after the initiation of the experimental procedure, the left kidneys of rats in all five groups were removed for histological examination, and their blood was drawn for biochemical measurements. Result Median malondialdehyde (MDA) and glutathione peroxidase (GPx) levels were, respectively, 39.4 (5.04) nmol/mL and 25.8 (8.01) nmol/minute/mL in group I, 77.9 (12.38) nmol/mL and 5.8 (1.95) nmol/minute/mL in group II, 48.7 (12.1) nmol/mL and 9.1 (2.3) nmol/minute/mL in group III, 58.5 (23.83) nmol/mL and 8.4 (2.1) nmol/minute/mL in group IV, and 44.8 (4.97) nmol/mL and 13.8 (3.73) nmol/minute/mL in group V. There was a statistically significant difference among the groups in terms of MDA and GPx levels (p<0.05 for both). The median numbers of apoptotic cells were 1 (1), 8 (2.25), 3 (1.25), 23.5 (9), and 7 (I) in groups I, II, III, IV, and V, respectively. There was a statistically siginificant difference among the groups in terms of apoptotic cell number (p<0.05). Conclusion R. rosea extract was shown to alleviate the renal damage induced by UUO through its antioxidant effects. The mechanism by which R. rosea extract causes these effects merits further investigation. PMID:23806024

  5. Evidence for sodium-calcium exchange in the guinea-pig ureter.

    PubMed Central

    Aickin, C C; Brading, A F; Burdyga, T V

    1984-01-01

    The effects of high-K and low-Na solutions on the smooth muscle of the guinea-pig ureter have been examined in both normal tissues, and tissues in which the Na pump had been blocked by exposure to K-free solutions or ouabain (high-Na tissues). Tension recording, membrane potential measurements and ion analysis were used. High-K solutions depolarize normal tissues, leading to action potential generation and phasic contractions followed, at concentrations greater than 20-30 mM, by cessation of action potentials and the development of a biphasic contracture which declines slowly during continuous exposure. The contracture is abolished by Ca-antagonist drugs, procaine and Ca-free solutions. Short exposures of normal tissues to Na-free solutions do not result in tension development. Longer exposures may initiate tension, depending on the Na substitute used. Sucrose causes depolarization of the cells and spike development associated with phasic contractions, superimposed on a small contracture; Li depolarizes the cells but causes no tension generation; Tris hyperpolarizes the cells and a small increase in basal tone may be seen. On exposure to K-free solutions or ouabain, the tissues do not develop significant tone but their response to short application of high-K solutions grows with time. The tissues also develop the ability to contract on short applications of low-Na solutions. The low-Na contractures are resistant to concentrations of Ca antagonists that abolish the K responses of normal tissues, but are abolished in Ca-free solutions. The ability of the tissues to contract in Na-free solutions is accompanied by an increase in intracellular Na and loss of intracellular K. Even after several hours' exposure to ouabain, however, the tissues still contain significant amounts of K and the membrane potential is the same as, or more negative than that in normal tissues. Therefore it appears that another mechanism, apart from the Na pump, can regulate intracellular Na. On continuous exposure to Na-free solutions, the contracture declines rapidly. The decline is associated with a loss of intracellular Na. The Na-free contracture is larger when K rather than Tris is used as the substitute. This difference persists in the presence of a concentration of Mn that abolishes the K contracture of normal tissues but is abolished by high concentrations (10 mM) of procaine.(ABSTRACT TRUNCATED AT 400 WORDS) PMID:6323700

  6. High-grade Carcinoma of the Proximal Ureter With Negative Nephroureteroscopy Detected by a Positive FISH Test: A Rare Case Report.

    PubMed

    Zhang, Guoxian; Steinbach, Daniel; Gajda, Miezcyslaw; Franiel, Tobias; Grimm, Marc-Oliver; Horstmann, Marcus

    2015-09-01

    Upper tract urothelial carcinomas in the proximal ureter are an uncommon disease. We present a case in which it was firstly detected by fluorescence in situ hybridization and not by endoscopy and radiologic imaging. Consequently, a radical nephroureterectomy with excision of the bladder cuff was performed as the gold standard treatment. PMID:26793540

  7. High-grade Carcinoma of the Proximal Ureter With Negative Nephroureteroscopy Detected by a Positive FISH Test: A Rare Case Report

    PubMed Central

    Zhang, Guoxian; Steinbach, Daniel; Gajda, Miezcyslaw; Franiel, Tobias; Grimm, Marc-Oliver; Horstmann, Marcus

    2015-01-01

    Upper tract urothelial carcinomas in the proximal ureter are an uncommon disease. We present a case in which it was firstly detected by fluorescence in situ hybridization and not by endoscopy and radiologic imaging. Consequently, a radical nephroureterectomy with excision of the bladder cuff was performed as the gold standard treatment. PMID:26793540

  8. The relationship between the action potential, intracellular calcium and force in intact phasic, guinea-pig uretic smooth muscle

    PubMed Central

    Burdyga, T V; Wray, Susan

    1999-01-01

    We investigated the relationship between the action potential, Ca2+ and phasic force in intact guinea-pig ureter, following physiological activation. The action potential elicited a Ca2+ transient consisting of three components: a fast increment, associated with the first action potential spike, a slower increment, associated with subsequent spikes and the initial part of the plateau component, and a steady-state phase associated with the plateau. Prolongation of the plateau, by agonists, prolonged the third component of the Ca2+ transient and increased force amplitude and duration. The force-Ca2+ relationship during phasic contractions showed hysteresis; more force was produced as Ca2+ declined than when it rose. Paired pulse stimuli suggested that the delay between Ca2+ and force was not due to mechanical properties. Wortmannin, which has been shown to selectively inhibit force and myosin light chain (MLC) phosphorylation in the guinea-pig ureter, did not affect electrical activity or Ca2+ but significantly increased the delay, suggesting that myosin phosphorylation is a major contributor to it. Prolongation of the duration of the [Ca2+]i transient, at unchanged amplitude, increased force. The rise of [Ca2+]i did not limit the rate of contraction. Slowing of the rate of [Ca2+]i rise abolished the hysteresis between Ca2+ and force. Cooling reduced force, increased the delay and hysteresis between Ca2+ and force, but did not affect the rate of rise of Ca2+. The reduction in force could be compensated, by increasing the duration of the Ca2+ transient. We suggest that in vivo, steady-state force-Ca2+ relationships are not applicable in phasic smooth muscles. Furthermore, agonists increase force mainly by prolonging the action potential, which increases the duration of the [Ca2+] signal. PMID:10545150

  9. 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)

  10. 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 nondiabetic males). Interstitial cells were stained immunohistochemically with antihuman CD117 (ckit) rabbit polyclonal antibody, Vimentin, and Connexin43. Neural tissue was stained with synaptophysin. The number of ICs and neurons was evaluated and compared between the groups (diabetic versus nondiabetic). Results The mean number of ckit (+) 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

  11. 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

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

    PubMed Central

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

    2004-01-01

    Recent data have shown Ca2+-dependent activation of Rho-kinase by sustained depolarization of arterial smooth muscle. Visceral smooth muscles, however, contract phasically in response to action potentials and it is unclear whether Ca2+-dependent or -independent Rho-kinase activation occurs. We have therefore investigated this, under physiologically relevant conditions, in intact ureter. Action potentials, ionic currents, Ca2+ transients, myosin light chain (MLC) phosphorylation and phasic contraction evoked by action potentials in guinea-pig and rat ureter were investigated. In rat, but not guinea-pig ureter, three Rho-kinase inhibitors, Y-27632, HA-1077 and H-1152, significantly decreased phasic contractions and Ca2+ transients. Voltage- and current-clamp data showed that Rho-kinase inhibition reduced the plateau component of the action potential, inhibited Ca2+-channels and, indirectly, Ca2+-activated Cl− channels. The Ca2+ channel agonist Bay K8644 could reverse these effects. The K+ channel blocker TEA could also reverse the inhibitory effect of Y-27632 on the action potential and Ca2+ transient. Ca2+ transients and inward current, activated by carbachol-induced sarcoplasmic reticulum Ca2+release, were not affected by Rho-kinase inhibition. Rho-kinase inhibition produced a Ca2+-independent increase in the relaxation rate of contraction, associated with acceleration of MLC dephosphorylation, which was sensitive to calyculin A. These data show for the first time that: (1) Rho-kinase has major effects on Ca2+ signalling associated with the action potential, (2) this effect is species dependent and (3) Rho-kinase controls relaxation of phasic contraction of myogenic origin. Thus Rho-kinase can modulate phasic smooth muscle in the absence of agonist, and the mechanisms are both Ca2+-dependent, involving ion channels, and Ca2+-independent, involving MLC phosphorylation activity. PMID:15331677

  13. Right sided double inferior vena cava with obstructed retrocaval ureter: Managed with single incision multiple port laparoscopic technique using "Santosh Postgraduate Institute tacking ureteric fixation technique"

    PubMed Central

    Singh, Shivanshu; Garg, Nitin

    2015-01-01

    Right double inferior vena cava with obstructed retrocaval ureter is an extremely rare anomaly with only a few reported cases in the literature. To the best of our knowledge, this is the first case report describing ureteric repair by use of a single-incision laparoscopic technique. In addition, this report addresses the underlying surgical challenges of this repair and provides a brief review of the embryology of this anomaly. The "Santosh Postgraduate Institute ureteric tacking fixation technique" provides ease of end-to-end uretero-ureteric anastomosis in a single-incision laparoscopic surgery. PMID:25874048

  14. Injury - kidney and ureter

    MedlinePLUS

    ... such as uric acid (which can occur with gout or treatment of bone marrow, lymph node, or other disorders) ... by toxic substances or illnesses (for example, chelation therapy ... Pain medicines Eliminating medicines or exposure to substances ...

  15. Investigation of factors affecting the intracellular sodium activity in the smooth muscle of guinea-pig ureter.

    PubMed Central

    Aickin, C C

    1987-01-01

    1. The intracellular Na+ activity (aNai) of the smooth muscle cells from guinea-pig ureter has been measured using double-barrelled Na+-sensitive micro-electrodes. aiNa in modified Krebs solution at 35 degrees C was of a mean 7.4 +/- 2.9 mM (n = 32, S.D. of an observation), equivalent to a Na+ equilibrium potential (ENa) of +66.7 mV. Membrane potential (Em) was of a mean -50.8 +/- 4.6 mV. 2. Inhibition of the Na+ pump by application of ouabain or removal of external K+ (K+o) resulted in a restricted rise of aNai. The rate of rise was faster in the presence of ouabain (10(-4) M) but the stabilized aNai was not significantly different from that observed after the prolonged absence of K+o. The mean aiNa recorded after prolonged Na+ pump inhibition was 20.6 +/- 5.5 mM (n = 28), equivalent to an ENa of +39.6 mV. Neither removal of K+o after aNai had stabilized in the presence of ouabain nor application of ouabain after aNai had stabilized in K+-free solution caused a rise in aiNa, suggesting that the Na+ pump was fully inhibited by either procedure. 3. Reduction of Na+o resulted in a rapid fall in aiNa against the electrochemical gradient, both before and after Na+ pump inhibition. At each level of Na+o, aNai stabilized such that ENa remained approximately constant in either condition. Readdition of Na+o resulted in a rapid recovery of aNai. 4. Elevation of Ca2+o (at constant Na+o) caused a fall in aNai of much the same time course as that observed on reduction of Na+o, both before and after Na+ pump inhibition. The extent of the fall was dependent upon the initial aNai. Reduction of Ca2+o resulted in a rise in aNai. 5. Elevation of the external divalent cation concentration with Mn2+ or, to a lesser extent, Mg2+ reduced aiNa in the presence of a functional Na+ pump. But after prolonged exposure to ouabain or K+-free solution, elevation of Mg2+o had no effect on aiNa while application of Mn2+o caused a slow rise. These results suggest that Ca2+o affects aiNa in two ways. One is mimicked by Mg2+ and Mn2+ and is probably due to alteration of the Na+ leak. The other is a specific effect, revealed by Na+ pump inhibition. 6. It is concluded that aiNa can be maintained far from equilibrium in the absence of a functional Na+ pump. Several lines of evidence are discussed which indicate the participation of Na+-Ca2+ exchange in Na+ extrusion in this condition. PMID:2443670

  16. 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.

  17. 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.

  18. AB112. Long-term result of ileal-ureter substitution in ureteral urothelial carcinoma patients: a single-center experience

    PubMed Central

    Ou, Yin-Chien; Yang, Wen-Horng

    2015-01-01

    Objective In the southwest coast of Taiwan, the high prevalence rate of upper tract urothelial carcinomas (UTUCs) has been described. Renal preserving surgeries are of great importance when ureteral urothelial carcinoma (UC) happens in solitary kidney, in bilateral upper urinary tract simultaneously, or in patients with chronic kidney disease. We present the single center experience of total ureterectomy plus ileal-ureteral substitution for the ureteral UCs in the southwest of Taiwan over the last two decades. Methods We retrospectively reviewed patients who had undergone total ureterectomy plus ileal-ureteral substitution for ureteral UC at our center from January 1988 to December 2013. Chart review was done to obtain the information including age, sex, underlying medical diseases, oncology status before the surgery, baseline renal function, long-term renal function, duration of hospitalization, perioperative surgical complications, long-term complications, and oncological outcomes. Results Overall, 8 patients were treated with ileal ureteral substitution for ureteral UC, with a mean follow-up period of 66.5 months. All the resected ureters had confirmed to have UC on the final pathology reports. A total of four major complications (grade III) and 1 minor complication (grade I-II) developed according to the Clavien-Dindo complication grading system during a 30-day post-operative period. No perioperative mortality occurred in these patients. There were 3 patients (37.5%) who experienced long-term complications, including recurrent urinary tract infection and recurrent gross hematuria. At the end of follow-up, the renal function remained stable in 4 patients (50.0%), improved in 2 patients (25.0%), and deteriorated in 2 patients (25.0%). Only one of the deteriorated patient required long-term hemodialysis (12.5%). About the oncological outcome, only 1 patient (12.5%) was found to have tumor recurrence over the pelvic-ileal anastomotic site. Conclusions Ileal-ureteral substitution has been described as a reserved procedure for an extensively diseased ureter that other reconstructive procedures are not feasible. It provides good long-term outcomes for preservation of renal function, and also has acceptable safety concerns. In carefully selected patients, the procedure can also be carried out as nephro-sparing surgery for patients who have ureteral malignancy.

  19. 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 420 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

  20. 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 (3.80.5 vs 3.60.7, p value: 0.13) between MRU methods. The interobserver agreement was excellent with a ? 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.

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

    NASA Astrophysics Data System (ADS)

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

    2004-07-01

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

  2. Extrinsic Obstruction of the Ureter

    MedlinePLUS

    ... Works? Male Urinary Tract Medical Illustration Copyright © 2015 Nucleus Medical Media, All rights reserved Female Urinary Tract Medical Illustration Copyright © 2015 Nucleus Medical Media, All rights reserved The bladder and ...

  3. Cancer - renal pelvis or ureter

    MedlinePLUS

    ... to manufacture leather goods, textiles, plastics, and rubber Smoking Patients with a history of bladder cancer are also at risk. ... medications, including over-the-counter pain medicine. Stop ... you may be exposed to substances that are toxic to the kidneys.

  4. Use of computed tomography scout film and Hounsfield unit of computed tomography scan in predicting the radio-opacity of urinary calculi in plain kidney, ureter and bladder radiographs

    PubMed Central

    Chua, Michael E.; Gomez, Odina R.; Sapno, Lorelei D.; Lim, Steve L.; Morales, Marcelino L.

    2014-01-01

    Objective: The objective of this study is to determine the diagnostic utility of computed tomography (CT)- scout film with an optimal non-contrast helical CT scan Hounsfield unit (HU) in predicting the appearance of urinary calculus in the plain kidneys, ureter, urinary bladder (KUB)-radiograph. Methods: A prospective cross-sectional study was executed and data were collected from June 2007 to June 2012 at a tertiary hospital. The included subjects were diagnosed to have <10mm urolithiasis with non-contrast helical CT scan and KUB X-ray, which were carried out on the same day. Both KUB radiographs and CT-scout film were read by two qualified radiologists with inter-observer standardization prior to the study. Urolithiasis characteristics such as stone location, CT attenuation value, CT-scout film and KUB radiograph appearance were recorded independently by two observers. Univariate logistic analysis with receiver operating characteristic curve was generated to determine the best cut-off HU value of urolithiases not identified in CT-scout film, but determined radio-opaque in KUB X-ray. Subsequently, its sensitivity, specificity, predictive values and likelihood ratios were calculated. Statistical significance was set at P value of 0.05 or less. Results: Two hundred and three valid cases were included. 73 out of 75 CT-scout film detected urolithiasis were identified on plain radiograph and determined as radio-opaque. The determined best cut off value of HU utilized for prediction of radiographic characteristics was 630HU at which urinary calculi were not seen at CT-scout film and were KUB X-ray radio-opaque. The set HU cut-off was established of ideal accuracy with an overall sensitivity of 82.2%, specificity of 96.9% and a positive predictive value of 96.5% and negative predictive value of 83.5%. Conclusion: Urolithiases identified on the CT-scout film were also seen as radiopaque on the KUB radiograph while those stones not visible on the CT-scout film, but above the optimal HU cut-off value of 630 are also likely to be radiopaque. PMID:25125894

  5. 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 ...

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

    MedlinePLUS

    ... KidsHealth in the Classroom What Other Parents Are Reading Signing Kids Up for Sports 15-Minute Meal: ... radiologist (a doctor who is specially trained in reading and interpreting X-ray and ultrasound images) will ...

  7. Mllerianosis of ureter: a rare cause of hydronephrosis.

    PubMed

    Li, Wei-Ming; Yang, Sheau-Fang; Lin, Hang-Ching; Juan, Hsu-Cheng; Wu, Wen-Jeng; Huang, Chun-Hsiung; Wang, Chii-Jye; Li, Ching-Chia

    2007-06-01

    Mllerianosis of the urinary tract is a very rare and morphologically complex tumor-like lesion. It is composed of several types of mllerian-type lesions, including endometriosis, endocervicosis, and endosalpingiosis. We present a case of ureteral mllerianosis in woman with a history of a cesarean section about 20 years previously but with silent clinical symptoms. She was treated with segmental ureteral resection, followed by ureteroureteral anastomosis. The pathogenesis and treatment of this lesion are discussed. PMID:17572222

  8. Computed tomography of transitional-cell carcinoma of the renal pelvis and ureter

    SciTech Connect

    Baron, R.L.; McClennah, B.L.; Lee, J.K.T.; Lawson, T.L.

    1982-07-01

    Preoperative staging of transitional-cell carcinoma of the upper urinary tract is important for identification of those tumors amenable to limited resection. Twenty-two patients were examined using computed tomography (CT), and three patterns were noted: (a) a focal intraluminal mass, (b) ureteral wall thickening with luminal narrowing, and (c) an infiltrating mass. In most cases, attenuation was similar to that of soft tissue; one tumor was calcified. Tumors of the renal pelvis may exhibit contrast enhancement. In 11 cases, excretory urography was inadequate or not attempted. CT demonstrated the site and cause of obstruction in all cases and proved to be a useful noninvasive staging procedure for suspected or proved transitional-cell carcinoma of the upper urinary tract.

  9. 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

  10. Asymptomatic extraperitoneal inguinoscrotal hernia involving ureter: A case presentation and review of the literature

    PubMed Central

    Falidas, Evangelos; Gourgiotis, Stavros; Veloudis, George; Exarchou, Elena; Vlachos, Konstantinos; Villias, Constantinos

    2015-01-01

    An inguinoscrotal hernia is a common disorder that usually contains intraperitoneal organs (small intestine, colon, appendix, ovaries). Extraperitoneal ureteral herniation into an inguinoscrotal hernia is a rare condition and often associated with congenital abnormalities or postoperative anatomic changes. A high index of suspicion is needed in order to avoid intraoperative ureteric injuries. We herein report the case of a ureteric herniation into an inguinoscrotal hernia incidentally found during a scheduled hernia repair. PMID:26604607

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

    MedlinePLUS

    ... New types of treatment are being tested in clinical trials. This summary section describes treatments that are ... want to think about taking part in a clinical trial. For some patients, taking part in a ...

  12. Analysis of factors affecting spontaneous expulsion of ureteral stones that may predict unfavorable outcomes during watchful waiting periods: What is the influence of diabetes mellitus on the ureter?

    PubMed Central

    Choi, Taesoo; Choi, Seung-Kwon; Kim, Dong Soo; Lee, Dong-Gi; Min, Gyeong Eun; Jeon, Seung Hyun; Lee, Hyung-Lae; Jeong, In-Kyung

    2015-01-01

    Purpose The aim of our study was to evaluate the association of several factors with spontaneous stone expulsion, including ureteral stone characteristics (size, location, hydronephrosis, perinephric stranding), types of medications prescribed (?-blocker, low-dose steroid), and other possible demographic and health-history factors (gender, age, serum creatinine, underlying diabetes mellitus [DM], and hypertension). Materials and Methods A total of 366 patients with ureteral stones were enrolled. All patients underwent watchful waiting without any invasive procedures. Initial diagnoses of ureteral stones were confirmed by computed tomography scans, which were taken at approximately 1-month intervals to check for stone expulsion. Univariate and multivariate analyses were conducted to identify significant factors that contributed to stone expulsion. Results Among 366 patients, 335 patients (91.5%) experienced spontaneous stone passage during a mean follow-up period of 2.952.62 weeks. The patients were divided into two groups depending on the success of spontaneous stone passage. Univariate analyses revealed that stone location (p=0.003), stone size (p=0.021), and underlying DM (p<0.001) were significant predictors of stone passage. Multivariate analyses confirmed that stone size (p=0.010), stone location (p=0.008), and underlying DM (p=0.003) were independent predictive factors affecting stone passage. Conclusions Stone size, location, and underlying DM were confirmed to be significant predictive factors for spontaneous passage of ureteral stones. Urologists should consider active procedures, such as shock wave lithotripsy or ureteroscopy, rather than conservative management in patients presenting with proximally located stones, large ureteral stones, or underlying DM. PMID:26078843

  13. 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

  14. Site of impaction of ureteric calculi requiring surgical intervention.

    PubMed

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

    2014-02-01

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

  15. 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

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

    ClinicalTrials.gov

    2016-03-31

    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

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

    ClinicalTrials.gov

    2016-03-01

    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

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

    ClinicalTrials.gov

    2015-08-04

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

  19. An unusual cause of back pain in an achondroplastic man.

    PubMed

    Mantle, M; Kingsnorth, A N

    2003-06-01

    A case is described of a 47-year-old man with achondroplasia who presented with lower back pain radiating to his left loin. An intravenous urogram (IVU) showed hydronephrosis on the left side and a dilated left ureter passing down into the left inguinal region. A CT scan confirmed a left inguinal hernia containing the left ureter causing ureteric obstruction. The hernia was repaired using the Lichtenstein technique with the ureter replaced retroperitoneally. A postoperative IVU showed recovery in renal function but with a persistently dilated left ureter that was not obstructed. A review of the literature regarding inguinal herniation involving the ureter is presented. PMID:12820033

  20. Sorafenib in Treating Patients With Regional or Metastatic Cancer of the Urothelium

    ClinicalTrials.gov

    2014-05-20

    Adenocarcinoma of the Bladder; 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; Squamous Cell Carcinoma of the Bladder; Stage III Bladder Cancer; Stage IV Bladder Cancer; Transitional Cell Carcinoma of the Bladder; Urethral Cancer Associated With Invasive Bladder Cancer

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

    ClinicalTrials.gov

    2016-03-17

    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

  2. Unusual drainage of the main kidney on accessory kidney

    PubMed Central

    Erdem, Glnur; U?ra?, Murat; Demirz, Sevgi

    2014-01-01

    Patients with an accessory kidney are characterized by an excessive number of kidneys. The ureter of the accessory kidney either drains separately into the bladder or merges with the ureter of the main kidney. In our case, interestingly, the ureter of the left main kidney drained directly into the accessory kidney and the ureter of the latter was the common drainage route for both. The drainage of a normal kidney via the ureter of an accessory kidney has not been reported in the literature, so far. The aim of this report is to present the case with radiological findings and to emphasize the effects of this situation on planned surgical procedures. A 62-year-old female patient had an interesting abnormality on the left collecting system, which was revealed on excretory urography (EU), retrograde urography (RU) and multidetector computed tomography (MDCT). A kinky left ureter, which formed a U shape, was revealed on EU. On MDCT, an accessory kidney was revealed at the anterior aspect of the middle zone of left main kidney. The ureter of the main left kidney drained directly into the accessory kidney. The course of this drainage was confirmed by retrograde urography. An accessory kidney is a rare entity associated with horseshoe kidney, ectopic ureter draining into the vagina, bifid collecting system and coarctation of the aorta. In our case, an unusual association between the ureters of the main and accessory kidneys was revealed, which may have an impact on planned surgery in the groin and retroperitoneal areas. PMID:26328163

  3. Analgesic nephropathy

    MedlinePLUS

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

  4. 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

  5. Kidney Surgery Codes

    Cancer.gov

    Kidney, Renal Pelvis, and Ureter Kidney C649, Renal Pelvis C659, Ureter C669 (Except for M9727, 9733, 9741-9742, 9764-9809, 9832, 9840-9931, 9945-9946, 9950-9967, 9975-9992) Codes 00 None; no surgery of primary site; autopsy ONLY 10 Local tumor

  6. Suspected Urine Leak in a Pediatric Renal Transplant Patient With Prune Belly Syndrome.

    PubMed

    Liu, Bin; Kaplan, Summer L; Zhuang, Hongming

    2016-03-01

    Patients with prune belly syndrome usually have tortuous ureters, which can cause difficulty in the interpretation of renal scan used to evaluate possible urine leak after renal transplant. We reported a renal scan finding in a pediatric renal transplant patient with prune belly syndrome. The radioactivity in the dilated ureter, which was lateral to the renal transplant, appears to be urine leak. PMID:26447390

  7. 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

  8. 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.

  9. 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

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

    PubMed Central

    Kuzaka, Boles?aw; Borkowski, Tomasz; Kuzaka, Piotr; Szostek, Grzegorz

    2014-01-01

    Background There is a paucity of data addressing the blood supply in the surgically reconstructed ureter, and complete lack of microangiographic studies of the reconstructed ureter with the use of a free bladder mucosa flap. The present study evaluated the blood supply in the reconstructed dog ureter after a 5-centimeter segment resection, supplemented by a tube constructed from a free bladder mucosa flap. Material/Methods Female mongrel dogs (n=29) were used in this study. Under general anaesthesia, a 5-centimeter autologous free bladder mucosa flap was used to construct a tube, which was afterwards grafted to replace a 5-centimeter ureter resection. After a period of 3 months (n=2) and after 1 year (n=2), microangiography was performed to assess the revascularization of the grafted ureter. Results In our study, we observed the continuity of the ureter, but the grafted reconstruction was narrowed by the cicatrization in about 86% (n=25) of cases. This resulted in the development of hydronephrosis, as described in previous publications. The ureteral wall was covered by a normal urothelium, but consisted of fibrous connective tissue, which failed to restore a regular (normal) coat. The reconstructed segment showed no smooth muscle cells. A few smooth monocytes were found only at the border with intact portions of the ureter. The microangiography performed at the end of the experiments showed no vascularization of the restored segment of the ureter. Conclusions The experiments showed a whole regeneration of urothelium in the transected and reanastomosed ureters. However, there was no regeneration of the muscular coat and a complete lack of revascularization. PMID:24980521

  11. 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 Tc-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

  12. 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 ...

  13. Bochdalek hernia with obstructive uropathy.

    PubMed

    Song, Young S; Hassani, Cameron; Nardi, Peter M

    2011-06-01

    Bochdalek hernias are postero-medial diaphragmatic defects that usually contain peritoneal fat and often remain asymptomatic. We present a unique case in which involvement of the adjacent ureter in the hernia defect resulted in obstructive uropathy. PMID:20579710

  14. 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

    2016-02-19

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

  15. MPH Urinary Practicum : Breeze Training Transcript: Feb 20 07

    Cancer.gov

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

  16. Urinary Tract Infections (UTIs)

    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 ...

  17. Ureteral retrograde brush biopsy

    MedlinePLUS

    ... take a sample of tissue from the kidney ( renal pelvis or calyx) or ureter. It is performed when an x-ray or other test has shown a suspicious area (lesion), or there are abnormal cells in the urine.

  18. 21 CFR 876.5900 - Ostomy pouch and accessories.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... created opening of the small intestine, large intestine, or the ureter on the surface of the body). This... bag, ostomy drainage bag with adhesive, stomal bag, ostomy protector, and the ostomy size...

  19. Kidney stones - what to ask your doctor

    MedlinePLUS

    A kidney stone is a solid piece of material that forms in your kidney. The kidney stone may be stuck in your ureter (the tube that carries urine from your kidneys to your bladder). It also may be stuck ...

  20. 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 ...

  1. Reflux nephropathy

    MedlinePLUS

    ... transplant or from injury to the ureter. Risk factors for reflux nephropathy include: Abnormalities of the urinary tract Personal or family history of vesicoureteral reflux Repeat urinary tract infections

  2. Ureterovaginal fistula linked to a retained pessary.

    PubMed

    Dmitry, Fridman; Ambereen, Sleemi

    2014-09-01

    The vaginal pessary is a safe and effective method for the correction of uterovaginal prolapse. Complications are uncommon, but include fistula formation. We report a case of fistulous communication between the ureter and vagina that developed in a patient who had had a pessary for more than 8 years. She initially presented with urinary retention secondary to complete procidentia and declined surgical intervention. The patient was not compliant with follow-up. Eventually, she was scheduled for a vaginal hysterectomy and pelvic floor reconstruction, during which the communicating tract was discovered between the ureter and vagina. Ultimate treatment involved stenting of the ureter and interval ureteroneocystostomy. Fistulae can develop between the ureter and the vagina in the case of procidentia and a retained pessary. PMID:24525663

  3. 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 ...

  4. Pazopanib in Treating Patients With Metastatic Urothelial Cancer

    ClinicalTrials.gov

    2014-05-22

    Distal Urethral Cancer; 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

  5. Urine and Urination

    MedlinePLUS

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

  6. [URETERAL TISSUE ENGINEERING: CHALLENGES AND PROSPECTS].

    PubMed

    Glybochko, P V; Alaev, Ju G; Vinarov, A Z; Butnaru, D V; Titov, A S; Bibikova, E E; Sevostjanova, S I

    2015-01-01

    A broad range of pathologic conditions of the ureter (strictures, obliterations, fistulas, and so on) requiring reconstructive plastic surgery is a challenging urological problem. A variety of approaches to solve the problem indicates the need of searching for new opportunities. A new direction in reconstructive surgery of the ureter is the tissue engineering. Tissue engineering involves the usage of matrices and cells. The matrices can be used both with cultured cells, and without them. This review represents the results of preclinical studies on feasibility of tissue engineering using as a matrix both natural and synthetic materials for different ureter impairments. Presently, there are no data on the use of tissue-engineering for the ureter reconstruction in clinical trials (i.e. involving human subjects). The results of studies presented in the review inspire certain optimism, but ureteral tissue-engineering is a difficult task requiring a balanced approach and well-thought-out design of preclinical studies. PMID:26390567

  7. MPH Urinary Rules: Breeze Training Transcript: Feb 16 07

    Cancer.gov

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

  8. Muscles of the Lower Extremity

    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 & ...

  9. Endocrine Glands & Their Hormones

    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 & ...

  10. Urinary Bladder

    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 & ...

  11. Thymus

    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 & ...

  12. Regions of the Digestive System

    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 & ...

  13. Structure of Skeletal Muscle

    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 & ...

  14. Axial Skeleton

    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 & ...

  15. Appendicular Skeleton

    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 & ...

  16. Muscles of the Trunk

    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 & ...

  17. Components of the Urinary System

    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 & ...

  18. 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 & ...

  19. Muscles of the Upper Extremity

    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 & ...

  20. Spleen

    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 & ...

  1. Classification & Structure of Blood Vessels

    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. [Possibilities of testing sex steroid effects in the uropoietic system].

    PubMed

    Voigt, R; Klinger, G; Schneider, H J

    1978-10-01

    Progesterone as the main representative of gestagen-effective sexual steroide does not cause allone a statistically significant dilation of the lumina of the ureters compared with the adequate values of the control urogrammes. The fact that in pregnant rabbits no dilation of the ureters and of the renal pelvis was to be found allows the suspicion that during the pregnancy of the animal species used there are other mechanical conditions than during the human gravidity. PMID:735464

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

    PubMed Central

    Kaba, Mehmet; Kaba, Sultan; Kaya, Tacettin Yekta; Eren, Hseyin; Pirini, Necip

    2014-01-01

    Ureteral fibroepithelial polyps are rarely seen benign tumors with mesodermal origin. These polyps can involve kidney, pelvis, ureter, bladder, and urethra. The most common symptoms are hematuria and flank pain. The choice of treatment is either endoscopic or surgical resection of polyp by sparing kidney. Here, we presented a pediatric case with giant, fibroepithelial polyp that mimics bladder tumor, originating from middle segment of the ureter. PMID:24716071

  4. A giant pedunculated urothelial polyp mimicking bladder mass in a child: a rare case.

    PubMed

    Kaba, Mehmet; Kaba, Sultan; Kaya, Tacettin Yekta; Eren, Hseyin; Pirini, Necip

    2014-01-01

    Ureteral fibroepithelial polyps are rarely seen benign tumors with mesodermal origin. These polyps can involve kidney, pelvis, ureter, bladder, and urethra. The most common symptoms are hematuria and flank pain. The choice of treatment is either endoscopic or surgical resection of polyp by sparing kidney. Here, we presented a pediatric case with giant, fibroepithelial polyp that mimics bladder tumor, originating from middle segment of the ureter. PMID:24716071

  5. [Use of pyelo-cystic anastomosis in ureteral obliteration after kidney transplantation].

    PubMed

    Perlin, D V; Darenkov, S P; Petrova, M V; Anashkin, V A; Okhobotov, D A; Aleksandrov, I V

    2003-01-01

    Reconstruction of the urinary tract because of ureteral stricture after kidney transplantation is a serious problem. In development of obliteration of the recipient's ureter near anastomosis and in the absence of own ureters reconstruction is made by pyelocystoanastomosis. A case is reported of a successful use of this method in reconstruction of the urinary tract. Preoperative preparation includes transcutaneous nephrostomy. Sometimes Boary flap is used. The arising reflux had insignificant effect on the transplant's function. PMID:12621966

  6. Extracorporeal Ureteric Stenting for Pediatric Laparoscopic Pyeloplasty.

    PubMed

    Kocherov, Stanislav; Lev, Genady; Chertin, Leonid; Chertin, Boris

    2016-04-01

    Introduction We aimed to evaluate a novel technique for ureteric stent insertion during dismembered pediatric laparoscopic pyeloplasty. Patients and Methods Following identification and dissection of the ureteropelvic junction (UPJ) with the proximal part of ureter, the ureter is dismembered just proximal to the UPJ at the level of the renal pelvis, allowing use of the excess pelvic tissue for further manipulation of the ureter. Then the abdomen is desufflated and the ureter delivered to the skin level. The externalized ureter is then spatulated and the stent inserted in an antegrade fashion to the bladder. The first stitch for further laparoscopic anastomosis is applied to the lower part of the spatulated ureteric end and then following insufflations the ureter is returned to the abdomen. The laparoscopic anastomosis is completed in a routine fashion. Results Over the past 4 years, we have used this technique in 26 children (17 boys and 9 girls) with median age of 4 years (range, 2-18 years). Left pyeloplasty was performed in 16 and right pyeloplasty in the remaining 10 patients. The mean (range) time of insertion was 6 minutes (range, 4-7 minutes). All stents were correctly placed. In one patient, the stent dislodged to distal part of the ureter. No other intraoperative or postoperative complications related to our technique of stent insertion were observed. Conclusion Our data show that extracorporeal antegrade ureteric stent insertion is an easy-to-learn and a safe and reliable technique for pediatric dismembered pyeloplasty. It obviates the problem of having the stent in the pelvis during dissection and the need for patient repositioning. PMID:25774958

  7. Endoluminal sonography of the urinary tract: preliminary observations.

    PubMed

    Goldberg, B B; Bagley, D; Liu, J B; Merton, D A; Alexander, A; Kurtz, A B

    1991-01-01

    Endoluminal sonography of the urinary tract was performed by using endoluminal ultrasound transducers contained within 2-mm-diameter catheters. The catheters were inserted into the urinary bladder via the urethra and advanced into the ureters and renal pelvis under cystoscopic control; then, cross-sectional images of the bladder, ureters, and renal pelvis were obtained. Two dogs and seven human patients were studied. In one dog, a 4.5-mm pseudopolyp, which was surgically created in the bladder wall, was successfully imaged; in the other, stones 2 mm or larger inserted into the bladder were identified. Of the seven patients, sonography showed stones embedded in the renal parenchyma (one patient) and the mucosa of the distal ureter (one patient). These were ultimately confirmed by their eventual removal. In a third, sonography showed a tumor of the distal ureter and identified the depth of the tumor. This was confirmed by biopsy. In a fourth, sonography clearly showed a crossing vessel as the cause for narrowing of the proximal ureter. In a fifth, sonography showed that the cause of a ureteral stricture was idiopathic. In the last two cases, sonography did not reveal a cause for hematuria. In these last three cases, negative sonographic results were confirmed by direct ureteroscopic examinations and follow-up studies. Our observations based on this limited study suggest that endoluminal sonography is a useful procedure for diagnosing diseases of the urinary tract. Further study is warranted. PMID:1898578

  8. Urinary tract cryptosporidiosis in commercial laying hens.

    PubMed

    Trampel, D W; Pepper, T M; Blagburn, B L

    2000-01-01

    Formalin-fixed kidney tissues from adult egg-laying chickens in two houses of an egg-production complex in the upper Midwest were submitted to Iowa State University for histopathologic examination. An increased incidence of visceral gout, average daily mortality 1%-2% higher than expected, and egg production within normal limits were observed in both houses. Numerous developing stages of Cryptosporidium were observed on the apical surface of epithelial cells lining renal collecting tubules and ureters. Scanning and transmission electron microscopy were used to visualize colonization of cryptosporidia, disruption of microvilli, and exfoliation of parasitized epithelial cells. Lymphoplasmacytic infiltration in the wall of ureters and hyperplasia of parasitized epithelial cells resulted in partial obstruction of ureters, which may have induced visceral gout in affected hens. This is the first report of urinary tract cryptosporidiosis occurring in adult hens in a modern commercial egg-production facility. PMID:10879932

  9. 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.

  10. Segmentary ureteral resection followed by ureteroneocystostomy associated with radical hysterectomy and partial cystectomy in a patient with bulky residual disease after chemoirradiation for invasive cervical cancer - A case report -

    PubMed Central

    Bacalba?a, N; B?lescu, I

    2014-01-01

    Cervical cancer represents the second most frequent malignancy in women worldwide, a significant number of cases still being diagnosed in an advanced stage of the disease. In some of these cases, local invasion is already present at the moment of diagnosis and even if neo-adjuvant chemoirradiation is performed in some patients, it persists at the moment of surgery. In these cases, more aggressive surgical procedures are needed in order to obtain a good control of the disease. The case of a 50-year-old patient diagnosed with locally advanced cervical cancer invading the right ureter is presented, in whom this aspect was present even after neo-adjuvant chemoirradiation and in whom a total radical hysterectomy with bilateral en bloc adnexectomy with partial cystectomy and the invaded zone of the right ureter was performed. The ureter was then mobilized and reimplanted in the urinary bladder through a neocystostomy. The postoperative course was uneventful. PMID:25713622

  11. 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

  12. On the calibre of the ureteric lumen.

    PubMed Central

    Hoyes, A D; Barber, P

    1978-01-01

    The cross sectional appearances of the lumen of rat ureter were compared in specimens fixed by perfusion and by immersion and processed for electron microscopy. After efficient perfusion fixation in untreated animals, and in animals previously injected with 6-hydroxydopamine, there was substantial dilatation of the ureter, and the lumen was approximately circular in section. In inadequately perfused and immersion-fixed material the lumen was usually narrowed, and was either slit-like or stellate in appearance. Ultrastructural examination indicated that closure of the lumen was accompanied by the development in the cells of the muscle coat of the features usually associated with contraction, and the possibility that the appearance of the ureter in well perfused specimens approximated to its state in vivo was discussed. Images Figs. 1-4 Fig. 5 Fig. 6 PMID:649499

  13. 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.

  14. 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

  15. [Transurethral ureteroscopic removal of ureteral calculi].

    PubMed

    Kawamura, N; Nishimura, T; Akimoto, M

    1986-04-01

    Rigid ureteroscopy was used for transurethral removal of ureteral stones. Calculi were extracted under direct vision using flexible grasping forceps or a stone basket. If the size of the stone precluded the use of these techniques, we disintegrated the stone using an electro-hydraulic lithotriptor (EHL) or ultrasonic lithotriptor (USL). Between January, 1985 and October, 1985, 35 ureteroscopic procedures were performed for removal of ureteral stones. In 27 cases (77%) the stone was removed successfully. All stones could be removed in mid and lower ureter. However, in upper ureter, the success rate was only 50%. In 8 instances, ureteroscopy failed to remove the ureteral calculus and 6 underwent percutaneous nephrolithotomy, 2 open surgery. Of the ureteral stones, 12 were removed with grasping forceps or a basket manipulation. EHL and USL were used successfully to remove calculi in 15 cases. To make smooth passage of the ureteroscope, a 6F UPJ occlusion balloon catheter was introduced into the ureter and the balloon was inflated in the intramural ureter for 24 hours preoperatively. We have found this to be a useful procedure for smooth passage of the ureteroscope. Most common complication of ureteroscopic stone removal was fever (29%). In 1 case, the ureter was penetrated by the scope. The patient was treated with an indwelling ureteral catheter for 2 weeks. After the catheter was removed, an excretory urogram demonstrated normal ureter without extravasation or obstruction. We conclude that ureteroscopic stone removal can be done safely with careful passage of the scope and careful manipulation of calculi. PMID:3739860

  16. Ureteral fibroepithelial polyp in an owl monkey (Aotus nancymae).

    PubMed

    Gozalo, A S; Hoffmann, V J; Lambert, L E

    2006-07-01

    Ureteral fibroepithelial polyps are benign mesodermal tumors in humans that occur predominantly in the proximal ureter. During a routine necropsy of a wild-caught, research nave, adult, male, Aotus nancymae, the left ureter just distal to the renal pelvis contained a pedunculated, lobulated neoplasm with a narrow stalk at the base projecting into the lumen. The left renal pelvis was found to be mildly dilated. The histologic characteristics of the ureteral mass were consistent with a fibroepithelial polyp. To our knowledge, this is the first report describing a ureteral fibroepithelial polyp in a nonhuman primate. PMID:16847004

  17. Imaging of Urinary System Trauma.

    PubMed

    Gross, Joel A; Lehnert, Bruce E; Linnau, Ken F; Voelzke, Bryan B; Sandstrom, Claire K

    2015-07-01

    Computed tomography (CT) imaging of the kidney, ureter, and bladder permit accurate and prompt diagnosis or exclusion of traumatic injuries, without the need to move the patient to the fluoroscopy suite. Real-time review of imaging permits selective delayed imaging, reducing time on the scanner and radiation dose for patients who do not require delays. Modifying imaging parameters to obtain thicker slices and noisier images permits detection of contrast extravasation from the kidneys, ureters, and bladder, while reducing radiation dose on the delayed or cystographic imaging. The American Association for the Surgery of Trauma grading system is discussed, along with challenges and limitations. PMID:26046510

  18. Inguinoscrotal hernias involving urologic organs: A case series.

    PubMed

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

    2014-05-01

    We report 2 cases of inguinoscrotal hernias involving urologic organs. The first case involved an elderly gentleman with a history of micturition by squeezing his scrotum. He was diagnosed as having a right-sided indirect inguinal hernia involving the right ureter and bladder. Treatment was surgical. The second case involved an achondroplastic male who presented with acute kidney injury. He had bilateral hydronephrosis and ureteric obstruction secondary to an ureteroinguinal herniation bilaterally. The presentation, diagnosis, and treatment of inguinoscrotal hernias involving the bladder and ureters are discussed. PMID:25024798

  19. Ureteral Embolization to Prevent Thrombotic Obstruction of Nephrostomy Catheters in the Context of Refractory Hemorrhagic Radiation Cystitis with Severe Vesicoureteral Reflux

    PubMed Central

    Yarlagadda, Vidhush; Pettibon, Keith; Ertel, Nathan

    2016-01-01

    We present a case of refractory hemorrhagic radiation cystitis in a patient who failed conservative management and was unable to undergo operative urinary diversion secondary to multiple comorbidities. His management was complicated by recurrent obstruction of his nephrostomy catheters due to marked ureteral thrombus formation from blood refluxing into the ureters from the urinary bladder. We were successful in treating his condition by occluding his distal ureters with a combination of embolization coils and glue to prevent the reflux of blood in order to allow his nephrostomy catheters to function properly.

  20. 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

  1. A rare complication after renal transplantation: Forgotten stent.

    PubMed

    Karab?cak, Mustafa; Ipekci, Tumay; Isoglu, Cemal Selcuk; Keskin, Mehmet Zeynel; Ekin, Rahmi Gokhan; Budak, Salih; Turk, Hakan; Celik, Orcun; Ilbey, Yusuf Ozlem

    2015-06-01

    In renal transplantation surgery, double J stents (DJS) are often used to reduce complications, protect the anastomosis between ureter and bladder, provide drainage in ureteral obstructions and enhance healing if there is an ureter injury. Urinary tract infections, hematuria and irritative voiding symptoms are the early complications of DJS. Migration, fragmentation, encrustation and rarely sepsis are among the late complications of DJS. In this report we describe a renal transplantation case whose DJS stent was forgotten because the patient did not attend the regular follow-up and noticed 5 years after surgery. PMID:26150043

  2. 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

  3. Contralateral Renal Cell Carcinoma Ureteric Metastases Can Arise on Tyrosine Kinase Adjuvant Therapy and Be Effectively Treated by Endoscopic Laser Excision and Ablation

    PubMed Central

    Reid, Sarah L.; Arestis, Nikolas J.; Lamb, Gavin W. A.

    2014-01-01

    Renal cell carcinoma (RCC) uncommonly metastasizes to the ureter and rarely to the contralateral ureter. We describe the presentation of 2 successive contralateral ureteric metastases from RCC in our institution. The first represents the only reported metachronous ureteric deposit on adjuvant sorafenib after laparoscopic radical nephrectomy for RCC. The other presented with a synchronous lesion after radiological work-up. Both lesions were treated with endoscopic excision and laser ablation with preservation of the renal unit and no local recurrence. We report these cases and discuss the literature. PMID:25105052

  4. 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

  5. What I Need to Know about My Child's Urinary Tract Infection

    MedlinePLUS

    ... tract is the body’s drainage system for removing wastes and extra water. The urinary tract includes two kidneys , two ureters , ... kidneys process about 3 ounces of blood, removing wastes and extra water. The wastes and extra water make up the ...

  6. Sonographic diagnosis of a presumed ureteral tear in a horse.

    PubMed

    Diaz, Olga Seco; Zarucco, Laura; Dolente, Brett; Reef, Virginia B

    2004-01-01

    A 14-year-old thoroughbred gelding was presented for the evaluation of acute abdominal pain. Rectally, there was a soft fluctuant painful swelling dorsal to the bladder and to the right of the midline. The creatinine concentration of the peritoneal fluid was 15 mg/dl. Transrectal ultrasonographic examination of the urinary tract revealed a large collection of fluid dissecting from the pelvic portion of the right ureter ventrally through the right side of the bladder wall and into the retroperitoneal space, and a thickened right ureter and bladder wall at the level of the trigone. Cystoscopically there was moderate hemorrhage within the wall of the bladder. Ultrasonography revealed air within the retroperitoneal fluid collection after ureteral catheterization, confirming the preliminary diagnosis of a tear in the right ureter. The gelding was treated medically. After 48 h of hospitalization, nuclear scintigraphy revealed normal clearance from both kidneys and no apparent leakage from the right ureter. The ureteral tear and urinoma were monitored using transrectal ultrasound until resolution. The horse was successfully returned to racing. This case establishes the value of diagngstic ultrasound in the diagnosis and monitoring of a traumatic ureteral tear in a horse. PMID:15005365

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

    PubMed Central

    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

  8. 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. ...

  9. Complete Genome Sequence of a Novel Chimpanzee Polyomavirus from a Western Common Chimpanzee

    PubMed Central

    van Persie, Jolanda; Buitendijk, Hester; Fagrouch, Zahra; Bogers, Willy; Haaksma, Tom; Kondova, Ivanela

    2016-01-01

    We report here the full-length genome sequence of a novel chimpanzee polyomavirus. Viral sequences were recovered from colon, bladder, and ureter tissue from a western common chimpanzee. The virus is genetically closely related to the human BK polyomavirus. PMID:26798086

  10. 21 CFR 876.5990 - Extracorporeal shock wave lithotripter.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... or ureter. The primary components of the device are a shock wave generator, high voltage generator... generated using electrostatic spark discharge (spark gap), electromagnetically repelled membranes, or... acoustic lens. The shock waves are created under water within the shock wave generator, and are...

  11. An unusual presentation of enzootic bovine leukosis.

    PubMed Central

    Sparling, A M

    2000-01-01

    A 6-year-old, Holstein x Simmental cow diagnosed with pyelonephritis had increasing difficulty rising and became recumbent, despite treatment with antibiotics. A serological test for the bovine leukemia virus was positive; at necropsy, the left kidney and ureter and the myocardium showed lesions of lymphosarcoma, confirmed by histology. PMID:10769770

  12. Ureteric foreign body following previous aorto-iliac graft

    PubMed Central

    da Silva, Vitor; Taylor, Jonathan

    2015-01-01

    Foreign bodies in the ureter are extremely rare. We report a case of an 82-year-old man who, after an incidental presentation with asymptomatic hydroureteronephrosis, had an intraureteric foreign body. The patient was managed with atraumatic endoscopic extraction of the specimen. PMID:26029300

  13. 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

  14. Ureteral Dilatation with No Apparent Cause on Intravenous Urography: Normal or Abnormal? A Pilot Study

    PubMed Central

    Rathi, Vinita; Agrawal, Sachin; Bhatt, Shuchi; Sharma, Naveen

    2015-01-01

    A pilot study was done in 18 adults to assess the significance of ureteral dilatation having no apparent cause seen on Intravenous Urography (IVU). A clinicoradiological evaluation was undertaken to evaluate the cause of ureteral dilatation, including laboratory investigations and sonography of the genitourinary tract. This was followed, if required, by CT Urography (using a modified technique). In 9 out of 18 cases, the cause of ureteral dilatation on laboratory investigations was urinary tract infection (6) and tuberculosis (3). In the remaining 9 cases, CTU identified the cause as extrinsic compression by a vessel (3), extrinsic vascular compression of the ureter along with ureteritis (2), extrinsic vascular impression on the right ureter and ureteritis in the left ureter (1), ureteral stricture (2), and ureteral calculus (1). Extrinsic vascular compression and strictures did not appear to be clinically significant in our study. Hence, ureteral dilatation without any apparent cause on intravenous urogram was found to be clinically significant in 12 out of 18 (66.6%) cases. We conclude that ureteral dilatation with no apparent cause on IVU may indicate urinary tract tuberculosis, urinary tract infection (E. coli), or a missed calculus. Thus, cases with a dilated ureter on IVU, having no obvious cause, should undergo a detailed clinicoradiological evaluation and CTU should be used judiciously. PMID:26576150

  15. Malignant paraganglioma in a cougar (Puma concolor).

    PubMed

    Duhamelle, Alexis; Langlois, Isabelle; Pey, Pascaline; Tremblay, Josée; Ruel, Hélène; Parent, Joane; Lussier, Joanie; Doré, Monique

    2014-12-01

    A 7½-yr-old male cougar (Puma concolor) was presented with a 2-wk history of progressive hindlimb abnormalities. An abdominal mass was palpated on physical examination. Computed tomography of the abdomen showed a mass surrounding the left ureter. A postmortem diagnosis of paraganglioma was established. PMID:25632701

  16. Horseshoe kidney transplantation

    PubMed Central

    Kanyri, Zsolt; Zdori, Gergely; Zsom, Lajos; Berhs, Mariann; Hamar, Mtys; Kbor, Krisztina; Pter, Antal

    2015-01-01

    Horseshoe kidney is a fusion anomaly found in approximately one in 400600 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

  17. Complete Genome Sequence of a Novel Chimpanzee Polyomavirus from a Western Common Chimpanzee.

    PubMed

    van Persie, Jolanda; Buitendijk, Hester; Fagrouch, Zahra; Bogers, Willy; Haaksma, Tom; Kondova, Ivanela; Verschoor, Ernst J

    2016-01-01

    We report here the full-length genome sequence of a novel chimpanzee polyomavirus. Viral sequences were recovered from colon, bladder, and ureter tissue from a western common chimpanzee. The virus is genetically closely related to the human BK polyomavirus. PMID:26798086

  18. Is Hydronephrosis a Complication after Anterior Lumbar Surgery?

    PubMed

    Parks, Ruth M; Behrbalk, Eyal; Mosharraf, Syed; Mller, Roger M; Boszczyk, Bronek M

    2015-12-01

    Study Design?Prospective follow-up design. Objective?Ureteral injury is a recognized complication following gynecologic surgery and can result in hydronephrosis. Anterior lumbar surgery includes procedures like anterior lumbar interbody fusion (ALIF) and total disk replacement (TDR). Anterior approaches to the spine require mobilization of the great vessels and visceral organs. The vascular supply to the ureter arising from the iliac arteries may be compromised during midline retraction of the ureter, which could theoretically lead to ureter ischemia and stricture with subsequent hydronephrosis formation. Methods?Potential candidates with previous ALIF or TDR via anterior retroperitoneal access between January 2008 and March 2012 were chosen from those operated on by a single surgeon in a university hospital setting (n?=?85). Renal ultrasound evaluation of hydronephrosis was performed on all participants. Simple descriptive and inferential statistics were used to generate results. Results?A total of 37 voluntary participants were recruited (23 male, 14 female subjects; average age 51.8 years). The prevalence of hydronephrosis in our population was 0.0% (95% confidence interval 0 to 8.1%). Conclusions?Retraction of the ureter across the midline in ALIF and TDR does not result in an increase in hydronephrosis and appears to be a safe surgical technique. PMID:26682096

  19. Is Hydronephrosis a Complication after Anterior Lumbar Surgery?

    PubMed Central

    Parks, Ruth M.; Behrbalk, Eyal; Mosharraf, Syed; Mller, Roger M.; Boszczyk, Bronek M.

    2015-01-01

    Study Design?Prospective follow-up design. Objective?Ureteral injury is a recognized complication following gynecologic surgery and can result in hydronephrosis. Anterior lumbar surgery includes procedures like anterior lumbar interbody fusion (ALIF) and total disk replacement (TDR). Anterior approaches to the spine require mobilization of the great vessels and visceral organs. The vascular supply to the ureter arising from the iliac arteries may be compromised during midline retraction of the ureter, which could theoretically lead to ureter ischemia and stricture with subsequent hydronephrosis formation. Methods?Potential candidates with previous ALIF or TDR via anterior retroperitoneal access between January 2008 and March 2012 were chosen from those operated on by a single surgeon in a university hospital setting (n?=?85). Renal ultrasound evaluation of hydronephrosis was performed on all participants. Simple descriptive and inferential statistics were used to generate results. Results?A total of 37 voluntary participants were recruited (23 male, 14 female subjects; average age 51.8 years). The prevalence of hydronephrosis in our population was 0.0% (95% confidence interval 0 to 8.1%). Conclusions?Retraction of the ureter across the midline in ALIF and TDR does not result in an increase in hydronephrosis and appears to be a safe surgical technique. PMID:26682096

  20. [Post-traumatic rupture in ureteropelvic junction obstruction syndrome: two case reports].

    PubMed

    Roy, C; Tuchmann, C; Pfleger, D; Lang, H; Saussine, C; Jacqmin, D

    2001-02-01

    Post-traumatic rupture of UPJ obstruction is a rare event, with few reported cases in the literature. Diagnosis is suggested on imaging studies, especially US and CT findings. The presence of an anterior pelvic hematoma associated with thinning of kidney parenchyma, very distended pelvis and non dilated ureter is suggestive of pre-existing pathology. PMID:11428214

  1. Endoluminal urologic ultrasound.

    PubMed

    Goldberg, B B; Liu, J B

    1991-01-01

    Miniature transducer-containing catheters (6 French 20 MHz and 9 French 12.5 MHz) have been inserted into the urethra, urinary bladder, ureter and renal pelvis. Real-time 360 degrees cross sectional ultrasound images were obtained delineating a variety of normal and abnormal structures in both animal models and humans. With this approach it was possible to measure wall thickness as well as adjacent external structures such as blood vessels, lymph nodes and muscle. It was possible to diagnose a variety of abnormalities including embedded stones in the ureter and renal pelvis, crossing blood vessels producing compression of the ureter and tumors within the urinary bladder and ureter. In addition, these transducer-containing catheters show promise in assisting in tumor staging and biopsy guidance. These specially developed transducer-containing catheters, intended originally for placement in blood vessels, show great promise in becoming important new tools in a wide variety of non-vascular lumina and surgically created openings in many areas of the body. From our initial results we can already predict that non-vascular endoluminal ultrasound will assume an important role in the evaluation of a variety of urologic abnormalities. PMID:1947836

  2. Acquired Cystic Kidney Disease

    MedlinePLUS

    ... onset of disease. People with ACKD already have chronic kidney disease when they develop cysts. Kidneys Ureters Bladder What ... kidney failure and finding treatment to stop its progression. The NIDDK’s Division ... Diseases sup ports basic research into normal kidney function ...

  3. 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

  4. 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.

  5. [Diagnostic and therapeutic advantages of rigid ureteroscopy: retrospective study of 304 cases].

    PubMed

    Hajri, M; Ben Amna, M; Achich, A; Ben Mouelli, S; Bacha, K; Ben Hassine, L; Chebil, M; Ayed, M

    2000-12-01

    Uretroscopy has become a common tool for the diagnosis and management of the upper urinary tract. Between April 1994 and Decembre 1999, 304 ureteroscopy procedures were performed. The most common therapeutic procedure was stone manipulation in 299 cases (distal ureter 259 cases, mid-ureter 23 cases, lumber ureter eight cases and staged in nine cases). Procedure was made by a rigid ureteroscope 8.5 Ch or 11.5 Ch. Dorinia was used in 175 cases (57.5%) with or without fragmentation by ultrasound. Therapeutic ureteroscopy was also used to remove a double-J stent that had migrated into the pelvic ureter in one case and in three cases of ureteral tumor. It was used in one case to confine the extrinsic compression of a ureteral stenosis. Median follow up was 12 months (6-36 months). The overall success rate was 87.6%. Results are comparable in men and women (P = 0.8). Success rate was 90% in single lithiasis and 76.2% in case of numerous stones (P = 0.0094). There was a statistically significant difference in success rate between stones 15 mm or under in size (89% stone-free) and those 15 mm (66% stone-free) or larger. In conclusion, rigid ureteroscopy is a minimally invasive and reliable technique for the management of ureteric calculi and for the diagnosis and treatment of other ureteric lesion. PMID:11147085

  6. 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 pelvis and ureters. Overall, there was a positive association between radiation and the combined category of cancer of the renal parenchyma, renal pelvis and ureters (ERR/Sv = 0.60, 90% CI: 0.09, 1.30). Updated follow-up of the LSS cohort provides substantial additional information on the association between radiation and cancer of the renal pelvis and ureter, a site not examined in recent reports on analyses of these data. The results are suggestive of differences between the different regions of the kidney in sensitivity to the carcinogenic effects of ionizing radiation. PMID:20518663

  7. [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

  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. Clinical outcome of transperitoneal ureterocutaneostomy using the transverse mesocolon.

    PubMed

    Furubayashi, Nobuki; Negishi, Takahito; Kashiwagi, Eiji; Fukuda, Atsushi; Nakamura, Motonobu

    2013-07-01

    The aim of the present study was to demonstrate that the treatment outcome of transperitoneal ureterocutaneostomy using the transverse mesocolon is not inferior to that of conventional retroperitoneal ureterocutaneostomy. The enrolled subjects were 26 patients who underwent ureterocutaneostomy among a total of 160 cases of urinary diversion performed at our institution between March, 2004 and November, 2011. A total of 11 cases and 18 ureters were treated by transperitoneal ureterocutaneostomy via the transverse mesocolon, with 7 bilateral ureterocutaneostomy cases. All the cases of retroperitoneal ureterocutaneostomy were unilateral, totaling 15 patients and 15 ureters. Postoperative adverse events (ileus, acute pyelonephritis), catheter-free status and renal function [blood urea nitrogen (BUN) and serum creatinine (Cr) values] were retrospectively evaluated between the groups treated by the different surgical procedures. Ileus was only observed in 1 case and improvement was achieved through conservative therapy alone (P=0.827). Acute pyelonephritis developed in 3 (27.3%) transperitoneal and 8 (53.3%) retroperitoneal cases, with all the cases recovering following treatment with antibiotics alone (P=0.199). A catheter-free status was achieved in 3 cases (27.3%) and 4 ureters (22.2%) in the transperitoneal group and in 2 cases and 2 ureters (13.3%) in the retroperitoneal group (P=0.393). There was no significant change in renal function (BUN and serum Cr values) in the transperitoneal ureterocutaneostomy cases at the postoperative, early postoperative (1 month following surgery) or the final follow-up examination (P=0.739 and 0.078). In conclusion, transperitoneal ureterocutaneostomy allows for the construction of a cutaneous stoma using a shorter ureter, with a treatment outcome that is comparable to that of retroperitoneal ureterocutaneostomy. PMID:24649235

  10. 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

  11. Distribution of ureteral stones and factors affecting their location and expulsion in patients with renal colic

    PubMed Central

    Moon, Young Joon; Kim, Hong-Wook; Kim, Jin Bum; Chang, Young-Seop

    2015-01-01

    Purpose To evaluate the distribution of ureteral stones and to determine their characteristics and expulsion rate based on their location. Materials and Methods We retrospectively reviewed computed tomography (CT) findings of 246 patients who visited our Emergency Department (ED) for renal colic caused by unilateral ureteral stones between January 2013 and April 2014. Histograms were constructed to plot the distribution of stones based on initial CT findings. Data from 144 of the 246 patients who underwent medical expulsive therapy (MET) for 2 weeks were analyzed to evaluate the factors responsible for the stone distribution and expulsion. Results The upper ureter and ureterovesical junction (UVJ) were 2 peak locations at which stones initially lodged. Stones lodged at the upper ureter and ureteropelvic junction (group A) had a larger longitudinal diameter (4.21 mm vs. 3.56 mm, p=0.004) compared to those lodged at the lower ureter and UVJ (group B). The expulsion rate was 75.6% and 94.9% in groups A and B, respectively. There was no significant difference in the time interval from initiation of renal colic to arrival at the ED between groups A and B (p=0.422). Stone diameter was a significant predictor of MET failure (odds ratio [OR], 1.795; p=0.005) but the initial stone location was not (OR, 0.299; p=0.082). Conclusions The upper ureter and UVJ are 2 peak sites at which stones lodge. For stone size 10 mm or less, initial stone lodge site is not a significant predictor of MET failure in patients who have no previous history of active stone treatment in the ureter. PMID:26495073

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

    PubMed Central

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

    2013-01-01

    Objectives Ureteral reimplantation (UR) is the gold standard for the surgical treatment of vesicoureteral reflux (VUR) but few studies have documented its long-term results. We reviewed late cystography (LC) results following successful UR. Methods We performed a retrospective chart review of all children with primary VUR who underwent successful open UR (grade 0 VUR into the reimplanted ureter(s) on initial cystogram) at our institution from January 1990 December 2002. We identified successful UR patients who underwent LC ? 1 year after UR and reviewed the results for the presence of recurrent VUR into the reimplanted ureter(s). Results 794 patients underwent successful open UR for primary VUR, of whom 60 (7.6%) had a subsequent LC. Preoperative VUR grade was ?II in 20 (34.5%), ?III in 38 (65.5%). Median age at UR was 3.5 years (IQR: 1.36.2 years); 51 (85%) were female. UR was intravesical in 45 (75%) and bilateral in 19 (32%). LC was performed at a median of 38.7 months after UR (IQR: 19.666.1 months). Indication for LC was febrile UTI in 16 (27%), non-febrile UTIs in 15 (25%), follow-up of contralateral VUR in 16 (27%) and other clinical indications in 13 (21%). The recurrence rate was 0%; of the 79 reimplanted ureters, 100% (95% CI: 95.4100) had no VUR (grade 0). Conclusions Among children who underwent successful open UR for primary VUR, there was no VUR recurrence on extended follow-up. This suggests that the late durability of open anti-reflux surgery is excellent. PMID:22245304

  13. [Replacement continent bladder in dogs by opening an antro-pyloric graft onto the abdominal wall (seven cases between 1980 and 1983)].

    PubMed

    Bourdelat, D; Vrsansky, P; Gruel, Y; Babut, J M

    1996-01-01

    To determine the usefulness of antral bladder controlled by the pyloric sphincter denervated for urological applications, bladder replacement was performed in 17 dogs using the antral segment with its own sphincter, initially with the pylorus supplied by the left gastro-epiploic artery, and later by the right gastro-epiploic artery. The smooth pyloric muscle was denervated to obtain permanent spasm and pulled through the striated anterior abdominal muscle. Both ureters were anastomosed by a Cohen's procedure. The best results were obtained with a gastric pouch supplied by the right gastro-epiploic artery; dissection and reimplantation of the ureters in the gastric wall are difficult. IVP and cystography indicated good function of the antral pouch, with no reflux. The antral bladder controlled by the denervated pyloric sphincter could be a possible alternative in the surgical management of neurogenic or exstrophic bladder. PMID:8767812

  14. Mast cell sarcoma with megakaryocytic differentiation in a calf.

    PubMed

    Fujimoto, Ayako; Wada, Yoshihiro; Kanada, Toshiaki; Ishikawa, Yoshiharu; Kadota, Koichi

    2012-12-01

    A case of mast cell sarcoma in a 5-month-old Holstein female calf is described. Macroscopically, enlargement of the spleen, lymph nodes, tonsils and kidneys was noted, and there were tumor masses in the neck region and on the pleura and peritoneum. The pericardium and uterine and ureter walls were also involved by tumor. Most neoplastic cells had eosinophilic granules, which were metachromatic and positive for naphthol AS-D chloroacetate esterase and tryptase, whereas smaller numbers of cells were positive for factor VIII-related antigen, a marker of megakaryocytes. Some of the predominant type of these tumor cells were found within the epithelia of the lungs, tonsils, gastrointestinal tract, liver, ureters, urinary bladder and uterus. Their normal counterparts were considered to be globule leukocytes. PMID:22813945

  15. Robotic surgery for treatment of chyluria.

    PubMed

    Barman, Naman; Palese, Michael

    2016-03-01

    Chyle is a milky lymphatic fluid that is normally formed in the small intestine to aid in the absorption of dietary fats. Occasionally, chyle leaks into the kidney, ureter, or bladder, which results in chyluria. Chyluria is most commonly caused by the parasite Wuchereria bancrofti and is therefore extremely rare in the USA. The use of robotic surgery for treatment has been suggested as a viable option, but has not been thoroughly reported in the literature. This article reviews the literature on the various treatment options for chyluria and presents the case of a 75-year-old Indian female from the USA who was diagnosed with non-parasitic, persistent chyluria and treated with right robotic ureterolysis, renal hilar dissection and intraperitonealization of the ureter. PMID:26861449

  16. Treatment of Ureterosciatic Hernia with a Ureteral Stent

    PubMed Central

    Yanagi, Koji; Kan, Akinobu; Sejima, Takehiro; Takenaka, Atsushi

    2015-01-01

    A 92-year-old woman was referred to our hospital from a family practice with the chief of complaint of vomiting. Subsequent computed tomography imaging revealed left hydroureteronephrosis without clear evidence of ureteral stones or ureteral tumors and that the lower part of the ureter was shifted to the outside of the cavum pelvis minor from the greater sciatic foramen. Retrograde pyelography was performed, and the shadow of a mass, which constricted and obstructed the distal left ureter, was observed. The patient was diagnosed with ureterosciatic hernia, and a left retrograde ureteral stent was indwelled and the hernia was repaired. Cases of ureterosciatic hernia are very rare. We describe one case of ureterosciatic hernia and review the relevant literature. PMID:25960996

  17. Percutaneous removal of ureteral calculi: clinical and experimental results.

    PubMed

    Hunter, D W; Castaneda-Zuniga, W R; Young, A T; Cardella, J; Lund, G; Rysavy, J A; Hulbert, J; Lange, P; Reedy, P; Amplatz, K

    1985-08-01

    Between May 1983 and October 1984, 51 patients who had 68 ureteral stones underwent treatment at the University of Minnesota. All 68 stones were removed successfully using percutaneous techniques. The 100% success rate is a great improvement over previous results at our institution. The primary factors appear to be the development of the retrograde-flush technique, familiarity with and access to a wider range of methods, and the increasing use of the retrograde ureterorenoscope to see stones in the lower ureter. The average patient was a 45-year-old man who had no other medical problems. The average hospital stay was 6.8 days. Experimental studies with dogs indicate that injection rates of up to 30 ml/sec of contrast material through a retrograde catheter in the ureter are safe if a vent is present in the upper collecting system. PMID:4011895

  18. [Morbus Ormond (idiopatic retroperitoneal fibrosis)].

    PubMed

    Michaligov, A; Plank, L; Jezkov, A; Manka, V; Makovick, P; Mokn, M

    2011-05-01

    Idiopathic retroperitoneal fibrosis (IRF) is a rare condition characterized by the development of fibrotic tissue around the abdominal aorta and iliac arteries and often involves structures as ureters and the inferior vena cava. The age at onset of signs and symptoms is between 40-60 years, males predominane over females. In most cases the clinical manifestation is presented as compressive syndrom of ureters, therefore the first known cases were described by urologists. In this report we present the case of 37-years old male examinated for persistent fever about 38 degrees C and high inflammatory activity in spite of empiric antibiotic therapy. Positron emission tomography (PET) showed locality of high metabolic activity of fluorodeoxyglucose with maximum paraaortal left. Microscopic examination of extracted mass showed presence of fibrous and inflammatory components. With clinical presentation, imaging and histological findings we made out the diagnosis of idiopathic retroperitoneal fibrosis--morbus Ormond. PMID:21695934

  19. [Efficiency of endoscopic treatment of primary vesicoureteral reflux depending on bulking agent].

    PubMed

    Abdullaev, F K; Kulaev, V D; Nikolaev, V V

    2013-01-01

    From June 1991 to December 2011, endoscopic treatment of vesicoureteral reflux (VUR) was performed more than in 4,000 children aged 4 months to 17 years. As bulking agents, teflon paste, DAM +, urodex, and vantris were used. A comparative evaluation of the effectiveness of single endoplasty with various bulking agents in children with I-V degree primary VUR, who had no gross congenital abnormalities in ureterovesical anastomosis, such as paraureteral diverticula, complete duplicated ureter or extravesicalisation of ureter, and not suffered from chronic cystitis, was performed. It was found that the use of Teflon paste led to elimination of reflux in 102 (95.3%) of 107 patients, vantris--in 52 (92.9%) of 56 patients, DAM(+)--in 145 (77.8%) of 186, urodex--in 47 (68.1%) of 69 patients. Among modern bulking agents meet all safety requirements, vantris is recommended for the optimal treatment of vesicoureteral reflux in children. PMID:23789372

  20. An outbreak of urolithiasis in single-comb white Leghorn pullets.

    PubMed

    Fitz-Coy, S H; Edgar, S A; Hoerr, F J

    1988-01-01

    An outbreak of urolithiasis characterized by high mortality and emaciation in a flock of leghorn pullets is reported. The etiology was not ascertained. Other signs were swollen feet associated with articulate gout. Visceral gout, atrophy, or irregular hypertrophy of the kidneys were also observed. Many birds had one or both ureters enlarged with white uroliths. Microscopic lesions were urate granulomas, necrosis and loss of kidney parenchyma associated with tubular dilation, and edematous and fibrotic interstitium. PMID:3196272

  1. Excising multiple ureteral cysts endoscopically utilizing the OmniPlus-Max 80 W holmium laser

    PubMed Central

    Blewniewski, Mariusz; R?a?ski, Waldemar

    2015-01-01

    We present a rare case of ureteral cysts in the left ureter treated by an endoscopic holmium laser. These cysts caused asymptomatic hydronephrosis in the left kidney. Complete cyst removal was performed by a ureteroscopically applied holmium laser. Six months post-procedure, the patient had no recurrence, which suggests that endoscopic excision is an optimal treatment for this disorder. Periodic ureteroscopic examination is indicated for further observation. PMID:25624968

  2. Danazol in the management of ureteral obstruction secondary to endometriosis

    SciTech Connect

    Rivlin, M.E.; Krueger, R.P.; Wiser, W.L.

    1985-08-01

    A case is reported in which a woman was diagnosed with ureteral obstruction secondary to endometriosis after cystourethrogram, retrograde pyelogram and a renal scan. After unsuccessful treatment with danazol, a retroperitoneal ureteroneocystotomy was performed. The ureter was found to be obstructed by dense fibrous tissue that contained endometrial glands. It was concluded that danazol is unlikely to relieve endometriotic ureteric obstruction once dense fibrosis has occurred. 8 references, 2 figures.

  3. Laser division of intraluminal sutures.

    PubMed

    Bagley, D H; Schultz, E; Conlin, M J

    1998-08-01

    Neodymium:YAG and holmium:YAG lasers were used to remove intraluminal sutures from three patients. In two, the suture was in the bladder and had served as a nidus for stone formation. In the other, the suture was in the ureter. An in vitro study showed that the Nd:YAG laser could divide all types of suture readily, whereas the Ho:YAG laser could divide all materials except Gortex. These cases illustrate another application for lasers. PMID:9726402

  4. Ureteral metastasis of a prostatic adenocarcinoma

    PubMed Central

    Otta, Renan Javier; Gordillo, Carlos; Fernndez, Inmaculada

    2015-01-01

    The ureter is a rare location of metastasis for any kind of primary tumour. The first case of truly ureteral metastasis was described by Stow in 1909. Regarding prostatic metastasis, the frequency is much lower with only 43 cases reported in the last century. We present a case of an exceedingly rare ureteral metastasis of a prostatic adenocarcinoma. In spite of its low incidence, it should be considered in patients with ureteral obstruction and concurrent prostatic adenocarcinoma. PMID:25844106

  5. RETROSPECTIVE EVALUATION OF INTERFRACTION URETERAL MOVEMENT IN DOGS UNDERGOING RADIATION THERAPY TO ELUCIDATE APPROPRIATE SETUP MARGINS.

    PubMed

    Yoshikawa, Hiroto; Nolan, Michael W; Lewis, Dustin W; Larue, Susan M

    2016-03-01

    Radiation-induced ureteral damage can result in serious complications (i.e., hydronephrosis). Also, ureters can be included in planning target volume (PTV) such as ureteral invasion of urinary bladder carcinoma. Therefore, knowing the interfractional movement of the ureters is critical for creation of appropriate planning organs at risk (pOAR) and PTV. This retrospective and descriptive study of 17 dogs with genitourinary carcinomas that underwent intensity-modulated, image-guided radiation therapy (IM-IGRT) was conducted to describe the movement and calculate suggested pOAR/PTV expansions at three locations (at the levels of third lumbar vertebra, immediately cranial to vesicoureteral junction [VUJ], and midway between those two) and from two perspectives: during a course of (1) IM-IGRT, where position verification is performed using soft tissue registration when the dogs underwent clinical IM-IGRT; (2) radiation therapy whereby position verification is performed using planar radiography with a corresponding bony registration. This registration was performed by fusing the radiation planning computed tomography (CT) and cone-beam CTs using bony landmarks. With soft tissue registration, findings supported the use of larger pOAR expansion (0.7-1.8 cm) for the mid region of the ureters compared to the areas near VUJ (0.7-1.1 cm). With bony registration, findings supported the use of larger pOAR/PTV expansions (1.6-1.7 cm) for dorsal direction bilaterally at areas near VUJ compared to those with soft tissue registration (0.9-1.0 cm). The results of this study should help radiation oncologists use appropriate ureter expansions for specific patient orientations and positioning verification methods. PMID:26634416

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

    PubMed

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

    2012-01-01

    A 23-year-old female had bilateral ureteral stents placed due to bilateral renal stones and hydronephrosis. The bilateral ureteral stents were changed every 3 months. A kidney ureter bladder (KUB) film showed left encrustation along the ureteral stent thus necessitating removal; however, the ureteral stent could not be removed cystoscopically. The ureteral stent was, therefore, extracted using flexible ureteroscopy (URS) with a holmium (Ho): yttrium aluminum garnet (YAG) laser. PMID:22548081

  7. Ureterolithotripsy in a paediatric population: a single institution's experience.

    PubMed

    Jurkiewicz, Beata; Z?bkowski, Tomasz; Samotyjek, Joanna

    2014-04-01

    This study presents one institution's experiences in ureterolithotripsy (URSL)--a particular endoscopic treatment modality. The incidence and prevalence of urolithiasis in the paediatric population continues to increase. However, the choice of the most appropriate treatment remains a challenging problem for paediatric surgeons. Between January 2006 and June 2013, the Department of Pediatric Surgery performed 157 URSLs. The patient population consisted of 126 children (60 girls and 66 boys) aged 10 months-17 years and having a body mass >8 kg. Dilatation of the pyelocalyceal system along with dilatation of the ureter above the concrement was present in all patients. Pneumatic, laser (Ho:YAG--pulsed laser), ultrasonic lithotripters with rigid, flexible ureteroscopes of 4.5/6 and 6.5/8 Ch were used. URSL was performed in 157 cases. During the first session, excellent results were obtained in 134 of 157 cases (85.3 %). In 15 cases (9.6 %), a second URSL was required. In five cases (3.2 %), URSL was performed a third time. A final stone-free rate of 98.1 % was obtained within the ureter. In three cases (1.9 %), complications were observed. In ten cases (6.37 %), a pigtail catheter was placed and retained in the ureter. URSL is a very good and effective endoscopic treatment for the removal of concrements localized in ureters. These concrements cause alterations in flow from the upper urinary tract in children. Because of the relatively small diameter and volume of the urinary tract in children aged <5 years, URSL in this population requires great precision, experience, and technical skill. PMID:24368682

  8. Deletion (11)(q14.1q21)

    SciTech Connect

    Stratton, R.F.; Lazarus, K.H.; Ritchie, E.J.L.; Bell, A.M.

    1994-02-01

    The authors report on a 4-year-old girl with moderate development delay, horseshoe kidney, bilateral duplication of the ureters with right upper pole obstruction, hydronephrosis and nonfunction, and subsequent Wilms tumor of the right lower pole. She had an interstitial deletion of the long arm of chromosome 11 involving the region 11(q14.1q21). 22 refs., 2 figs., 1 tab.

  9. Is a secondary procedure necessary in every case of failed endoscopic treatment for vesicoureteral reflux?

    PubMed Central

    Jung, Hyun Jin; Im, Young Jae; Lee, Yong Seung; Kim, Myung Joo

    2015-01-01

    Purpose Endoscopic treatment (ET) has become a widely accepted procedure for treating vesicoureteral reflux (VUR). However, patients followed up after ET over long periods have reported persistent or recurrent VUR. We evaluated the natural course of failed ET in patients who required further treatments to help physicians in making decisions on the treatment of VUR. Materials and Methods We retrospectively reviewed the medical records of patients who were diagnosed with VUR and underwent ET from January 2006 to December 2009. A total of 165 patients with 260 ureters underwent ET. We compared the parameters of the patients according to ET success or failure and evaluated the natural course of the patients after ET failure. Results Mean VUR grade and positive photon defect were higher in the failed ET group than in the successful ET group. Six months after the operation, persistent or recurrent VUR was observed in 76 ureters (29.2%), and by 16.3 months after the operation, VUR resolution was observed in 18 ureters (23.7%). Twenty-five ureters (32.9%) without complications were observed conservatively. Involuntary detrusor contraction was found in 1 of 9 (11.1%) among the secondary ET success group, whereas in the secondary ET failure group, 4 of 6 (66.7%) had accompanying involuntary detrusor contraction. Conclusions Patients in whom ET fails can be observed for spontaneous resolution of VUR unless they have febrile urinary tract infection or decreased renal function. Urodynamic study may be helpful in deciding whether a secondary procedure after ET failure is necessary. PMID:25964842

  10. [Fistula between the bladder and vagina and perforation after implantation of a wall stent for ureteral stricture].

    PubMed

    Meyer, S; Fahlbusch, M; Thon, W F

    2010-04-01

    The implantation of metal stents in the ureter is an alternative therapeutic option for treating ureteral strictures of different origins. We report the case of a female patient who was treated with a ureteral wall stent because of stenosis caused by radiotherapy. Subsequently the stent migrated into the bladder and led to incrustation and stone formation. This finally led to development of a vesicovaginal fistula and bladder perforation into the os pubis. PMID:19859690

  11. Silent But Giant: Giant ureteric calculus in a 7-year-old boy

    PubMed Central

    Mak, D; Wragg, R; Chandran, H; McCarthy, R; Parashar, K

    2010-01-01

    Giant ureteric calculi are extremely rare in children. We present a case of a child who was originally admitted for observation following non-accidental injury and had an episode of painless haematuria as an inpatient. Ultrasonography demonstrated left hydronephrosis and a 2cm echogenic area in the proximal ureter. A plain abdominal radiograph surprisingly revealed two left ureteric calculi, one 7cm and the other 4cm in length. Stone extraction was achieved using an open left ureterolithotomy and pyelolithotomy. PMID:24946326

  12. [Acquired phimosis, or preputial sclero-atrophic lichen in children].

    PubMed

    Baron, M; Heloury, Y; Stalder, J F; Bureau, B; Bouchot, O; Auvigne, J

    1991-01-01

    From 1979 to 1988, 8 cases of balanitis xerotica obliterans were histologically demonstrated in children at Nantes University Hospital. In 6 of these 8 patients, whose average age at the time of consultation was 9.4 years, the phimosis was obviously acquired or recurrent, and the prepuce was sclerous, thick, and produced a tight distal phimosis. One child coming to consultation for relapsing urinary infections at once presented with a long, tight stenosis of the anterior ureter, associated with a dilatation of the upstream ureter and a filiform stream of urine. All the children were circumcised, and the histological study of the specimen demonstrated characteristic lesions in the superficial derma. During the same operation, meatostomy was performed in two children presenting with meatal stenosis. Six of 8 children were followed up with an average time lapse of 6 months: one of them presented with an involvement of the glans penis and a moderate meatal stenosis, which disappeared spontaneously. No improvement occurred for the child presenting with an extensive stenosis of the anterior ureter, in spite of the local instillation of androgens then of corticoids, but his left kidney was dilated on sonograms. Balanitis xerotica obliterans in children is often not recognized and regarded as a common phimosis; it can be suspected because of the clinical features of the phimosis. The condition must be confirmed by the histological study of a circumcision specimen, then followed up regularly to prevent any risk of involvement of the glans, of the ureteral meatus or of the anterior ureter. PMID:1960184

  13. Elucidating the Life History and Ecological Aspects of Allodero hylae (Annelida: Clitellata: Naididae), A Parasitic Oligochaete of Invasive Cuban Tree Frogs in Florida.

    PubMed

    Andrews, Jessee M; Childress, Jasmine N; Iakovidis, Triantafilos J; Langford, Gabriel J

    2015-06-01

    Given their ubiquitous nature, it is surprising that more oligochaete annelid worms (Annelida: Clitellata) have not adopted an endoparasitic lifestyle. Exceptions, however, are the understudied members of the genus Dero (Allodero) that parasitize the ureters of tree frogs and toads. This study experimentally explores the life cycle and host specificity of Allodero hylae, the worm's use of chemical cues in host searching, and its seasonal prevalence and abundance over a year-long collection period on the Florida Southern College campus. A total of 2,005 A. hylae was collected from the ureter, urinary bladder, or expressed urine of wild Osteopilus septentrionalis ; a significant positive correlation was found between host snout-vent length and parasite intensity for female but not male hosts. Monthly prevalence of A. hylae reached a peak of 58% in April, but never dropped below 20% in any month; mean abundance peaked March-May, whereas few worms were recovered in December and January. Confirming a parasitic lifestyle, wild-collected hosts with intense infections, typically >40 worms, showed obvious dilatation of the ureter wall, and some young-of-the-year O. septentrionalis exposed to A. hylae in the laboratory were killed by the apparent rupture of the host's ureter. The worm has a direct life cycle: worms expelled in the host's urine are capable of locating and re-infecting other hosts within aquatic microhabitats such as bromeliad tanks, and worms can survive for weeks in a free-living environment, even undergoing a morphological change. Further, chemotaxis assays found a positive response to a tree frog attractant for worms recently removed from hosts. Overall, this study provides the first multifaceted investigation on the life history and ecology of any Allodero spp., which offers new insights into an understudied endoparasitic oligochaete. PMID:25730299

  14. Basic investigation of laser therapy for the ureteral stricture using ultraviolet argon laser and multifiber catheter

    NASA Astrophysics Data System (ADS)

    Daidoh, Yuichiro; Arai, Tsunenori; Murai, Masaru; Suda, Akira; Kikuchi, Makoto; Nakamura, Hiroshi; Komime, Yukikuni; Utsumi, Atsushi

    1992-06-01

    In order to develop new, easy, and safe treatment for urinary tract stricture, we investigated the laser plasty using a combination of an uv Ar laser for ablation and a novel multi-fiber catheter for laser delivery. To investigate the characteristics of the uv Ar laser ablation to ureteral tissue, the experiment in vitro was performed. The ureter was clearly ablated with sufficient thin coagulation layer. The proper laser power for the tissue ablation was about 0.5 W for 0.4 mm core-diameter fiber. The multi-fiber catheter (1.6 mm in outer diameter) consisted of 13 pixels of silica glass fibers (0.2 mm in core diameter) for laser delivery and a through lumen (0.9 mm in inner diameter) for guidewire. The catheter was inserted into a canine ureter under the general anesthesia. The ureter and urinary tract were irradiated using about 0.6 W of laser power at the catheter tip with 40s duration. The irradiated urinary tract tissues were histologically investigated. The ureter was ablated up to the submucosa layer. The urinary tract endotherium was eliminated by the laser ablation without the carbonization. No perforation was found at various irradiation conditions. To investigate the ureteral tissue damage of the uv Ar laser irradiation, the serosa temperature was measured by a thermocouple. The temperature elevation of the serosa could be restricted up to 60 degree(s)C, at which the protein was not coagulated. We concluded that the combination of uv Ra laser and multi-fiber catheter offered easy, reliable therapy for coronary structure.

  15. [A clinical study of associated bladder tumor in patients with renal pelvic and ureteral tumor].

    PubMed

    Sugano, O; Shouji, N; Horigome, T; Uchi, K; Katou, H

    1995-08-01

    We investigated the incidence of associated bladder tumor and prognosis in 101 cases with a pathological diagnosis of transitional cell carcinoma, selected from those with renal pelvic and ureteral tumor whom we had encountered over the 18 years between April 1976 and March 1993. Among these 101 cases, the incidence of associated bladder tumor was noted in 42 (41.6%), 23 (22.8%) with coexistence and 19 (18.8%) with subsequence. As for the primary site of renal pelvis and ureter, the coexistence was 15.4% and subsequence 20.5% in renal pelvis, and the coexistence was 24.6% and subsequence 19.3% in ureter, and the coexistence was 60.0% and subsequence 0.0% in both renal pelvis and ureter. The incidence of coexistent bladder tumor was high in both renal pelvis and ureter, but no significant difference was noted. As for the stage, the incidence of coexistence was high in T1, while subsequence was high in T2, but no significant difference was noted. As for the grade, the incidence of coexistence was high in G2, but no significant difference was noted. The 5 year survival rate was 58.2% in those without, 54.2% with coexistence, and 82.5% with subsequent bladder tumor, with a significant difference (p < 0.05) between the last two groups. The interval of subsequent bladder tumor ranged from 4 to 164 months (mean 27.7 months), with the incidence within 2 years being approximately 70.0%. It was found that the renal pelvic and ureteral tumors are frequently associated bladder tumor while associated bladder tumor dose not appear to have an ill effect on the prognosis. Therefore it is necessary that patients with renal pelvic and ureteral tumor be observed closely for 5 years, especially for the initial 2 years. PMID:7474623

  16. Jacquet erosive diaper dermatitis in a young girl with urinary incontinence.

    PubMed

    Hara, M; Watanabe, M; Tagami, H

    1991-06-01

    We report a case of Jacquet erosive diaper dermatitis (dermatitis syphiloides posterosiva) in a 9-year-old girl suffering from urinary incontinence due to an ectopic opening of a left double ureter into the vaginal vestibule. The toilet paper that she used as an absorbent was thought to be one of the factors causing the eruption. The lesions cleared with topical application of a nonsteroidal antiinflammatory ointment and zinc oxide ointment, in conjunction with the use of sanitary napkins. PMID:1923987

  17. Urinary Diversions

    PubMed Central

    Davis, Ian

    1991-01-01

    Once the bladder has been removed or declared non-functional, some form of urinary diversion must be performed. The diversion can be as simple as bringing the ureters to the skin and as complicated as the creation of a functioning neobladder. The indications for and expectations of the most common types of diversion are explained. Some new techniques for continent diversion are described. PMID:21229045

  18. Cancer Research Repository for Individuals With Cancer Diagnosis and High Risk Individuals.

    ClinicalTrials.gov

    2014-12-12

    Pancreatic Cancer; Thyroid Cancer; Lung Cancer; Esophageal Cancer; Thymus Cancer; Colon Cancer; Rectal Cancer; GIST; Anal Cancer; Bile Duct Cancer; Duodenal Cancer; Gallbladder Cancer; Gastric Cancer; Liver Cancer; Small Intestine Cancer; Peritoneal Surface Malignancies; Familial Adenomatous Polyposis; Lynch Syndrome; Bladder Cancer; Kidney Cancer; Penile Cancer; Prostate Cancer; Testicular Cancer; Ureter Cancer; Urethral Cancer; Hypopharyngeal Cancer; Laryngeal Cancer; Lip Cancer; Oral Cavity Cancer; Nasopharyngeal Cancer; Oropharyngeal Cancer; Paranasal Sinus Cancer; Nasal Cavity Cancer; Salivary Gland Cancer; Skin Cancer; CNS Tumor; CNS Cancer; Mesothelioma

  19. Chronic renal failure in a patient with bilateral ureterocele

    PubMed Central

    Dada, Samuel A.; Rafiu, Mojeed O.; Olanrewaju, Timothy O.

    2015-01-01

    Ureterocele is a congenital anomaly, in which there is mal-development of the caudal segments of the ureter. There is a female preponderance with most cases seen in Caucasians. Among the reported complications of this condition, chronic renal failure occurring in the setting of ureterocele has not been well documented. We report a case of a young girl with bilateral ureterocele presenting with chronic renal failure, whose management presented a diagnostic failure and inadequate treatment. PMID:26108593

  20. Chronic renal failure in a patient with bilateral ureterocele.

    PubMed

    Dada, Samuel A; Rafiu, Mojeed O; Olanrewaju, Timothy O

    2015-07-01

    Ureterocele is a congenital anomaly, in which there is mal-development of the caudal segments of the ureter. There is a female preponderance with most cases seen in Caucasians. Among the reported complications of this condition, chronic renal failure occurring in the setting of ureterocele has not been well documented. We report a case of a young girl with bilateral ureterocele presenting with chronic renal failure, whose management presented a diagnostic failure and inadequate treatment. PMID:26108593

  1. Effective radiation exposure evaluation during a one year follow-up of urolithiasis patients after extracorporeal shock wave lithotripsy

    PubMed Central

    Tekinarslan, Erdem; Keskin, Suat; Buldu, İbrahim; Sönmez, Mehmet Giray; Karatag, Tuna; Istanbulluoglu, Mustafa Okan

    2015-01-01

    Introduction To determine and evaluate the effective radiation exposure during a one year follow-up of urolithiasis patients following the SWL (extracorporeal shock wave lithotripsy) treatment. Material and methods Total Effective Radiation Exposure (ERE) doses for each of the 129 patients: 44 kidney stone patients, 41 ureter stone patients, and 44 multiple stone location patients were calculated by adding up the radiation doses of each ionizing radiation session including images (IVU, KUB, CT) throughout a one year follow-up period following the SWL. Results Total mean ERE values for the kidney stone group was calculated as 15, 91 mSv (5.10-27.60), for the ureter group as 13.32 mSv (5.10-24.70), and in the multiple stone location group as 27.02 mSv (9.41-54.85). There was no statistically significant differences between the kidney and ureter groups in terms of the ERE dose values (p = 0.221) (p >0.05). In the comparison of the kidney and ureter stone groups with the multiple stone location group; however, there was a statistically significant difference (p = 0.000) (p <0.05). Conclusions ERE doses should be a factor to be considered right at the initiation of any diagnostic and/or therapeutic procedure. Especially in the case of multiple stone locations, due to the high exposure to ionized radiation, different imaging modalities with low dose and/or totally without a dose should be employed in the diagnosis, treatment, and follow-up bearing the aim to optimize diagnosis while minimizing the radiation dose as much as possible. PMID:26568880

  2. Prosthetic Sphincter Controls Urination

    NASA Technical Reports Server (NTRS)

    Tenny, John B., Jr

    1986-01-01

    People who lost muscular control of urinary canal through disease or injury aided by prosthetic sphincter. Implanted so it surrounds uretha, sphincter deflated and inflated at will by wearer to start and stop urina tion. Operating pressure adjusted after implantation to accommodate growth or atrophy of urinary canal and prevent tissue damage from excess pressure. Principle adapted to other organs, such as colon, ureter, or ileum.

  3. Biodegradable Ureteral Stents

    NASA Astrophysics Data System (ADS)

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

    2008-09-01

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

  4. Deletion of the miR-143/145 Cluster Leads to Hydronephrosis in Mice

    PubMed Central

    Medrano, Silvia; Sequeira-Lopez, Maria Luisa S.; Gomez, R. Ariel

    2015-01-01

    Obstructive nephropathy, the leading cause of kidney failure in children, can be anatomic or functional. The underlying causes of functional hydronephrosis are not well understood. miRNAs, which are small noncoding RNAs, regulate gene expression at the post-transcriptional level. We found that miR-145-5p, a member of the miR-143/145 cluster that is highly expressed in smooth muscle cells of the renal vasculature, was present in the pelvicalyceal system and the ureter. To evaluate whether the miR-143/145 cluster is involved in urinary tract function we performed morphologic, functional, and gene expression studies in mice carrying a whole-body deletion of miR-143/145. miR-143/145deficient mice developed hydronephrosis, characterized by severe papillary atrophy and dilatation of the pelvicalyceal system without obvious physical obstruction. Moreover, mutant mice showed abnormal ureteral peristalsis. The number of ureter contractions was significantly higher in miR-143/145deficient mice. Peristalsis was replaced by incomplete, short, and more frequent contractions that failed to completely propagate in a proximal-distal direction. Microarray analysis showed 108 differentially expressed genes in ureters of miR-143/145deficient mice. Ninety genes were up-regulated and 18 genes were down-regulated, including genes with potential regulatory roles in smooth muscle contraction and extracellular matrix-receptor interaction. We show that miR-143/145 are important for the normal peristalsis of the ureter and report an association between the expression of these miRNAs and hydronephrosis. PMID:25307343

  5. Ureteroscopy and holmium:YAG laser lithotripsy: an emerging definitive management strategy for symptomatic ureteral calculi in pregnancy

    NASA Astrophysics Data System (ADS)

    Watterson, James D.; Girvan, Andrew R.; Beiko, Darren T.; Nott, Linda; Wollin, Timothy A.; Razvi, Hassan A.; Denstedt, John D.

    2003-06-01

    Objectives: Symptomatic urolithiasis in pregnancy that does not respond to conservative measures has traditionally been managed with ureteral stent insertion or percutaneous nephrostomy (PCN). Holmium:yttrium-aluminum-garnet (YAG) laser lithotripsy using state-of-the-art ureteroscopes represents an emerging strategy for definitive stone management in pregnancy. The purpose of this study was to review the results of holmium laser lithotripsy in a cohort of patients who presented with symptomatic urolithiasis in pregnancy. Methods: A retrospective analysis was conducted at 2 tertiary stone centers from January 1996 to August 2001 to identify pregnant patients who were treated with ureteroscopic holmium laser lithotripsy for symptomatic urolithiasis or encrusted stents. Eight patients with a total of 10 symptomatic ureteral calculi and 2 encrusted ureteral stents were treated. Mean gestational age at presentation was 22 weeks. Mean stone size was 8.1 mm. Stones were located in the proximal ureter/ureteropelvic junction (UPJ) (3), mid ureter (1), and distal ureter (6). Results: Complete stone fragmentation and/or removal of encrusted ureteral stents were achieved in all patients using the holmium:YAG laser. The overall procedural success rate was 91%. The overall stone-free rate was 89%. No obstetrical or urological complications were encountered. Conclusions: Ureteroscopy and holmium laser lithotripsy can be performed safely in all stages of pregnancy providing definitive management of symptomatic ureteral calculi. The procedure can be done with minimal or no fluoroscopy and avoids the undesirable features of stents or nephrostomy tubes.

  6. Ureteral stricture formation after ureteroscope treatment of impacted calculi: A prospective study

    PubMed Central

    Singam, Praveen; Ho, Christopher Chee Kong; Sridharan, Radhika; Hod, Rozita; Bahadzor, Badrulhisham; Goh, Eng Hong; Tan, Guan Hee; Zainuddin, Zulkifli

    2015-01-01

    Purpose Urinary calculi is a familiar disease. A well-known complication of endourological treatment for impacted ureteral stones is the formation of ureteral strictures, which has been reported to occur in 14.2% to 24% of cases. Materials and Methods This was a prospective study. Ureterotripsy treatment was used on patients with impacted ureteral stones. Then, after 3 months and 6 months, the condition of these patients was assessed by means of a kidney-ureter-bladder (KUB) ultrasound. If the KUB ultrasound indicated moderate to serious hydronephrosis, the patient was further assessed by means of a computed tomography intravenous urogram or retrograde pyelogram to confirm the occurrence of ureteral strictures. Results Of the 77 patients who participated in the study, 5 developed ureteral strictures. Thus, the stricture rate was 7.8%. An analysis of the intraoperative risk factors including perforation of the ureter, damage to the mucous membrane, and residual stone impacted within the ureter mucosa revealed that none of these factors contributed significantly to the formation of the ureteric strictures. The stone-related risk factors that were taken into consideration were stone size, stone impaction site, and duration of impaction. These stone factors also did not contribute significantly to the formation of the ureteral strictures. Conclusions This prospective study failed to identify any predictable factors for ureteral stricture formation. It is proposed that all patients undergo a simple postoperative KUB ultrasound screening 3 months after undergoing endoscopic treatment for impacted ureteral stones. PMID:25598938

  7. Congenital Bilateral Mid Ureteral Stenosis: A Rare Finding.

    PubMed

    Harshawardhan Vedpalsingh, Tanwar; Avinash Vijay, Joshi; Vinayak Gorakhnath, Wagaskar; Manoj Vilas, Bachhav; Sudarshan Omprakash, Daga

    2015-05-01

    Bilateral congenital mid ureteric stenosis is a very rare entity causing hydroureteronephrosis. The pathophysiology and aetiology of this condition is uncertain. Congenital functional obstruction of the mid ureter has only 17 reported cases, that too of unilateral pathology. We report a case of an 11-year-old male child who was presented with left sided lump in abdomen since one year. On bilateral retrograde ureteropyelography (RGP), bilateral mid ureteric stenosis was documented at the level of pelvic brim. Tc99m Diethylene Triamine Pentacaetic Acid (DTPA) scan showed non functioning left kidney and decreased function and retention on right side. We did a left nephroureterectomy and uretero-ureterostomy without tapering over a Double-J stent (DJ), with excision of stenosed segment on right side. Pathological review of the ureteric segments of both sides revealed proximal dilatation with non-specific thickening of the muscular wall of the stenosed segments of ureter. The differential diagnosis must additionally include ureteral valves and fibro epithelial polyps. Important role of intravenous pyelography in such cases must be emphasized to localize the pathology site. In addition, retrograde ureteropyelography is essential in management of this anomaly to delineate the stenosed segment of the ureter preoperatively, so that the surgeon can be well prepared with final plan of management. PMID:26155518

  8. Possible complications of ureteroscopy in modern endourological era: two-point or "scabbard" avulsion.

    PubMed

    Gaizauskas, Andrius; Markevicius, Marius; Gaizauskas, Sergejus; Zelvys, Arunas

    2014-01-01

    Indication has led ureteroscopy to be a worldwide technique, with the expected appearance of multiple types of complications. Severe complications are possible including ureteral perforation or avulsion. Ureteral avulsion has been described as an upper urinary tract injury related to the action of blunt trauma, especially from traffic accidents, being the mechanism of injury, the result of an acute deceleration/acceleration movement. With the advent of endourology, that term is also applied to the extensive degloving injury resulting from a mechanism of stretching of the ureter that eventually breaks at the most weakened site, or ureteral avulsion is referred to as a discontinuation of the full thickness of the ureter. The paper presents a case report and literature review of the two-point or "scabbard" avulsion. The loss of long segment of the upper ureter, when end-to-end anastomosis is not technically feasible, presents a challenge to the urological surgeon. In the era of small calibre ureteroscopes these complications, due to growing incidence of renal stones will become more and more actual. Our message to other urologists is to know such a complication, to know the ways of treatment, and to analyse ureteroscopic signs, when to stop or pay attention. PMID:25610699

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

    NASA Astrophysics Data System (ADS)

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

    1991-07-01

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

  10. Treatment of Ureteroarterial Fistulae with Covered Vascular Endoprostheses and Ureteral Occlusion

    SciTech Connect

    Bilbao, Jose I. Cosin, Octavio; Bastarrika, Gorka; Rosell, David; Zudaire, Javier; Martinez-Cuesta, Antonio

    2005-04-15

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

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

    SciTech Connect

    Nishimura, Noriko Matsumura, Fumio; Vogel, Christopher F.A.; Nishimura, Hisao; Yonemoto, Junzo; Yoshioka, Wataru; Tohyama, Chiharu

    2008-09-15

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

  12. Lower urinary tract development and disease

    PubMed Central

    Rasouly, Hila Milo; Lu, Weining

    2013-01-01

    Congenital Anomalies of the Lower Urinary Tract (CALUT) are a family of birth defects of the ureter, the bladder and the urethra. CALUT includes ureteral anomalies such as congenital abnormalities of the ureteropelvic junction (UPJ) and ureterovesical junction (UVJ), and birth defects of the bladder and the urethra such as bladder-exstrophy-epispadias complex (BEEC), prune belly syndrome (PBS), and posterior urethral valves (PUV). CALUT is one of the most common birth defects and is often associated with antenatal hydronephrosis, vesicoureteral reflux (VUR), urinary tract obstruction, urinary tract infections (UTI), chronic kidney disease and renal failure in children. Here, we discuss the current genetic and molecular knowledge about lower urinary tract development and genetic basis of CALUT in both human and mouse models. We provide an overview of the developmental processes leading to the formation of the ureter, bladder, and urethra, and different genes and signaling pathways controlling these developmental processes. Human genetic disorders that affect the ureter, bladder and urethra and associated gene mutations are also presented. As we are entering the post-genomic era of personalized medicine, information in this article may provide useful interpretation for the genetic and genomic test results collected from patients with lower urinary tract birth defects. With evidence-based interpretations, clinicians may provide more effective personalized therapies to patients and genetic counseling for their families. PMID:23408557

  13. Use of ureteral access sheaths in ureteroscopy.

    PubMed

    Kaplan, Adam G; Lipkin, Michael E; Scales, Charles D; Preminger, Glenn M

    2016-03-01

    The ureteral access sheath (UAS) facilitates the use of flexible ureteroscopy, enabling improved minimally invasive management of complex upper urinary tract diseases. The UAS, which comes in a variety of diameters and lengths, is passed in a retrograde fashion, aided by a hydrophilic coating and other features designed to confer smooth passage into the ureter with sufficient resistance to kinking and buckling. Use of a UAS has the advantage of enabling repeated passage of the ureteroscope while minimizing damage to the ureter, thus improving the flow of irrigation fluid and visualization within the urethra with reductions in operative times, which improves both the effectiveness of the surgery and reduces the costs. Placement of the UAS carries an increased risk of ureteral wall ischaemia and injury to the mucosal or muscular layers of the ureter, and a theoretically increased risk of ureteral strictures. A ureteral stent is typically placed after ureteroscopy with a UAS. Endourologists have found several additional practical uses of a UAS, such as the percutaneous treatment of patients with ureteral stones, and solutions to other endourological challenges. PMID:26597613

  14. Urine excretion strategy for stem cell-generated embryonic kidneys.

    PubMed

    Yokote, Shinya; Matsunari, Hitomi; Iwai, Satomi; Yamanaka, Shuichiro; Uchikura, Ayuko; Fujimoto, Eisuke; Matsumoto, Kei; Nagashima, Hiroshi; Kobayashi, Eiji; Yokoo, Takashi

    2015-10-20

    There have been several recent attempts to generate, de novo, a functional whole kidney from stem cells using the organogenic niche or blastocyst complementation methods. However, none of these attempts succeeded in constructing a urinary excretion pathway for the stem cell-generated embryonic kidney. First, we transplanted metanephroi from cloned pig fetuses into gilts; the metanephroi grew to about 3 cm and produced urine, although hydronephrosis eventually was observed because of the lack of an excretion pathway. Second, we demonstrated the construction of urine excretion pathways in rats. Rat metanephroi or metanephroi with bladders (developed from cloacas) were transplanted into host rats. Histopathologic analysis showed that tubular lumina dilation and interstitial fibrosis were reduced in kidneys developed from cloacal transplants compared with metanephroi transplantation. Then we connected the host animal's ureter to the cloacal-developed bladder, a technique we called the "stepwise peristaltic ureter" (SWPU) system. The application of the SWPU system avoided hydronephrosis and permitted the cloacas to differentiate well, with cloacal urine being excreted persistently through the recipient ureter. Finally, we demonstrated a viable preclinical application of the SWPU system in cloned pigs. The SWPU system also inhibited hydronephrosis in the pig study. To our knowledge, this is the first report showing that the SWPU system may resolve two important problems in the generation of kidneys from stem cells: construction of a urine excretion pathway and continued growth of the newly generated kidney. PMID:26392557

  15. Holmium:YAG laser treatment of ureteral calculi: A 5-year experience.

    PubMed

    Farkas, A; Pteri, L; Lorincz, L; Salah, M A; Flask, T; Varga, A; Tth, Cs

    2006-09-01

    The purpose of this study was to provide an account of the 5-year experience we have gained using holmium:yttrium-aluminium-garnet (Ho:YAG) lasertripsy in the treatment of ureteral stones. One-hundred thirty-seven transurethral ureterolithotripsies were performed in 131 patients. A Ho:YAG laser device, fibres with diameters of 360 and 550 mum, a video camera as well as semi-rigid and flexible ureterorenoscopes were used. Results showed that the direct success rates-which meant stone-free ureters on the first post-operative day-in the upper, middle and lower ureters were 84.6, 88.7 and 94.8%, respectively. The final success rates--which meant stone-free ureters 4 weeks after the operation without a second intervention--were 84.6, 96.7 and 96.7%, respectively. The pulsatile Ho:YAG laser beam fragmented all kinds of stones easily. No ureteral stricture or reflux was identified during the follow-up period. The advantages of Ho lasertripsy outweighed its disadvantages. Based on our experience, the Ho:YAG laser is one of the most effective and safest energy sources in the treatment of ureteral calculi. PMID:16897107

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

    USGS Publications Warehouse

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

    2003-01-01

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

  17. Intraoperative electron-beam radiotherapy and ureteral obstruction

    SciTech Connect

    Miller, Robert C.; Haddock, Michael G.; Petersen, Ivy A.; Gunderson, Leonard L.; Furth, Alfred F.

    2006-03-01

    Purpose: To quantify the risk of ureteral obstruction (UO) after intraoperative electron-beam radiotherapy (IOERT). Methods and Materials: One hundred forty-six patients received IOERT of 7.5 to 30 Gy to 168 ureters; 132 patients received external radiotherapy. Results: Follow-up ranged from 0.01 to 19.1 years (median, 2.1 years). The rates of clinically apparent type 1 UO (UO from any cause) after IOERT at 2, 5, and 10 years were 47%, 63%, and 79%, respectively. The rates of clinically apparent type 2 UO (UO occurring at least 1 month after IOERT, excluding UO caused by tumor or abscess and patients with stents) at 2, 5, and 10 years were 27%, 47%, and 70%, respectively. Multivariate analysis revealed that the presence of UO before IOERT (p < 0.001) was associated with an increased risk of clinically apparent type 1 UO. Increasing IOERT dose (p < 0.04) was associated with an increased risk of clinically apparent type 2 UO. UO rates in ureters not receiving IOERT at 2, 5, and 10 years were 19%, 19%, and 51%, respectively. Conclusions: Risk of UO after IOERT increases with dose. However, UO risk for ureters not receiving IOERT was also high, which suggests an underlying risk of ureteral injury from other causes.

  18. The role of imaging in the diagnosis and management of renal stone disease in pregnancy.

    PubMed

    Masselli, G; Weston, M; Spencer, J

    2015-12-01

    The distinction of pain in pregnancy due to urolithiasis from that related to physiological dilation of the renal tract is a common conundrum as renal colic is one of the commonest causes for non-obstetric pain in pregnancy. Ultrasound is the first-line imaging test but although it may demonstrate renal dilation, it may not show the cause. Magnetic resonance imaging (MRI) is able to make the distinction. Physiological dilation will show smooth tapering of the ureter in the middle third as it is compressed between the gravid uterus and the retroperitoneum. Obstruction due to calculi causes renal enlargement and perinephric oedema. When a stone is lodged in the lower ureter, a standing column of dilated ureter will be seen below the physiological constriction. The stone itself may be shown. Computed tomography (CT) is an acceptable alternative if there is a contraindication to MRI, but even low-dose regimes involve some ionising radiation. This paper serves to highlight the role of MRI compared to US and CT in the imaging of renal colic in pregnancy. Multidisciplinary collaboration between obstetricians, urologists, and radiologists is required for effective management. PMID:26454345

  19. [Experiences with expert opinion in gynecological urology].

    PubMed

    Kruschwitz, S

    1984-01-01

    Lesions of the ureters and the bladder are represented with a relatively high portion of 40% within all gynaecological and obstetrical cases under expert opinion in the Central Office for Medical Expert Opinion. The so far mostly practisized judgement as an operational risk could not generally be consented. It is therefore that the Central Office for Medical Expert Opinion elaborated the directive No. 9: "Medical expert opinion of urological complications connected to gynaecological operations". The directive first of all means to coordinate the work within the expert opinion commissions at district level; it furtheron motivates the operator to think over his mode of action. Experiences from expert opinion result in perceiving the following main points: Even in technically simple operations the operator must know the course of the ureter; 2. if its course is not clear it must be made visible dependent on the operational situation in each case; 3. the preoperative methods of urological diagnosis have to be appropriate to the intended operation; 4. even in smallest grounds for suspicion of a lesion or complication a consequent control is necessary; a detailed documentation of the operational course is needed for various reasons; 6. the correction of lesions of the ureters and the bladder requires experience and operational ability. Because of possible grave damages to the woman the operator must be conscious of the limits of his ability. Details are demonstrated by examples of the Central Office for Medical Expert Opinion. PMID:6506903

  20. Case-Control Study of Arsenic in Drinking Water and Kidney Cancer in Uniquely Exposed Northern Chile

    PubMed Central

    Ferreccio, Catterina; Smith, Allan H.; Durn, Viviana; Barlaro, Teresa; Bentez, Hugo; Valds, Rodrigo; Aguirre, Juan Jos; Moore, Lee E.; Acevedo, Johanna; Vsquez, Mara Isabel; Prez, Liliana; Yuan, Yan; Liaw, Jane; Cantor, Kenneth P.; Steinmaus, Craig

    2013-01-01

    Millions of people worldwide are exposed to arsenic in drinking water. The International Agency for Research on Cancer has concluded that ingested arsenic causes lung, bladder, and skin cancer. However, a similar conclusion was not made for kidney cancer because of a lack of research with individual data on exposure and dose-response. With its unusual geology, high exposures, and good information on past arsenic water concentrations, northern Chile is one of the best places in the world to investigate the carcinogenicity of arsenic. We performed a case-control study in 20072010 of 122 kidney cancer cases and 640 population-based controls with individual data on exposure and potential confounders. Cases included 76 renal cell, 24 transitional cell renal pelvis and ureter, and 22 other kidney cancers. For renal pelvis and ureter cancers, the adjusted odds ratios by average arsenic intakes of <400, 4001,000, and >1,000 g/day (median water concentrations of 60, 300, and 860 g/L) were 1.00, 5.71 (95% confidence interval: 1.65, 19.82), and 11.09 (95% confidence interval: 3.60, 34.16) (Ptrend < 0.001), respectively. Odds ratios were not elevated for renal cell cancer. With these new findings, including evidence of dose-response, we believe there is now sufficient evidence in humans that drinking-water arsenic causes renal pelvis and ureter cancer. PMID:23764934

  1. Urinary Incontinence in Juvenile Female Soft-Coated Wheaten Terriers: Hospital Prevalence and Anatomic Urogenital Anomalies.

    PubMed

    Callard, Jason; McLoughlin, Mary A; Byron, Julie K; Chew, Dennis J

    2016-01-01

    Urinary incontinence in juvenile female dogs is often associated with urogenital anatomic anomalies. Study objectives include: (1) determine hospital prevalence of urinary incontinence in juvenile female soft-coated wheaten terriers (SCWTs) compared to other affected dogs; (2) characterize anatomic anomalies affecting urinary incontinent juvenile female SCWTs utilizing uroendoscopy; and (3) compare incidence of ectopic ureters, paramesonephric remnants, and short urethras in juvenile female urinary incontinent SCWTs to other juvenile female dogs with urinary incontinence. We hypothesize juvenile SCWTs have an increased prevalence of urinary incontinence and an increased incidence of ectopic ureters, paramesonephric remnants, and short urethras compared to non-SCWTs with urinary incontinence within our hospital population. Medical records of female dogs 6 mo of age and younger with clinical signs of urinary incontinence and video uroendoscopic evaluation presenting to The Ohio State University Veterinary Medical Center from January 2000 to December 2011 were reviewed. Twelve juvenile SCWTs and 107 juvenile non-SCWTs met the inclusion criteria. Juvenile SCWTs were found to have an increased hospital prevalence of urinary incontinence compared to other affected breeds. Observed anomalies in SCWTs include: ectopic ureters, shortened urethras, paramesonephric remnants, and bifid vaginas. This information will help guide veterinarians in recognizing a breed-related disorder of the lower urogenital tract in SCWTs. PMID:26606208

  2. The effect of cyclopiazonic acid on excitation-contraction coupling in guinea-pig ureteric smooth muscle: role of the sarcoplasmic reticulum

    PubMed Central

    Burdyga, Theodor V; Wray, Susan

    1999-01-01

    We have investigated the effect of cyclopiazonic acid (CPA), an inhibitor of the sarcoplasmic reticulum (SR) Ca2+-ATPase on excitation-contraction (EC) coupling in guinea-pig ureter, by measuring membrane currents, action potentials, intracellular [Ca2+] and force. CPA (20 μm) significantly enhanced the amplitude and duration of phasic contractions of ureteric smooth muscle associated with action potentials. This was accompanied by an increase in the duration of the intracellular Ca2+ transient in intact tissue and single cells but not their amplitude. However, CPA also slowed the rate of rise, and fall, of the force and Ca2+ transients. Membrane potential recordings showed that CPA produced a small depolarization and a large increase in the duration of the plateau phase of the action potential. Patch-clamp studies showed marked inhibition of outward potassium current in the presence of CPA and an inhibition of spontaneous transient outward currents (STOCs). CPA had no effect on inward Ca2+ current. These data suggest that the SR plays a major role in modulating the excitability of the ureter, particularly via curtailing the action potential duration. This in turn will shorten the Ca2+ transient and decrease force. This negative action on developed force predominates over any small role it may play in initiating force in the guinea-pig ureter. PMID:10358124

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

    NASA Astrophysics Data System (ADS)

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

    2005-07-01

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

  4. Endoscopic Management of Vesicoureteral Reflux in Children in Kosova

    PubMed Central

    Berisha, Murat; Hyseni, Nexhmi; Statovci, Sejdi; Grajqevci, Salih; Xhiha, Butrint

    2014-01-01

    Introduction: Vesicoureteral reflux (VUR) in children has been treated with subureteric deflux injection of Deflux (dextranomer hyaluronic acid copolymer) since 2009. The aim of this study was to analyze the results of endoscopic treatment of VUR in our clinic. Methods: Between March 2009 and December 2013, fifty-five children underwent endoscopic subureteral injection of Deflux in 78 ureters. Two months postoperatively voiding cystourethrogram (VCUG) was performed. This study examined the disappearance of VUR and urinary tract infection (UTI) as well as the quality of life during long-term follow-up. Results: The study included 55 patients (40 females and 15 males) with 78 refluxing ureters. There were 22 refluxed ureters altogether and 33 children had a unilateral reflux (two duplicated systems). All patients were treated, from the age 6 months up to 12 years old. The mean age of patients was 5.2 years. There has been no complications, but with few recurrences. In 6 patients (16.6%), endoscopic treatment with deflux was done twice, while in three patients (8.5%), the endoscopic treatment with deflux was performed three times, because of recurrence. Conclusion: We recommend the use of endoscopic Deflux injection as first line treatment for children with VUR. Endoscopic subureteral injection of Deflux is a minimally invasive method for VUR treatment in pediatric patients and is associated with low morbidity. PMID:25132708

  5. Congenital Bilateral Mid Ureteral Stenosis: A Rare Finding

    PubMed Central

    Avinash Vijay, Joshi; Vinayak Gorakhnath, Wagaskar; Manoj Vilas, Bachhav; Sudarshan Omprakash, Daga

    2015-01-01

    Bilateral congenital mid ureteric stenosis is a very rare entity causing hydroureteronephrosis. The pathophysiology and aetiology of this condition is uncertain. Congenital functional obstruction of the mid ureter has only 17 reported cases, that too of unilateral pathology. We report a case of an 11-year-old male child who was presented with left sided lump in abdomen since one year. On bilateral retrograde ureteropyelography (RGP), bilateral mid ureteric stenosis was documented at the level of pelvic brim. Tc99m Diethylene Triamine Pentacaetic Acid (DTPA) scan showed non functioning left kidney and decreased function and retention on right side. We did a left nephroureterectomy and uretero-ureterostomy without tapering over a Double-J stent (DJ), with excision of stenosed segment on right side. Pathological review of the ureteric segments of both sides revealed proximal dilatation with non-specific thickening of the muscular wall of the stenosed segments of ureter. The differential diagnosis must additionally include ureteral valves and fibro epithelial polyps. Important role of intravenous pyelography in such cases must be emphasized to localize the pathology site. In addition, retrograde ureteropyelography is essential in management of this anomaly to delineate the stenosed segment of the ureter preoperatively, so that the surgeon can be well prepared with final plan of management. PMID:26155518

  6. Family Caregiver Palliative Care Intervention in Supporting Caregivers of Patients With Stage II-IV Gastrointestinal, Gynecologic, and Urologic Cancers

    ClinicalTrials.gov

    2015-10-30

    Healthy, no Evidence of Disease; Localized Transitional Cell Cancer of the Renal Pelvis and Ureter; Metastatic Transitional Cell Cancer of the Renal Pelvis and Ureter; Psychosocial Effects of Cancer and Its Treatment; Recurrent Bladder Cancer; Recurrent Cervical Cancer; Recurrent Colon Cancer; Recurrent Gastric Cancer; Recurrent Ovarian Epithelial Cancer; Recurrent Ovarian Germ Cell Tumor; Recurrent Pancreatic Cancer; Recurrent Rectal Cancer; Recurrent Renal Cell Cancer; Recurrent Transitional Cell Cancer of the Renal Pelvis and Ureter; Recurrent Urethral Cancer; Recurrent Uterine Sarcoma; Regional Transitional Cell Cancer of the Renal Pelvis and Ureter; Stage II Bladder Cancer; Stage II Renal Cell Cancer; Stage II Urethral Cancer; Stage IIA Cervical Cancer; Stage IIA Colon Cancer; Stage IIA Gastric Cancer; Stage IIA Ovarian Epithelial Cancer; Stage IIA Ovarian Germ Cell Tumor; Stage IIA Pancreatic Cancer; Stage IIA Rectal Cancer; Stage IIA Uterine Sarcoma; Stage IIB Cervical Cancer; Stage IIB Colon Cancer; Stage IIB Gastric Cancer; Stage IIB Ovarian Epithelial Cancer; Stage IIB Ovarian Germ Cell Tumor; Stage IIB Pancreatic Cancer; Stage IIB Rectal Cancer; Stage IIB Uterine Sarcoma; Stage IIC Colon Cancer; Stage IIC Ovarian Epithelial Cancer; Stage IIC Ovarian Germ Cell Tumor; Stage IIC Rectal Cancer; Stage III Bladder Cancer; Stage III Pancreatic Cancer; Stage III Renal Cell Cancer; Stage III Urethral Cancer; Stage IIIA Cervical Cancer; Stage IIIA Colon Cancer; Stage IIIA Gastric Cancer; Stage IIIA Ovarian Epithelial Cancer; Stage IIIA Ovarian Germ Cell Tumor; Stage IIIA Rectal Cancer; Stage IIIA Uterine Sarcoma; Stage IIIB Cervical Cancer; Stage IIIB Colon Cancer; Stage IIIB Gastric Cancer; Stage IIIB Ovarian Epithelial Cancer; Stage IIIB Ovarian Germ Cell Tumor; Stage IIIB Rectal Cancer; Stage IIIB Uterine Sarcoma; Stage IIIC Colon Cancer; Stage IIIC Gastric Cancer; Stage IIIC Ovarian Epithelial Cancer; Stage IIIC Ovarian Germ Cell Tumor; Stage IIIC Rectal Cancer; Stage IIIC Uterine Sarcoma; Stage IV Bladder Cancer; Stage IV Gastric Cancer; Stage IV Ovarian Epithelial Cancer; Stage IV Ovarian Germ Cell Tumor; Stage IV Pancreatic Cancer; Stage IV Renal Cell Cancer; Stage IV Urethral Cancer; Stage IVA Cervical Cancer; Stage IVA Colon Cancer; Stage IVA Rectal Cancer; Stage IVA Uterine Sarcoma; Stage IVB Cervical Cancer; Stage IVB Colon Cancer; Stage IVB Rectal Cancer; Stage IVB Uterine Sarcoma; Ureter Cancer

  7. Evaluation of Extracorporeal Shock Wave Lithotripsy (ESWL): Efficacy in Treatment of Urinary System Stones

    PubMed Central

    Junuzovic, Dzelaludin; Prstojevic, Jelena Kovacevic; Hasanbegovic, Munira; Lepara, Zahid

    2014-01-01

    ABSTRACT Introduction: Elimination of stone is determined by size and its localization. Stone from the ureter in 80% of cases can be eliminated spontaneously. If the stone by its characteristics is not spontaneously eliminated, taken are further steps and therapeutic protocols to solve this problem. Material and methods: The study was prospective, open and comparative. It was conducted at the Urology Clinic Clinical Center of Sarajevo University in the period from 2007 to 2013. The study included 404 patients with urinary tract lithiasis treated by ESWL. ESWL treatment is performed on the machine Siemens Model Lithostar Multiline, which has a combined ultrasonographic and fluoroscopic display, large energy density in order to obtain optimum focus (without damaging surrounding tissue) and minimal pain that on rare occasions requires for mild sedation-sedation. Results: From a total of 404 patients included in the study there were 234 (57.92%) male and 170 (42.08%) female patients. The most common type of stone both in female and male patients was calcium type. From a total of 262 calcium stones, 105 of them (40.07%) was present in female patients and 157 (59.92%) in male. Share of infectious type of stone in female patients was 63 (49.60%) and 64 among males (50.39%). Other stones were less abundant in both the gender groups and their total number was only 17. In women their frequency was 2 (13.33%) and 13 among males (86.67%). There was a significant difference in the frequency of different types of stones by gender (x2 = 11.47, p = 0.009). Conclusion: There was no statistically significant correlation between the number of treatments and localization of stones in the ureter, as well as a statistically significant correlation between the size of the stone and the localization of calculus in the ureter. PMID:25568579

  8. [Uretero-colic fistula. Apropos of 2 cases complicating sigmoid diverticulitis after surgery].

    PubMed

    Faye, R; Lehur, P A; Buzelin, J M; Malyy, F; Leborgne, J

    1982-01-01

    The authors report on two cases of uretero-colic fistulization in the post-operative period, following surgery for infectious complications involving sigmoidal diverticulitis. In the aftermath of surgery for sigmoidal diverticula, the appearance of very liquid stools at the exact moment when the infectious and semi-occlusive picture seems to resolve, the occurrence of a uro-steraceous fistula should make one suspect a uretero-colic fistula. Air pyelography and the retrograde opacification of the ureter following a radio-opaque enema are diagnostic. The IVU does not help to establish a firm diagnosis but is useful for showing the state of the adjacent kidney and above all the state of the contralateral kidney. In regard to the sepsis which accompanies these complications (there is nearly always a pericolic abscess at the site of the utero-colic fistula) all attempts at repair are futile. Only nephrectomy may be sometimes appropriate. At the same time, nothing except treatment of the infectious focus (colic or pericolic) will safeguard the patient from the risk of further infection which might end in death. The risk of damage to the ureter which sigmoidal diverticular surgery carries, necessitates the following precautions: a pre-operative IVU, a painstaking dissecting-out and well wide of the neighbouring ureter, the systematic injections of dye to colour the urine at the time of operation in order to avoid ureteric injury and of course to ensure the repair of any injury as soon as it happens. It is only possible to save the adjacent kidney and protect the normal urinary outlet if the ureteric lesion is properly identified at operation. PMID:7161516

  9. Ureteral stenosis after kidney transplantation. A study on 869 consecutive transplants.

    PubMed

    Faenza, A; Nardo, B; Catena, F; Scolari, M P; d'Arcangelo, G L; Buscaroli, A; Rossi, C; Zompatori, M

    1999-01-01

    Ureteral obstruction with impaired urine flow is the most common urological complication following renal transplantation. From December 1976 to December 1997, 869 kidney grafts were performed by our kidney transplantation group, 96 from living related donors and 773 from cadaver donors (736 first grafts and 37 regrafts). A stricture of the ureter (SU) was observed in 27 cases with a follow-up ranging from 18 months to 18 years after the graft and 11 months to 11 years after the treatment of the SU. In six patients, SU was immediately apparent and limited to the anastomosis: they were obviously technical flaws. In all the other patients, there was a free interval ranging from 2 months to 11 years after surgery; the SU usually involved the entire ureter, suggesting multiple etiologies. Repeated urinary infections could be a cause but immunological problems might be more determinant. In our series, acute rejection was more common than chronic so that the correction of SU was followed in many cases by a good and long lasting result (up to 11 years). In our experience, SU was not a dangerous complication even in patients in whom for different reasons (mainly refusal of treatment) the therapy was delayed - even if anuria occurred, no case of graft loss or serious damage were observed. At the beginning of our experience, the diagnosis of SU was based on urography, and therapy has always been re-operation. For 15 years, the diagnosis of SU has been based on routine echographic surveillance, which was intensified after each rejection, and the first treatment of SU in the last 8 years was re-operation in early technical SU and interventional radiology (balloon dilatation with or without temporary stent) in other cases. When it failed or in case of recurrence, surgical correction was performed utilizing the native ipsilateral or contralateral ureter for a uretero-ureterostomy. PMID:10551998

  10. Tissue Engineering of Ureteral Grafts: Preparation of Biocompatible Crosslinked Ureteral Scaffolds of Porcine Origin.

    PubMed

    Koch, Holger; Hammer, Niels; Ossmann, Susann; Schierle, Katrin; Sack, Ulrich; Hofmann, Jrg; Wecks, Mike; Boldt, Andreas

    2015-01-01

    The surgical reconstruction of ureteric defects is often associated with post-operative complications and requires additional medical care. Decellularized ureters originating from porcine donors could represent an alternative therapy. Our aim was to investigate the possibility of manufacturing decellularized ureters, the characteristics of the extracellular matrix (ECM) and the biocompatibility of these grafts in vitro/in vivo after treatment with different crosslinking agents. To achieve these goals, native ureters were obtained from pigs and were decellularized. The success of decellularization and the ECM composition were characterized by (immuno)histological staining methods and a DNA-assay. In vitro: scaffolds were crosslinked either with carbodiimide (CDI), genipin (GP), glutaraldehyde, left chemically untreated or were lyophilized. Scaffolds in each group were reseeded with Caco2, LS48, 3T3 cells, or native rat smooth muscle cells (SMC). After 2?weeks, the number of ingrown cells was quantified. In vivo: crosslinked scaffolds were implanted subcutaneously into rats and the type of infiltrating cells were determined after 1, 9, and 30?days. After decellularization, scaffold morphology and composition of ECM were maintained, all cellular components were removed, DNA destroyed and strongly reduced. In vitro: GP and CDI scaffolds revealed a higher number of ingrown 3T3 and SMC cells as compared to untreated scaffolds. In vivo: at day 30, implants were predominantly infiltrated by fibroblasts and M2 anti-inflammatory macrophages. A maximum of MMP3 was observed in the CDI group at day 30. TIMP1 was below the detection limit. In this study, we demonstrated the potential of decellularization to create biocompatible porcine ureteric grafts, whereas a CDI-crosslink may facilitate the remodeling process. The use of decellularized ureteric grafts may represent a novel therapeutic method in reconstruction of ureteric defects. PMID:26157796

  11. Preclinical assessment of the new 1440-nm-wavelength Nd:YAG laser for fragmenting ureteral calculi in an ex-vivo pig model

    NASA Astrophysics Data System (ADS)

    Wollin, Timothy A.; Moore, Ronald B.; Tulip, John; Mourad, Walid A.; McPhee, Malcolm S.

    1996-05-01

    The dual wavelength Nd:YAG (multi-YAG) laser has excellent stone ablating properties. To investigate the safety of this laser for fragmenting ureteral calculi, an ex vivo animal study was undertaken to study acute tissue interactions associated with multi-YAG laser lithotripsy. Human ureteral calculi were implanted in ureters harvested from swine (n equals 42). Direct vision ureteroscopic laser lithotripsy was performed while varying pulse energy (0.3 to 1.5 Joules) and pulse frequency (5 to 15 Hz). All ureters were then examined histologically, graded for tissue injury, and compared to controls. Photofragmentation was associated with mucosal denudation and/or focal mucosal necrosis (grade 0 and 1) in 37/42 cases. Four treatments caused necrosis involving up to two thirds of the ureteral wall (grade 2) and 1/42 had grade 3 changes (transmural necrosis). Ureteroscopic examination alone produced grade 0 to 1 injuries. Logistic regression analysis revealed that pulse energy (p equals 0.47), total energy used for fragmentation (p equals 0.82), and stone weight (p equals 0.64) were not significant predictors of higher grade tissue injury. Pulse frequency (p equals 0.14) began to approach significance. Of the five ureters with grade 2 or greater injury, four were associated with a pulse frequency of 15 Hz. Our findings show that multi-YAG laser lithotripsy is associated with acute tissue changes ranging from mucosal denudation to different levels of coagulative necrosis. Low grade injury is most common and would have minimal potential for strictures. Although higher grade tissue injury is possible, all grade 2 and 3 injuries were microscopically focal in nature. Therefore, multi-YAG laser lithotripsy can be performed with acceptable levels of acute tissue injury at pulse energies up to 1.5 Joules and at pulse frequencies less than 15 Hz.

  12. Variations in renal morphometry: A hospital-based Indian study

    PubMed Central

    Rathore, Ranjeet S.; Mehta, Nisarg; Pillai, Biju S.; Sam, Mohan P.; Upendran, Binu; Krishnamoorthy, H.

    2016-01-01

    Introduction: The currently available standard renal nomograms for comparison of renal dimensions in India are based on the measurements made in the Western population. The objectives of our study were to identify variations in renal morphometric parameters in subjects with no known renal disease in a hospital-based Indian population and to find out any correlation between renal volumes with split renal functions and body mass index (BMI). Materials and Methods: One hundred and fifty-one subjects undergoing contrast-enhanced computerized tomography (CT) scan for various purposes, including donor nephrectomy, from June 2012 to August 2014 were included in the study. The renal and ureteral dimensions were assessed from the contrast-enhanced CT scan images of these patients. Results: The mean length, width, thickness and volume of the left kidney were 11.02 ± 1.13 cm, 5.21 ± 0.75 cm, 4.65 ± 0.84 cm and 138.22 ± 29.81 mL, respectively, and those for the right kidney were 10.86 ± 1.12 cm, 5.13 ± 0.77 cm, 4.73 ± 0.95 cm and 137.54 ± 34.48 mL, respectively. The mean length of the left ureter was 23.51 ± 1.48 cm and that of the right ureter was 23.24 ± 1.93 cm. The mean volume of the kidneys in males and females was also different. The volume of the kidney did not statically correlate with the split glomerular filtration rate ((P = 0.12) and BMI (P = 0.52)). Conclusions: Our study revealed that there exist differences in various morphometric parameters of the kidney and ureter in different subsets of the Indian population attending our hospital as compared with the standard values quoted in the world literature. PMID:26941497

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

    NASA Astrophysics Data System (ADS)

    Ogiela, Marek R.; Tadeusiewicz, Ryszard

    2000-04-01

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

  14. Intramuscular nerve distribution in bladder and the relationship between intramuscular ganglia and bladder function in man and dog

    PubMed Central

    Zhao, Zeju; Xu, Qian; Lu, Li; Luo, Xu; Fu, Xiaoyun

    2014-01-01

    In clinical, the relationship between bladder intramuscular nerve and function is also elusive. This study aims to compare the bladder intramuscular nerve distribution and its characteristics and significance in human and dog. Eleven dogs bladders were stained by Sihlers and HE techniques. Fifteen human bladders were adopted by Sihlers staining, using 10% formaldehyde to fix 12 weeks, 7 by HE dyeing fixes 24 hours. Results indicated that mans bladder was triangularpyramid-shaped. While dogs bladder was spherical-shaped and its muscle fibers arrange were irregularly shaped. Longitudinal muscle of the outer layer is fleshy, the terminal is at the bladder neck without exception, and vesical trigone has relatively obvious three layers of structure. After dyeing dogs bladder was transparent jelly, the nerve was purple color, enter bladder at the ureter-bladder junction with different forms. Mans bladder nerves, no ganglion, were more trivial than that of dogs, and with smaller branches, the large nerve ganglion. The links with the nerve fibers and forms the network on the dogs bladder wall, and the nerve fibers crosses comparatively little on both the left and right sides in the midline. The right nerve branch gains advantage on the mans bladder wall, the situations is opposite on the dogs. In conclusion, bladder nerves which scatter to the bladder wall have branches to lower ureter at the ureter-bladder junction, the structure and distribution of intramuscular nerves are different, the existence of intramuscular ganglia is relating to the bladder function both in man and dog. PMID:25664008

  15. Late effects of intraoperative radiation therapy on retroperitoneal tissues, intestine, and bile duct in a large animal model

    SciTech Connect

    Sindelar, W.F.; Tepper, J.E.; Kinslla, T.J.; Barnes, M.; DeLuca, A.M.; Terrill, R.; Matthews, D.; Johnstone, P.A.S.; Anderson, W.J.; Bollinger, B.K.

    1994-07-01

    The late histopathological effects of intraoperative radiotherapy (IORT) on retroperitoneal tissues, intestine, and bile duct were investigated in dogs. Fourteen adult foxhounds were subjected to laparotomy and varying doses (0-45 Gy) of IORT (11 MeV electrons) delivered to retroperitoneal tissues including the great vessels and ureters, to a loop of defunctionalized small bowel, or to the extrahepatic bile duct. One control animal received an aortic transection and reanastomosis at the time of laparotomy; another control received laparotomy alone. This paper describes the late effects of single-fraction IORT occurring 3-5 years following treatment. Dogs receiving IORT to the retroperitoneum through a 4 X 15 cm portal showed few gross or histologic abnormalities at 20 Gy. At doses ranging from 30-45 Gy, radiation changes in normal tissues were consistently observed. Retroperitoneal fibrosis with encasement of the ureters and great vessels developed at doses {ge}30 Gy. Radiation changes were present in the aorta and vena cava at doses {ge}40 Gy. A 30 Gy dog developed an in-field malignant osteosarcoma at 3 years which invaded the vertebral column and compressed the spinal cord. A 40 Gy animal developed obstruction of the right ureter with fatal septic hydronephrosis at 4 years. Animals receiving IORT through a 5 cm IORT portal to an upper abdominal field which included a defunctionalized loop of small bowel, showed few gross or histologic abnormalities at a dose of 20 Gy. At 30 Gy, hyaline degeneration of the intestinal muscularis layer of the bowel occurred. At a dose of 45 Gy, internal intestinal fistulae developed. One 30 Gy animal developed right ureteral obstruction and hydronephrosis at 5 years. A dog receiving 30 Gy IORT through a 5 cm portal to the extrahepatic bile duct showed diffuse fibrosis through the gastroduodenal ligament. These canine studies contribute to the area of late tissue tolerance to IORT. 7 refs., 3 figs., 5 tabs.

  16. Tissue Engineering of Ureteral Grafts: Preparation of Biocompatible Crosslinked Ureteral Scaffolds of Porcine Origin

    PubMed Central

    Koch, Holger; Hammer, Niels; Ossmann, Susann; Schierle, Katrin; Sack, Ulrich; Hofmann, Jrg; Wecks, Mike; Boldt, Andreas

    2015-01-01

    The surgical reconstruction of ureteric defects is often associated with post-operative complications and requires additional medical care. Decellularized ureters originating from porcine donors could represent an alternative therapy. Our aim was to investigate the possibility of manufacturing decellularized ureters, the characteristics of the extracellular matrix (ECM) and the biocompatibility of these grafts in vitro/in vivo after treatment with different crosslinking agents. To achieve these goals, native ureters were obtained from pigs and were decellularized. The success of decellularization and the ECM composition were characterized by (immuno)histological staining methods and a DNA-assay. In vitro: scaffolds were crosslinked either with carbodiimide (CDI), genipin (GP), glutaraldehyde, left chemically untreated or were lyophilized. Scaffolds in each group were reseeded with Caco2, LS48, 3T3 cells, or native rat smooth muscle cells (SMC). After 2?weeks, the number of ingrown cells was quantified. In vivo: crosslinked scaffolds were implanted subcutaneously into rats and the type of infiltrating cells were determined after 1, 9, and 30?days. After decellularization, scaffold morphology and composition of ECM were maintained, all cellular components were removed, DNA destroyed and strongly reduced. In vitro: GP and CDI scaffolds revealed a higher number of ingrown 3T3 and SMC cells as compared to untreated scaffolds. In vivo: at day 30, implants were predominantly infiltrated by fibroblasts and M2 anti-inflammatory macrophages. A maximum of MMP3 was observed in the CDI group at day 30. TIMP1 was below the detection limit. In this study, we demonstrated the potential of decellularization to create biocompatible porcine ureteric grafts, whereas a CDI-crosslink may facilitate the remodeling process. The use of decellularized ureteric grafts may represent a novel therapeutic method in reconstruction of ureteric defects. PMID:26157796

  17. Postoperative ureteral obstruction after endoscopic treatment for vesicoureteral reflux

    PubMed Central

    Chung, Jae Min; Park, Chang Soo

    2015-01-01

    Purpose We undertook this study to evaluate the incidence, risk factors, management, and outcome of postoperative ureteral obstruction after endoscopic treatment for vesicoureteral reflux (VUR). Materials and Methods Ninety patients undergoing endoscopic treatment for VUR were retrospectively reviewed and classified into two groups according to ureteral obstruction: the nonobstruction group (83 cases, 122 ureters; mean age, 7.02.8 years) and the obstruction group (7 cases, 10 ureters; mean age, 6.28.1 years). We analyzed the following factors: age, sex, injection material, laterality, voiding dysfunction, constipation, renal scarring, preoperative and postoperative ultrasound findings, endoscopic findings, injection number, and injection volume. Additionally, we reviewed the clinical manifestations, natural course, management, and outcome of ureteral obstruction after endoscopic treatment. Results The incidence of ureteral obstruction after endoscopic treatment was 7.6% (10/132 ureters). The type of bulking agent used and injection volume tended to be associated with ureteral obstruction. However, no significant risk factors for obstruction were identified between the two groups. Three patients showed no symptoms or signs after the onset of ureteral obstruction. Most of the patients with ureteral obstruction experienced spontaneous resolution within 1 month with conservative therapy. Two patients required temporary ureteral stents to release the ureteral obstruction. Conclusions In our experience, the incidence of ureteral obstruction was slightly higher than in previous reports. Our study identified no predictive risk factors for developing ureteral obstruction after endoscopic treatment. Although most of the ureteral obstructions resolved spontaneously within 1 month, some cases required drainage to relieve symptoms or to prevent renal function deterioration. PMID:26175873

  18. Characteristics of Calculi in the Urinary Tract

    PubMed Central

    Prstojevic, Jelena Kovacevic; Junuzovic, Dzelaludin; Hasanbegovic, Munira; Lepara, Zahid; Selimovic, Mirsad

    2014-01-01

    Introduction: Elimination of stone is determined by size and its localization. Stone from the ureter in 80% of cases can be eliminated spontaneously. If the stone by its characteristics is not spontaneously eliminated, taken are further steps and therapeutic protocols to solve this problem. Material and methods: The study was prospective, open and comparative. It was conducted at the Urology Clinic Clinical Center of Sarajevo University in the period from 2007 to 2013. The study included 404 patients with urinary tract lithiasis treated by ESWL. ESWL treatment is performed on the machine Siemens Model Lithostar Multiline, which has a combined ultrasonographic and fluoroscopic display, large energy density in order to obtain optimum focus (without damaging surrounding tissue) and minimal pain that on rare occasions requires for mild sedation-sedation. Results: From a total of 404 patients included in the study there were 234 (57.92%) male and 170 (42.08%) female patients. The most common type of stone both in female and male patients was calcium type. From a total of 262 calcium stones, 105 of them (40.07%) was present in female patients and 157 (59.92%) in male. Share of infectious type of stone in female patients was 63 (49.60%) and 64 among males (50.39%). Other stones were less abundant in both the gender groups and their total number was only 17. In women their frequency was 2 (13.33%) and 13 among males (86.67%). There was a significant difference in the frequency of different types of stones by gender (?2 = 11.47, p = 0.009). Conclusion: There was no statistically significant correlation between the number of treatments and localization of stones in the ureter, as well as a statistically significant correlation between the size of the stone and the localization of calculus in the ureter. PMID:25568625

  19. Pure laparoscopic and robot-assisted laparoscopic reconstructive surgery in congenital megaureter: a single institution experience.

    PubMed

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

    2014-01-01

    To report our experience of pure laparoscopic and robot-assisted laparoscopic reconstructive surgery in congenital megaureter, seven patients (one bilateral) with symptomatic congenital megaureter underwent pure laparoscopic or robot-assisted laparoscopic surgery. The megaureter was exposed at the level of the blood vessel and was isolated to the bladder narrow area. Extreme ureter trim and submucosal tunnel encapsulation or papillary implantations and anti-reflux ureter bladder anastomosis were performed intraperitoneally by pure laparoscopic or robot-assisted laparoscopic surgery. The clinical data of seven patients after operation were analyzed, including the operation time, intraoperative complications, intraoperative bleeding volumes, postoperative complications, postoperative hospitalization time and pathological results. All of the patients were followed. The operation was successfully performed in seven patients. The mean operation times for pure laparoscopic surgery and robotic-assistant laparoscopic surgery were 175 (range: 150-220) and 187 (range: 170-205) min, respectively, and the mean operative blood loss volumes were 20 (range: 10-30) and 28.75 (range: 15-20) ml, respectively. There were no intraoperative complications. The postoperative drainage time was 5 (range: 4-6) and 5.75 (range: 5-6) d, respectively, and the indwelling catheter time was 6.33 (range: 4-8) d and 7 (range: 7-7) d, respectively. The postoperative hospitalization time was 7.67 (range: 7-8) d and 8 (range: 7-10) d, respectively. There was no obvious pain, no secondary bleeding and no urine leakage after the operation. Postoperative pathology reports revealed chronic urothelial mucosa inflammation. The follow-up results confirmed that all patients were relieved of their symptoms. Both pure laparoscopic and robot-assisted laparoscopic surgery using different anti-reflux ureter bladder anastomoses are safe and effective approaches in the minimally invasive treatment of congenital megaureter. PMID:24924420

  20. Effects of PDE5 Inhibitors and sGC Stimulators in a Rat Model of Artificial Ureteral Calculosis

    PubMed Central

    Sandner, Peter; Tinel, Hanna; Affaitati, Giannapia; Costantini, Raffaele; Giamberardino, Maria Adele

    2015-01-01

    Urinary colics from calculosis are frequent and intense forms of pain whose current pharmacological treatment remains unsatisfactory. New and more effective drugs are needed to control symptoms and improve stone expulsion. Recent evidence suggested that the Nitric Oxide (NO) / cyclic guanosine monophosphate (cGMP) / phosphodiesterase type 5 (PDE5) system may contribute to ureteral motility influencing stone expulsion. We investigated if PDE5 inhibitors and sGC stimulators influence ureteral contractility, pain behaviour and stone expulsion in a rat model of ureteral calculosis. We investigated: a)the sex-specific PDE5 distribution in the rat ureter; b)the functional in vitro effects of vardenafil and sildenafil (PDE5 inhibitors) and BAY41-2272 (sGC stimulator) on induced ureteral contractility in rats and c)the in vivo effectiveness of vardenafil and BAY41-2272, alone and combined with ketoprofen, vs hyoscine-N-butylbromide alone or combined with ketoprofen, on behavioural pain indicators and stone expulsion in rats with artificial calculosis in one ureter. PDE5 was abundantly expressed in male and female rats’ ureter. In vitro, both vardenafil and BAY41-2272 significantly relaxed pre-contracted ureteral strips. In vivo, all compounds significantly reduced number and global duration of “ureteral crises” and post-stone lumbar muscle hyperalgesia in calculosis rats. The highest level of reduction of the pain behaviour was observed with BAY41-2272 among all spasmolytics administered alone, and with the combination of ketoprofen with BAY41-2272. The percentage of stone expulsion was maximal in the ketoprofen+BAY41-2272 group. The NO/cGMP/PDE5 pathway is involved in the regulation of ureteral contractility and pain behaviour in urinary calculosis. PDE5 inhibitors and sGC stimulators could become a potent new option for treatment of urinary colic pain. PMID:26509272

  1. Laparoscopic ureterolithotomy; which is better: Transperitoneal or retroperitoneal approach?

    PubMed Central

    Khalil, Mostafa; Omar, Rabea; Abdel-baky, Shabieb; Mohey, Ahmed; Sebaey, Ahmed

    2015-01-01

    Objective This was a prospective study to compare the outcome of laparoscopic transperitoneal ureterolithotomy (LTU) with laparoscopic retroperitoneal ureterolithotomy (LRU) as a primary treatment for a large stone in the proximal ureter. Material and methods A total of 24 patients with a solitary, large (>1.5 cm), and impacted stone in the proximal ureter was selected and randomly divided into two groups. The first group included 13 patients who were treated by LTU, and the second group included 11 patients who were treated by LRU. Patient demographics and stone characteristics as well as the operative and postoperative data of both groups were compared and statistically analyzed. Results There was no significant difference between the two groups regarding patient demographics and stone characteristics. The mean operative time was significantly shorter in the LTU group than in the LRU group [116.2±21.8 min vs 137.3±17.9 min, respectively (p=0.02)]. The mean time to oral intake was significantly longer in the LTU group than in the LRU group [21.2±4.9 h vs 15.5±2.8 h, respectively (p=0.002)]. There was significant higher rate (27.3%) of changing to open surgery in LRU (p=0.04). The stone-free rate was significantly higher in the LTU group than in the LRU group [100% vs. 72.8%, respectively (p=0.03)]. There was no statistically significant difference between the two groups regarding the mean blood loss, mean hospital stay, mean analgesia dose, blood transfusion rate, postoperative fever, and stone migration during surgery. Conclusion Both approaches of laparoscopic ureterolithotomy are effective in treating large impacted stones in the proximal ureter. LTU has significantly shorter operative time and lower rate of open conversion but has a significantly longer time to oral intake. PMID:26623147

  2. On the Mechanisms Whereby Temperature Affects Excitation-Contraction Coupling in Smooth Muscle

    PubMed Central

    Burdyga, Theodor V.; Wray, Susan

    2002-01-01

    Moderate cooling of smooth muscle can modulate force production and may contribute to pathophysiological conditions, but the mechanisms underlying its effects are poorly understood. Interestingly, cooling increases force in rat ureter, but decreases it in guinea pigs. Therefore, this study used ureteric smooth muscle as a model system to elucidate the mechanisms of the effects of cooling on excitation-contraction coupling. Simultaneous recordings of force, intracellular [Ca2+], and electrical activity were made in intact ureter and ionic currents measured in isolated cells. The increase in force amplitude in rat ureter with cooling was found to be due to a significant increase in the duration of the Ca2+ transient. This in turn was due to a marked prolongation of the action potential. In guinea pigs, both these parameters were much less affected by cooling. Examination of membrane currents revealed that differences in ion channel contribution to the action potential underlie these differences. In particular, cooling potentiated Ca2+-activated Cl− currents, which are present in rat but not guinea pig ureteric smooth muscle, and prolonged the plateau of the action potential and Ca2+ entry. The force-Ca2+ relationship revealed that the increased duration of the Ca2+ transient was sufficient in the rat, but not in the guinea pig, to overcome kinetic lags produced in both species by cooling and potentiate force. Ca2+ entry and release processes were largely temperature-insensitive, but the rate of relaxation was very temperature-sensitive. Effects of cooling on myosin light chain phosphatase, confirmed in experiments using calyculin A, appear to be the predominant mechanisms affecting relaxation. Thus, smooth muscle is diverse in its response to temperature, even when experimental variables, such as the mode of stimulation, are removed. Although the biochemical and mechanical events accompanying contraction are likely to be affected in similar ways by temperature, differences in electrical events lead to subsequent differences in these processes between smooth muscles. PMID:11773241

  3. Acellularization-Induced Changes in Tensile Properties Are Organ Specific - An In-Vitro Mechanical and Structural Analysis of Porcine Soft Tissues

    PubMed Central

    Aust, Gabriela; Boldt, Andreas; Fritsch, Sebastian; Keil, Isabel; Koch, Holger; Möbius, Robert; Scheidt, Holger A.; Wagner, Martin F. X.; Hammer, Niels

    2016-01-01

    Introduction Though xenogeneic acellular scaffolds are frequently used for surgical reconstruction, knowledge of their mechanical properties is lacking. This study compared the mechanical, histological and ultrastructural properties of various native and acellular specimens. Materials and Methods Porcine esophagi, ureters and skin were tested mechanically in a native or acellular condition, focusing on the elastic modulus, ultimate tensile stress and maximum strain. The testing protocol for soft tissues was standardized, including the adaption of the tissue’s water content and partial plastination to minimize material slippage as well as templates for normed sample dimensions and precise cross-section measurements. The native and acellular tissues were compared at the microscopic and ultrastructural level with a focus on type I collagens. Results Increased elastic modulus and ultimate tensile stress values were quantified in acellular esophagi and ureters compared to the native condition. In contrast, these values were strongly decreased in the skin after acellularization. Acellularization-related decreases in maximum strain were found in all tissues. Type I collagens were well-preserved in these samples; however, clotting and a loss of cross-linking type I collagens was observed ultrastructurally. Elastins and fibronectins were preserved in the esophagi and ureters. A loss of the epidermal layer and decreased fibronectin content was present in the skin. Discussion Acellularization induces changes in the tensile properties of soft tissues. Some of these changes appear to be organ specific. Loss of cross-linking type I collagen may indicate increased mechanical strength due to decreasing transverse forces acting upon the scaffolds, whereas fibronectin loss may be related to decreased load-bearing capacity. Potentially, the alterations in tissue mechanics are linked to organ function and to the interplay of cells and the extracellular matrix, which is different in hollow organs when compared to skin. PMID:26960134

  4. The Characteristics of Recurrent Upper Tract Urothelial Carcinoma after Radical Nephroureterectomy without Bladder Cuff Excision

    PubMed Central

    Kang, Minyong; Jeong, Chang Wook; Kwak, Cheol; Kim, Hyeon Hoe

    2015-01-01

    Purpose To investigate oncological outcomes based on bladder cuff excision (BCE) during radical nephroureterectomy (RNU) for upper tract urothelial carcinoma (UTUC) and to provide clinical evidence of tumor recurrence in patients without BCE. Materials and Methods We retrospectively collected data of 372 consecutive patients who underwent RNU at our institution from May 1989 through October 2010. After excluding some data, we reviewed 336 patients for the analysis. Results Of the patients who underwent RNU with BCE (n=279, 83.0%) and without BCE (n=57, 17.0%), patients without BCE had poorer cancer-specific and overall survival rates. Among 57 patients without BCE, 35 (61.4%) experienced tumor recurrence. Recurrence at the remnant ureter resulted in poor oncological outcomes compared to those in patients with bladder recurrence, but better outcomes were observed compared to recurrence at other sites. No significant predictors for tumor recurrence at the remnant ureter were identified. In patients without BCE, pathological T stage [hazard ratio (HR), 5.73] and lymphovascular invasion (HR, 3.65) were independent predictors of cancer-specific survival, whereas age (HR, 1.04), pathological T stage (HR, 5.11), and positive tumor margin (HR, 6.50) were independent predictors of overall survival. Conclusion Patients without BCE had poorer overall and cancer-specific survival after RNU than those with BCE. Most of these patients experienced tumor recurrence at the remnant ureter and other sites. Patients with non-organ confined UTUC after RNU without BCE may be considered for adjuvant chemotherapy with careful follow-up. PMID:25683984

  5. Adenocarcinoma of the Ileal Conduit in a Patient Born With Classic Bladder Exstrophy

    PubMed Central

    Ko, Joan S.; Di Carlo, Heather N.; Gupta, Angela D.; Ross, Ashley E.; Eckhauser, Frederic E.; Bivalacqua, Trinity J.

    2013-01-01

    Bladder exstrophy is a rare birth defect that typically requires patients to undergo multiple surgical procedures throughout the course of their childhood. Many ultimately undergo operations that use segments of bowel for the reconstruction and/or augmentation of the urinary tract, which imparts an increased risk of malignancy in these patients. We present the case of a 59-year-old man with a history of bladder exstrophy managed with ureterosigmoidostomies revised to an ileal conduit who developed a large adenocarcinoma in the ileal conduit that extended into small bowel, sigmoid colon, and ureter.

  6. Management of a Case of Severe Pelvic Fracture Related Bladder Trauma

    PubMed Central

    Myers, Jeremy B.; Hotaling, James M.; Brant, William O.; Enniss, Toby M.

    2015-01-01

    A 62-year-old male was admitted after being struck by a bus. He sustained a severe pelvic fracture, sigmoid colon injury, and both intraperitoneal and extraperitoneal bladder injury. He underwent initial successful bladder repair. However, at 7days post-operatively he manifested a leak from the repair and urine was evident coming from the pins of his pelvic external fixator. A repeat cystogram showed massive extravasation, which was managed by operative ligation of the lower ureters and placement of percutaneous nephrostomy tubes. He underwent ureteral reconstruction and colostomy reversal at 9months. He has both bladder and bowel control.

  7. A Rare Complication Observed during Percutaneous Nephrolithotomy: Foreign Body Migration from the Right Kidney to the Left Lung

    PubMed Central

    Kaba, Mehmet; Pirini, Necip; Kaba, Sultan; obano?lu, Ufuk; Ery?lmaz, Recep; Eren, Hseyin

    2014-01-01

    Percutaneous nephrolithotomy (PNL) is the first-line treatment in large, multiple stones and lower calyceal stones. Majority of complications associated with PNL are minor and clinically insignificant. It was seen that distal piece (2 cm in size) of ureter catheter observed at pelvis was found at the parenchyma of left lung on the perioperative fluoroscopy in the patient undergoing PNL for right kidney stone. We presented this complication to stress that a foreign body can pass into circulation presumably through venous injury and can migrate to the lung. PMID:26171308

  8. A Rare Complication Observed during Percutaneous Nephrolithotomy: Foreign Body Migration from the Right Kidney to the Left Lung.

    PubMed

    Kaba, Mehmet; Pirini, Necip; Kaba, Sultan; obano?lu, Ufuk; Ery?lmaz, Recep; Eren, Hseyin

    2015-06-01

    Percutaneous nephrolithotomy (PNL) is the first-line treatment in large, multiple stones and lower calyceal stones. Majority of complications associated with PNL are minor and clinically insignificant. It was seen that distal piece (2 cm in size) of ureter catheter observed at pelvis was found at the parenchyma of left lung on the perioperative fluoroscopy in the patient undergoing PNL for right kidney stone. We presented this complication to stress that a foreign body can pass into circulation presumably through venous injury and can migrate to the lung. PMID:26171308

  9. Unusual appearance for urinary bladder obstruction detected with 99mTc-MDP bone scintigraphy.

    PubMed

    Wright, Chadwick L; Sharma, Akash

    2015-12-01

    Unanticipated but clinically significant nonosseous findings can be detected during routine bone scintigraphy. We present a case of an 83-year-old man who presented with a pathologic fracture of the right femur. Whole-body bone scintigraphy for osseous staging revealed intense radiotracer accumulation in the kidneys and ureters but no activity within the urinary bladder. The patient had not voided for 14 hours. A Foley catheter was inserted, and more than 2000 mL of urine was drained, most consistent with urinary bladder obstruction. Subsequent repeat images demonstrated marked reduction of the renal and ureteral activity with trace activity in the urinary bladder. PMID:26544902

  10. A Rare Case of Pneumoureter: Emphysematous Pyelitis versus Emphysematous Pyelonephritis.

    PubMed

    Hiremath, Rudresh; Mahesh; Padala, Krishna Prasanthi; Swamy, Kumar; Pailoor, Aruna

    2015-11-01

    Emphysematous pyelitis is a rare benign entity which is defined as isolated gas production in the pelvicalyceal system, ureters or in the urinary bladder as a consequence of acute bacterial renal infection. In this case report we present a case with no prior medical history of diabetes or urinary obstruction who presented with uncontrolled hyperglycaemia for the first time associated with emphysematous pyelonephritis. Further, the imaging differences between emphysematous pyelonephritis (EPN) and emphysematous pyelitis (EP) has been discussed along with the approach and their management. PMID:26676155

  11. A sewing needle in the liver: 6 years later.

    PubMed

    Senol, Altug; Isler, Mehmet; Minkar, Tahsin; Oyar, Orhan

    2010-04-01

    A 27-year-old male patient was admitted for renal colic. In the radiographic findings of his kidney-ureter-bladder, a 6-cm-long sewing needle was detected in the right upper abdominal region. The needle displayed a direction toward the diaphragm, and the center of the needle had a radiolucent discontinuity. He refused to be operated. No complication was observed during the 6-year follow-up. Foreign bodies in the liver are generally recommended to be removed. This case is the first one in the literature with a needle in the liver remaining for 6 years without a change of location or causing a complication. PMID:20224315

  12. Metastatic carcinoma of probable transitional cell origin in 66 free-living California sea lions (Zalophus californianus), 1979 to 1994.

    PubMed

    Gulland, F M; Trupkiewicz, J G; Spraker, T R; Lowenstine, L J

    1996-04-01

    Sixty-six (18%) cases of widely metastatic carcinoma of probable transitional cell origin were identified in 370 California sea lions (Zalophus californianus) stranded alive along the central California (USA) coast, between January 1979 and December 1994. Live animals were usually emaciated and anorectic, with perineal edema and occasionally hind-flipper paralysis or paresis. Large yellow caseous masses were observed in the sub-lumbar lymph nodes, often extending around the ureters resulting in hydroureter. Histologically, metastases were usually widespread, and the primary neoplastic focus undetectable. This is the highest reported prevalence among necropsied animals of neoplasia in a pinniped population to date. PMID:8722262

  13. A case report of laparoscopic ipsilateral ureteroureterostomy in children with renal duplex

    PubMed Central

    Wong, Yuen Shan; Tam, Yuk Him; Pang, Kristine Kit Yi

    2016-01-01

    We report on two children aged 2 and 6 years, who underwent laparoscopic ipsilateral ureteroureterostomy for their renal duplex anomalies. Both patients had complete duplex and were investigated by ultrasound, micturating cystourethrogram, magnetic resonance urography, and radioisotope scan. One patient had high-grade vesicoureteral reflux to lower moiety complicated with recurrent urinary tract infections, while the other had obstruction to upper moiety due to ectopic ureter. The pathological moieties of both patients were functional. Both patients underwent laparoscopic ipsilateral ureteroureterostomy uneventfully without any intraoperative complications. Postoperative imagings confirmed successful outcomes after surgery. PMID:27014651

  14. A Rare Case of Pneumoureter: Emphysematous Pyelitis versus Emphysematous Pyelonephritis

    PubMed Central

    Mahesh; Padala, Krishna Prasanthi; Swamy, Kumar; Pailoor, Aruna

    2015-01-01

    Emphysematous pyelitis is a rare benign entity which is defined as isolated gas production in the pelvicalyceal system, ureters or in the urinary bladder as a consequence of acute bacterial renal infection. In this case report we present a case with no prior medical history of diabetes or urinary obstruction who presented with uncontrolled hyperglycaemia for the first time associated with emphysematous pyelonephritis. Further, the imaging differences between emphysematous pyelonephritis (EPN) and emphysematous pyelitis (EP) has been discussed along with the approach and their management. PMID:26676155

  15. Asymptomatic ureteral rupture secondary to chronic urinary retention from massive prostatic enlargement

    PubMed Central

    Sarmah, Piyush B.; Noah, Anthony; Kelly, Brian D.; Ryan, Peter G.

    2015-01-01

    Non-traumatic ureteral rupture has been reported more frequently, resulting from increased intraluminal pressures from distal urinary tract obstruction. We report the case of a 77-year-old man presenting with chronic urinary retention secondary to massive prostatic enlargement through acute kidney injury. Ultrasound scan detected a shallow left perinephric fluid collection with a possible bladder mass, demonstrated on flexible cystoscopy to be a massive median lobe of prostate. Computed tomography confirmed extravasation of urine from the left proximal ureter. In the absence of specific symptoms, the patient had successful conservative management with antibiotics and urinary catheterization for his acute episode, although declined further surgical intervention. PMID:26521159

  16. Influence of Saline on Temperature Profile of Laser Lithotripsy Activation

    PubMed Central

    Silva, Igor N.; Donalisio da Silva, Rodrigo; Gustafson, Diedra; Sehrt, David; Kim, Fernando J.

    2015-01-01

    Abstract Purpose: We established an ex vivo model to evaluate the temperature profile of the ureter during laser lithotripsy, the influence of irrigation on temperature, and thermal spread during lithotripsy with the holmium:yttrium-aluminum-garnet (Ho:YAG) laser. Materials and Methods: Two ex vivo models of Ovis aries urinary tract and human calcium oxalate calculi were used. The Open Ureteral Model was opened longitudinally to measure the thermal profile of the urothelium. On the Clinical Model, anterograde ureteroscopy was performed in an intact urinary system. Temperatures were measured on the external portion of the ureter and the urothelium during lithotripsy and intentional perforation. The lithotripsy group (n=20) was divided into irrigated (n=10) and nonirrigated (n=10), which were compared for thermal spread length and values during laser activation. The intentional perforation group (n=10) was evaluated under saline flow. The Ho:YAG laser with a 365 μm laser fiber and power at 10W was used (1J/Pulse at 10 Hz). Infrared Fluke Ti55 Thermal Imager was used for evaluation. Maximum temperature values were recorded and compared. Results: On the Clinical Model, the external ureteral wall obtained a temperature of 37.4°C±2.5° and 49.5°C±2.3° (P=0.003) and in the Open Ureteral Model, 49.7°C and 112.4°C with and without irrigation, respectively (P<0.05). The thermal spread along the external ureter wall was not statically significant with or without irrigation (P=0.065). During intentional perforation, differences in temperatures were found between groups (opened with and without irrigation): 81.8°±8.8° and 145.0°±15.0°, respectively (P<0.005). Conclusion: There is an increase in the external ureteral temperature during laser activation, but ureteral thermal values decreased when saline flow was applied. Ureter thermal spread showed no difference between irrigated and nonirrigated subgroups. This is the first laser lithotripsy thermography study establishing the framework to evaluate the temperature profile in the future. PMID:25154455

  17. Ureteral Hernia Mimicking Retrocrural Lymphadenopathy in 18F-FDG PET/CT.

    PubMed

    Almeida, Lanamar; Carvalhaes, Felipe; Bitencourt, Almir; Moreira, Fernando

    2015-08-01

    An 82-year-old woman was submitted to (18)F-FDG PET/CT to evaluate an indeterminate solitary lung nodule identified on chest CT. At the examination, there was a hypermetabolic area at the topography of the right retrocrural region, mimicking a lymphadenopathy on axial images. After careful analysis of multiplanar CT images, it was better characterized as a loop of the ureter insinuating itself by a small diaphragmatic hernia. Ureteral hernia is a rare entity with few cases reported in the literature. This case demonstrates the importance of conducting careful evaluation of multiplanar CT images to avoid false-positive results on PET/CT. PMID:26125547

  18. The clinical significance of dilatation of the collecting system in the transplanted kidney.

    PubMed

    Balchunas, W R; Hill, M C; Isikoff, M B; Morillo, G

    1982-01-01

    The significance of dilatation of the collecting system of the transplanted kidney and its relationship to bladder distention was reviewed in 39 renal recipients examined by sonography (94 studies). The degree of pelvicaliceal (PCS), ureteral, and bladder distention was graded and correlated with the 24-h urine output, nuclear renal scan, and clinical follow-up. marked PCS distention can indicate obstruction (33%), especially when there is no associated bladder distention (60%) and a fluid collection lies along the path of the ureter. The 24-hr urine output did not influence the degree of PCS distention. PMID:6804526

  19. A Congenital High Flow Arteriovenous Malformation of the Bladder Presenting With Polypoid Cystitis and Ureteral Obstruction.

    PubMed

    Addo, Eric A; Emtage, Justin; Massis, Kamal; Hernandez, David J

    2015-11-01

    A 21-year-old male with a history of Down's syndrome presented with hematuria and right flank pain. Computed Tomography (CT) of the abdomen/pelvis revealed right hydronephrosis and a right-sided pelvic vascular abnormality. Angiography revealed an arteriovenous malformation (AVM) fed by the right superior and inferior vesical arteries and nephrostogram showed a long segment of obstructed distal right ureter. Cystoscopy revealed erythema and edema of the right hemi-bladder and biopsy diagnosed polypoid cystitis. Treatment was performed by transarterial embolization with ethylene vinyl alcohol copolymer. Follow up cystoscopy and retrograde pyelography at 3months post-procedure showed resolution of all visible pathology. PMID:26793545

  20. Retrograde ejaculation following open ureteric reimplantation: a case report

    PubMed Central

    2009-01-01

    Introduction Retrograde ejaculation is not a recognized complication of ureteric reimplantation surgery. We describe this unusual complication in a 25-year-old man, with no other cause for his ejaculatory dysfunction. Case presentation A 25-year-old Caucasian man presented with left hydronephrosis ascribed to a megaureter. Following open reimplantation of the ureter, the patient developed retrograde ejaculation that did not respond to medical therapy. Conclusion The key result reported here is that retrograde ejaculation is a possible complication of open pelvic surgery, for which patients should receive counselling. This is relevant for both urologists and general physicians who consult relatively young men with ejaculatory difficulties. PMID:19918274

  1. Imaging diagnosis-aortic aneurysm and ureteral obstruction secondary to umbilical artery abscessation in a 5-week-old foal.

    PubMed

    Nogradi, Nora; Magdesian, K Gary; Whitcomb, Mary Beth; Church, Molly; Spriet, Mathieu

    2013-01-01

    A 5-week-old foal was evaluated for fever and hematuria of 3 days duration. Cystoscopy localized the blood to be originating from the left ureter. Abdominal ultrasonography revealed left hydronephrosis, hydroureter, and omphaloarteritis of the left umbilical artery with abscess formation that communicated with an arterial structure. Computed tomography (CT) revealed a large aortic aneurysm within the center of the abscess. An exploratory celiotomy was performed and the infection was nonresectable. The prognosis for life was grave; therefore the colt was euthanized. Necropsy findings confirmed the antemortem diagnosis. Ultrasound and CT imaging in this case provided an accurate antemortem diagnosis. PMID:23496157

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

    PubMed Central

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

    1996-01-01

    1. We have altered intracellular (pHi) and extracellular pH (pHo) in the smooth muscle of guinea-pig ureter and determined the effects on evoked phasic contractions. In order to investigate the mechanisms underlying the effects of pH alteration, intracellular Ca2+ ([Ca2+]i), pHi, electrical activity and force were measured. 2. Intracellular acidification, produced by the weak acid butyrate, application of CO2 at constant pHo or removal of weak bases, greatly increased phasic contractions. Alkalinization with weak bases or by removal of CO2 inhibited contractions. The results were similar whether Hepes or CO2-HCO3-buffered the solutions. 3. Phasic contractions were preceded by intracellular Ca2+ transients in the ureter. Acidification of the cytoplasm led to an increase in the amplitude of the Ca2+ transient, and alkalinization decreased its magnitude. 4. In the ureter the action potential leads to Ca2+ influx, therefore electrophysiological recordings of its configuration were made during alteration of pHi. Acidification led to the action potential duration and amplitude being increased, whereas alkalinization shortened the action potential and reduced its amplitude. 5. As the effects of acidification on the action potential resembled the effects of blocking of K+ channels, we investigated whether pHi alteration was able to alter tension when K+ channels were blocked by tetraethylammonium. Acidification was unable to potentiate force under these conditions nor did alkalinization decrease force. 6. External pH over the range 6.8-8.0 had little or no effect on pHi, phasic contractions and [Ca2+]i. Tonic contractions were enhanced, however, when pHo was increased. 7. These data suggest that pHi alteration in the guinea-pig ureter modulates the action potential, probably by alteration of K+ currents. Subsequent changes in [Ca2+]i and contraction then occur. A potentiating effect of acidic pH on force is not common in muscle, but may be a characteristic of the smooth muscle of the urinary tract. Changes of pHo had little effect on phasic force or pHi, but modulated tonic contractions. The possible physiological significance of these results is discussed. PMID:8799906

  3. Chyluria: is retrograde pyelogram mandatory prior to endoscopic sclerotherapy?

    PubMed Central

    Paul, Sagorika; Kumar, Manoj; Singh, Viswajeet; Sankhwar, Satyanarayan

    2014-01-01

    Chyluria is the passage of milky urine due to a lymphourinary fistula secondary to lymphatic stasis caused by obstruction of the lymphatic flow. This can be caused by parasitic or non-parasitic infections. Though chyluria is a commonly encountered entity in clinical practice particularly in developing countries like India, it is rarely discussed in English literature. We report a case of chyluria with right bifid ureter in a 50-year-old male patient who was treated with intrarenal pelvic instillation of 1% silver nitrate (AgNO3) and emphasis on the diagnostic implication of retrograde pyelography prior to endoscopic sclerotherapy in managing chyluria particularly in renal anomalies. PMID:24395870

  4. A Congenital High Flow Arteriovenous Malformation of the Bladder Presenting With Polypoid Cystitis and Ureteral Obstruction

    PubMed Central

    Addo, Eric A.; Emtage, Justin; Massis, Kamal; Hernandez, David J.

    2015-01-01

    A 21-year-old male with a history of Down's syndrome presented with hematuria and right flank pain. Computed Tomography (CT) of the abdomen/pelvis revealed right hydronephrosis and a right-sided pelvic vascular abnormality. Angiography revealed an arteriovenous malformation (AVM) fed by the right superior and inferior vesical arteries and nephrostogram showed a long segment of obstructed distal right ureter. Cystoscopy revealed erythema and edema of the right hemi-bladder and biopsy diagnosed polypoid cystitis. Treatment was performed by transarterial embolization with ethylene vinyl alcohol copolymer. Follow up cystoscopy and retrograde pyelography at 3months post-procedure showed resolution of all visible pathology. PMID:26793545

  5. How a dentist's name became a synonym for a life-saving device: the story of Dr. Charles Stent.

    PubMed

    Ring, M E

    2001-07-01

    Stents have been used in numerous medical disciplines, as well as in oral surgical procedures. Uses range from rebuilding mandibles and constructing new ureters, to keeping coronary arteries patent after angioplasty. The earliest use of the word "stent" to describe this item was in 1916, when a Dutch plastic surgeon described how he used a dental impression compound as a matrix around which to form tissue in the process of rebuilding a shattered face. What is generally unknown is that the word "stent" derives from the name of an English dentist, who invented this impression compound in 1856. PMID:11484317

  6. Psoas Abscess Secondary to Urinary Tract Fungal Infection

    PubMed Central

    Aldamanhori, Reem; Barakat, Alaa; Al-Madi, Maha; Kamal, Baher

    2015-01-01

    Psoas abscess is a rare condition where infection spreads from a nearby or distant septic focus to the psoas sheath. The causative bacterial organisms at distal sites reach the psoas via lymphatic or hematogenous spread, whereas infection from nearby sites that include the urinary system reaches the psoas directly. There are few reports that account for bacterial infection after endourological procedures as the cause of direct spread of infection to the psoas muscle.2 We report a case of psoas abscess caused by fungal infection that spread from an injured left ureter to the psoas sheath.

  7. [The implantation of human kidney stones--a simple experimental model (author's transl)].

    PubMed

    Chaussy, C; Eisenberger, F; Wanner, K

    1977-01-01

    Human kidney stones of different chemical components were implanted into the renal pelvis of 15 mongrel dogs. In the first surgical intervention the ureter was ligated near the bladder. Eight days later a second laparotomy was performed. It was possible to implant concrements with a diameter of about 1 - 1.5 cm into the dilated pelvis. At the same time urinary stasis was removed by a neoureterostomy. This method offers a unique experimental model for the evaluation of problems involved in litholysis of human kidney stones by chemical and physical methods. PMID:847860

  8. Primary extra-renal clear cell renal cell carcinoma masquerading as an adrenal mass: A diagnostic challenge.

    PubMed

    Hasan, Roumina; Kumar, Sandeep; Monappa, Vidya; Ayachit, Anurag

    2015-01-01

    We present the first case of a nonmetastasizing renal cell carcinoma (RCC) masquerading as an adrenal mass, in the presence of normal bilateral native kidneys, in a young adult. The possibility of this mass developing in a supernumerary kidney was ruled out, since no identifiable renal tissue, pelvis or ureters was seen within the mass, nor was any separate systemic arterial supply to the mass seen. The diagnosis of extra-renal clear cell RCC was based on cyto-morphological features, further confirmed by immunohistochemistry findings. The origin of this extra-renal clear cell renal cell is proposed to be from the mesodermal embryonic rests. PMID:26692677

  9. Primary extra-renal clear cell renal cell carcinoma masquerading as an adrenal mass: A diagnostic challenge

    PubMed Central

    Hasan, Roumina; Kumar, Sandeep; Monappa, Vidya; Ayachit, Anurag

    2015-01-01

    We present the first case of a nonmetastasizing renal cell carcinoma (RCC) masquerading as an adrenal mass, in the presence of normal bilateral native kidneys, in a young adult. The possibility of this mass developing in a supernumerary kidney was ruled out, since no identifiable renal tissue, pelvis or ureters was seen within the mass, nor was any separate systemic arterial supply to the mass seen. The diagnosis of extra-renal clear cell RCC was based on cyto-morphological features, further confirmed by immunohistochemistry findings. The origin of this extra-renal clear cell renal cell is proposed to be from the mesodermal embryonic rests. PMID:26692677

  10. Ureteric lymphoma as a rare cause of right lower ureteric obstruction.

    PubMed

    Sreenivas, Jayaram; Mallya, Ashwin; Karthikeyan, Vilvapathy Senguttuvan; Amirtham, Usha

    2016-01-01

    Primary lymphoid neoplasms of the urinary tract are exceedingly rare, with only 21 cases being reported and comprising less than 5% of all primary extranodal lymphomas. We report a case of a 45-year-old man who presented with right flank pain and weight loss, and who was found to have a stricture in the right lower ureter causing ureteral obstruction. Histopathology revealed lower ureteric non-Hodgkin lymphoma, which, on further evaluation, was found to be isolated ureteric lymphoma. The patient was doing well after six cycles of R-CHOP chemotherapy. This case is being reported as a rare cause of distal ureteric obstruction. PMID:26825937

  11. Continent cutaneous diversion and external genitalia reconstruction in a child with severe variety urogenital sinus and ambiguous genitalia.

    PubMed

    Khemchandani, Sajni I

    2015-01-01

    The diagnosis and management of a child with ambiguous genitalia and severe variety of urogenital sinus with a high vesico-vaginal confluence is challenging. This 4-year-old female child had solitary right kidney with ectopic ureter opening in high variety of urogenital sinus with hypo-plastic urinary bladder and incontinence. We describe genitourinary reconstruction with complete functional rehabilitation in this child. This complex problem was managed with continent urinary diversion with Penn pouch and refashioning of external genitalia, rendering continence and near normal female external genitalia. The child and parents are happy with continence and aesthetically normal external genitalia. PMID:25829673

  12. [Computer modeling in surgical treatment of rectum cancer].

    PubMed

    Glishkov, N I; Mucukaev, Kh M; Pavelets, K V; Lebedev, A K; Chernykh, D A

    2011-01-01

    154 patients with rectal cancer were divided into the main group and the control group. All of them were investigated using endorectal and intraoperative sonography, spiral computer tomography and magnetic resonance tomography. Basing on the data of radial diagnostics pelvis model with tumour projection into rectum, bladder, ureters, prostate, uterus and vagina was recieved in all patients from the main group using Power SHAPE programm. Application of modern radial techniques and 3D modeling in diagnostics of rectal cancer contributes to adequate extent of surgical treatment adjacent with increased amount of radical operations (from 50% to 81,5%) and improvement of prognosis and survival rate in postoperative period. PMID:22408802

  13. Fornix Rupture in Duplex Kidney due to Internal Iliac Artery Aneurysm

    PubMed Central

    Mahawong, Phitsanu; Srisuwan, Tanop; Rerkasem, Kittipan

    2016-01-01

    A 70-year-old man presented with severe pain on the right side of the abdomen for 7 days. An abdominal CT angiographic scan showed an impending rupture of a large right internal iliac artery aneurysm which compressed to a right ureter causing hydroureteronephrosis. Fornix rupture of a right duplex kidney was also detected. Selective embolization of right gluteal arteries and then ligation of the right internal iliac artery and right ureterotomy with double J stenting were performed. At the 4-month follow-up appointment, an abdominal ultrasound demonstrated a decrease in the size of the aneurysm and no hydroureteronephrosis after the removal of double J stent. PMID:26989554

  14. [Lympho-renal fistula in lymphatic imaging].

    PubMed

    Jurgov, T; Pavkovcekov, O; Drahovsk, V; Podrack, L

    1989-03-01

    On the case of 10 years old boy with chyluria the authors emphasize the importance of lymphographic examination for proving the pyelolymphatic connection. The lymphographic examination was applied after the complete examination including computer tomography and ultrasound, since these examinations did not prove changes of the urinary and lymphatic systems which could explain the milky clouding of the urine lasting for several months. Changes in the biochemical profile were significant as well as non-constant ejaculation of milky cloudy urine from the opening of the right ureter. The lymphographic examination proved the link between the lymphatic urinary systems with changes on the lymphatic vessels and nodes. PMID:2731298

  15. [Classification and natural history of bladder tumors].

    PubMed

    Allory, Yves

    2014-12-01

    Urinary bladder tumors are mainly of urothelial type. Classifications include stage and grade to provide with the required prognostic factors and help to select the most adequate treatment. Though somatic mutations in bladder tumors are known, their used for targeted therapy are restricted to clinical trials. Upper urinary tract tumors are classified as urinary bladder tumor at histological level, but tumor staging is specified according to calyx, renal pelvis or ureter location; in young patients with upper urinary tract tumor, a Lynch syndrome should be eliminated. PMID:25668829

  16. Immortalisation of human urothelial cells.

    PubMed

    Petzoldt, J L; Leigh, I M; Duffy, P G; Sexton, C; Masters, J R

    1995-01-01

    A cell line derived from the urothelium lining the ureter of a 12-year-old girl was immortalised using a temperature-sensitive SV40 large T-antigen gene construct, and designated UROtsa. Following immortalisation, UROtsa cells expressed SV40 large T-antigen, but did not acquire characteristics of neoplastic transformation, including growth in soft agar or the development of tumours in nude mice. Metaphase spreads had a normal chromosomal appearance and number. UROtsa cells remained permissive for cell growth at 39 degrees C, indicating that they did not retain temperature sensitivity. UROtsa provides an in vitro model of "normal" urothelium. PMID:8788275

  17. [Ureteroscopy. Experience and results].

    PubMed

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

    1991-09-01

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

  18. Bilateral Ureteral Obstruction in Children after Appendectomy

    PubMed Central

    Grande, M.; Lisi, G.; Bianchi, D.; Bove, P.; Miano, R.; Esser, A.; De Sanctis, F.; Neri, A.; Grande, S.; Villa, M.

    2015-01-01

    Acute renal failure due to bilateral ureteral obstruction is a rare complication after appendectomy in children. We report a case of bilateral ureteric obstruction in a 14-year-old boy nine days after surgery for an acute appendicitis. After saline-filling of the urinary bladder, transabdominal ultrasound demonstrated bilateral hydronephrosis of moderate degree. No abscess was found with CT but presence of millimetric stones on both distal ureters was shown, with bilateral calyceal dilatation. Cystoscopy revealed inflammatory changes in the bladder base. Following introduction of bilateral ureteric stents, there was rapid normalisation of urinary output and serum creatinine. PMID:26295001

  19. Ureteral replacement with appendix in pediatric renal transplantation.

    PubMed

    Corbetta, Juan P; Weller, Santiago; Bortagaray, Juan I; Durn, Victor; Burek, Carol; Sager, Cristian; Lopez, Juan C

    2012-05-01

    Ureteral necrosis is an uncommon complication following RT which can adversely affect outcome. Even though authors agree that the native ureter ought to be preserved, there are cases in which graft function can only be salvaged by ureteral substitution. The scant references in the literature on the use of the appendix for left ureteral replacement in children prompted us to report the following two cases in whom the technique was employed and to assess the evolution of graft function in these patients. PMID:22151119

  20. Image-guided surgery using near-infrared fluorescent light: from bench to bedside

    NASA Astrophysics Data System (ADS)

    Boogerd, Leonora S. F.; Handgraaf, Henricus J. M.; van de Velde, Cornelis J. H.; Vahrmeijer, Alexander L.

    2015-03-01

    Due to its relatively high tissue penetration, near-infrared (NIR; 700-900 nm) fluorescent light has the potential to visualize structures that need to be resected (e.g. tumors, lymph nodes) and structures that need to be spared (e.g. nerves, ureters, bile ducts). Until now, most clinical trials have focused on suboptimal, non-targeted dyes. Although successful, a new era in image-guided surgery has begun by the introduction of tumor-targeted agents. In this paper, we will describe how tumor-targeted NIR fluorescent imaging can be applied in a clinical setting.

  1. [Primary obstructive megaureter in infants: medical or surgical treatment? Apropos of 24 cases].

    PubMed

    Vidal, V; Fremond, B; Chapuis, M; Babut, J M

    1988-01-01

    The authors analyse 24 cases of primary obstructive megaureter diagnosed before the age of 3 months. 18 were discovered by antenatal echography between 28 and 39 weeks, whereas 6 were detected by the occurrence of early urinary tract infection. Initial investigations included echography, intravenous urography and micturating cystouretrogram. Primary megaureter was bilateral in 14 cases, unilateral in 12. According to the urographic classification of Beurton, there were 12 ureters stage III, 12 stage II, 10 stage I. 15 patients were operated, 4 of them during the first months (2 reimplantations, 2 urinary diversions). 12 were submitted to later reimplantation at the mean age of 15 months, one had a non functioning kidney removed. 9 were non operated and treated conservatively by antibacterials and regular supervision. Results analysis evaluated according to radiological stage and treatment showed that in more cases, surgery should be differed initially. Complete clinical and radiological resolution is possible even in severe obstructions. Antibacterial treatment beginning at birth favorises regression of dilated ureter. Thus reimplantation should be deferred undercover of regular biological and radiological survey. The age of 12 to 18 months is the most technically favorable time to ureteric reimplantation. PMID:3058813

  2. Biological consequences of fiber fragmentation with pulsed laser lithotripsy

    NASA Astrophysics Data System (ADS)

    Bruhn, Erich W.; Go, Peter M. N. Y. H.; McClane, Robert W.; Hunter, John G.; Straight, Richard C.

    1990-06-01

    Fiber tip breakage during urinary and biliary laser lithotripsy has been recognized to occur with several laser types. This phenomenon has also been seen with Q-switched Nd:YAG laser lithotripsy. Our aim was to determine the biological consequences of this event in the canine ureter and bile duct. In an excised tissue preparation, urinary and biliary stones were impacted in a canine ureter and common bile duct. Three and four hundred micron quartz laser fibers were placed in direct contact with the stone. Normal saline coaxial irrigation was initiated at 75 xal/min. A Q-switched Nd:YAG laser was activated at repetition rates from 1O-30 Hz. and pulse energies from 10-30 mJ. The tissue was sectioned and microscopic examination of the fragmentation site was performed. Histological exam revealed the persistence of large numbers of fiber fragments in the lumen and imnbedded in the epithelium at the lithotripsy site. Fragments varied greatly in size and appeared to have angular, sharp edges We conclude that irrigation can not be relied upon to remove the fiber fragments from the lithotripsy sites and that the biological consequences of fiber fragmentation may be greater than previously believed. Glass fragments "blown" into the epitheliumu will often result in glass granulomas, which may eventually cause obstruction of closed lumninal structures. This raises serious concern for the presence of any fiber breakage during laser lithotripsy.

  3. Carcinoid tumor associated with adjacent dysplastic columnar epithelium in the renal pelvis: A case report and literature review.

    PubMed

    Kim, Sung Sun; Choi, Chan; Kang, Taek Won; Choi, Yoo Duk

    2016-01-01

    Carcinoid tumors are well documented in the pulmonary and gastrointestinal systems, but very rare in the urinary tract, especially in the renal pelvis. We report on a 60-year-old female patient who presented with left flank pain and fever. Abdominal computed tomography demonstrated a heterogeneously enhancing mass in the left renal pelvis and a stone at the left proximal ureter. Multiple parenchymal lesions were also observed, which were identified as uneven caliectasis displaying air-fluid levels and renal parenchymal atrophy. The patient underwent simple nephro-ureterectomy. Macroscopically, a polypoid mass was observed in the renal pelvis. Microscopically, the tumor revealed acinar, tubular, and solid pattern and was composed of small, monotonous and hyperchromatic cells. Lining epithelia in renal pelvis and ureter revealed columnar epithelia with dysplastic change. The tumor cells were positive for chromogranin A, synaptophysin, CD56, and focally positive for cytokeratin. Immunohistochemical staining of synaptophysin and chromogranin A highlighted the neuroendocrine cells in the columnar epithelium. Ki-67 (1:50; MIB-1) labeling index was less than 1% in the area with highest uptake. We report here a case of carcinoid tumor of the renal pelvis that was associated with adjacent dysplastic columnar epithelium. PMID:26644387

  4. New valve-mechanical model of urinary tract function: the theory of biological dual valves

    PubMed Central

    Szendr?, Peter

    2011-01-01

    Introduction Until now, peristalsis has been the only known method of urine transport. The main objective of this paper was to study urinary tract function especially the upper urinary tract, the ureter from a new mechanical point of view. The physical (physical dual valves) and biological basis (biological dual valves) of a new functional model is presented based on previous observations and knowledge. Methods A review of the literature was performed, with special emphasis on ureter motility. Results After analyzing the anatomy and physiology of the urinary tract, complemented by basic physical observations, the authors have developed a new valve-mechanical model of urinary tract function. A comprehensive mechanical hypothesis is also presented, integrating the role of peristalsis. Conclusions The authors believe that the new theory enhances previous knowledge. From a structural point of view, the urinary tract may be considered to consist of dualvalves. The dual-valve mechanism combined with peristalsis allows better explanation of the function of the upper urinary tract in particular. The main conclusion is that the flow in the urinary tract must be studied integrally within the body. This new theory does not contradict well-known and acknowledged theories, and moreover, it may help solve certain medical problems. PMID:24578880

  5. The Role of Ureteral Relaxation in the Promotion of Stone Passage

    NASA Astrophysics Data System (ADS)

    Davenport, Kim; Timoney, Anthony G.; Keeley, Francis X.

    2007-04-01

    In order to promote stone passage in renal colic, we must first understand normal ureteral activity and how this is affected by the presence of a stone. Measuring normal ureteral activity in humans is difficult without the use of invasive methods or techniques which in themselves may affect peristalsis. Monitoring the activity during confirmed renal colic is even more difficult and virtually impossible. Both animal and human studies have therefore been used in an attempt to understand the physiology of the ureter and how this is affected by the presence of a stone. Using this knowledge, drugs can be used to alter the behavior of the ureter in an attempt to promote stone passage. Peristalsis has always been thought to be essential to allow stone passage and therefore it has been necessary to determine whether stone passage occurs by promotion of ureteral activity or by smooth muscle relaxation. Research indicates that drugs which allow continued peristalsis whilst preventing the increased uncoordinated activity seen in renal colic would be the most advantageous. The alpha-1A-adrenoceptor antagonists are the most effective drugs to date.

  6. Ontogeny and osmoregulatory function of the urinary system in the Persian sturgeon, Acipenser persicus (Borodin, 1897).

    PubMed

    Abadi, Z Taghizadeh Rahmat; Khodabandeh, S; Charmantier, G; Charmantier-Daures, M; Lignot, J H

    2014-10-01

    The structure of the kidney and the localization of Na(+), K(+)-ATPase (NKA) immunopositive cells were examined throughout the postembryonic development of the Persian sturgeon, Acipenser persicus, from newly hatched prelarvae (10mm) to 20 days post hatch (20 DPH) larvae (31mm). Investigations were conducted through histology and immunohistochemistry by using the light and immunofluorescence microscopy. The pronephros was observed in newly hatched prelarvae. The cells lining the distal pronephric tubules and their collecting ducts showed laterally expressed NKA immunofluorescence that later extended throughout the whole cytoplasm. Mesonephrogenous placodes and pre-glomeruli were distinguished at 2 DPH along the collecting ducts posteriorly. Their tubules were formed and present in kidney mesenchyma, differentiated into neck, proximal, distal and collecting segments at 7 DPH when NKA immunopositive cells were observed. Their distal and collecting tubules showed an increasing immunofluorescence throughout their cytoplasm while the glomeruli remained unstained. From D 9 to D 17, the epithelial layer of pronephric collecting duct changed along the mesonephros to form ureters. Ureters, possessing isolated strong NKA immunopositive cells, appeared as two sac-like structures hanging under the trunk kidney. Since NKA immunopositive cells were not observed on the tegument or along the digestive tract of newly hatched prelarva, and also the gills are not formed yet, the pronephros is the only osmoregulatory organ until 4 DPH. At the larval stage, the pronephros and mesonephros are functional osmoregulatory organs and actively reabsorb necessary ions from the filtrate. PMID:25024093

  7. Renal excretory sectors.

    PubMed

    Burykh, M P

    2002-01-01

    One thousand and ninety-four normal human kidneys and 18 abnormal (with duplication of the ureter) were studied by the corrosion method and pyelography followed by topometric and mathematics analyses. It was found that the renal pelvis is a calicopelvic complex built up of renal calices, urine ducts and renal pelvis. Before opening into the renal pelvis, renal calices join together forming urine ducts (superior and inferior; or superior, middle and inferior; or superior, middle anterior, middle posterior and inferior) which transport urine to the container, the renal pelvis. It can be seen that groups of renal calices with pyramids and their surrounding cortical substance form the renal excretory sectors of the kidneys where the processes of uropoiesis and transportation of urine through elements of the nephron and calicopelvic complex take place. These are two (superior and inferior), three (superior, middle and inferior) or four (superior, middle anterior, middle posterior and inferior) renal excretory sectors. The existence of renal excretory sectors is proved by congenital anomalies of the calicopelvic complex such as duplication of the ureter, where urine ducts of the superior and inferior renal excretory sectors do not form a renal pelvis but run separately to the urinary bladder. On the basis of anatomical data obtained, renal excretory sectors may be distinguished, analogous to bronchopulmonary segments in lungs. These data about renal excretory sectors will contribute to further improvement in the operative technique of renal partial resections as well as to anatomical nomenclature. PMID:12375073

  8. Retrograde Positive Contrast Urethrocystography of the Fish Urogenital System

    PubMed Central

    Pugliese, Michela; Pietro, Simona Di; Zaccone, Daniele; Giorgianni, Pietro; Bonfiglio, Rossella

    2014-01-01

    The radiological differences between the urinary tract of??Dicentrarchus labrax, Sparus aurata, Tinca tinca, and Cyprinus carpio are shown. In fresh water teleosts the urinary bladder is sigmoid and a short urethra leads to the urinary pore. Genital and anal pores are present. In Sparus aurata the urinary bladder has a globoid shape. In Dicentrarchus labrax the urinary bladder is smaller and elongate. In both marine teleosts a single urogenital pore is visible. Positive contrast was used to survey the urogenital system and evaluate shape and size of the bladder, urethra, ureter, and gonadal ducts. Results demonstrate the morphological variability of the urinary bladder and the craniodorsal entry of the ureters into the bladder. It is envisaged that this work will provide baseline information for further imaging studies for investigating the urogenital morphology and can be applied to identify disorders in fishes. Furthermore, the main interest of this study is that it demonstrates the morphological variability of the lower urinary system that exists between different species of fishes. PMID:25180198

  9. Management of symptomatic ureteral calculi during pregnancy: Experience of 23 cases

    PubMed Central

    Abdel-Kader, Mohammad S.; Tamam, Abdel-Aziz; Elderwy, Ahmad A.; Gad, Mohammad; El-Gamal, Mohammad A.; Kurkar, Adel; Safwat, Ahmed S.

    2013-01-01

    Purpose: To present our experience in the management of symptomatic ureteral calculi during pregnancy. Materials and Methods: Twenty-three pregnant women, aged between 19 and 28 years presented to the obstetric and urology departments with renal colic (17 cases, 73.9%) and fever and renal pain (6 cases, 26.1%); suggesting ureteric stones. The diagnosis was established by ultrasonography (abdominal and transvaginal). Outpatient follow-up consisted of clinical assessment and abdominal ultrasonography. Follow-up by X-ray of the kidneys, ureter, and bladder (KUB), or intravenous urography (IVU) was done in the postpartum period. Results: Double J (DJ) stent was inserted in six women (26%) with persistent fever followed by extracorporeal shock wave lithotripsy (ESWL) one month post-partum. Ureteroscopic procedure and pneumatic lithotripsy were performed for 17 women (distal ureteric stone in 10, middle ureter in 5, and upper ureteric stone in 2). Stone-free rate was 100%. No urologic, anesthetic, or obstetric complications were encountered. Conclusions: Ureteroscopy, pneumatic lithotripsy, and DJ insertion could be a definitive and safe option for the treatment of obstructive ureteric stones during pregnancy. PMID:24311902

  10. Long-term effects of pediatric extracorporeal shockwave lithotripsy on renal function

    PubMed Central

    Akin, Yigit; Yucel, Selcuk

    2014-01-01

    Introduction Extracorporeal shock wave lithotripsy (ESWL) is a well-known and successful treatment modality. In addition, it can be used in premature infants. ESWL is used to treat kidney and ureter stones in children. However, although it is a preferred noninvasive treatment in that setting, there is debate about its long-term effects on growing kidneys in children. Objectives To investigate the long-term effects of pediatric ESWL on renal function in light of updated literature. Methods PubMed and Medline were searched for studies on ESWL in a pediatric population with keywords including efficacy, child, kidney calculi, ureter calculi, lithotripsy, injury, vascular trauma, and shock waves. The research was limited to the English literature during a period from 1980 to 2014. In total, 3,000 articles were evaluated, but only 151 papers were considered. Only the manuscripts directly related to the reviewed subjects were included in the current study. Results However, the acute effects of ESWL in kidney are well-described. Although there are limited studies on the long-term effects of ESWL in children, there is a widespread opinion that ESWL is not affecting renal functions in the long-term. Conclusion ESWL is a safe, effective, and noninvasive treatment option in children. Although ESWL can cause some acute effects in the kidney, there is no long-term effect on the growing kidneys of children. PMID:24892029

  11. Management of iatrogenic ureteral injury

    PubMed Central

    Burks, Frank N.

    2014-01-01

    Iatrogenic injury to the ureter is a potentially devastating complication of modern surgery. The ureters are most often injured in gynecologic, colorectal, and vascular pelvic surgery. There is also potential for considerable ureteral injury during endoscopic procedures for ureteric pathology such as tumor or lithiasis. While maneuvers such as perioperative stenting have been touted as a means to avoid ureteral injury, these techniques have not been adopted universally, and the available literature does not make a case for their routine use. Distal ureteral injuries are best managed with ureteroneocystostomy with or without a vesico-psoas hitch. Mid-ureteral and proximal ureteral injuries can potentially be managed with ureteroureterostomy. If the distal segment is unsuitable for anastomosis then a number of techniques are available for repair including a Boari tubularized bladder flap, transureteroureterostomy, or renal autotransplantation. In rare cases renal autotransplantation or ureteral substitution with gastrointestinal segments may be warranted to re-establish urinary tract continuity. Laparoscopic and minimally invasive techniques have been employed to remedy iatrogenic ureteral injuries. PMID:24883109

  12. [Ammonium acid urate stone due to laxative abuse: a case report].

    PubMed

    Kato, Yuji; Hou, Kyokushin; Saga, Yuji; Yamaguchi, Satoshi; Yachiku, Sunao; Kawakami, Norihiro

    2004-11-01

    We report a case of ammonium acid urate stone due to laxative abuse. A 27-year-old female complained of left flank pain. Computed tomography revealed bilateral ureter stones (right 16.5 x 9.0 mm; left 4 mm), while left ureter stone was radiolucent on the plain X ray film. Bilateral hydronephrosis was seen, but no therapy was performed for the right stone, because 99mTc-MAG3 scintigraphy revealed that right kidney had no function. The left stone was successfully removed by transurethral approach. The stone was revealed to be an ammonium acid urate by infrared spectrophotometry. She had been taking many laxatives (bisacodyl, sennoside, aloe extract) for 12 years to control her body weight. Ammonium acid urate stones are rarely seen in developed countries. We have reviewed 9 cases in Japan, describing ammonium acid urate stones due to laxative abuse. Among these patients, 24-hour urine volume and excretion in urinary sodium were decreased, and serum aldosterone was increased. The involvement of laxative abuse should be considered when ammonium acid urate is formed in a woman with a low body mass index. PMID:15628542

  13. Radiological findings and the clinical importance of megacalycosis

    PubMed Central

    Kalaitzis, Christos; Patris, Emmanuel; Deligeorgiou, Evangelia; Sountoulides, Petros; Bantis, Athanasios; Giannakopoulos, Stilianos; Touloupidis, Stavros

    2015-01-01

    Objective To describe the radiological findings and the clinical importance of megacalycosis. Materials and methods On the basis of a case report and literature review, diagnostic criteria and clinical significance of megacalycosis are presented. Result Megacalycosis is mostly asymptomatic and is usually discovered either accidentally or as a result of its complications, such as stone formation, flank pain, hematuria, infection, and fever. The renal pelvis, infundibulum, and ureter are not dilated. Calyces have a semilunar configuration rather than the conventional triangular or conical form. The tip of each pyramid is flat, and the calyces possess neither fornix nor papillae impressions. The number of calyces is increased compared to the healthy condition, typically from 20–25. The renal parenchyma has a normal width but with a slight narrowing of the renal medulla. The kidney exhibits normal function, in particular with respect to its ability to concentrate the urine. Conclusion Megacalycosis is a rare, usually unilateral dilatation of the kidney calyces in the presence of a normal, undilated renal pelvis and ureter. Its pathological significance lies in the occurrence of complications. PMID:26528455

  14. CD40 Generation 2.5 Antisense Oligonucleotide Treatment Attenuates Doxorubicin-induced Nephropathy and Kidney Inflammation.

    PubMed

    Donner, Aaron J; Yeh, Steve T; Hung, Gene; Graham, Mark J; Crooke, Rosanne M; Mullick, Adam E

    2015-01-01

    Preclinical and clinical data suggest CD40 activation contributes to renal inflammation and injury. We sought to test whether upregulation of CD40 in the kidney is a causative factor of renal pathology and if reduction of renal CD40 expression, using antisense oligonucleotides (ASOs) targeting CD40, would be beneficial in mouse models of glomerular injury and unilateral ureter obstruction. Administration of a Generation 2.5 CD40 ASO reduced CD40 mRNA and protein levels 75-90% in the kidney. CD40 ASO treatment mitigated functional, transcriptional, and pathological endpoints of doxorubicin-induced nephropathy. Experiments using an activating CD40 antibody revealed CD40 is primed in kidneys following doxorubicin injury or unilateral ureter obstruction and CD40 ASO treatment blunted CD40-dependent renal inflammation. Suborgan fractionation and imaging studies demonstrated CD40 in glomeruli before and after doxorubicin administration that becomes highly enriched within interstitial and glomerular foci following CD40 activation. Such foci were also sites of ASO distribution and activity and may be predominately comprised from myeloid cells as bone marrow CD40 deficiency sharply attenuated CD40 antibody responses. These studies suggest an important role of interstitial renal and/or glomerular CD40 to augment kidney injury and inflammation and demonstrate that ASO treatment could be an effective therapy in such disorders. PMID:26623936

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

    NASA Astrophysics Data System (ADS)

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

    1993-05-01

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

  16. OCT-aided anastomosis platform study in the rodent model

    NASA Astrophysics Data System (ADS)

    Huang, Yong; Tong, Dedi; Zhu, Shan; Wu, Lehao; Ibrahim, Zuhaib; Lee, WP Andrew; Brandacher, Gerald; Kang, Jin U.

    2014-02-01

    Anastomosis is one of the most commonly performed procedure in the clinical environment that involves tubular structures, such as blood vessel, lymphatic vessel, seminal duct and ureter. Suture based anastomosis is still the foundation for most basic surgical training and clinical operation, although alternate techniques have been developed and under development. For those tubular-structure-anastomosis, immediate real-time post-operative evaluation of the surgical outcome is critical to the success of surgery. Previously evaluation is mostly based on surgeons' experience. Fourier-domain optical coherence tomography is high-speed, high-resolution noninvasive 3D imaging modality that has been widely used in the biomedical research and clinical study. In this study we used Fourier-domain optical coherence tomography as an evaluation tool for anastomosis of lymphatic vessels, ureter and seminal duct in rodent model. Immediate post-operative and long term surgical site data were collected and analyzed. Critical clinical parameters such as lumen patency, anastomosed site narrowing and suture error detection are provided to surgeons.

  17. Progesterone--specific binding sites in the kidney of the female baboon

    SciTech Connect

    Weaker, F.J.; Herbert, D.C.; Sheridan, P.J.

    1984-10-01

    The uptake and retention of a radiolabeled synthetic progestin, ORG 2058, was studied in the urinary tract of the female baboon. Four estrogen-primed baboons were injected intravenously with 2.5 micrograms./kg. body weight of 3H-ORG 2058. One animal, which served as a control, received an additional injection of 2.5 mg./kg. body weight of unlabeled progesterone. One hour after the injections, the animals were killed and the kidneys, ureters and urinary bladder were removed and processed for autoradiography. Localization of progestin was observed in the nuclei of the convoluted and straight segments of the distal tubule, the ascending thick limb of the loop of Henle and both cortical and medullary collecting tubules. Connective tissue cells were also labeled in the medulla and cortex of the kidney. An absence of silver grains was noted in the renal corpuscle, all segments of the proximal tubule and the thin loop of Henle. Concentration of the tritiated steroid was not observed in either the ureter or bladder or in any portions of the urinary tract of the control animal. This study suggests that progesterone has a direct effect via a progesterone specific receptor on the various target cells that sequestered the 3H-ORG 2058.

  18. Gentics of urogenital abnormalities in ACI inbread rats.

    PubMed

    Cramer, D V; Gill, T J

    1975-08-01

    The frequency of urogenital abnormalities in adult ACI rats was 18.8%. These abnormalities consisted of a spectrum of defects ranging from focal aplasia of the ureter to the complete absence of the ureter, kidney, and tubular genital tract on the affected side. When ACI rats with normal urogenital tracts tracts were crossed with F344 rats the frequency of the defects decreased to a constant level in the F1, F2, and F3 generations. There was no clearly significant decrease in the frequency of the defects in the backcross offspring of (ACI times F344)F1 times ACI matings, but there was a significant and dramatic decrease in the backcross to F344 rats. Attempts to select against these defects by brother-sister matings among normal ACI rats were not successful: 5 generations of inbreeding did not alter the frequency of the urogenital abnormalities. The frequency of the abnormalities was the same in the offspring of affected parents as in the offspring of normal parents, indicating homozygosity of the factors responsible for the defects. The results suggest that the transmission of these defects is polygenic. PMID:1162622

  19. Case of intra-abdominal spindle cell tumor after laparoscopic resection of sigmoid colon cancer.

    PubMed

    Okada, Naoya; Nakamura, Fumitaka; Nanno, Yoshihide; Takada, Minoru; Ambo, Yoshiyasu; Kishida, Akihiro; Kashimura, Nobuichi; Shinohara, Toshiya

    2016-02-01

    We herein report a rare case of a patient who developed a spindle cell tumor at the inferior mesenteric artery clipping site. A 58-year-old man underwent laparoscopy-assisted sigmoid colectomy for sigmoid colon cancer. As follow-up, CT scans were performed every 6 months after the primary surgery. At the 1-year CT, an nodular soft tissue density mass measuring 54?mm in diameter was found in the mesentery. Although we initially suspected locoregional recurrence of the colon cancer resected 1 year earlier, PET-CT showed that the tumor was unrelated to the previous cancer. During the subsequent laparotomy, the mass appeared to originate from the inferior mesenteric artery clipping site, and it adhered to the jejunum and the left ureter. We completely resected the tumor and part of the jejunum, which we separated from the abdominal aorta and left ureter. The tumor was histologically diagnosed of a spindle cell tumor. The patient has been free from recurrence since the surgery more than 4.5 years ago. Preoperative PET-CT was helpful in ruling out local recurrence of colon cancer, which might have made palliative care a better option than surgical resection. PMID:26781531

  20. Use of invisible near infrared light fluorescence with indocyanine green and methylene blue in urology. Part 2

    PubMed Central

    Markuszewski, Marcin; Rho, Young Soo; Matuszewski, Marcin

    2014-01-01

    Introduction In the second part of this paper, concerning the use of invisible near infrared light (NIR) fluorescence with indocyanine green (ICG) and methylene blue (MB) in urology, other possible uses of this new technique will be presented. In kidney transplantation, this concerns allograft perfusion and real time NIRguided angiography; moreover, perfusion angiography of tissue flaps, NIRF visualization of ureters, NIRguided visualization of urinary calcifications, NIRF in male infertility and semen quality assessment. In this part, we have also analysed cancer targeting and imaging fluorophores as well as cost benefits associated with the use of these new techniques. Material and methods PubMed and Medline databases were searched for ICG and MB use in urological settings, along with data published in abstracts of urological conferences. Results Although NIRguided ICG and MB are still in their initial phases, there have been significant developments in a few more major domains of urology, including 1) kidney transplantation: kidney allograft perfusion and vessel reconstruction; 2) angiography perfusion of tissue flaps; 3) visualization of ureters; 4) visualization of urinary calcifications; and 5) NIRF in male infertility and semen quality assessment. Conclusions Near infrared technology in urology is at its early stages. More studies are needed to assess the true potential and limitations of the technology. Initial studies show that this pioneering tool may influence various aspects of urology. PMID:25247093

  1. Modified laparoscopic intravesical nonrefluxing ureteral reimplantation with psoas hitch using a submucosal tunneling.

    PubMed

    Kim, Chang-Hee; Ro, Joo Hwan; Jung, Han

    2014-12-01

    We aimed to study the safety and efficacy of the cystoscopy-assisted nonrefluxing ureteral reimplantation technique using submucosal tunneling during laparoscopic ureteroneocystostomy (UNC) with a psoas hitch in patients with distal ureter stricture after gynecologic surgery. We reviewed six female patients who underwent gynecological surgeries. All patients showed persistent postoperative distal ureter stricture or obstruction. These patients underwent laparoscopic nonrefluxing UNC with a psoas hitch using a submucosal tunneling technique combined with cystoscopy at our institute. They had corrective surgery at an average of 13.3 weeks after ureteral injury. The short-term success was confirmed either by voiding cystourethrography (VCU) or by diuretic isotope renal scan (MAG-3) conducted 3 months after the operation. None of the patients showed evidence of postoperative stricture at the reimplanted site and reflux on either MAG-3 renal scan or VCU. None of the patients showed major or minor complications during follow-up. It is safe and feasible to perform the laparoscopic nonrefluxing UNC with a psoas hitch using a submucosal tunneling technique combined with cystoscopy for ureteral stricture. PMID:25610823

  2. Clinical benefits of tubeless umbilical cutaneous ureterostomy

    PubMed Central

    Numakura, Kazuyuki; Tsuchiya, Norihiko; Takahashi, Makoto; Tsuruta, Hiroshi; Akihama, Susumu; Saito, Mitsuru; Inoue, Takamitsu; Narita, Shintaro; Huang, Mingguo; Satoh, Shigeru; Habuchi, Tomonori

    2015-01-01

    Introduction: We assess a novel technique of tubeless bilateral cutaneous ureterostomy, with a single umbilical stoma, for bladder cancer patients with short ureters after cystectomy. The benefit of cutaneous ureterostomy is equal to other incontinent urinary diversions, when the tubeless procedure is successfully achieved. This simple technique makes it easy to monitor the upper urinary tract (UUT) and is beneficial to patients with a high risk of UUT recurrence. Methods: This old and new surgical technique was used to perform total cystectomy and urinary diversion on three patients with bladder cancer at a high risk of UUT recurrence. Results: Two men and one woman (mean age: 73 years) underwent this surgery and the mean follow-up period was 8.3 years. The surgical approaches were laparotomy (n = 2) and laparoscopy (n = 1). One case developed para-stomal erosion, whereas another developed ureteral stenosis requiring catheter reinsertion. Although postoperative hydronephrosis was observed in all cases, the mean preoperative and postoperative serum creatinine levels were 0.70 and 0.76, respectively. UUT recurrence was not observed during the follow-up period. Conclusion: This tubeless umbilical cutaneous ureterostomy procedure greatly improves the outcome of urinary diversion for cancer patients with short ureters at a high risk of UUT recurrence. The benefits are equivalent to other urinary diversions when the tubeless procedure is successfully achieved. PMID:26225182

  3. Arsenic in drinking water and incidence of urinary cancers.

    PubMed

    Guo, H R; Chiang, H S; Hu, H; Lipsitz, S R; Monson, R R

    1997-09-01

    The associations between arsenic ingestion and cancers of the bladder and kidney have been documented in Taiwan. To evaluate further such associations for urinary cancers of various cell types, we conducted an ecologic study encompassing 243 townships using cancer registry data of patients diagnosed between 1980 and 1987. We used the proportions of wells with various specified arsenic levels in each township as indicators of exposure and evaluated the effects of urbanization and smoking by an urbanization index and the number of cigarettes sold per capita. In both genders, we observed associations of high arsenic levels in drinking water with transitional cell carcinomas of the bladder, kidney, and ureter and all urethral cancers combined. We also observed such associations in adenocarcinomas of the bladder in males, but not in squamous cell carcinomas of the bladder or renal cell carcinomas or nephroblastomas of the kidney. There was also a positive association between the urbanization index and transitional cell carcinomas of the ureter in males. The number of cigarettes sold per capita was not a good predictor for urinary cancers. The results indicate that the carcinogenicity of arsenic may be cell type specific. PMID:9270957

  4. Characterization of nanostructured ureteral stent with gradient degradation in a porcine model

    PubMed Central

    Wang, Xiaoqing; Shan, Hongli; Wang, Jixue; Hou, Yuchuan; Ding, Jianxun; Chen, Qihui; Guan, Jingjing; Wang, Chunxi; Chen, Xuesi

    2015-01-01

    A tubular poly(ε-caprolactone) (PCL)/poly(lactide-co-glycolide) (PLGA) ureteral stent composed of nanofibers with micropores was fabricated by double-needle electrospinning. The stent was ureteroscopically inserted into six Changbai pigs, and the commercial polyurethane Shagong® stent was inserted into four pigs as control. Intravenous pyelography revealed that the PCL/PLGA stent gradually degraded from the distal end to proximal terminal, and all stents were completely degraded at 10 weeks post-insertion. No significant difference was observed in hydronephrosis severity between the two groups. The levels of serum creatinine and urine pH remained similar throughout the study in the two groups, but the number of white blood cells in the urine was significantly higher in the Shagong® stent group. On Day 70, histological evaluation indicated equivalent histological severity scores in the middle and distal ureter sections and bladder in the two groups. However, the PCL/PLGA stent-implanted pigs had significantly lower mean severity scores in the kidney and proximal ureter sites. These data revealed that the PCL/PLGA stent degraded in a controlled manner, did not induce obstruction, and had a lower urothelial impact in comparison to the Shagong® stent, indicating that the stent exhibited great potential for clinical application. PMID:25945051

  5. Technical and clinical outcomes of ureteral stenting in cats with benign ureteral obstruction: 69 cases (2006-2010).

    PubMed

    Berent, Allyson C; Weisse, Chick W; Todd, Kimberly; Bagley, Demetrius H

    2014-03-01

    OBJECTIVE--To evaluate the technical, short-term, and long-term outcomes in cats with benign ureteral obstructions treated by means of double-pigtail ureteral stent placement. DESIGN--Retrospective case series. ANIMALS--69 cats (79 ureters). PROCEDURES--The diagnosis of benign ureteral obstruction was made via abdominal ultrasonography, radiography, and ureteropyelography. Ureteral stent placement was attempted endoscopically, surgically, or both, with fluoroscopic guidance. The medical records were reviewed for pre-, intra-, and postoperative data; complications; and outcome. RESULTS--69 cats (79 ureters) had stent placement attempted for various causes: ureterolithiasis (56/79 [71%]), stricture (10/79 [13%]), both ureterolithiasis and stricture (12/79 [15%]), or a purulent plug (1/79 [1%]). Stent placement was successful in 75 of 79 ureters (95%). Median number of stones per ureter was 4 (range, 0 to > 50), and 67 of 79 (85%) had concurrent nephrolithiasis. Preoperative azotemia was present in 95% (66/69) of cats (median creatinine concentration, 5.3 mg/dL [range, 1.1 to 25.8 mg/dL]), and 71% (49/69) remained azotemic (median, 2.1 mg/dL [range, 1.0 to 11.8 mg/dL]) after successful surgery. Procedure-related, postoperative (< 7 days), short-term (7 to 30 days), and long-term (> 30 days) complications occurred in 8.7% (6/69; 7/79 ureters), 9.1% (6/66), 9.8% (6/61), and 33% (20/60) of cats, respectively; most of these complications were minor and associated with intermittent dysuria or the need for ureteral stent exchange. The perioperative mortality rate was 7.5% (5/69), and no deaths were procedure related. The median survival time was 498 days (range, 2 to > 1,278 days). For patients with a renal cause of death, median survival time was > 1,262 days, with only 14 of 66 cats (21%) dying of chronic kidney disease. Nineteen (27%) cats needed a stent exchange (stricture in-growth [n = 10], migration [4], ureteritis [2], dysuria [2], pyelonephritis [1], or reflux [1]). No patient died of the procedure or recurrent ureteral obstruction. CONCLUSIONS AND CLINICAL RELEVANCE--Results of the present study indicated that ureteral stenting is an effective treatment for benign ureteral obstructions in cats regardless of obstructive location, cause, or stone number. The perioperative morbidity and mortality rates were lower than those reported with traditional ureteral surgery. The short- and long-term complications were typically minor but may necessitate stent exchange or use of an alternative device, particularly with ureteral strictures. The prognosis for feline ureteral obstructions after ureteral stenting could be considered good when the procedure is performed by trained specialists. PMID:24548231

  6. RADIO FREQUENCY ABLATION OF SMALL RENAL TUMORS: INTERMEDIATE RESULTS

    PubMed Central

    HWANG, J. J.; WALTHER, M. M.; PAUTLER, S. E.; COLEMAN, J. A.; HVIZDA, J.; PETERSON, JAMES; LINEHAN, W. M.; WOOD, B. J.

    2008-01-01

    Purpose With evolving radio frequency technology, the clinical application of radio frequency ablation (RFA) has been actively investigated in the treatment for small renal tumors. We present our intermediate patient outcomes after RFA. Materials and Methods Since January 2001, 17 patients with a total of 24 hereditary renal tumors ranging from 1.2 to 2.85 cm were treated with RFA using the 200 W Cool-tip RF System (Radionics, Burlington, Massachusetts) under laparoscopic (9) or percutaneous (8) guidance and had a minimum 1-year followup. A percutaneous approach was considered unsuitable if kidney tumors were contiguous to bowel, ureter or large vessels. Treatment eligibility criteria included an average tumor diameter of less than 3.0 cm, tumor growth during 1 year and solid appearance with contrast enhancement (HU change greater than 20) on computerized tomography (CT). Postoperative followup consisted of CT with and without intravenous contrast, and renal function assessment at regular intervals. Results Median patient age was 38 years (range 20 to 51). At a median followup of 385 days (range 342 to 691), median tumor or thermal lesion diameter decreased from 2.26 to 1.62 cm (p = 0.0013), and only 1 lesion (4%), which was located centrally near the hilum, exhibited contrast enhancement (HU change greater than 10) on CT at 12 months. Of the 15 renal tumors ablated laparoscopically, 13 were in direct contact with the bowel and 2 were abutting the ureter, necessitating mobilization before RFA. Laparoscopic ultrasound was used to guide radio frequency electrode placement and monitor the ablation process in these cases. Operative time and intraoperative blood loss (mean ± standard mean of error) were 243 ± 29 minutes and 67 ± 9 cc, respectively. In 1 patient whose ureter was adherent to the tumor a ureteropelvic junction obstruction developed after laparoscopic RFA, requiring open repair. Conclusions At the minimum 1-year followup 23 of 24 ablated tumors lacked contrast uptake on CT, meeting our radiographic criteria of successful RFA treatment. RFA treatment of small renal tumors using the Radionics system appears to result in superior treatment outcomes compared to those of earlier series with lower radio frequency power generators. A high wattage generator might attain more consistent energy deposition with subsequent cell death in the targeted tissue due to less convective heat loss. PMID:15076283

  7. Ureteric Suture Urolithiasis Following Open Emergency Ureteric Repair

    PubMed Central

    Sarmah, Piyush B.; Kelly, Brian D.; Devarajan, Raghuram

    2016-01-01

    Suture urolithiasis is an unusual but recognised phenomenon following surgery on the urinary tract. We report a case in a 30-year-old man who sustained a gunshot injury to the left ureter in Burundi and underwent open ureteric repair in a regional hospital. He migrated to the UK and presented one year later with left loin pain. An intravenous urogram revealed two foci of calcification to the left of L3, within a peri-ureteric position. The patient underwent left-sided ureteroscopy where two calculi each formed around a nylon suture were discovered within a ureteric pseudo-diverticulum, and basketed. This is the first reported case of suture urolithiasis occurring following ureteric surgery. PMID:26989371

  8. Fibromyxoid nephrogenic adenoma protruding in a renal cortical cyst. A rare morphological variant in an outstanding location.

    PubMed

    Khedaoui, Radia; Encabo, Beatriz; Tardo, Juan C

    2016-02-01

    Nephrogenic adenoma (NA) is an unusual, benign lesion of the urinary tract, generally presenting in the bladder and with less frequency in the renal pelvis, urethra or ureter. It consists of tubules, microcysts and papillae lined by a single layer of low cuboidal epithelium without atypia. Recently, a fibromyxoid variant mimicking an infiltrating mucinous adenocarcinoma has been described. We report hereby the case of a 70-year-old female with a fibromixoid NA protruding in a renal cortical cyst. Only one case of NA in a renal cortical cyst has been found in the literature and it was of the classical type. The development of a NA in a renal cortical cyst lends support to the theory that the NA results from proliferation of secondarily implanted exfoliated renal epithelial cells. PMID:26706600

  9. [A case of percutaneous BCG perfusion therapy for CIS of upper urinary tract CIS after radical cystectomy with ileal neobladder].

    PubMed

    Obayashi, Koki; Miki, Jun; Kasai, Kanako; Tashiro, Kojiro; Tsuduki, Shunsuke; Bando, Shigehiro; Ishii, Gen; Suzuki, Kan; Kimura, Takahiro; Kishimoto, Koichiro; Egawa, Sin

    2014-09-01

    We report a case of percutaneous bacillus Calmette-Gurin (BCG) perfusion therapy for carcinoma in situ (CIS) of upper urinary tract after radical cystectomy with ileal neobladder. A 42-year-old man underwent radical cystectomy and ileal neobladder diversion due to the recurrence of CIS in prostatic urethra after transurethral resection of bladder tumor 3 times and 2 courses of intravesical BCG therapy. Final pathological findings showed the presence of CIS in the right distal ureteral margin. After the radical cystectomy, our diagnosis was CIS in the right residual ureter, because of positive urine cytology and negative radiographic findings in the upper urinary tract. We performed the percutaneous BCG perfusion therapy for CIS of the right upper urinary tract after the construction of the percutaneous nephrostomy by intentionally inducing hydronephrosis. No recurrence was found after 3 years of BCG perfusion therapy. PMID:25293799

  10. A man with dark urine and shortness of breath: a case-based review of paravalvular leaks.

    PubMed

    Curtain, James P; O'Brien, James William

    2016-01-01

    A 62-year-old man presented to his general practitioner with a 10-day history of dark red urine. Subsequent blood tests revealed an acute kidney injury and anaemia. His only medical history was a prosthetic mitral valve replacement 30?years previously for rheumatic valve disease. Following referral to a urology service, initial investigations, including CT KUB (kidneys, ureters, bladder), excluded a urological cause for his presentation. A haemolysis screen was positive. A transthoracic echocardiogram reported severe aortic stenosis and aortic incompetence. A transoesophageal echocardiogram revealed a paravalvular leak at the prosthetic mitral valve. The patient was referred to a regional cardiothoracic centre, and underwent a repeat mitral valve replacement and an aortic valve replacement. PMID:26791121

  11. Engineering Better Lithotripters.

    PubMed

    Chaussy, Christian G; Tiselius, Hans-Gran

    2015-08-01

    Although shock wave lithotripsy (SWL) remains an excellent non-invasive method for active removal of stones from the ureter and kidney, its popularity has decreased during recent years and the arguments for choosing endoscopic procedures rather than the only non-invasive surgical procedure are usually based on the opinion that SWL results are inferior to those obtained with endoscopic methods. It is considered that slow technical progress has not sufficiently met the requirements of disintegration, reduced need of repeated treatments, shorter treatment duration and less negative effects on tissues. This article summarises some recently published articles that address these problems and have the aim of improving the function of lithotripters. Modification of the shock wave geometry, elimination or control of cavitation bubbles, and different techniques of disintegration studied in in vitro and in animal experiments suggest several possible future directions that might provide a basis for development of a new "gold standard" lithotripter. PMID:26077353

  12. [The role of Pax2 in regulation of kidney development and kidney disease].

    PubMed

    Hou, Xiao-Ming; Chen, Xing; Wang, Yu-Lin

    2011-09-01

    Paired box2 (Pax2) gene plays a crucial role in kidney development and is expressed in the nephric duct, mesenchyme of pronephrons, mesonephrons, and metanephrons with special spatial and temporal characteristic. Research in animals indicate that Pax2 can interact with many important transcription factors such as Gdnf, Ret, SHH, Wnt4, and Fgf to organize the nephric linage specification, pro/mesonephric tubule formation and descent, emergence of the ureteric bud, branching morphogenesis, and nephron induction. Pax2 is associated with various congenital renal and ureter malformations, and the mutation is easist to detected in Renal-coloboma syndrome. In renal cell carcinoma, Wilms tumor and many acquired kidney diseases Pax2 is expressed abnormally, whose diagnose and therapy value will be the focus of further research. This paper reviews the molecular structure, expression and regulation of Pax2 in kidney development and diseases. PMID:21951793

  13. In vivo regeneration of renal vessels post whole decellularized kidneys transplantation

    PubMed Central

    Lin, KeZhi; Yu, YaLing; Zhao, LiNa; Chu, TingGang; Wu, LiZhi; Alkhawaji, Ali; Li, MiaoZhong; Shao, YingKuan; Li, Ting; Lou, XinFa; Chen, ShiXin; Tang, MaoLin; Mei, Jin

    2015-01-01

    Nearly 50 million patients in China live with end-stage renal disease (ESRD), and only about 4000 patients may receive kidney transplantation. The purpose of this study was to investigate regeneration of renal vessels post whole decellularized kidneys transplantation in vivo. We decellularized kidneys of donor rats by perfusing a detergent through the abdominal aorta, yielding feasible extracellular matrix, confirmed for acellularity before transplantation. Based on the concept of using the body as a bioreactor, we orthotopically transplanted the kidney and ureter scaffolds in recipient rats, and found the regeneration of vessels including artery and vein in the renal sinus following a spontaneous recanalization. Although the findings only represent an initial step toward the ultimate goal of the generation of fully functional kidneys in vivo, these findings suggest that the body itself, as the bioreactor, is a viable strategy for kidney regeneration. PMID:26575172

  14. In vivo regeneration of renal vessels post whole decellularized kidneys transplantation.

    PubMed

    Zhang, JianSe; Wang, ZhiBin; Lin, KeZhi; Yu, YaLing; Zhao, LiNa; Chu, TingGang; Wu, LiZhi; Alkhawaji, Ali; Li, MiaoZhong; Shao, YingKuan; Li, Ting; Lou, XinFa; Chen, ShiXin; Tang, MaoLin; Mei, Jin

    2015-12-01

    Nearly 50 million patients in China live with end-stage renal disease (ESRD), and only about 4000 patients may receive kidney transplantation. The purpose of this study was to investigate regeneration of renal vessels post whole decellularized kidneys transplantation in vivo. We decellularized kidneys of donor rats by perfusing a detergent through the abdominal aorta, yielding feasible extracellular matrix, confirmed for acellularity before transplantation. Based on the concept of using the body as a bioreactor, we orthotopically transplanted the kidney and ureter scaffolds in recipient rats, and found the regeneration of vessels including artery and vein in the renal sinus following a spontaneous recanalization. Although the findings only represent an initial step toward the ultimate goal of the generation of fully functional kidneys in vivo, these findings suggest that the body itself, as the bioreactor, is a viable strategy for kidney regeneration. PMID:26575172

  15. Tissue-engineered urinary conduits.

    PubMed

    Kates, Max; Singh, Anirudha; Matsui, Hotaka; Steinberg, Gary D; Smith, Norm D; Schoenberg, Mark P; Bivalacqua, Trinity J

    2015-03-01

    The role of tissue engineering in the cystectomy population rests on the principle of sparing healthy intestinal tissue while replacing diseased bladder. Over the last 25years advances in cell biology and material science have improved the quality and durability of bladder replacement in animals. The neo-urinary conduit ([NUC]-Tengion) employs autologous fat smooth muscle cells which are seeded onto synthetic, biodegradable scaffolds. This seeded construct is then implanted in the patient and purportedly regenerates native urinary tissue to serve as a passive channel connecting the ureters to the skin surface. Preclinical animal studies as well as the first phase I human trial implanting the NUC are reviewed. While the ultimate goal of creating a durable, effective, tissue-engineered conduit is still in its infancy, important technical and experimental strides have been made. PMID:25677229

  16. Pathologic effects of intracavitary irradiation with californium-252. [Miniature swine

    SciTech Connect

    Sullivan, M.F.; Beamer, J.L.; Cross, F.T.; Lund, J.E.; Mahony, T.D.; Endres, G.W.; Buschbom, R.L.

    1980-12-01

    The effect of exposures of miniature swine to /sup 252/Cf afterloading tubes placed in the cervix uteri with a tandem applicator were compared with those effects resulting from /sup 226/Ra sources. Dosimetry for the adjacent normal tissues was established by surgically attaching termolumuniscent dosimeters (TLDs) at the various sites, as well as by theoretical calculation. Changes were observed in the rectum, urinary bladder, ureters and cervix as both early, < 75 days, and late, > 75 days, consequences of exposure. Changes in the rectum, urinary bladder and uterine cervix at risk in radiotherapy were used to calculate RBEs for both early and late complications. The overall value for early fibrosis was 4.34 +- 0.41. For late fibrosis the overall value was 6.73 +- 0.43, indicating that the repair potential of these tissues is not as good after neutron exposure. RBEs for vasculitis and muscle degeneration were similar.

  17. [Urachal cyst: an unusual cause of intestinal obstruction].

    PubMed

    Rodrguez-Rubio, F I; Robles, J E; Abad, J I; Rosell, D; Agera, L; Zudaire, J J; Berin, J M

    1993-10-01

    Contribution of one case of urachal cyst in a patient initially diagnosed with intestinal obstruction due to a probable colon-sigma neoplasia. The patient underwent discharge colostomy after finding an extension of the likely tumour to abdominal wall, bladder and right ureter. Later, the patient was reassessed and the CT showed a mass in the bladder's anterior edge with disclosure of purulent material and inflammatory cytology through the PAAF. The treatment performed was partial cystectomy, closure of colostomy and rectum-sigma re-anastomosis. Histological diagnosis was urachal cyst, abscess and pyogenic membranes, with no evidence of tumoral tissue. The idiosyncrasy of this urachal cyst is the simulation of an intestinal obstructive process of tumoral origin. Differential diagnosis in these intestinal processes rarely includes urachal cyst. PMID:8165946

  18. Embolomycotic Aneurysm of External Iliac Artery

    PubMed Central

    Tern, Nemesio A.; Gonzalez, Nerio M.; Garca, Luis; Gonzalez, Freddy E.; Rivera, Humberto E.

    1989-01-01

    We report a case of embolomycotic aneurysm of the right iliac artery secondary to bacterial endocarditis. The patient, a 33-year-old woman, presented with unilateral hydronephrosis and lower extremity edema caused by aneurysmal compression of the ipsilateral ureter and the external iliac vein. She was treated with ligation and an extraperitoneal left-external-iliac-artery to right-femoral-artery bypass using a knitted Dacron prosthesis. Since her surgery, our patient has been well except for persistence of moderate leg edema. To the best of our knowledge, we are reporting the 1st case of embolomycotic external-iliac-artery aneurysm secondary to bacterial endocarditis and resulting in hydronephrosis and venous insufficiency. (Texas Heart Institute Journal 1989;16:51-55) Images PMID:15227238

  19. 45,X/47,XXX Mosaicism and Short Stature.

    PubMed

    Everest, Erica; Tsilianidis, Laurie A; Haider, Anzar; Rogers, Douglas G; Raissouni, Nouhad; Schweiger, Bahareh

    2015-01-01

    We describe the case of a ten-year-old girl with short stature and 45,X/47,XXX genotype. She also suffered from vesicoureteric reflux and kidney dysfunction prior to having surgery on her ureters. Otherwise, she does not have any of the characteristics of Turner nor Triple X syndrome. It has been shown that this mosaic condition as well as other varieties creates a milder phenotype than typical Turner syndrome, which is what we mostly see in our patient. However, this patient is a special case, because she is exceptionally short. Overall, one cannot predict the resultant phenotype in these mosaic conditions. This creates difficulty in counseling parents whose children or fetuses have these karyotypes. PMID:26137340

  20. Laser welding with an albumin stent: experimental ureteral end-to-end anastomosis

    NASA Astrophysics Data System (ADS)

    Xie, Hua; Shaffer, Brian S.; Prahl, Scott A.; Gregory, Kenton W.

    2000-05-01

    Porcine ureters were anastomosed using an albumin stent and diode laser in vitro. The albumin stent provided precise apposition for an end to end anastomosis and enhanced welding strength. The anastomosis seam was lasered with an 810 nm diode laser using continuous wave and pulse light through a hand-held 600 micrometer noncontact optical fiber. Tensile strength, burst pressures, operative times, total energy and thermal damaged were measured in this study. The results demonstrated that using an albumin stent to laser weld ureteral anastomoses produces strong weld strengths. The liquid albumin solder also provided satisfactory welding strength. There were no significant differences of tissue thermal damage between the albumin stent alone, liquid solder alone and both combination groups. Thermal damage to tissue depended on laser setting and energy. This study determined the appropriate laser setting parameters to perform in vivo ureteral end to end anastomosis.

  1. Abdominal lipomatosis attributed to tall fescue toxicosis in deer.

    PubMed

    Wolfe, B A; Bush, M; Monfort, S L; Mumford, S L; Pessier, A; Montali, R J

    1998-12-15

    Five adult female Eld's deer died acutely or were euthanatized because of clinical signs including anorexia, signs of depression, and uremia. On necropsy, these deer had large masses of necrotic abdominal fat constricting the ureters, causing hydroureter and hydronephrosis. The herd from which these deer originated was maintained on pastures consisting primarily of tall fescue, samples from which were subsequently confirmed to be infected with an endophytic fungus that is known to cause similar lesions in cattle. A retrospective study of deaths in this herd revealed a sharp increase in incidence of abdominal lipomatosis since 1994. Physical examinations on the herd revealed > 90% of females to be affected. Endophyte-infected tall fescue forage was concluded to be a major factor in the development of lipomatosis in these deer. Other contributing factors were considered. Lesions caused by endophyte-infected fescue can be severe, and this disease can develop in nondomestic species. PMID:9861975

  2. Risks and Benefits of Early Catheter Removal After Renal Transplantation.

    PubMed

    Guler, S; Cimen, S; Hurton, S; Molinari, M

    2015-12-01

    Although many advances in renal transplantation have occurred over recent decades, bladder catheterization has remained a constant practice to facilitate the identification of the dome of the bladder by retrograde infusion of antibiotic solutions in its lumen prior to the creation of the cystoureteric anastomosis. In addition, the presence of the Foley catheter prevents possible tension on the newly created anastomosis between the ureter and the bladder as it allows continuous external drainage of urine and is very useful to monitor perioperative fluid balance. Although urethral catheterization provides several benefits, the optimal duration of catheterization remains a subject of controversy. The primary aim of this paper is to review the available scientific literature on the management of urethral catheters after renal transplantation and assess the pros and cons of early vs late catheter removal. PMID:26707302

  3. Laparo-endoscopic single-site (LESS) bilateral nephroureterectomy for patients with end-stage renal disease.

    PubMed

    Chung, Shiu-Dong; Tsai, Yao-Chou; Wang, Shuo-Meng; Hung, Shun-Fa; Huang, Chao-Yuan; Chueh, Shih-Chieh; Yu, Hong-Jeng

    2013-02-01

    We present the first report of LESS bilateral nephroureterectomy via the transperitoneal approach using the home-made single port. Two patients received LESS bilateral nephroureterectomies and bladder cuffs resection with homemade single ports, which were created by using an Alexis wound retractor as an access platform through a 4 cm incision. Distal ureters were resected through the same incision with Endo-loop. No additional ports were used and both procedures were completed successfully without traditional laparoscopic/open conversion or complication. LESS nephreoureterectomy with bladder cuff excision was performed in 460 and 635 minutes with an estimated blood loss of 50 and 400 mL, respectively. Patients were discharged on postoperative day 3 and 7, respectively. Our report demonstrates that LESS bilateral nephroureterectomy and bladder cuff resection is a safe and feasible procedure for urothelial carcinoma of upper urinary tract in patients at dialysis. PMID:23121219

  4. A Novel Mutation in SLC3A1 Gene in Patients With Cystinuria.

    PubMed

    Markazi, Samaneh; Kheirollahi, Majid; Doosti, Abbas; Mohammadi, Mehrdad; Koulivand, Leila

    2016-01-01

    Cystinuria is an inherited disease characterized by the formation of cystine calculi in the kidneys, ureters,  and bladder. Cystinuria is associated with mutation in the SLC3A1 and SLC7A9 genes. These defects prevent appropriate reabsorption of dibasic amino acids lysine, ornithine, and arginine. Cystinuria is classified as type I (silent heterozygotes) and non-type I (heterozygotes with urinary hyperexcretion of cystine). In molecular term, cystinuria is classified as type A (mutations on SLC3A1 gene) and type B (mutations on SLC7A9 gene). This report describes 7 patients with early onset of cystine calculus formation. We are report a new mutation in SLC3A1 gene in exon 1. A novel nucleotide substitution c.-29A>G was found in exon 1 of the SLC3A1 gene, which had not been reported elsewhere previously. PMID:26837681

  5. Ureteric Suture Urolithiasis Following Open Emergency Ureteric Repair.

    PubMed

    Sarmah, Piyush B; Kelly, Brian D; Devarajan, Raghuram

    2016-02-01

    Suture urolithiasis is an unusual but recognised phenomenon following surgery on the urinary tract. We report a case in a 30-year-old man who sustained a gunshot injury to the left ureter in Burundi and underwent open ureteric repair in a regional hospital. He migrated to the UK and presented one year later with left loin pain. An intravenous urogram revealed two foci of calcification to the left of L3, within a peri-ureteric position. The patient underwent left-sided ureteroscopy where two calculi each formed around a nylon suture were discovered within a ureteric pseudo-diverticulum, and basketed. This is the first reported case of suture urolithiasis occurring following ureteric surgery. PMID:26989371

  6. INFLUENCE OF EXPERIMENTAL KIDNEY DAMAGE ON HISTOCHEMICALLY DEMONSTRABLE LIPASE ACTIVITY IN THE RAT. COMPARISON WITH ALKALINE PHOSPHATASE ACTIVITY.

    PubMed

    Wachstein, M

    1946-06-30

    Lipase activity was found in the cytoplasm of the proximal convoluted tubules in tissue sections of rat, rabbit, dog, mouse, hamster, and guinea pig, stained according to Gomori's method. Uranium and mercury poisoning do not inactivate the enzyme in necrotic cells of the proximal convoluted tubules. Its activity diminished in the atrophic and regenerating cells of the kidneys of rats, surviving the acute phase of the intoxication. In the acute stage of choline deficiency marked reduction in enzymatic activity was seen in the necrotic tubules, and in the atrophied and regenerating tubules in the subacute stage. Lipase activity was markedly diminished in hydronephrotic kidneys 10 to 12 days after ligation of the ureter. In sections stained for alkaline phosphatase activity nearly identical alterations were found. Experimental damage influences both histochemically demonstrable enzymes in a similar manner. PMID:19871551

  7. Myxosporidan parasites for pumpkinseed (Lepomis gibbosus L.) from Ontario.

    PubMed

    Cone, D K; Anderson, R C

    1977-08-01

    Five species of myxosporideans were found in pumpkinseed (Lepomis gibbosus L.) from Ryan Lake, Algonquin Park, Ontario. Myxobolus osburni Herrick 1936 was found in pancreatic tissue. Myxobilatus ohioensis (Herrick 1941) Davis 1944 was found in the ureters and urinary bladder. Three new species are described, namely, Myxobolus uvuliferis sp. n. (in the fibrous capsule surrounding the metacercariae of Uvulifer ambloplitis (Hughes 1927), Myxobolus magnaspherus sp. n. (in the parietal peritoneum) and Myxobolus dechtiari sp. n. (in the gills). Myxobolus uvuliferis sp. n. is most similar to M. osburni, but its spores are subspherical and not spherical. Myxobolus magnaspherus sp. n. is most similar to Myxobolus gigas Auerbach 1906, but its spores are wider than long, and they have exceedingly long polar filaments. Myxobolus dechtiari sp. n. is similar to Myxobolus karelicus Petruschewsky 1940 but it lacks an intercapsular appendix. PMID:407348

  8. Extensive colonic stricture due to pelvic actinomycosis.

    PubMed

    Kim, J C; Cho, M K; Yook, J W; Choe, G Y; Lee, I C

    1995-04-01

    A 36-year-old woman presented with a palpable tender mass at the left lower quadrant of the abdomen. She had suffered from constipation for five years and had a previous history of intrauterine device-use for one year. Preoperative barium enema and abdominopelvic CT showed a compatible finding of rectosigmoid colon cancer or left ovary cancer. She underwent segmental resection of the sigmoid colon along with the removal of left distal ureter, left ovary and salpinx. Pathologic examination revealed actinomycotic abscesses containing sulfur granules. Thereafter, she took parenteral ampicillin (50mg/kg/day) for one month and oral amoxicillin (250mg, tid) for 2 months consecutively. The patient has no specific problems for 6 months after surgical resection and long-term antibiotic therapy. This report may be the first of intrauterine device-associated pelvic actinomycosis involving both sigmoid colon and rectum extensively. PMID:7576294

  9. [Statistics on the operations at the Department of Urology, Toyota Memorial Hospital during an 11-year period (1987-1997)].

    PubMed

    Tamaki, M; Maeda, S; Yamada, T; Nakano, M; Yamamoto, N; Kawada, Y; Deguchi, T

    1999-04-01

    A clinical statistic survey was carried out on the operations performed at our Hospital from 1987 through 1997. The total number of operations was 3,383 and the number of operations excluding extracorporeal shock wave lithotripsy (ESWL) was 1,672, consisting of 227 (13.6%) operations of the kidney and ureter, 194 (11.6%) operations of the bladder, 481 (28.8%) operations of the prostate and urethra, and 705 (42.2%) operations of the penis and scrotal contents. Since new endourological technology and ESWL were developed for clinical application, the mode of operation has dramatically changed during the last 11 years, trending toward minimally invasive surgery. PMID:10363155

  10. Obstructed Hemivagina with Ipsilateral Renal Anomaly.

    PubMed

    Santos, Xiomara M; Dietrich, Jennifer E

    2016-02-01

    The association of obstructed hemivagina with ipisilateral renal anomaly (OHVIRA) is a well-described entity. While there has been an increased familiarity with this disorder, the exact incidence of OHVIRA is unknown. Our aim was to review the available literature on this topic, look at common presentations, and uncommon presentations. This condition is a well-described entity but requires careful evaluation, because unique presentations do occur. Diagnostic challenges include time of presentation and symptoms associated with presentation. Surgical challenges include microperforation of the hemivaginal septum, pelvic inflammatory disease, thick septum, or high septum. Each of these must be managed carefully. Although a solitary kidney is frequently thought to be associated with OHVIRA, dysplastic kidneys, pelvic kidneys, or ectopic ureters can occur. Prompt and accurate diagnosis is essential for relief of symptoms and prevention of complications. To minimize problems associated with delayed diagnosis, magnetic resonance imaging evaluation is recommended along with referral to a center with expertise in these conditions. PMID:26165909

  11. Laparoscopic Nephroureterectomy: The Distal Ureteral Dilemma

    PubMed Central

    Srirangam, Shalom J.; van Cleynenbreugel, Ben; van Poppel, Hein

    2009-01-01

    Transitional cell carcinoma affecting the upper urinary tract, though uncommon, constitutes a serious urologic disease. Radical nephroureterectomy remains the treatment of choice but has undergone numerous modifications over the years. Although the standard technique has not been defined, the laparoscopic approach has gained in popularity in the last two decades. The most appropriate oncological management of the distal ureteral and bladder cuff has been a subject of much debate. The aim of the nephroureterectomy procedure is to remove the entire ipsilateral upper tract in continuity while avoiding extravesical transfer of tumor-containing urine during bladder surgery. A myriad of technical modifications have been described. In this article, we review the literature and present an overview of the options for dealing with the lower ureter during radical nephroureterectomy. PMID:19020654

  12. 45,X/47,XXX Mosaicism and Short Stature

    PubMed Central

    Everest, Erica; Tsilianidis, Laurie A.; Haider, Anzar; Rogers, Douglas G.; Raissouni, Nouhad; Schweiger, Bahareh

    2015-01-01

    We describe the case of a ten-year-old girl with short stature and 45,X/47,XXX genotype. She also suffered from vesicoureteric reflux and kidney dysfunction prior to having surgery on her ureters. Otherwise, she does not have any of the characteristics of Turner nor Triple X syndrome. It has been shown that this mosaic condition as well as other varieties creates a milder phenotype than typical Turner syndrome, which is what we mostly see in our patient. However, this patient is a special case, because she is exceptionally short. Overall, one cannot predict the resultant phenotype in these mosaic conditions. This creates difficulty in counseling parents whose children or fetuses have these karyotypes. PMID:26137340

  13. Quantitative autoradiography of angiotensin II receptors in brain and kidney: focus on cardiovascular implications

    SciTech Connect

    Gehlert, D.R.; Speth, R.C.; Wamsley, J.K.

    1985-01-01

    Quantitative techniques of receptor autoradiography have been applied to localize (/sup 125/I)-angiotensin II binding sites in brain and kidney. High densities of autoradiographic grains, indicating the presence of angiotensin II receptors, have been localized to several rat brain nuclei including the dorsal motor nucleus of the vagus, nucleus of the solitary tract, anterior pituitary, locus coeruleus and several hypothalamic nuclei. Cat thoracic spinal cord exhibited a high density of sites over the intermedio-lateral cell column. In sections of rat kidney, angiotensin II receptors were detected in the glomerulus, vasa recta and ureter. The cardiovascular implications of these results are apparent and relate angiotensin II to hypertensive mechanisms. Thus, angiotensin II represents an endocoid which is involved in control of blood pressure through its effects on peripheral organs as well as the central nervous system.

  14. Therapy for vesicoureteral reflux: antibiotic prophylaxis, urotherapy, open surgery, endoscopic injection, or observation?

    PubMed

    Elder, Jack S

    2008-03-01

    Vesicoureteral reflux (VUR) refers to the retrograde flow of urine from the bladder into the ureter and renal pelvis. It generally results from congenital maldevelopment of the ureterovesical junction, although VUR may develop in individuals with abnormally high detrusor pressure. VUR increases a child's susceptibility to pyelonephritis and renal scarring. Treatment goals include the prevention of pyelonephritis, reflux nephropathy, and other complications of reflux. Treatment alternatives include antibiotic prophylaxis, urotherapy (correction of voiding dysfunction), and surgical correction (open, injection therapy, or laparoscopic). Recent studies have challenged the presumed benefit of prophylaxis in children with VUR, while long-term retrospective studies have documented a high rate of hypertension in adults with reflux nephropathy. In addition, the risk of persistent VUR in adulthood is unresolved. These reports have stimulated a reevaluation of the role of various treatment options in children with VUR. PMID:18419999

  15. Hazards to bladder and intestinal tissues from intravesical underwater electrical discharges from a surgical electronic lithoclast.

    PubMed

    Tidd, M J; Wright, H C; Oliver, Y; Wallace, D M; Porteous, M

    1976-07-23

    Previous studies have shown that electronic lithoclast discharges produce effects resembling an underwater explosion. It was predicted that the shock wave produced by each discharge could damage nearby gas-containing gut through a mechanism known to be associated with underwater detonations. Effects associated with rapid oscillation of the vapour bubble produced could cause damage to the wall of the bladder. Investigation of lithoclast discharges in vivo on goat, and in vitro on sheep bladders demonstrated perforation of both. In vitro studies in the rabbit demonstrated the predicted greater susceptibility of air-filled gut over that filled with fluid. These hazards would be even greater in the ureter and caution in the use of electronic fragmentation of vesical and ureteric calculi is urged in the light of these findings. PMID:960320

  16. Modern management of stone disease in patients with a solitary kidney

    PubMed Central

    Tkocz, Micha?; Ziaja, Damian

    2011-01-01

    Analysing the data available in the literature, contemporary methods of treatment of nephrolithiasis are limited to the methods of minimally invasive percutaneous nephrolithotomy (PCNL) and ureterorenoscopic lithotripsy (URSL), not excluding their use in the presence of developmental abnormalities and kidney impairment only. Minimally invasive methods have become standard procedures. A complement to ineffective URSL and PCNL treatment is extracorporeal shock wave lithotripsy. This is confirmed by 30 years of observation in the only treatment of kidney calculi by Alken launched in 1981 and continued by Jones et al. Before the era of endoscopic procedures (PCNL and URSL) effectively removed the only deposits in the kidney in open operations. Minimally invasive treatments are recommended for patients with localized deposits in the pelvicalyceal system or solitary kidney ureter. They are recognized as safe and effective treatment in a solitary kidney in particular in patients who have already been operated on. PMID:23255993

  17. Is the Left Kidney the Right One for Kidney Donation in Women Planning on Future Pregnancy?

    PubMed Central

    Kıran, H.; Kıran, G.; Arıkan, D.; Yüzbaşıoğlu, M.; Bakacak, M.; Ercan, Ö.; Köstü, B.

    2015-01-01

    The kidney transplantation surgery requires left nephrectomy because of the anatomical disadvantages. But hydroureteronephrosis is the most significant renal functional alteration of pregnancy, accounted for by both hormonal and mechanical factors. Dilatation of the ureters and renal pelvis is more prominent on the right side than the left side and is seen in up to 80% of pregnant women. A 23-year-old woman who become pregnant after 4 months from left kidney donation was admitted to our emergency department with acute right kidney injury during her 39th week of pregnancy. She did not response to conservative treatment and required emergency delivery because of the progressive increase in her serum creatinine levels. After delivery, progressive decrease at creatinine level had been observed and in one month, it had reached the normal level. Mother candidates should be advised they donate their kidneys after completing their childbearing if possible, or undergo right nephrectomy. PMID:26576264

  18. Nephrectomy in an Asian small-clawed otter (Amblonyx cinereus) with pyelonephritis and hydronephrosis secondary to ureteral obstruction.

    PubMed

    Higbie, Christine T; Carpenter, James W; Armbrust, Laura J; Klocke, Emily; Almes, Kelli

    2014-09-01

    A 10-yr-old, captive, intact male Asian small-clawed otter (Amblonyx cinereus) with a history of bilateral nephrolithiasis was presented for acute-onset lethargy and inappetance of 5 days duration. On physical examination, the otter was about 8% dehydrated and a palpable fluid wave was present in the abdomen. An abdominal ultrasound revealed hydronephrosis of the left kidney and a hyperechoic structure present within the lumen of the left ureter, causing an obstruction. A urinalysis revealed struvite crystalluria, bacteriuria, and an elevated pH. Following 4 days of antibiotic therapy, a left ureteronephrectomy was performed. Upon opening the kidney to retrieve calculi, a large amount of purulent material was noted within the renal pelvis. To the authors' knowledge, this is the first documented case of a nephrectomy in an Asian small-clawed otter. Nephrectomy should be considered as a viable option for treatment of ureteral obstruction, hydronephrosis, or severe pyelonephritis. PMID:25314845

  19. Don’t get caught out! A rare case of a calcified urachal remnant mimicking a bladder calculus

    PubMed Central

    Rodrigues, Jonathan Carl Luis; Gandhi, Sanjay

    2013-01-01

    Computer tomography through the kidneys, ureters and bladder (CT KUB) is the mainstay investigation of suspected renal tract calculi. However, several pathologies other than renal tract calculi can cause apparent urinary bladder calcification. We describe the case of a 45 year old man who presented with left sided renal colic. Prone CT KUB performed on admission revealed a calcified urachal remnant mimicking a urinary bladder calculus in the dependent portion of the urinary bladder, confirmed by reviewing the multi-planar reformatted images. This is the first reported case in the literature of this phenomenon. We discuss the importance of using multi-planar reformatted images (MPR) and maximum intensity projection images (MIP), as well as careful review of previous imaging, in making the correct diagnosis. We also discuss the differential diagnoses that should be considered when presented with urinary bladder calcification. PMID:23705044

  20. Primary Pleomorphic Undifferentiated Sarcoma-a Rare Renal Localization: A Case Report.

    PubMed

    Mellas, Soufiane; Bouchikhi, Ahmed Amine; Tazi, Mohamed-Fadl; Khallouk, Abdelhak; Elammari, Jallal-Eddin; El Fassi, Mohamed-Jamal; Mellas, Naoufal; Farih, Moulay Hassan

    2012-01-01

    Undifferentiated pleomorphic sarcoma is known as a soft tissue sarcoma. Very few cases of this tumor originating from the renal parenchyma or renal capsule have been reported. We report a case of a 70-year-old patient admitted for enormous ureterohydronephrosis and pyelonephritis due to a pelvic ureter lithiasis. After draining by ureteral double J catheter, a nephroureterectomy was performed for nonfunctional kidney confirmed by scintigraphy. The histopathological study shows a pleomorphic undifferentiated sarcoma. The patient was sent to oncologists. Chemotherapy was proposed but the family decided to stop the treatment. The patient passed away 10 months later. Clinicians and pathologists should be aware of the very low occurrence of this renal tumor, which is extremely rare. Currently there is no consensus about its management. Our case extends the literature concerning this tumor. PMID:23213617

  1. Inguinal hernia containing bladder and ureteroneocystostomy: a rare cause for acute renal graft dysfunction.

    PubMed

    Coelho, Hugo; Nunes, Pedro; Canhoto, Carolina; Temido, Paulo

    2016-01-01

    A 77-year-old man presented with acute graft dysfunction 25?years after a renal transplant in the left iliac fossa. He also had an asymptomatic left inguinal hernia. Renal ultrasound showed a significant pyelocalicial dilation of the kidney graft and the patient was submitted to a percutaneous nephrostomy. An antegrade nephrostogram was performed, which showed a dilated ureter and the bladder included in the left inguinal hernia that caused the obstructive uropathy. Concomitant retrograde cystography also showed a significant portion of the bladder in the hernia sac. The patient was submitted to inguinal hernia repair, which resolved the obstruction. We present a rare and potentially curable cause of obstructive uropathy in a transplant recipient; it is possible to revert graft dysfunction and prevent graft loss if the condition is recognised early. PMID:26912768

  2. [Extracorporeal lithotripsy and our future approach in lithiasis].

    PubMed

    Schmidt, A; Geist, E; Eisenberger, E G

    1994-01-01

    It can be claimed that ESWL is an optimal alternative for ablation of calculi by external shock waves. The new developments in ESWL focus more on the economic aspects of treatment rather than enhancing its efficacy or reducing the side effects. The routine indications of ESWL are well known and widely accepted. Similarly, its limitations are well defined: silent caliceal calculi, diverticular caliceal calculi, nephrolithiasis in horseshoe kidney, medullary sponge kidney and residual fragments after ESWL. Although endourology offers new, less invasive and less traumatic ways for stone ablation, such as lasertripsy, mini flexible ureteroscopes and ureteropyeloscopes, the indication for a more aggressive approach in the cases mentioned above is limited to the symptomatic cases. For calculi in the distal ureter, only the ureteroscope and intraureteral laser open new and interesting possibilities in the near future. PMID:7944603

  3. RENAL AND CLOACAL CRYPTOSPORIDIOSIS (CRYPTOSPORIDIUM AVIAN GENOTYPE V) IN A MAJOR MITCHELL'S COCKATOO (LOPHOCHROA LEADBEATERI).

    PubMed

    Curtiss, Jeffrey B; Leone, Angelique M; Wellehan, James F X; Emerson, Jessica A; Howerth, Elizabeth W; Farina, Lisa L

    2015-12-01

    A 7-yr-old male Major Mitchell's cockatoo (Lophochroa leadbeateri) presented with a recent history of lethargy and anorexia. Physical examination revealed poor body condition and cloacal prolapse. Abnormalities on serum chemistry included severe hyperuricemia and hyperphosphatemia with a low calcium-to-phosphorus ratio. Symptomatic treatment was initiated including intravenous fluids and antibiotics. The bird continued to decline and died within a few days. Visceral gout and renal and cloacal pathology were observed on gross necropsy. Histopathology revealed chronic inflammation within the kidney, ureter, and cloaca in association with protozoal organisms and an invasive cloacal adenocarcinoma tumor. The location and morphology was consistent with Cryptosporidium sp., confirmed by immunohistochemistry and molecular testing. Direct sequencing identified Cryptosporidium avian genotype V. To the author's knowledge, this is the first reported infection of Cryptosporidium avian genotype V associated with clinical disease in birds and the first renal Cryptosporidium infection in a psittacine. PMID:26667555

  4. Endoluminal US: experiments with nonvascular uses in animals.

    PubMed

    Goldberg, B B; Liu, J B; Merton, D A; Kurtz, A B

    1990-04-01

    Catheters containing miniature ultrasound (US) transducers, originally developed for intravascular evaluation of plaque, were used in a series of in vivo and in vitro animal experiments to image a variety of nonvascular lumina. Measurements of the wall thickness and echotexture of the urethra, urinary bladder, ureter, renal pelvis, bile ducts, small bowel, fallopian tubes, and uterus were carried out. Close correlation between the US images and actual anatomic specimens was obtained. Structures outside of the lumen were identified and confirmed with both direct visualization and radiographic localization. Two small stones artificially inserted into the renal pelvis and a polyp-like projection artificially created within the fallopian tube were clearly identified by using the US probe. These initial US studies demonstrate the potential feasibility of these miniature transducers contained within catheters for intraluminal analysis in humans. PMID:2179992

  5. [BENIGN OVARIAN PATHOLOGY FINDINGS IN PRE-OPERATIVE AND INTRA-OPERATIVE SIGNS SUGGESTIVE OF MALIGNANCY--CASE SERIES].

    PubMed

    Armand, Hristamian; Hristamian, Veselka

    2015-01-01

    Case 1--22 year old patient with dense permagnum adult teratoma, ascites, ipsilateral hydro-ureter and hydro-nephrosis, elevated C -125 level a pseudo- military peritoneal spread. Case 2--19 -year old patient with endometrial kystoma, originating at the uterine fundus with with elevated C-125 levels. Case 3--22 year old patient with monstrous tecoma permagnum, ascites and concomitant pleural effusions as in Meigs syndrome. Case 4--66 year old patient, multiparous with granular cell tumor, recurrent uterine bleeds and endometrial poliposis, with ambiguous C-125 level and congenital uterus bicornis bicolis anomaly. Cases are presented in chronological order, with detailed description and accompanying abundant photo images. PMID:26137781

  6. Radionuclide studies of chronic schistosomal uropathy

    SciTech Connect

    Lamki, L.M.; Lamki, N.

    1981-08-01

    Fifty patients with chronic urinary tract schistosomiasis were studied with /sup 99m/Tc-DTPA. All had a flow study, sequential analog imaging, and digital imaging for 25-35 minutes (20-sec. frames). Time-activity curves (DTPA renograms) were extracted; 12 patients had /sup 131/I-Hippuran probe renograms as well. Renal changes included diminished perfusion and structural abnormalities ranging from minor calyceal dilatation to overt hydronephrosis. Ureteral changes included dilatation, tortuosity, and kinking. Marked distortion of the ureterovesical tunction was seen in some patients due to periureteral and perivesicular fibrosis, which is a major factor in upper urinary tract damage. Renograms showed varying obstruction and parenchymal damage. Nuclear medicine complements excretory urography and is sometimes preferable for visualization of the ureters. After the initial urogram, sequential DTPA scanning and renography are sufficient for follow-up.

  7. Radionuclide studies of chronic schistosomal uropathy. [/sup 99m/Tc-DTPA; /sup 131/I-hippuran

    SciTech Connect

    Lamki, L.M.; Lamki, N.

    1981-08-01

    Fifty patients with chronic urinary tract schistosomiasis were studied with /sup 99m/Tc-DTPA. All had a flow study, sequential analog imaging, and digital imaging for 25 to 35 min (20-sec frames). Time-activity curves (DTPA renograms) were extracted; 12 patients had /sup 131/I-Hippuran probe renograms as well. Renal changes included diminished perfusion and structural abnormalities ranging from minor calyceal dilatation to overt hydronephrosis. Ureteral changes included dilatation, tortuosity, and kinking. Marked distortion of the ureterovesical junction was seen in some patients due to periureteral and perivesicular fibrosis, which is a major factor in upper urinary tract damage. Renograms showed varying obstruction and parenchymal damage. Nuclear medicine complements excretory urography and is sometimes preferable for visualization of the ureters. After the initial urogram, sequential DTPA scanning and renography are sufficient for follow-up.

  8. Sirenomelia type VI (sympus apus) in one of dizygotic twins at Chiang Mai University Hospital.

    PubMed

    Nokeaingtong, Kwannapas; Kaewchai, Sirirat; Visrutaratna, Pannee; Khuwuthyakorn, Varangthip

    2015-01-01

    Those born with sirenomelia, a rare congenital anomaly, have features resembling a mermaid. Characteristics of sirenomelia are a single lower limb, sacral and pelvic bone defects, and anorectal and urogenital malformations. There is an increased incidence of sirenomelia in males and twins. This case was a preterm male, dizygotic twin and product of in vitro fertilisation. The baby was born by caesarean section due to breech presentation. He was found to have a fused lower extremity and absent external genitalia and anus. The baby passed away shortly after birth due to severe respiratory failure. Radiographic findings showed small lung volume and pneumothoraces. There were multiple segmental fusions of the vertebrae. Single femur and single tibia were presented in a fused lower limb. Autopsy demonstrated large intestinal atresia, intra-abdominal testes, absence of kidney, ureter and bladder, single umbilical artery, agenesis of blood vessels at lower extremity and agenesis of sacrum and coccyx. PMID:25976191

  9. Human polyomavirus (BK) infection and ureteric stenosis in renal allograft recipients.

    PubMed Central

    Coleman, D V; Mackenzie, E F; Gardner, S D; Poulding, J M; Amer, B; Russell, W J

    1978-01-01

    Human polyomavirus (BK) was detected in two renal allograft recipients as a result of routine examination of Papanicolaou-stained smears of urinary sediment in the light microscope. Infection with this recently identified virus was confirmed by virus isolation and electron microscopy. The cytological, histological, and ultrastructural changes due to the virus are described, and virus excretion is correlated with the clinical progress of the patients and the pathological findings. The transplant ureters in both patients were found to be ulcerated and stenosed, and virus-infected cells were observed in the ureteric epithelium. We suggest that the administration of high-dose steroids in transplantation may permit active infection with human polyomavirus to occur in ureteric epithelium which has been damaged by ischaemia or inflammation. Images Fig. 1 Fig. 2 Fig. 3 Fig. 4 Fig. 5 Fig. 6 Fig. 7 Fig. 8 Fig. 9 Fig. 10 PMID:205555

  10. Sir Michael Francis Addison Woodruff (1911-2001) FRS DSc MD MS FRCS.

    PubMed

    Leigh, Winston

    2011-02-01

    Michael Woodruff performed the first successful renal transplant in the UK and described the technique of joining the ureter of the transplant to the bladder. He contributed to all aspects of transplantation biology and was responsible for the design of the first purpose-built transplant unit in the world. As a Japanese prisoner of war at Changi in Singapore, Michael Woodruff studied the effects of malnutrition and devised a machine for extracting vitamins and trace elements from grass. After the war he demonstrated that the anterior chamber of the eye was an immunologically privileged site. He was the first person to describe 'adaptation'. He showed that antilymphocytic serum was effective as an immunosuppressive agent for homografts. PMID:21350076

  11. Peristaltic pumping of solid particles immersed in a viscoelastic fluid

    NASA Astrophysics Data System (ADS)

    Chrispell, John; Fauci, Lisa

    2010-11-01

    Peristaltic pumping of fluid is a fundamental method of transport in many biological processes. In some instances, particles of appreciable size are transported along with the fluid, such as ovum transport in the oviduct or kidney stones in the ureter. In some of these biological settings, the fluid may be viscoelastic. In such a case, a nonlinear constitutive equation to describe the evolution of the viscoelastic contribution to the stress tensor must be included in the governing equations. Here we use an immersed boundary framework to study peristaltic transport of a macroscopic solid particle in a viscoelastic fluid governed by a Navier-Stokes/Oldroyd-B model. Numerical simulations of peristaltic pumping as a function of Weissenberg number are presented. We examine the spatial and temporal evolution of the polymer stress field, and also find that the viscoelasticity of the fluid does hamper the overall transport of the particle in the direction of the wave.

  12. A complex case of abdominal pain in a patient with pelviureteric junction obstruction.

    PubMed

    Wolak, Przemys?aw; Golabek, Tomasz; Obarzanowski, Mateusz; Ch?osta, Piotr

    2014-06-01

    Pelviureteric junction (PUJ) obstruction is a condition frequently encountered in both adult and pediatric patients. Congenital abnormalities and crossing lower-pole renal vessels are the most common underlying pathologies in both men and women. This report presents a case of a young woman who was complaining of intermittent abdominal pain in whom right-sided hydronephrosis was diagnosed. The patient was scheduled for a laparoscopic right-sided Anderson-Hynes pyeloplasty. During the procedure a partly extraperitoneal appendix, with extensive adhesions to the posterior abdominal wall abutting on the ureter just below the obstructed PUJ, was identified. The patient underwent dismembered laparoscopic Anderson-Hynes pyeloplasty with concurrent appendectomy for likely dual pathologies being responsible for her symptoms. PMID:25097699

  13. Bladder neck rupture following perineal bull horn injury: a surgical challenge.

    PubMed

    Padilla-Fernandez, B; Diaz-Alferez, F J; Garcia-Garcia, M A; Herrero-Polo, M; Velasquez-Saldarriaga, J F; Lorenzo-Gomez, M F

    2012-01-01

    Pelvic-abdominal injuries caused by goring are serious lesions which require rapid diagnosis and urgent treatment in the context of a polytraumatized patient. The simultaneous rupture of both the bladder and the prostatic-membranous urethra occurs in 10%-29% of males with pelvic fractures but bladder neck injuries in adults are rarer. Unstable pelvic fractures, bilateral fractures of the ischiopubic branches (also referred to as fractures from falling astride) and the diastasis of the pubic symphysis are those that have the greatest likelihood of injuring both the posterior urethra and the bladder. We present a case of perineal bull horn injury with muscle laceration, bone fractures, scrotal avulsion and rupture of the bladder neck involving the right ureter which required two operations to be repaired. PMID:23066348

  14. The development of a laser for stone fragmentation and its place in the management of stones in the era of extracorporeal lithotripsy.

    PubMed

    Watson, G

    1990-01-01

    The parameters of a laser which govern stone fragmentation are the pulse duration, wavelength and fibre diameter. The pulse duration is the most important parameter governing fibre transmission. The shorter the pulse duration the less tissue damage and the easier the plasma production at the stone surface but the greater the difficulty to transmit the laser energy through the fibre. At 1 microsecond pulse duration the laser wavelength is highly significant because it governs the degree of absorption at the stone surface necessary for plasma production. Transmission of this laser energy through 200 micron core fibres is straightforward. Fragmentation is achieved by placing the fibre in contact with the stone surface. There is negligible tissue injury. A miniaturised ureteroscope has been developed specifically for the laser. This appears to be easier to use and carries less risk of instrumentational injury to the ureter. PMID:1983282

  15. Comparison of the pulsed dye and holmium lasers for stone fragmentation: in-vitro studies and clinical experience

    NASA Astrophysics Data System (ADS)

    Watson, Graham M.; Smith, Neil

    1993-05-01

    The pulsed dye laser used with a 1 microsecond pulse duration at 504 nm delivered via a 320 micron core fiber is designed specifically for ureteric calculi. The threshold for stone fragmentation is in the region of 40 to 50 mJ for the majority of stones. Fragmentation is efficient in the 60 to 70 mJ range but for some stones 100 mJ is required. The Candela MDL 2000 (Candela Corporation) is capable of delivering 140 mJ. This laser has minimal effect on tissue. The holmium laser delivers 300 microsecond pulses of 2.1 microns wavelength (Sunrise Technologies and Coherent Ltd). A maximum of 1 J per pulse at 5 Hz is usually recommended because of the significant action on tissue. Even using this regimen significant damage can be inflicted on the ureter. In this paper the action of these two laser regimens on stones is contrasted.

  16. Renal carcinosarcoma: case report and review of literature.

    PubMed

    Chiu, Kuan-Chi; Lin, Mena-Chiao; Liang, Yen-Ching; Chen, Chen-Yin

    2008-01-01

    Carcinosarcoma is a malignancy that occurs very rarely in the renal pelvis, and only a very limited number of cases has been documented. These tumors are composed of both malignant mesenchymal and epithelial elements. Unlike the cases described so far, this carcinosarcoma of the renal pelvis was characterized by quick recurrence, following complete surgical resection. Carcinosarcomas of the renal pelvis are known to be rapid in progression and associated with a poor prognosis. They usually metastasize soon after surgery, but very little information is available on the histologic types that characterize the recurrent tumors. We presented a histologically proven case of renal carcinosarcoma extending from renal pelvis. Convalescence was uneventful, and fifteen months after the operation, he is alive with no recurrence or metastasis. If a rapidly growing tumor is detected that seems to originate from the kidney with extension to ureter and bladder, carcinosarcoma should be included in the differential diagnosis. PMID:19016157

  17. [Design of a multifunctional and transparent urinary system model].

    PubMed

    Hu, Wengang; Huang, Chibing; Feng, Jiayu; Zhang, Yinfu; Wang, Jin; Xu, Xiaoting; Song, Yajun; Sun, Zhen; Chen, Yirong

    2014-04-01

    This article describes a novel Multifunctional and Transparent Urinary System Model (MTUSM), which can be applied to anatomy teaching, operational training of clinical skills as well as simulated experiments in vitro. This model covers kidneys, ureters, bladder, prostate, male and female urethra, bracket and pedestal, etc. Based on human anatomy structure and parameters, MTUSM consists of two transparent layers i. e. transparent organic glass external layer, which constraints the internal layer and maintains shape of the model, and transparent silica gel internal layer, which possesses perfect elasticity and deformability. It is obvious that this model is preferable in simulating the structure of human urinary system by applying hierarchical fabrication. Meanwhile, the transparent design, which makes the inner structure, internal operations and experiments visual, facilitates teaching instruction and understanding. With the advantages of simple making, high-findelity, unique structure and multiple functions, this model will have a broad application prospect and great practical value. PMID:25039130

  18. [A case of ureteritis in Henoch-Shnlein purpura].

    PubMed

    Moyano, M J; Alvarez, J; Milln, A; Amor, J

    2006-01-01

    Henoch-Schnlein purpura (HSP) is a multisystemic disorder mainly affecting the skin, joints, gastrointestinal tract, and kidneys but sometime rare complications that have been reported include urologic manifestations. We report a case of a 63 year old man was admitted to the hospital because a neurologic abnormalities, gastrointestinal blood loss and acute renal failure. One year before HSP was dignosed by percutaneous renal biopsy. A few days later admission the temperature was 38 masculineC and urine cultures yielded Echerichia Coli. An angio-magnetic resonance of the abdomen showed a marked dilatation of the distal left ureter with a level inside. Therapy with corticosteroids improved a clinical features and the usual renal function was recovered. PMID:17117908

  19. [Application of rowatinex in the perioperative period in the extracorporeal shock wave lithotripsy].

    PubMed

    Popkov, V M; Bliumberg, B I; Osnovin, O V; Shatylko, T V

    2014-01-01

    Despite the high efficacy and safety of ESWL used to disintegrate stones in pyelocaliceal system and upper ureter, the issue of further reduction of the risk of complications of this procedure remains unresolved. The inclusion ofphytopreparations with anti-inflammatory and lithokinetic properties in the scheme of perioperative treatment is one of the ways for prevent complications of ESWL. The effect of the drug Rowatinex on the process of discharge of calculi fragments after ESWL is evaluated. The frequency and intensity of qualitative changes of urine after appointment this drug were assessed. It is concluded that Rowatinex has positive impact on the final result of ESWL in the case of its inclusion in the complex medical treatment, which manifests in terms of reducing the time of discharge of fragments, mitigation of subjective symptoms, as well as reducing the frequency of subclinical bacteriuria and severe complications. PMID:24956667

  20. [Urine incontinence in childhood; the importance of a good micturition history].

    PubMed

    Ab, E; van Diemen-Steenvoorde, J A A M; de Jong, T P V M

    2002-02-01

    Four children, three girls aged 9, 5.5 and 6.5 years, and a boy aged 8 years, suffered from urinary incontinence. The underlying conditions, urge syndrome with urge incontinence, ectopic ureter, meatus stenosis, and pelvic floor dysfunction, respectively, were identified and treated, after which the children were no longer incontinent. Diurnal incontinence is present in 2-3% of 7-year-olds. Incontinence is accompanied by recurrent urinary tract infections and vesicoureteric reflux in 40% of cases. A combination of these two disorders can lead to impaired renal function. Especially in girls, involuntary urine loss is usually based on dysfunctional voiding, a non-neurogenic coordination problem between the detrusor muscle of the bladder and the pelvic floor. A careful history is the most important tool in reaching the correct diagnosis. PMID:11851076

  1. Intestinal type villous adenoma of the renal pelvis.

    PubMed

    Hudson, Jill; Arnason, Thomas; Merrimen, Jennifer L O; Lawen, Joseph

    2013-01-01

    Intestinal type villous adenomas are uncommon in the genitourinary tract. Most reported cases have been located in the urinary bladder or urachus. Villous adenoma arising in the renal pelvis or ureter is very rare. We present a case of an 81-year-old female who presented with difficulty voiding and mucosuria. A computed tomography scan identified right-sided hydronephrosis, renal parenchymal atrophy, nonobstructing calculi and a lower pole renal mass. She underwent open right nephrectomy. Histopathologic examination of the kidney revealed an intestinal type villous adenoma of the renal pelvis with high-grade dysplasia and focal areas suspicious for invasive adenocarcinoma. We review the four previously reported cases of intestinal type villous adenoma in the renal pelvis and discuss diagnosis and management of this unusual neoplasm. PMID:23671505

  2. Effects of experimental obstructive hydronephrosis on the immature nephrons in newborn rats.

    PubMed

    Josephson, S; Robertson, B; Rodensj, M

    1989-01-01

    Partial obstruction of the left ureter was created in rats less than 36 h of age and its effects were studied at the age of 2-6 days. A considerable hydronephrosis with distension of the kidney developed within 1 day after obstruction, but there was no parenchymal weight reduction. The thickness of the mature, inner cortical layer was significantly decreased, suggesting a delay in the differentiation of the cortex. The parenchymal weight reduction, previously documented in our laboratory after long-standing ureteric obstruction, may thus be caused by a retardation of renal growth, which is never caught up, rather than by an atrophy of renal parenchyma or other destructive tissue lesions. PMID:2728126

  3. Percutaneous Radiofrequency Ablation for Treatment of Recurrent Retroperitoneal Liposarcoma

    SciTech Connect

    Keil, Sebastian Bruners, Philipp; Brehmer, Bernhard; Mahnken, Andreas Horst

    2008-07-15

    Percutaneous CT-guided radiofrequency ablation (RFA) is becoming more and more established in the treatment of various neoplasms, including retroperitoneal tumors of the kidneys and the adrenal glands. We report the case of RFA in a patient suffering from the third relapse of a retroperitoneal liposarcoma in the left psoas muscle. After repeated surgical resection and supportive radiation therapy of a primary retroperitoneal liposarcoma and two surgically treated recurrences, including replacement of the ureter by a fraction of the ileum, there was no option for further surgery. Thus, we considered RFA as the most suitable treatment option. Monopolar RFA was performed in a single session with a 2-cm umbrella-shaped LeVeen probe. During a 27-month follow-up period the patient remained free of tumor.

  4. Trans-urethral ultrasound (TUUS) imaging for visualization and analysis of the prostate and associated tissues

    NASA Astrophysics Data System (ADS)

    Holmes, David R., III; Robb, Richard A.

    2000-04-01

    Accurate assessment of pathological conditions in the prostate is difficult. Screening methods include palpation if the prostate gland, blood chemical testing, and diagnostic imaging. Trans-rectal Ultrasound (TRUS) is commonly used for the assessment of pathological conditions, however, TRUS is severely constrained by the relative distal location of the imaging probe. Trans-urethral Ultrasound (TUUS) may overcome some limitations of TRUS. A TUUS catheter was used to image the prostate, rectum, bladder, ureter, neuro-vascular bundles, arteries, and surrounding tissue. In addition, 360 degrees rotational scans were recorded for reconstruction into 3D volumes. Segmentation was challenging, however, new techniques such as active contour methods show potential. 3D visualizations, including both volume and surface rendering, were provided to clinicians off-line. On-line 3D visualization techniques are currently being developed. Potential applications of TUUS include: prostate cancer diagnosis and staging as well as image guided biopsy and therapy.

  5. Chronically Elevated Levels of Short-Chain Fatty Acids Induce T Cell-Mediated Ureteritis and Hydronephrosis.

    PubMed

    Park, Jeongho; Goergen, Craig J; HogenEsch, Harm; Kim, Chang H

    2016-03-01

    Short-chain fatty acids (SCFAs) are major products of gut microbial fermentation and profoundly affect host health and disease. SCFAs generate IL-10(+) regulatory T cells, which may promote immune tolerance. However, SCFAs can also induce Th1 and Th17 cells upon immunological challenges and, therefore, also have the potential to induce inflammatory responses. Because of the seemingly paradoxical SCFA activities in regulating T cells, we investigated, in depth, the impact of elevated SCFA levels on T cells and tissue inflammation in mice. Orally administered SCFAs induced effector (Th1 and Th17) and regulatory T cells in ureter and kidney tissues, and they induced T cell-mediated ureteritis, leading to kidney hydronephrosis (hereafter called acetate-induced renal disease, or C2RD). Kidney hydronephrosis in C2RD was caused by ureteral obstruction, which was, in turn, induced by SCFA-induced inflammation in the ureteropelvic junction and proximal ureter. Oral administration of all major SCFAs, such as acetate, propionate, and butyrate, induced the disease. We found that C2RD development is dependent on mammalian target of rapamycin activation, T cell-derived inflammatory cytokines such as IFN-γ and IL-17, and gut microbiota. Young or male animals were more susceptible than old or female animals, respectively. However, SCFA receptor (GPR41 or GPR43) deficiency did not affect C2RD development. Thus, SCFAs, when systemically administered at levels higher than physiological levels, cause dysregulated T cell responses and tissue inflammation in the renal system. The results provide insights into the immunological and pathological effects of chronically elevated SCFAs. PMID:26819206

  6. Morphology and putative function of the colon and cloaca of marine and freshwater snakes.

    PubMed

    Babonis, Leslie S; Womack, Molly C; Evans, David H

    2012-01-01

    Among tetrapods, evidence for postrenal modification of the urine by the distal digestive tract (including the colon and cloaca) is highly variable. Birds and bladderless reptiles are of interest because the colon and cloaca represent the only sites from which water and ions can be reclaimed from the urine secreted by the kidney. For animals occupying desiccating environments (e.g., deserts and marine environments), postrenal modification of the urine may directly contribute to the maintenance of hypo-osmotic body fluids. We compared the morphology and distribution of key proteins in the colon, cloaca, and urogenital ducts of watersnakes from marine (Nerodia clarkii clarkii) and freshwater (Nerodia fasciata) habitats. Specifically, we examined the epithelia of each tissue for evidence of mucus production by examining the distribution of mucopolysaccharides, and for evidence of water/ion regulation by examining the distribution of Na(+) /K(+) -ATPase (NKA), Na(+) /K(+) /Cl(-) cotransporter (NKCC), and aquaporin 3 (AQP3). NKCC localized to the basolateral epithelium of the colon, urodeal sphincter, and proctodeum, consistent with a role in secretion of Na(+), Cl(-) , and K(+) from the tissue, but NKA was not detected in the colon or any compartment of the cloaca. Interestingly, NKA was detected in the basolateral epithelium of the ureters, suggesting the urothelium may play a role in active ion transport. AQP3 was detected in the ureters and coprodeal complex, consistent with a role in urinary and fecal dehydration or, potentially, in the production of the watery component of the mucus secreted by the coprodeal complex. Since no differences in general cloacal morphology, production of mucus, or the distribution of ion transporters/water channels were detected between the two species, cloacal osmoregulation may either be regulated by proteins not examined in this study or may not be responsible for the differential success of N. c. clarkii and N. fasciata in marine habitats. PMID:21935975

  7. Uroplakins in Urothelial Biology, Function and Disease

    PubMed Central

    Wu, Xue-Ru; Kong, Xiang-Peng; Pellicer, Angel; Kreibich, Gert; Sun, Tung-Tien

    2013-01-01

    Urothelium covers the inner surfaces of the renal pelvis, ureter, bladder and prostatic urethra. Although morphologically indistinguishable, the urothelia in these anatomic locations differ in their embryonic origin and lineages of cellular differentiation, as reflected in their different uroplakin content, expandability during micturition and susceptibility to chemical carcinogens. Previously thought to be an inert tissue forming a passive barrier between the urine and blood, urothelia have recently been shown to have a secretory activity that actively modifies the urine composition. Urothelial cells express a number of ion channels, receptors and ligands, enabling them to receive and send signals and communicate with adjoining cells and their broader environment. The urothelial surface bears specific receptors that not only allow uropathogenic E. coli to attach to and invade into the bladder mucosa, but also provide a route by which the bacteria ascend via the ureters to the kidney to cause pyelonephritis. Genetic ablation of one or more uroplakin genes in mice causes severe retrograde vesicoureteral reflux, hydronephrosis and renal failure, conditions that mirror certain human congenital diseases. Clearly, abnormalities of the lower urinary tract can impact on the upper tract, and vice versa, through the urothelial connection. In this review, we highlight recent advances in the field of urothelial biology by focusing on the uroplakins, a group of urothelium-specific and differentiation-dependent integral membrane proteins. We discuss these proteins’ biochemistry, structure, assembly, intracellular trafficking and their emerging roles in urothelial biology, function and pathological processes. We also call attention to important areas where greater investigative efforts are warranted. PMID:19340092

  8. Laparoscopic urinary bladder diverticulectomy combined with photoselective vaporisation of the prostate

    PubMed Central

    Eret, Viktor; Strnsk, Petr; Trvn?ek, Ivan; Dolejov, Olga; Chud?ek, Zden?k; Petersson, Fredrik; Hes, Ond?ej; Ch?osta, Piotr

    2015-01-01

    Introduction Pseudodiverticulum of the urinary bladder is mostly a complication of subvesical obstruction (SO). The gold standard of treatment was open diverticulectomy with adenectomy. A more contemporary resolution is endoscopic, in two steps: the first transurethral resection of the prostate (TURP), the second laparoscopic diverticulectomy (LD). Aim To present a one-session procedure photoselective vaporisation of the prostate (PVP) with LD. Material and methods From 1/2011 to 6/2014, 14 LDs were performed: 1 LD only, 1 with laparoscopic radical prostatectomy, 12 combined with treatment of benign prostatic hyperplasia (BPH), 4 cases of TURP and LD in the second period. In 8 cases, PVP and LD in one session were combined. These 8 cases are presented. 3D CT cystography was used as a gold standard for assessment of diverticulum. Results The mean age was 66.5 5.5 (57.375.1) years, the mean size of the diverticulum 61.8 22.1 (2690) mm. The procedure starts in the lithotomy position. It includes PVP and stenting of the ureter(s). Changing of position and laparoscopy follows: four ports, transperitoneal extravesical approach. Photoselective vaporisation of the prostate was performed using the Green Light Laser HPS (1x) or XPS with cooled fibre MoXy (7x). The mean delivered energy in PVP was 205.1 106.4 (120458) kJ. The mean time of operation was 165.0 48.5 (90255) min. No postoperative complications were observed. One patient underwent TUR incision after 1 year for sclerosis of the bladder neck. Conclusions Pseudodiverticulum of the urinary bladder (with or without SO) is a relatively rare disease. One session of PVP (Green Light Laser XPS, MoXy fibre) and laparoscopic (transperitoneal extravesical) diverticulectomy is the preferred method for treatment of subvesical obstruction due to BPH and bladder diverticulum at our institution. PMID:25960795

  9. Urothelial Defects from Targeted Inactivation of Exocyst Sec10 in Mice Cause Ureteropelvic Junction Obstructions

    PubMed Central

    Fogelgren, Ben; Polgar, Noemi; Lui, Vanessa H.; Lee, Amanda J.; Tamashiro, Kadee-Kalia A.; Napoli, Josephine Andrea; Walton, Chad B.; Zuo, Xiaofeng; Lipschutz, Joshua H.

    2015-01-01

    Most cases of congenital obstructive nephropathy are the result of ureteropelvic junction obstructions, and despite their high prevalence, we have a poor understanding of their etiology and scarcity of genetic models. The eight-protein exocyst complex regulates polarized exocytosis of intracellular vesicles in a large variety of cell types. Here we report generation of a conditional knockout mouse for Sec10, a central component of the exocyst, which is the first conditional allele for any exocyst gene. Inactivation of Sec10 in ureteric bud-derived cells using Ksp1.3-Cre mice resulted in severe bilateral hydronephrosis and complete anuria in newborns, with death occurring 614 hours after birth. Sec10FL/FL;Ksp-Cre embryos developed ureteropelvic junction obstructions between E17.5 and E18.5 as a result of degeneration of the urothelium and subsequent overgrowth by surrounding mesenchymal cells. The urothelial cell layer that lines the urinary tract must maintain a hydrophobic luminal barrier again urine while remaining highly stretchable. This barrier is largely established by production of uroplakin proteins that are transported to the apical surface to establish large plaques. By E16.5, Sec10FL/FL;Ksp-Cre ureter and pelvic urothelium showed decreased uroplakin-3 protein at the luminal surface, and complete absence of uroplakin-3 by E17.5. Affected urothelium at the UPJ showed irregular barriers that exposed the smooth muscle layer to urine, suggesting this may trigger the surrounding mesenchymal cells to overgrow the lumen. Findings from this novel mouse model show Sec10 is critical for the development of the urothelium in ureters, and provides experimental evidence that failure of this urothelial barrier may contribute to human congenital urinary tract obstructions. PMID:26046524

  10. [Non-vascular interventional radiology nonvascular interventional radiology of the urinary tract].

    PubMed

    Miki, M

    1989-08-01

    Several kinds of nonvascular interventional radiology of the urinary tract are reviewed. Transurethral balloon dilation of the prostate (TU-DP) is a newly developed nonsurgical treatment for benign prostate hyperplasia, which is performed under local anesthesia with minimal morbidity and requires no hospitalization. The TUDP technique involves dilating the prostatic urethra and bladder neck to 75 F for 10 minutes under fluoroscopic control using a high-pressure dilating balloon. Long-term follow-up studies are required. Percutaneous nephrolithotomy (PNL) and transurethral ureterolithotomy (TUL) have signified a revolution in stone surgery of upper urinary tract. Indications for these treatments, endoscopic manipulation, complications and their clinical features are presented. The procedure of PNL consists of 3 steps, puncture for nephrostomy tract, tract dilation and stone removal. Among these steps the most important is the puncture and it should be effected through the calyx. During the operation, if there is too much bleeding, it can be discontinued at any time while keeping the track open. It is no longer necessary for the kidney to be free of stones at the end of the operation. TUL is performed with a rigid or flexible ureterorenoscope. Dilation of the ureteral orifice and the intramural ureter is necessary for passing the scopes. When they have been sufficiently dilated, the ureterorenoscope can be passed to the level of the renal pelvis through the urethra. Calculi have been removed successfully at a higher rate in lower ureter. Endopyelotomy may be performed safely as an initial procedure to correct congenital obstruction of the ureteropelvic junction. Recent advancements have permitted an approach to percutaneous resection for renal pelvic tumor in a solitary kidney or bilateral synchronous disease. There are great expectations for continuing important innovations in the field of interventional radiology. PMID:2476077

  11. Experimental approach to the correlation of hemodynamic changes with increases in urinary lactate dehydrogenase as a new parameter reflecting serious renal tissue damages.

    PubMed

    Schoenenberger, G A; Buser, S; Hagmaier, V; Locher, J T; Mihatsch, M; Rist, M; Rutishauser, G; Scheidegger, A M; Stdtler, K

    1979-01-01

    From previous investigations with nephroptotic patients increased urinary LDH was assumed to be a reliable marker indicating a renal tissue defect due to the organs descent in erect position. Animal experiments now allowed correlation of this enzymatic activity with controlled changes of anatomical and physiological parameters. Changes of the renal hemodynamics or urinary flow induced in acute experiments in dogs simulated kidney displacement in nephroptotic patients. Both ureters were cannulated for separate urine collection and one kidney was manipulated. The renal arterial or venous flow was reduced or the ureter was occluded under electromagnetic blood-flow control. Arterial constriction alone (30%/15 min) selectively caused a drastic decrease (approximately 80%) of Xenon wash-out (= nutrient-flow) in the renal cortex. Under the same conditions radio-labeled microspheres injected intracardially showed a centralization of the renal capillary blood flow from the outer cortex to the juxtamedullary zone. Urinary LDH activities increased up to 800% immediately after arterial constriction. In accordance with total LDH activity the percentage distribution of isoenzymes changed: LDH-I increased and the LDH-V decreased. Neither constriction of the renal vein nor ureteral occlusion had similar effects. In long-term experiments backward fixation of one kidney in rats would reflect the effects of kidney displacement over years in nephroptotic patients: animals were unilaterally nephrectomized and the remaining kidney was dislocated backwards (approximately 2,5 vertebrae) and fixed to the lateral pelvic wall. "Ptotic" rats showed during the following examinations a constant increase of urinary LDH up to 50% by 26 weeks postoperatively. In accordance with increased LDH the isotope nephrogram was pathological and arteriographies showed a stretched and narrowed renal artery. In a number of rats "ptotic" fixation was not effective enough. All these animals showed normal LDH, isotope nephrograms and arteriographies. Both animal experiments documented that reduced flow/hypoxia is essentially responsible for the tissue damage in the kidney manifested by increased release of urinary LDH. PMID:446069

  12. Fos expression in spinothalamic and postsynaptic dorsal column neurons following noxious visceral and cutaneous stimuli.

    PubMed

    Palecek, J; Paleckova, V; Willis, W D

    2003-07-01

    The spinothalamic tract (STT) has been classically viewed as the major ascending pathway for pain transmission while the dorsal column (DC) was thought to be involved primarily in signaling innocuous stimuli. Recent clinical studies have shown that limited midline myelotomy, which transects fibers in the DC, offers good pain relief in patients with visceral cancer pain. Experimental studies provided evidence that a DC lesion decreases the activation of thalamic neurons by visceral stimuli and suggested that this effect is due to transection of the axons of postsynaptic dorsal column (PSDC) neurons. In our study, Fos protein expression in retrogradely labeled STT and PSDC neurons in the lumbosacral enlargement in rats was used as an anatomical marker of enhanced activation to compare the role of these neurons in cutaneous and visceral pain. The noxious stimuli used were intradermal injection of capsaicin and distention of the ureter. Retrogradely labeled PSDC neurons were found in laminae III-IV and in the vicinity of the central canal. STT neurons were located in laminae I, III-VII and X. Ureter distention evoked Fos expression in PSDC and STT neurons located in all laminae in which retrogradely labeled cells were found, with the maximum in the L(2) spinal segment. The Fos-positive PSDC neurons represented a significantly higher percentage of the retrogradely labeled PSDC neurons (19.3+/-2.3% SEM) than of the STT Fos-positive neurons (13.2+/-1.5% SEM). Intradermal capsaicin injection also evoked Fos expression in both PSDC and STT neurons, but with no significant difference between these two, when expressed as a percentage of the retrogradely labeled cells (11.6+/-2.9% SEM, 10.8+/-1.1% SEM). These results show that both PSDC and STT neurons are activated by cutaneous and visceral noxious stimuli. Their particular role in transmission and modulation of painful stimuli needs to be investigated further. PMID:12855335

  13. Clinical effectiveness of the PolyScope endoscope system combined with holmium laser lithotripsy in the treatment of upper urinary calculi with a diameter of less than 2 cm

    PubMed Central

    GU, SI-PING; HUANG, YUN-TENG; YOU, ZHI-YUAN; ZHOU, XIAOMING; LU, YI-JIN; HE, CAO-HUI; QI, JUAN

    2013-01-01

    The aim of this study was to evaluate the clinical value of the PolyScope endoscope system in the treatment of upper urinary calculi with a diameter of <2 cm. A total of 86 patients hospitalized with upper urinary tract calculi were included. The patients were placed under general or spinal anesthesia and in a lithotomy position. Following the dilation of the ureter, a guide wire was inserted under the direct vision of an F8/9.8 rigid ureteroscope, and an F12/14 flexible ureteral access sheath was positioned along the guide wire. Holmium laser lithotripsy was subsequently performed, using an F8.0 PolyScope modular flexible ureteroscope. Plain film of the kidney-ureter-bladder (KUB) was performed 1 day subsequent to the surgery, in order to determine the result of the lithotripsy and the position of the double-J stent which was inserted after after holmium laser lithotripsy. In addition, in certain patients, KUB radiography was performed 24 weeks subsequent to the surgery, and extracorporeal shockwave lithotripsy (ESWL) was performed if the diameter of the residual stones was >6 mm. Lithotripsy was successful in 77 patients and the duration of the surgery ranged between 25 and 80 min (mean duration, 42 min). Little bleeding was observed. Three patients presented with a slight fever following the surgery; however, no ureteral perforation, high fever or septicemia was observed among the patients following anti-inflammatory treatment. The stone-free rate (SFR) of the single-pass lithotripsy was 89.5% (77/86) and the SFR with ESWL was 96.5% (83/86). The study demonstrated that the F8 modular flexible ureteroscope was safe, convenient and effective for the lithotripsy of upper-tract calculi. PMID:24137232

  14. Treatment of ureteral calculus obstruction with laser lithotripsy in an Atlantic bottlenose dolphin (Tursiops truncatus).

    PubMed

    Schmitt, Todd L; Sur, Roger L

    2012-03-01

    An adult female bottlenose dolphin (Tursiops truncatus) presented with acute anorexia secondary to progressive azotemia (blood urea nitrogen = 213 mg/dl, creatinine [Cr] = 9.5 mg/dl) and electrolyte abnormalities (K = 7.4 mEq/L). It was later diagnosed with postrenal obstruction secondary to bilaterally obstructing ureteral calculi seen on ultrasound. Treatment of the obstruction required two endoscopic procedures, cystoscopy for ureteral stent placement and ureteroscopy to perform intracorporeal lithotripsy on the obstructing calculi. Before the first procedure, the dolphin's azotemia was stabilized with aggressive fluid therapy, peritoneal dialysis, and treatment for acidosis. Diuresis subsequent to the fluid therapy enabled passage of the right obstructing urolith. For both endoscopic procedures, the dolphin was placed in left lateral recumbency due to the peritoneal dialysis catheter in the right retroperitoneal region. For the first procedure, a 12-French (Fr) flexible cystoscope was inserted retrograde into the bladder via the urethra, whereupon a calculus was seen obstructing the left ureteral orifice. A 4.8-Fr, 26-cm double-pigtail ureteral stent was placed up the left ureter to relieve the postrenal obstruction. Inadvertent proximal migration of the left ureteral stent occurred during the procedure. However, renal parameters (serum Cr = 5.8, K = 5.4) improved significantly by the next day. For the second procedure, 28 hr later, ureteroscopy was performed to treat the calculus and replace the existing stent with a longer stent. The left ureteral calculus was pulverized into tiny fragments by using a holmium:yttrium-aluminum-garnet laser inserted through a 6.9-Fr semirigid ureteroscope. The migrated stent was visualized in the distal left ureter and replaced with a 90-cm single-pigtail ureteral stent that was sutured exterior to the urogenital slit and removed 3 days later. Renal function normalized over the next several days, and the dolphin recovered over the next 2 mo. PMID:22448516

  15. Chromosome 3 duplication q21 leads to qter deletion p25 leads to pter syndrome in children of carriers of a pericentric inversion inv(3) (p25q21).

    PubMed Central

    Allderdice, P W; Browne, N; Murphy, D P

    1975-01-01

    Close phenotypic similarity between two cases carrying a rec(3) dup q,inv(3) (p25q21), 12 additional infants from the same inv (3)(p25q21) kindred who lived less than 1 year, and eight cases studied in other medical centers has led us to postulate the existence of a distinct chromosome 3 duplication-deletion syndrome. In the presence of trisomy for (3)q21 leads to qter and monosomy for (3)p25 leads to pter, the facial dysmorphy is unique: a distorted head shape due to irregular cranial sutures, thick low eyebrows, long eyelashes, persistent lanugo, distended veins on the scalp, hypertelorism, oblique palpebral fissures, a very short nose with a broad depressed bridge and anteverted nares, protruding maxilla, thin upper lip, micrognathia, low-set ears, and a short webbed neck. Port-wine stains, congenital glaucoma, cloudy corneas, cleft palate and harelip also occur frequently. Each infant has difficulty sucking and swallowing. Congenital anomalies of the cardiovascular system, of midgut rotation, and of the urogenital system are noted for the infants who died neonatally. Most frequent is a ventricular septal defect, followed by atrial septal defect, patent ductus arteriosus, patent foramen ovale, and coarctation of the aorta. Omphalocele, umbilical hernia, hyperplastic kidneys, polycystic kidneys, double ureter, hydro-ureter, hydronephrosis, and undescended testes often occur. The extremities are short in proportion to the length of the trunk. Clinodactyly, coxa valga, talipes, and spina bifida are frequently observed. Images Fig. 2 Fig. 3 Fig. 4 Fig. 5 Fig. 7 Fig. 8 PMID:1200027

  16. Bioelectric Impedance Analysis in the Diagnosis of Vesicoureteral Reflux

    PubMed Central

    Bayram, Meral Torun; Alaygut, Demet; Turkmen, Mehmet; Soylu, Alper; Kavukcu, Salih

    2015-01-01

    Background: Vesicoureteral reflux (VUR) is a common abnormality of the urinary tract in childhood. Objectives: As urine enters the ureters and renal pelvis during voiding in vesicoureteral reflux (VUR), we hypothesized that change in body water composition before and after voiding may be less different in children with VUR. Patients and Methods: Patients were grouped as those with VUR (Group 1) and without VUR (Group 2). Bioelectric impedance analysis was performed before and after voiding, and third space fluid (TSF) (L), percent of total body fluid (TBF%), extracellular fluid (ECF%), and intracellular fluid (ICF%) were recorded. After change of TSF, TBF, ECF, ICF (ΔTSF, ΔTBF%, ΔECF%, ΔICF%), urine volume (mL), and urine volume/body weight (mL/kg) were calculated. Groups 1 and 2 were compared for these parameters. In addition, pre- and post-voiding body fluid values were compared in each group. Results: TBF%, ECF%, ICF%, and TSF in both pre- and post-voiding states and ΔTBF%, ΔECF%, ΔICF%, and ΔTSF after voiding were not different between groups. However, while post-voiding TBF%, ECF% was significantly decreased in Group 1 (64.5 ± 8.1 vs 63.7 ± 7.2, P = 0.013 for TBF%), there was not post-voiding change in TSF in the same group. On the other hand, there was also a significant TSF decrease in Group 2. Conclusions: Bladder and ureter can be considered as the third space. Thus, we think that BIA has been useful in discriminating children with VUR as there was no decreased in patients with VUR, although there was decreased TSF in patients without VUR. However, further studies are needed to increase the accuracy of this hypothesis. PMID:26396698

  17. Efficacy of dextranomer hyaluronic acid and polyacrylamide hydrogel in endoscopic treatment of vesicoureteral reflux: A comparative study

    PubMed Central

    Blais, Anne-Sophie; Morin, Fannie; Cloutier, Jonathan; Moore, Katherine; Bolduc, Stéphane

    2015-01-01

    Introduction: Various bulking agents are available for vesicoureteral reflux (VUR) endoscopic treatment, but their inconsistent success rates and costs are concerns for urologists. Recently, polyacrylamide hydrogel (PAHG) has been shown to have a good overall success rate, which seems comparable to dextranomer hyaluronic acid (Dx/HA), currently the most popular bulking agent. Our objective was to compare the short-term success rate of PAHG and Dx/HA for VUR endoscopic treatment in children. Methods: We performed a prospective non-randomized study using PAHG and Dx/HA to treat VUR grades I to IV in pediatric patients. All patients underwent endoscopic sub-ureteric injection of PAHG or Dx/HA, using the double-HIT technique, followed by a 3-month postoperative renal ultrasound and voiding cystourethrogram. Treatment success was defined as the absence of de novo or worsening hydronephrosis and absence of VUR. Results: A total of 90 pediatric patients underwent an endoscopic injection: 45 patients (78 ureters) with PAHG and 45 patients (71 ureters) with Dx/HA. The mean injected volume of PAHG and Dx/HA was 1.1 mL and 1.0 mL, respectively. The overall success rate 3 months after a single treatment was 73.1% for PAHG and 77.5% for Dx/HA. Postoperatively, 1 patient in each group presented with acute pyelonephritis and 2 patients in the Dx/HA group developed symptomatic ureteral obstruction. Conclusion: Success rates of PAGH and Dx/HA in endoscopic injections for VUR treatment were comparable. The rate of resolution obtained with Dx/HA was equivalent to those previously published. The lower cost of PAHG makes it an interesting option. PMID:26225173

  18. Efficacy of extracorporeal shockwave lithotripsy using Dornier SII in different levels of ureteral stones

    PubMed Central

    Elkholy, Mohamed M.; Ismail, Hassan; Abdelkhalek, Mohamed A.; Badr, Mohamad M.; Elfeky, Mohamed M.

    2014-01-01

    Objective: The objective of this study was to evaluate the efficacy and safety of the Dornier lithotripter S II system in the treatment of ureteral calculi. Patients and Methods: A total of 97 cases which consists of 54 males and 43 females with ureteral stones were treated by extracorporeal shock wave lithotripsy (ESWL). Mean age was 42.6 years. Inclusion criteria were solitary radiopaque ureteral stones of radiological stone size of ?1 cm. The stones were not impacted, with normal kidney functions. Procedure time, number of shocks, energy used, number of sessions and complications were reported. The outcome of ESWL was also recorded. Results: Stones were in the abdominal (upper ureter) in 50% of patients, in pelvic (middle ureter) in 47% of patients. All patients had unilateral stones and the mean stone size in maximum length was) 10 mm). Good dye excretion passing the stone was noted in all patients. Mild hydronephrosis was found in 85% of cases. A total of 49 cases were treated by a single session, while in 35% of cases two sessions were enough and 16% received three sessions. The average number of shocks per session was 3125. The average number of shocks per patient was 5962.5 shocks and average energy was 204.3 Joules. The overall stone-free rate 3 months after lithotripsy was 94%. After a single session of lithotripsy, 49 patients (49%) became stone-free. Stone free rates after ESWL for upper, middle ureteral stones were 94%, 95.7% respectively. Additional procedures were needed in only 6 cases (6%) to render patients stone-free after lithotripsy. No serious complications occurred. Conclusion: The Dornier lithotripter S II is very effective in the treatment of ureteral calculi with no major complications. PMID:25371614

  19. Optimization of dosimetry and safety using the holmium laser for urology

    NASA Astrophysics Data System (ADS)

    van Swol, Christiaan F. P.; Verdaasdonck, Rudolf M.; Zeijlemaker, Bram Y. W.; Grimbergen, Matthijs C. M.; Boon, Tom A.

    1998-07-01

    The holmium laser has become accepted as a versatile instrument for urological applications, such as prostate resection, urethrotomy, tumor coagulation and lithotripsy. Presently, more powerful lasers have become available generating pulses up to 4 J at 80 W. The necessity of these high power systems in urology is ambiguous. In this study, the dosimetry as to efficacy and especially safety was investigated for various applications. The holmium laser ((lambda) equals 2.1 micrometer) emits its energy in 350 microsecond pulses which instantly turn water into vapor. Using high-speed photography explosive vapor bubbles with diameters over 10 mm were captured. The mechanical force of these bubbles, effectively fragments stones but may dilate and rupture a small lumen like the ureter. After implosion of the bubble, the energy of vaporization turns into heat. Depending on pulse energy and pulse repetition rate, tissue can be thermally affected up to 5 mm. For soft tissue applications, e.g., urethrotomy, prostatectomy or tumor coagulation, pulse energies of 0.5 - 1.5 J were applied at a high repetition rate (20 - 40 Hz) to provide sufficient coagulative and hemostatic effects. At higher pulse energies, the fiber tip was vibrating vigorously and the tissue was ripped to pieces decreasing hemostasis and visibility. For hard tissue applications, bursts of 0.5 J pulses at 5 Hz, proved to be sufficient to fragment all types of stones (including cystine) in the ureter and the bladder without mechanical or thermal damage to surrounding tissue. At higher settings, targeting the stone was less controlled and effective due to 'jumping' of the fiber tip with resulting mechanical and thermal trauma to the surrounding tissue. The holmium laser can be used effectively to coagulate and cut soft tissue and fragment stones at relatively low energy and power settings, thus minimizing the risk of complications.

  20. The induction of rat bladder cancer by 2-naphthylamine

    PubMed Central

    Hicks, R. M.; Wright, R.; Wakefield, J. St J.

    1982-01-01

    The widely held belief that 2-naphthylamine is not carcinogenic for the rat has been re-examined. Twenty female Wistar rats were dosed by gastric intubation weekly for 57 weeks with 2-naphthylamine, 300 mg/kg body wt, in arachis oil and 20 controls were given arachis oil alone. Animals which became moribund were killed during the course of the experiment and the remainder after 100 weeks. A 2-naphthylamine-treated animal died at 21 weeks; all others survived 57 weeks or longer. The urinary tracts of all but two 2-naphthylamine-treated animals, which were found dead and cannibalized, were examined histologically. No neoplastic disease of the urinary tract was present in control animals. In 10 of the 2-naphthylamine-treated rats there was neither neoplasia nor hyperplasia of the urothelium, but 4 of the 18 examined histologically had large, macroscopically visible bladder cancers; one of these also had bilateral transitional cell tumours of the kidney calyces and multiple tumours in both ureters. Another animal had bilateral urothelial cancers in the ureters. The histology and ultrastructure of these urothelial cancers were comparable to those of rat transitional-cell carcinomas experimentally induced with other chemical carcinogens. These results, considered in the context both of early and more recently published biochemical studies of 2-naphthylamine metabolism in the rat, support the possibility that production of the active carcinogenic metabolite in this species may be influenced by a pH-dependent, non-enzymic mechanism in the urine, which could account for individual, strain- and diet-related variations in response in the rat. ImagesFig. 1Fig. 2Fig. 3Fig. 4Figs 5(a), (b)Fig. 6Fig. 7Fig. 8Fig. 9Figs. 10(a), (b)Fig. 11 PMID:7138770

  1. Ureteroperitoneal fistula secondary to tubal sterilization by laparoscopy.

    PubMed

    Machuca, J; Martinez de la Ossa, R; Camara, M

    1996-12-01

    In Spain, a 32-year-old woman presented at Motril Hospital in Granada with pain and a fever arising 3 days after undergoing laparoscopic tubal sterilization with electrocoagulation at a nearby hospital. She had tenderness on palpation in the left lower quadrant of the abdomen. Since no pathology was evident on ultrasonography but laboratory studies revealed leucocytosis, the physicians diagnosed pelvic inflammatory disease and treated her with clindamicin and gentamicin. She returned to Motril Hospital a month later with pain in the lower left quadrant of the abdomen and in the left costovertebral angle and a fever of 2 days' duration. The physical examination indicated peritonitis. The hemoglobin level was 100 g/l; the hematocrit was 32%; and she had leucocytosis. Free fluid in the pelvic peritoneum and mild ureterohydronephrosis were found by ultrasonography and confirmed by IVP. Retrograde pyelography indicated an ureteric fistula with contrast medium passing to the Douglas pouch. The clinicians could not pass a catheter via the affected ureteric segment. Laparotomy revealed uroperitoneum with a hole at the posterior parietal peritoneum through which urine passed. Surgeons dissected the area up to the ureteric injury, presumably caused by electrocoagulation during laparoscopy, anastomosed the ureter end-to-end, and placed a 6 F stent catheter in the ureter for 10 days. The IVP 2 months later was normal. As new laparoscopic procedures emerge, there will be new cases of ureteric injury. The first treatment choice is percutaneous nephrostomy. Surgery should be the treatment choice for cases of failure or when clinicians suspect other complications associated with the ureteric injury. PMID:9014731

  2. The Pathology of Tumours of the Urinary Tract

    PubMed Central

    Newcomb, W. D.

    1939-01-01

    Attention is called to the difference between the pathologist's and the radiologist's point of view. The reasons for this difference are discussed with special emphasis on renal tumours. Classification of renal tumours. The first main groups are innocent and malignant. Are these really clear-cut or do they blend into one another? The commoner innocent renal tumours are adenoma, fibroma, myoma, lipoma, and angioma. These are rarely of any clinical importance but adenoma is a possible source of hypernephroma. Many elaborate classifications of cancer of the kidney have been proposed but the following four groups are sufficient for most puposes: Carcinoma, hypernephroma, sarcoma, and teratoid tumours. Much the commonest malignant renal tumour in adults is the hypernephroma, thought by Grawitz and others to be derived from ectopic adrenal rests. There is still no agreement concerning their origin but three views are held at the present time: (a) All are carcinoma of renal tubules. (b) Some are derived from renal tubules and some from ectopic adrenal. (c) All are formed from adrenal tissue. These views are discussed with special reference to material in St. Mary's Hospital Museum, and it is suggested that the first view is the most probable although the second cannot be excluded. The teratoid tumours are the commonest in infants and swine. The differences between them and hypernephromata are described. The renal Pelvis, ureter, and bladder all have tumours of the same type and can conveniently be considered together. Connective tissue tumours, both innocent and malignant, are very rare. Papilloma and carcinoma are rare in the pelvis and ureter, but commoner in the bladder. The relation between these two tumours is discussed. ImagesFig. 1Fig. 2Fig. 3Fig. 4Fig. 5Fig. 6Fig. 7Fig. 8Fig. 9Fig. 10Fig. 11Fig. 12Fig. 13Fig. 14Fig. 15Fig. 16Fig. 17Fig. 18 PMID:19992130

  3. Human Alpha Defensin 5 Expression in the Human Kidney and Urinary Tract

    PubMed Central

    Porter, Edith; Bevins, Charles L.; DiRosario, Julianne; Becknell, Brian; Wang, Huanyu

    2012-01-01

    Background The mechanisms that maintain sterility in the urinary tract are incompletely understood. Recent studies have implicated the importance of antimicrobial peptides (AMP) in protecting the urinary tract from infection. Here, we characterize the expression and relevance of the AMP human alpha-defensin 5 (HD5) in the human kidney and urinary tract in normal and infected subjects. Methodology/Principal Findings Using RNA isolated from human kidney, ureter, and bladder tissue, we performed quantitative real-time PCR to show that DEFA5, the gene encoding HD5, is constitutively expressed throughout the urinary tract. With pyelonephritis, DEFA5 expression significantly increased in the kidney. Using immunoblot analysis, HD5 production also increased with pyelonephritis. Immunostaining localized HD5 to the urothelium of the bladder and ureter. In the kidney, HD5 was primarily produced in the distal nephron and collecting tubules. Using immunoblot and ELISA assays, HD5 was not routinely detected in non-infected human urine samples while mean urinary HD5 production increased with E.coli urinary tract infection. Conclusions/Significance DEFA5 is expressed throughout the urinary tract in non-infected subjects. Specifically, HD5 is expressed throughout the urothelium of the lower urinary tract and in the collecting tubules of the kidney. With infection, HD5 expression increases in the kidney and levels become detectable in the urine. To our knowledge, our findings represent the first to quantitate HD5 expression and production in the human kidney. Moreover, this is the first report to detect the presence of HD5 in infected urine samples. Our results suggest that HD5 may have an important role in maintaining urinary tract sterility. PMID:22359618

  4. Treatment and outcome of fibroepithelial ureteral polyps: A systematic literature review

    PubMed Central

    Ludwig, Dina J.; Buddingh, Karel T.; Kums, Jan J.M.; Kropman, Ren F.; Roshani, Hossain; Hirdes, Willem H.

    2015-01-01

    Introduction: Fibroepithelial polyps of the ureter are rare. Cases and small series are reported in the literature. The treatment of choice, outcome and appropriate follow-up regimen remain unclear. Methods: We conducted a systematic literature review of papers reporting fibroepithelial polyps of the ureter in adult patients. Articles published before 1980 were excluded. Results: The search yielded 144 papers, of which 68 met the inclusion criteria. A reference scan from the included 68 yielded an additional 7 new articles. In total, our study included 75 articles (68 + 7). A total of 134 patients were described. Most patients had a single lesion (range: 110). The median length of the polyp was 4.0 cm (range: 0.417.0). The percentage of polyps resected endoscopically increased from 0% before 1985 to 67% after 2005. Two perioperative complications were reported in 72 procedures (2.8%): a deep venous thrombosis and a case of mesenteric lymphadenopathy. Both of these occurred after open surgery. Follow-up data were available for 57 patients. The median follow-up was 12 months (range: 1180). Four patients (7.0%) developed recurrent complaints: 2 had urinary stones, 1 had a ureteral stricture and 1 had recurrence of the polyp. Three of these events followed endoscopic resection, and occurred within a year after the procedure. Conclusion: Endoscopic resection of fibroepithelial polyps seems to be safe and effective. It is minimally invasive and should be considered the gold standard where endoscopic expertise is available. We advise follow-up imaging by computed tomographic intravenous urography after 3 months and ultrasound after 1 year to detect late complications. PMID:26425226

  5. Flexible ureteroscopic laser lithotripsy for upper urinary tract stone disease in patients with spinal cord injury.

    PubMed

    Tepeler, Abdulkadir; Sninsky, Brian C; Nakada, Stephen Y

    2015-11-01

    The objective of this study is to present the outcomes of flexible ureteroscopic laser lithotripsy (URS) for upper urinary tract stone disease in spinal cord injury (SCI) patients performed by a single surgeon. A retrospective analysis was performed for SCI patients treated with flexible URS for proximal ureter and kidney stone disease by a single surgeon between 2003 and 2013. Patient characteristics, operative outcomes, metabolic evaluation, and stone analyses were assessed in detail. A total of 27 URS procedures were performed for urolithiasis in 21 renal units of 19 patients. The mean age was 52.1 15.6 years (16-72) and mean BMI was 29.2 7.3 kg/m(2) (20-45.7). Etiology of SCI was trauma (n: 10), multiple sclerosis (n: 6), cerebrovascular accident (n: 1), or undetermined (n: 2). The mean stone size was 15.9 8.6 (6-40) mm. In the 27 URS procedures, stones were located in the ureter (n: 5), the kidney (n: 14), and both areas (n: 8). Mean hospitalization time was 2.0 2.4 (0-10) days. Postoperative complications were observed in 6 cases (22.2%). Three major complications included urosepsis (n: 1) and respiratory failure (n: 2), that were observed postoperatively and required admission to the intensive care unit. The 2 minor complications were hypotension, fever and UTI, and required medical treatment. Fourteen (66.6%) of the 21 renal units were stone free. Calcium phosphate carbonate (n: 9) and struvite (n: 5) were the primary stone compositions detected. Hypocitraturia (n: 6), hypercalciuria (n: 5), hypernaturia (n: 5), hyperoxaluria (n: 4), and hyperuricosuria (n: 1) were common abnormalities in 24-h urine analysis. Ureteroscopic laser lithotripsy can be an effective treatment modality for SCI patients with upper urinary tract calculi. PMID:25987450

  6. Intracorporeal lithotripsy with the holmium:YAG laser

    NASA Astrophysics Data System (ADS)

    Denstedt, John D.; Razvi, Hassan A.; Chun, Samuel S.; Sales, Jack L.

    1995-05-01

    A variety of devices are currently available for intracorporeal stone fragmentation. Recently a new wavelength of laser, the Holmium:YAG, has demonstrated a variety of potential urologic applications including ablation of soft tissue lesions as well as stone fragmentation. This laser has a wavelength of 2100 nm and operates in a pulsed mode. Energy is delivered through a 400 um quartz end-firing fiber. In this presentation we review our clinical experience with the Holmium:YAG laser for the treatment of renal and ureteral calculi. Over a 23 month period, 63 patients underwent 67 procedures. Seven procedures consisted of percutaneous nephrolithotripsy for large or staghorn renal calculi. Sixty procedures were performed for ureteral stones. Procedures for proximal ureteral stones (6) employed a retrograde approach using flexible ureteroscopes (8.5 or 9.8). Stones in the mid ureter (12) and distal ureter (42) were approached transurethrally using a 6.9 rigid ureteroscope. Complete stone fragmentation without the need for additional procedures was achieved in 82% of cases. Treatment failures included 1 stone migration into the renal pelvis during laser activation, 6 patients who had incomplete fragmentation and 3 patients in which laser malfunction precluded complete fragmentation. Stone analysis available in 23 patients revealed calcium oxalate monohydrate (15), calcium oxalate dihydrate (2), cystine (2), uric acid (3) and calcium phosphate (1). A single complication of ureteral perforation occurred when the laser was fired without direct visual guidance. Radiographic follow-up at an average of 16 weeks is available in 22 patients and has identified 2 patients with ureteral strictures that are not believed to be related to laser lithotripsy. In summary, we have found the Holmium:YAG laser to be a reliable and versatile device for intracorporeal lithotripsy. Its safety and efficacy make it a suitable alternative for performing intracorporeal lithotripsy of urinary calculi.

  7. Bilateral ureteral obstruction due to primary myelofibrosis caused hyperuricaemia.

    PubMed

    Cvetkovi?, Z P; Cvetkovi?, B R; Celeketi?, D; Milenkovi?, D; Perunici?-Pekovi?, G

    2010-01-01

    In healthy population, uric acid comprises the major component of 10-20% of renal stones. Extreme hiperuricaemia is seen in cancer patients with tumour lysis syndrome (TLS) which is classically associated with haematological malignancies with rapid tumour growth rates such as acute lymphoid leukaemia and high grade lymphomas. Primary melofibrosis (Agnogenic myeloid metaplasia-AMM) is a chronic myeloproliferative disease characterized by splenomegaly, a leukoerythroblastic blood picture, teardrop poikilocytosis and varying degrees of marrow fibrosis. Due to the increased extramedullary haematopoiesis, hiperuricemia may occur. However, TLS in patients with AMM is, according to the available literature, described just in one patient. In this paper we present a case of a 47-year-old male patient who was admitted to the hospital with symptoms of fatigue and small amount of urine, and clinical signs of plethora and enlarged spleen. The laboratory findings showed leuko-and erythrocytosis, increased levels of urea-BUN (32 mmol/l) and creatinine (766 mmol/l) as well as uric acid (920 mmol/l). The immediate abdominal ultrasound confirmed extreme splenomegaly, but also showed bilateral hydronephrosis of grade II-III with two stones in proximal part of right ureter and one in proximal part of left ureter as well as empty bladder. Stones were not seen on plain film. Since the patient was in complete anuria, with further rapid elevation of BUN and creatinine levels, bilateral ureteral stents were applicated together with extensive hydration, urine alkalization and administration of allopurinol which resulted in the complete recovery of kidney function. The bone marrow biopsy was also performed and histopathological diagnosis was: Hypercellulary phase of AMM. PMID:20949707

  8. Long-Term Lithium Use and Risk of Renal and Upper Urinary Tract Cancers

    PubMed Central

    Hallas, Jesper; Jensen, Boye L.; Madsen, Kirsten; Friis, Sren

    2016-01-01

    Lithium induces proliferation in the epithelium of renal collecting ducts. A recent small-scale cohort study reported a strong association between use of lithium and increased risk of renal neoplasia. We therefore conducted a large-scale pharmacoepidemiologic study of the association between long-term use of lithium and risk of upper urinary tract cancer, including renal cell cancer and cancers of the renal pelvis or ureter. We identified all histologically verified upper urinary tract cancer cases in Denmark between 2000 and 2012 from the Danish Cancer Registry. A total of 6477 cases were matched by age and sex to 259,080 cancer-free controls. Data on lithium use from 1995 to 2012 were obtained from the Danish Prescription Registry. We estimated the association between long-term use of lithium (?5 years) and risk of upper urinary tract cancer using conditional logistic regression with adjustment for potential confounders. Long-term use of lithium was observed among 0.22% of cases and 0.17% of controls. This yielded an overall nonsignificant adjusted odds ratio (OR) of 1.3 (95% confidence interval [95% CI], 0.82.2) for upper urinary tract cancer associated with long-term use of lithium. Analyses stratified by stage and subtype of upper urinary tract cancer revealed slight but nonsignificant increases in the ORs for localized disease (OR, 1.6; 95% CI, 0.83.0) and for renal pelvis/ureter cancers (OR, 1.7; 95% CI, 0.55.4). In conclusion, in our nationwide case-control study, use of lithium was not associated with an increased risk of upper urinary tract cancer. PMID:25941353

  9. Expression and Antimicrobial Function of Beta-Defensin 1 in the Lower Urinary Tract

    PubMed Central

    Becknell, Brian; Spencer, John David; Carpenter, Ashley R.; Chen, Xi; Singh, Aspinder; Ploeger, Suzanne; Kline, Jennifer; Ellsworth, Patrick; Li, Birong; Proksch, Ehrhardt; Schwaderer, Andrew L.; Hains, David S.; Justice, Sheryl S.; McHugh, Kirk M.

    2013-01-01

    Beta defensins (BDs) are cationic peptides with antimicrobial activity that defend epithelial surfaces including the skin, gastrointestinal, and respiratory tracts. However, BD expression and function in the urinary tract are incompletely characterized. The purpose of this study was to describe Beta Defensin-1 (BD-1) expression in the lower urinary tract, regulation by cystitis, and antimicrobial activity toward uropathogenic Escherichia coli (UPEC) in vivo. Human DEFB1 and orthologous mouse Defb1 mRNA are detectable in bladder and ureter homogenates, and human BD-1 protein localizes to the urothelium. To determine the relevance of BD-1 to lower urinary tract defense in vivo, we evaluated clearance of UPEC by Defb1 knockout (Defb1-/-) mice. At 6, 18, and 48 hours following transurethral UPEC inoculation, no significant differences were observed in bacterial burden in bladders or kidneys of Defb1-/- and wild type C57BL/6 mice. In wild type mice, bladder Defb1 mRNA levels decreased as early as two hours post-infection and reached a nadir by six hours. RT-PCR profiling of BDs identified expression of Defb3 and Defb14 mRNA in murine bladder and ureter, which encode for mBD-3 and mBD-14 protein, respectively. MBD-14 protein expression was observed in bladder urothelium following UPEC infection, and both mBD-3 and mBD-14 displayed dose-dependent bactericidal activity toward UPEC in vitro. Thus, whereas mBD-1 deficiency does not alter bladder UPEC burden in vivo, we have identified mBD-3 and mBD-14 as potential mediators of mucosal immunity in the lower urinary tract. PMID:24204930

  10. Effect of unilateral ureteral obstruction and anti-angiotensin II treatment on renal tubule cell apoptosis and interstitial fibrosis in rats.

    PubMed

    Radovi?, Nikola; Aralica, Gorana; Ljubanovi?, Danica Galesi?; Jelec, Vjekoslav; Kontek, Mladen

    2014-06-01

    Unilateral ureteral obstruction (UUO) results in a number of pathophysiological and morphological changes in the renal parenchyma, including interstitial inflammation and fibrosis, apoptotic changes of tubular and interstitial cells. Recent studies have indicated an association between renin-angiotensin system and apoptotic alterations in the kidney after unilateral obstructive nephropathy. In this study, the effect of ACE inhibitors and AT1 receptor antagonists on tubular cell apoptosis and interstitial fibrosis in obstructive nephropathy after UUO in rats was investigated. The study was conducted on Wistar rats with unilaterally ligated ureter and sham operated animals (control group). The rats with UUO were treated with ACE inhibitor (cilazapril) or AT1 receptor antagonists (losartan) and control group was treated with H2O. Sham-operated animals were treated in the same way. Tubular and interstitial cell apoptosis was detected morphologically by hematoxylin and eosin (HE) staining and terminal deoxynucleotidyl transferase-mediated nick end-labeling (TUNEL). The area of intersitial fibrosis was determined using computer-assisted image processing after Gomory silver impregnation of paraffin sections. All experimental animal groups with unilateral ureter ligation showed a significantly increased number of apoptotic tubular and interstitial cells in the obstructed kidney compared with the contralateral, unobstructed kidney. Histomorphometric analysis of renal interstitial fibrotic changes in the groups of rats treated with losartan or water showed a statistically significant difference (p < 0.05) between the operated and sham--operated animals. In conclusion, following UUO there is a significantly increased number of apoptotic tubular cells and interstitial fibrosis in the ipsilateral kidney compared with the contralateral kidney. ACE inhibitors and AT1 receptor antagonists could not decrease the extent of renal cells apoptosis and interstitial fibrosis after UUO. PMID:25144992

  11. Polypoid/papillary cystitis: a series of 41 cases misdiagnosed as papillary urothelial neoplasia.

    PubMed

    Lane, Zhaoli; Epstein, Jonathan I

    2008-05-01

    Polypoid cystitis and its more chronic phase papillary cystitis, which results as a reaction to injury to the bladder mucosa, is a benign lesion mimicking various papillary urothelial neoplasms. Analogous lesions occur throughout the urothelial tract and are referred to as polypoid urethritis, polypoid ureteritis, and polypoid pyelititis when present in the urethra, ureter, and renal pelvis, respectively. For simplicity, these lesions in different sites and papillary cystitis will typically be referred to as polypoid cystitis in this manuscript. A search of the consultation files from our institution from January 2000 to July 2007 was performed. Of 155 cases diagnosed as polypoid cystitis, we identified 41 cases that were diagnosed as papillary urothelial neoplasms by contributing pathologists and only sent to us, typically at the request of the urologist after the case had be signed out. For cases where information was available, clinical symptoms included bladder obstruction (n=7), gross hematuria (n=6), colovesicular fistula (n=4), follow-up status posttreatment of bladder and ureter carcinoma (n=4), bladder/urethral stones (n=2), benign prostate hyperplasia (n=2), follow-up after radiation for prostate cancer (n=2), long-standing urinary stents (n=2), and voiding dysfunction (n=1). Original diagnoses included noninvasive low grade papillary urothelial carcinoma (n=23), noninvasive high grade papillary urothelial carcinoma (n=6), papillary urothelial neoplasm of low malignant potential (n=5), papilloma (n=3), urothelial neoplasia (n=2), carcinoma in situ (n=1), and squamous carcinoma (n=1). The mean age at diagnosis was 63 years (range, 19 to 93 y; median 63 y). Male to female ratio was 3.1 to 1. Clinical symptoms varied with the most common manifestations, including gross hematuria, bladder/urethral stones, history of prostate cancer treated with radiation, follow-up after bladder/ureter carcinoma treatment, long-term urinary stents, and colovesicular fistulas. At cystoscopy, lesions were variably described as polypoid, trabeculations, bullous polyps, and diffuse erythema and edema. The locations of polypoid cystitis were bladder (n=34), ureteral orifice (n=2), urethra (n=2), renal pelvis (n=2), and undesignated (n=1). Architecturally, 31 cases had isolated papillary fronds with in 1 case branching papillary structures. The base of the papillary stalks were characterized as both broad and narrow (n=24), only broad (n=9), and only narrow (n=3). The overlying urothelium of polypoid cystitis was diffusely and focally thickened in 8 cases and 5 cases, respectively. Umbrella cells were identified in 32 cases. Acute and chronic inflammation was present in 28 cases, moderate in 15, and mild in 13 cases. Eleven cases showed chronic inflammation, mild in 10, and moderate in 1 case. Reactive urothelial atypia was noted in 26 cases with mitotic figures present in 22 cases, frequent in 3 and rare in 19 cases. Stroma edema was seen in 32 cases with fibrosis within the polypoid stalks seen in 16 cases. The key to correctly diagnosing polypoid/papillary cystitis is to recognize at low magnification the reactive nature of the process with an inflamed background that is edematous or densely fibrous with predominantly simple, non-branching, broad-based fronds of relatively normal thickness urothelium, and not focus at higher power on the exceptional frond that may more closely resemble a urothelial neoplasm either architecturally or cytologically. In cases where the diagnosis of papillary neoplasia is not straightforward and there is a question of polypoid cystitis, pathologists should seek clinical history that might suggest a reactive process. Because the urologist can more often better recognize the inflammatory nature of the lesion than the pathologist, the pathologist should hesitate diagnosing urothelial neoplasia when the cystoscopic impression is that of an inflammatory lesion. PMID:18379418

  12. Urinary tract ultrasonography in normal rams and in rams with obstructive urolithiasis

    PubMed Central

    Braun, Ueli; Schefer, Ursula; Föhn, Josef

    1992-01-01

    We determined the position, dimensions, and structure of the kidneys, ureters, bladder, and urethra in 20 healthy, adult rams by use of ultrasonography. The findings were compared with those of seven rams with obstructive urolithiasis, thus establishing criteria for the diagnosis of urolithiasis via ultrasonography. A 5.0 MHz convex transducer was placed over the right paralumbar fossa to examine the kidneys, and a 5.0 MHz linear rectal transducer was used to examine the bladder and urethra transrectally. All examinations were performed on standing rams. The left kidney had a length of 8.4 ± 0.3 cm (mean ± SD), a width of 4.7 ± 0.3 cm, and a depth of 4.4 ± 0.3 cm. The diameter of the renal sinus of the left kidney was 1.5 ± 0.2 cm. The circumference of the medullary pyramids measured 2.8 ± 0.3 cm. Similar ultrasonographic measurements were obtained for the right kidney. The mean diameter of the bladder of 12 rams was 7.5 ± 2.8 cm. The diameter of the bladder could not be determined in the remaining eight rams because it was greater than 10 cm and therefore beyond the penetration depth of the scanner. The only part of the urethra which could be visualized ultrasonographically was the internal urethral orifice. It had a diameter of 0.2 ± 0.1 cm. Ultrasonographic examination of seven rams with obstructive urolithiasis revealed a markedly dilated urethra and urinary bladder. Due to severe cystitis, the contents of the urinary bladder appeared as multiple, tiny, uniformly distributed echoes. The renal pelvis and medullary pyramids of both kidneys were dilated in four rams. In two rams, uroperitoneum and accumulation of urine in the abdomen were diagnosed via ultrasonography. In one ram this was due to a ruptured ureter and in one to a ruptured bladder. The results of this study indicate that ultrasonography is a useful aid in the diagnosis of obstructive urolithiasis. ImagesFigure 2.Figure 3.Figure 4.Figure 5.Figure 6.Figure 7. PMID:17424090

  13. Endoscopic treatment of vesicoureteric reflux with Deflux: a Canadian experience

    PubMed Central

    Guerra, Luis A; Khanna, Priya; Levasseur, Michele; Pike, John G; Leonard, Michael P

    2007-01-01

    Introduction Vesicoureteric reflux is a common problem encountered in urological practice. Traditionally, if medical management with low-dose antibiotic prophylaxis failed, the only alternative was ureteroneocystostomy. Recently, promising results with subureteric injection of dextranomer/hyaluronic acid copolymer (Deflux) have renewed interest in the endoscopic treatment of vesicoureteric reflux (VUR). Objective We reviewed the outcome of the subtrigonal injection (STING) procedure with Deflux at a single pediatric hospital and included the rate of VUR resolution and complications. Methods An Institutional Review Board approved the retrospective review of all cases of STING performed with Deflux at the Children's Hospital of Eastern Ontario, from April 2003 to October 2005. We used voiding cystourethrogram (VCUG) or radionuclide cystogram (RNC) for diagnosis of VUR. The most common indications for surgery were breakthrough infection, progression of renal scars and parental preference. A subureteral or intra-ureteral injection, at the 6 o'clock position, delivered the material to support the ureter and correct VUR. Results We reviewed the cases of 64 patients, 47 girls (73%) and 17 boys (27%), with a mean age of 6 years (range 1–17 yr) and a mean follow-up of 8 months (range 2–23 mo). A total of 26 patients (41%) had bilateral VUR and 38 (59%) had unilateral VUR (90 renal units were treated). Overall cure rate was 79.7% (51/64) per child and 74% (67/90) per renal unit. Among the 64 patients treated, 62.5% (40/64) were cured with a single injection, and a second and third injection raised the cure rate to 78% (50/64) and 79.7% (51/64), respectively. Contralateral low-grade de novo VUR was present in 7.9% (3/38) of the 38 unilateral cases. Postoperatively, de novo hydronephrosis developed in 3.3% (3/90) of the ureters, in 2 patients. Conclusions The endoscopic treatment of VUR with Deflux is a feasible outpatient procedure, requires minimal operating room time and is associated with low morbidity. In our study, it demonstrated a cure rate of 80% of patients and 74% of renal units. Dysfunctional voiding and neurogenic bladder (NB) do not seem to adversely affect results. STING should be considered for failed open reimplants, because it is much less morbid than redo reimplants. Further experience with the material and increased use of intraureteral injection may improve our cure rates. PMID:18542760

  14. Second cancer following lymphatic and hematopoietic cancers in Connecticut, 1935-82.

    PubMed

    Greene, M H; Wilson, J

    1985-12-01

    The risk of developing a second primary cancer was evaluated in approximately 19,000 persons with initial cancers of the lymphatic and hematopoietic system in Connecticut between 1935 and 1982. Significant excesses for all second cancers were observed among patients with leukemia (34%), Hodgkin's disease (70%), non-Hodgkin's lymphoma (25%), and multiple myeloma (24%). In general, the risk of second cancers was greater in males than in females, even for cohorts not showing an excess of surveillance-related prostate cancer. Among patients with leukemia, significant excesses of cancers of the lung, kidney/ureter, and prostate were noted; cutaneous melanoma was elevated only in males. These excesses did not persist in the small number of long-term survivors. Possible etiologic factors included tobacco smoking for lung and kidney cancers, medical surveillance artifact for prostate cancer, and immunosuppression for malignant melanoma and lung cancer. The large number and good prognoses of patients with chronic lymphocytic leukemia strongly influenced the pattern of second cancers when all leukemias were analyzed together; no evidence was found for an increased risk of second cancer in patients with acute lymphocytic leukemia. A disproportionate number of subsequent cancers, particularly those of the kidney and ureter, were diagnosed incidentally at autopsy. Patients with Hodgkin's disease displayed significant excesses of cancers of the buccal cavity and pharynx, lung, female breast, and thyroid. The latter 3 sites remained significantly elevated in long-term survivors (10 yr or more postdiagnosis), so that radiation therapy may have contributed to their development. Among persons with non-Hodgkin's lymphoma, cancers of the stomach, lung, brain, and connective tissue occurred excessively. The first 3 sites, plus cancers of the urinary bladder, remained elevated among long-term survivors. The brain cancer excess, not previously reported, may represent misclassification of central nervous system lymphoma. The risk of gastric cancer is reminiscent of similar findings in patients with both acquired and genetically determined immunodeficiency disorders. The alkylating agent, cyclophosphamide, used extensively in the treatment of non-Hodgkin's lymphoma, is known to cause bladder cancer in man.(ABSTRACT TRUNCATED AT 400 WORDS) PMID:4088298

  15. [Improvement of quality of life of patients with internal stents by changing the shape of the stents].

    PubMed

    Martov, A G; Ergakov, D V; Kornienko, S I; Aboian, I A; Pavlov, S V; Asfandiiarov, F R; Kalashnikov, E S

    2011-01-01

    Transurethral stenting of the ureter was made in 130 patients (51 males and 79 females, aged 19-81, mean age 51.3 years) after contact ureterolithotripsy (n=86), endoureterotomy (n=13) and endopyelotomy (n=31). All the patients received internal polyuretanic stents (size N 6 F) made by one company. The patients were randomized into two groups by the shape of the stent. Group 1 (n=65) received a modified mono-pigtail stent made of the standard polyuretanic double-pigtail stent by cutting off 2-4 cm of the distal end and distal (vesical) curl. In group 2 (n=65) stenting was made with standard double-pigtail stent. Questionnaire survey was made 2 weeks after stenting, 1 month before stent removal and 1.5 months after stent removal. In the postoperative period 12 patients of group 2 (18.5%) developed acute pyelonephritis resultant from vesicorenal reflux. In other cases pyelonephritis was managed by draining bladder with urethral catheter. In group 1 vesicoureteral reflux was absent, but in 3 cases (4.6%) there was an attack of acute pyelonephritis because of obstruction of the intramural (not intubated by the stent) part of the ureter with fragments of the crushed concrement. This attack required urgent ureterolithoextraction and removal of the stent in 2 cases, transcutaneous nephrostomy in 1 case. Mean postoperative stay in the hospital was 3.1 +/- 0.6 in group 1 and 6.7 +/- 1.2 (p = 0.001) days in group 2. The comparison of the stent-related symptoms 2 weeks after stenting and before stent removal showed that severity of the symptoms was significantly greater in group 2 vs group 1 (21.3 and 9.6, respectively). Thus, the proposed mono-pigtail stent reduces severity of stent-related symptoms 2.5 times and improves quality of life. Further prospective studies are planned for final assessment of efficacy of the modified stents and their influence on quality of life. PMID:21815451

  16. En route Spacing Tool: Efficient Conflict-free Spacing to Flow-Restricted Airspace

    NASA Technical Reports Server (NTRS)

    Green, S.

    1999-01-01

    This paper describes the Air Traffic Management (ATM) problem within the U.S. of flow-restricted en route airspace, an assessment of its impact on airspace users, and a set of near-term tools and procedures to resolve the problem. The FAA is committed, over the next few years, to deploy the first generation of modem ATM decision support tool (DST) technology under the Free-Flight Phase-1 (FFp1) program. The associated en route tools include the User Request Evaluation Tool (URET) and the Traffic Management Advisor (TMA). URET is an initial conflict probe (ICP) capability that assists controllers with the detection and resolution of conflicts in en route airspace. TMA orchestrates arrivals transitioning into high-density terminal airspace by providing controllers with scheduled times of arrival (STA) and delay feedback advisories to assist with STA conformance. However, these FFPl capabilities do not mitigate the en route Miles-In-Trail (MIT) restrictions that are dynamically applied to mitigate airspace congestion. National statistics indicate that en route facilities (Centers) apply Miles-In-Trail (MIT) restrictions for approximately 5000 hours per month. Based on results from this study, an estimated 45,000 flights are impacted by these restrictions each month. Current-day practices for implementing these restrictions result in additional controller workload and an economic impact of which the fuel penalty alone may approach several hundred dollars per flight. To mitigate much of the impact of these restrictions on users and controller workload, a DST and procedures are presented. The DST is based on a simple derivative of FFP1 technology that is designed to introduce a set of simple tools for flow-rate (spacing) conformance and integrate them with conflict-probe capabilities. The tool and associated algorithms are described based on a concept prototype implemented within the CTAS baseline in 1995. A traffic scenario is used to illustrate the controller's use of the tool, and potential display options are presented for future controller evaluation.

  17. Overexpression of Robo2 causes defects in the recruitment of metanephric mesenchymal cells and ureteric bud branching morphogenesis

    SciTech Connect

    Ji, Jiayao; Medical College of NanKai University, Tianjin ; Li, Qinggang; Xie, Yuansheng; Zhang, Xueguang; Cui, Shaoyuan; Shi, Suozhu; Chen, Xiangmei; Medical College of NanKai University, Tianjin

    2012-05-11

    Highlights: Black-Right-Pointing-Pointer Overexpression of Robo2 caused reduced UB branching and glomerular number. Black-Right-Pointing-Pointer Fewer MM cells surrounding the UB after overexpression of Robo2 in vitro. Black-Right-Pointing-Pointer No abnormal Epithelial Morphology of UB or apoptosis of mm cells in the kidney. Black-Right-Pointing-Pointer Overexpression of Robo2 affected MM cells migration and caused UB deficit. Black-Right-Pointing-Pointer The reduced glomerular number can also be caused by fewer MM cells. -- Abstract: Roundabout 2 (Robo2) is a member of the membrane protein receptor family. The chemorepulsive effect of Slit2-Robo2 signaling plays vital roles in nervous system development and neuron migration. Slit2-Robo2 signaling is also important for maintaining the normal morphogenesis of the kidney and urinary collecting system, especially for the branching of the ureteric bud (UB) at the proper site. Slit2 or Robo2 mouse mutants exhibit multilobular kidneys, multiple ureters, and dilatation of the ureter, renal pelvis, and collecting duct system, which lead to vesicoureteral reflux. To understand the effect of Robo2 on kidney development, we used microinjection and electroporation to overexpress GFP-Robo2 in an in vitro embryonic kidney model. Our results show reduced UB branching and decreased glomerular number after in vitro Robo2 overexpression in the embryonic kidneys. We found fewer metanephric mesenchymal (MM) cells surrounding the UB but no abnormal morphology in the branching epithelial UB. Meanwhile, no significant change in MM proliferation or apoptosis was observed. These findings indicate that Robo2 is involved in the development of embryonic kidneys and that the normal expression of Robo2 can help maintain proper UB branching and glomerular morphogenesis. Overexpression of Robo2 leads to reduced UB branching caused by fewer surrounding MM cells, but MM cell apoptosis is not involved in this effect. Our study demonstrates that overexpression of Robo2 by microinjection in embryonic kidneys is an effective approach to study the function of Robo2.

  18. The case study in the applicability of the improvements in the treatment of urinary system stone diseases in Anatolia: the last ten years with the sample of Western Black Sea region

    PubMed Central

    Turkan, Sadi; İrkılata, Lokman; Ekmekçioğlu, Ozan; Canat, Halil Lütfi; Dilmen, Cem; Özkaya, Muharrem

    2015-01-01

    Objective The prevalence of stone diseases is high in Turkey. Thanks to the technological improvements and to the increase in the number of qualified and experienced specialists in the last thirty years, there has been an increase in the application of minimally invasive methods in the stone disease surgery. This study, with a sample survey of Western Black Sea region, aims at revealing the changes and improvements in the treatment of stone diseases in different centers in Anatolia within the last ten years. Material and methods Six centers in 4 of the provinces of the Western Black Sea Region were selected and the patients’ files were retrospectively analyzed. The treatment methods that were recommended for and/or applied to the patients diagnosed with urinary stone diseases were recorded by years. The urinary stone diseases were divided into three separate groups; kidney, ureters and bladder. Treatment options were recorded into categories as open surgery, percutaneous nephrolithotripsy, retrograde intrarenal surgery, semirigid ureterorenoscopy, flexible ureterorenoscopy, and ESWL. Results A total of 26044 patients with stone diseases have been treated in the above-mentioned centers for the last 10 years. The distributions of the stone diseases in relation to their localization were as follows: - kidney stones: 9040 (34.7%), ureter stones: 15264 (58.6%), and bladder stones: 1740 (6.7%). As for the distribution of the treatment in relation to the treatment methods, it was seen that open surgery for 1032 (4%) patients, endoscopic surgery for 15038 (58%) patients, and ESWL for 9974 (38%) patients had been applied. While URS and PCNL are currently the commonly used treatment methods in the Western Black Sea Region, RIRS has begun to be used in a limited number of patients for the last 3 years. Conclusion Though being a little late, the advances in endrourology offer practical applications in the Western Black Sea region as well. Although this study suggests implications for the evaluating of the periphery outcomes of the improvements in stone disease treatments, for the planning of training schemes, and for equipment planning, further research based on more data from more centers is needed to have a nation-wide perspective. PMID:26516597

  19. The feasibility of ureteral tissue engineering using autologous veins: an orthotopic animal model with long term results

    PubMed Central

    2014-01-01

    Background In an earlier study we demonstrated the feasibility to create tissue engineered venous scaffolds in vitro and in vivo. In this study we investigated the use of tissue engineered constructs for ureteral replacement in a long term orthotopic minipig model. In many different projects well functional ureretal tissue was established using tissue engineering in animals with short-time follow up (12 weeks). Therefore urothelial cells were harvested from the bladder, cultured, expanded in vitro, labelled with fluorescence and seeded onto the autologous veins, which were harvested from animals during a second surgery. Three days after cell seeding the right ureter was replaced with the cell-seeded matrices in six animals, while further 6 animals received an unseeded vein for ureteral replacement. The animals were sacrificed 12, 24, and 48 weeks after implantation. Gross examination, intravenous pyelogram (IVP), H&E staining, Trichrome Masson’s Staining, and immunohistochemistry with pancytokeratin AE1/AE3, smooth muscle alpha actin, and von Willebrand factor were performed in retrieved specimens. Results The IVP and gross examination demonstrated that no animals with tissue engineered ureters and all animals of the control group presented with hydronephrosis after 12 weeks. In the 24-week group, one tissue engineered and one unseeded vein revealed hydronephrosis. After 48 weeks all tissue engineered animals and none of the control group showed hydronephrosis on the treated side. Histochemistry and immunohistochemistry revealed a multilayer of urothelial cells attached to the seeded venous grafts. Conclusions Venous grafts may be a potential source for ureteral reconstruction. The results of so far published ureteral tissue engineering projects reveal data up to 12 weeks after implantation. Even if the animal numbers of this study are small, there is an increasing rate of hydronephrosis revealing failure of ureteral tissue engineering with autologous matrices in time points longer than 3 months after implantation. Further investigations have to prove adequate clinical outcome and appropriate functional long-term results. PMID:25381044

  20. Reverse kinetics of angiopoietin-2 and endotoxins in acute pyelonephritis: Implications for anti-inflammatory treatment?

    PubMed

    Safioleas, Konstantinos; Giamarellos-Bourboulis, Evangelos J; Carrer, Dionyssia-Pinelopi; Pistiki, Aikaterini; Sabracos, Lambros; Deliveliotis, Charalambos; Chrisofos, Michael

    2016-05-01

    Based on former studies showing an antagonism between angiopoietin-2 (Ang-2) and bacterial endotoxins (LPS), we investigated the role of Ang-2 as immunomodulatory treatment. At first, kinetics of circulating LPS in Gram-negative pyelonephritis developing after urinary obstruction was studied. Serum LPS, interleukin (IL)-6 and Ang-2 were measured in 25 patients with acute pyelonephritis and sepsis before and after removal of the obstruction performed either with insertion of a pigtail catheter (n=12) or percutaneous drainage (n=13). At a second stage, Ang-2 was given as anti-inflammatory treatment in 40 rabbits one hour after induction of acute pyelonephritis by ligation of the ureter at the level of pelvo-ureteral junction and upstream bacterial inoculation. Survival was recorded; blood mononuclear cells were isolated and stimulated for the production of tumour necrosis factor-alpha (TNFα). The decrease in circulating LPS was significantly greater among patients undergoing drainage than pigtail insertion. This was accompanied by reciprocal changes of Ang-2 and IL-6. Treatment with Ang-2 prolonged survival from Escherichia coli pyelonephritis despite high levels of circulating LPS. When Ang-2 was given as treatment of Pseudomonas aeruginosa pyelonephritis, sepsis-induced decrease of TNFα production by circulating mononuclear cells was reversed without an effect on tissue bacterial overgrowth. It is concluded that Ang-2 and LPS follow reverse kinetics in acute pyelonephritis. When given as experimental treatment, Ang-2 prolongs survival through an effect on mononuclear cells. PMID:26844659

  1. Dual genetic diagnoses: Atypical hand-foot-genital syndrome and developmental delay due to de novo mutations in HOXA13 and NRXN1.

    PubMed

    Wallis, Mathew; Tsurusaki, Yoshinori; Burgess, Trent; Borzi, Peter; Matsumoto, Naomichi; Miyake, Noriko; True, Deanna; Patel, Chirag

    2016-03-01

    We describe a male patient with dual genetic diagnoses of atypical hand-foot-genital syndrome (HFGS) and developmental delay. The proband had features of HFGS that included bilateral vesicoureteric junction obstruction with ectopic ureters, brachydactyly of various fingers and toes, hypoplastic thenar eminences, and absent nails on both 4th toes and right 5th toe. The atypical features of HFGS present were bilateral hallux valgus malformations and bilateral preaxial polydactyly of the hands. Chromosomal microarray analysis identified a de novo 0.5?Mb deletion at 2p16.3, including the first four exons of the NRXN1 gene. Whole exome sequencing and subsequent Sanger sequencing identified a de novo missense mutation (c.1123G>T, p.Val375Phe) in exon 2 of the HOXA13 gene, predicted to be damaging and located in the homeobox domain. The intragenic NRXN1 deletion is thought to explain his developmental delay via a separate genetic mechanism. 2015 Wiley Periodicals, Inc. PMID:26590955

  2. Do New Vessel Sealing Devices and Harmonic Ace Increase Ureteric Injury in Total Laparoscopic Hysterectomy?

    PubMed Central

    Trivedi, Prakash; DCosta, Sylvia; Shirkande, Preeti; Wahi, Meenu; Kumar, Shilpi

    2009-01-01

    Objectives: To compare the risk of ureteric injury in total laparoscopic hysterectomy (TLH) using new vessel sealing devices (VSDs) and harmonic scalpel with simple scissors, bipolar and suturing. This was an evaluation of 1209 cases, carried out from May 1999 to April 2010. Design and Setting: A retrospective comparative study was carried out at a tertiary gynecological endoscopic unit. Materials and Methods: Out of 1209 patients, who had hysterectomies for various indications, TLH was done in 892 patients, 273 had vaginal hysterectomy and 44 had abdominal hysterectomy. We evaluated the incidence of ureteric injury in these cases. Results: There was no mortality. In the group of vaginal and abdominal hysterectomy, there were no ureteric injuries. In the TLH group, we had 390 cases with simple scissors, bipolar and suturing with no ureteric injury. In 502 cases, new VSDs, e.g., plasma kinetic gyrus, Martin Maxim with Robi grasper, with or without harmonic 5 mm scalpel/ace were used. There were five ureteric injuries, all on the right side (one double ureter): first case was with Martin Maxim and Robi grasper, two with plasma kinetic gyrus 10 mm trissector, one with harmonic scalpel and the last one with scissors. We evaluated the reasons for such ureteric injuries, with experienced laparoscopic surgeons and the best possible set up. There were seven conversions to open surgery out of 892 cases of TLH, more due to poor case selection. PMID:22442518

  3. Therapeutic role of template-based lymphadenectomy in urothelial carcinoma of the upper urinary tract

    PubMed Central

    Kondo, Tsunenori; Takagi, Toshio; Tanabe, Kazunari

    2015-01-01

    Lymphadenectomy for urothelial carcinoma of the upper urinary tract has attracted the attention of physicians. The mapping study of lymphatic spread has shown that a relatively wide area should comprise the regional nodes for tumors of the right renal pelvis or the right upper two-thirds of the ureter. A prospective study showed that an anatomical template-based lymphadenectomy significantly improved patient survival in tumors of the renal pelvis. This benefit was more evident for patients with pT2 stage tumors or higher. The risk of regional node recurrence is significant reduced by template-based lymphadenectomy, which is likely to be associated with improved patient survival. The removal of lymph node micrometastases is assumed to be the reason for therapeutic benefit following lymphadenectomy. The number of resected lymph nodes can be used to assess the quality of lymphadenectomy, but not to determine the extent of lymphadenectomy. The guidelines currently recommend lymphadenectomy for patients with muscle-invasive disease, even though the current recommendation grades are still low. The present limitation of lymphadenectomy is the lack of standardization of the extent of lymphadenectomy and the randomized trials. Further studies are warranted to collect the evidence to support lymphadenectomy. PMID:26677437

  4. Reproductive assessment of male elephants (Loxodonta africana and Elephas maximus) by ultrasonography.

    PubMed

    Hildebrandt, T B; Gritz, F; Pratt, N C; Schmitt, D L; Quandt, S; Raath, J; Hofmann, R R

    1998-06-01

    Transrectal ultrasonography was performed on five wild and two captive male African elephants (Loxodonta africana) and four captive male Asian elephants (Elephas maximus) to develop standards for assessment of reproductive health and status. The entire internal urogenital tract was visualized ultrasonographically by using a 3.5 MHz or a 7.5-MHz transducer in combination with a probe extension adapted for elephant anatomy. The findings were verified by postmortem ex situ ultrasound examinations in several individuals of each species. Each part of the internal urogenital tract was sonographically detectable except for the bulbourethral glands and the cranial portion of the ureters and ductus deferentes, which were only observed in situ in the neonate. Each structure visualized was measured and described. The size and morphology of the urogenital structures, especially the accessory glands, were indicative of breeding status, if known. There was a notable difference between African and Asian males in the size and morphology of the prostate gland and a slight difference in the shape of the ampullae. No other structure showed significant species differences. The detection of the location and description of the testes may provide information for modifying present castration procedures. Furthermore, ultrasound examination of the male accessory glands may aid in the identification of potential semen donors for assisted reproduction programs in captive elephants. PMID:9732024

  5. Urine leaks and urinomas: diagnosis and imaging-guided intervention.

    PubMed

    Titton, Ross L; Gervais, Debra A; Hahn, Peter F; Harisinghani, Mukesh G; Arellano, Ronald S; Mueller, Peter R

    2003-01-01

    Urine leaks from the kidney, ureter, bladder, and urethra most commonly result from trauma. Urinomas may be occult initially and may lead to complications such as abscess formation and electrolyte imbalances if not promptly diagnosed and appropriately managed. Radiologists play a key role in diagnosing urine leaks and determining their cause and extent. Contrast material-enhanced computed tomography (CT) with delayed imaging, CT cystography, and retrograde urethrography are the diagnostic imaging studies of choice. Studies such as intravenous pyelography, antegrade and retrograde pyelography, renal scintigraphy, and imaging-guided needle aspiration may play complementary diagnostic roles. In some instances, the role of the radiologist ends with the diagnosis of urine leaks, after which patients are treated conservatively or perhaps surgically. Uncomplicated renal urine leaks, extraperitoneal urinary bladder rupture, and type 1 urethral injuries are generally managed conservatively. Urine leaks that require more extensive, imaging-guided treatment can usually be managed safely and effectively with a combination of percutaneous urinoma drainage catheters, percutaneous nephrostomy catheters, ureteral stents, and bladder drainage. In the appropriate setting, use of these management options may reduce urinoma-related complications and limit or totally eliminate the need for urologic surgery. PMID:12975505

  6. Etio-pathogenic and morphological correlations in congenital hydronephrosis.

    PubMed

    Bo?oteanu, M?d?lina; Bo?oteanu, C; Deacu, Mariana; A?chie, Mariana; Bordei, P

    2011-01-01

    Hydronephrosis, "distension in varying degrees of pelvis and calyces, accompanied by progressive atrophy of renal parenchyma due to obstruction in urinary flow", is an apparently simple reno-urinary disease, but, in reality, by association of its own characters with those conferred by causative lesions, becomes of a significant complexity. The purpose of this paper is to demonstrate the plurivalent character of this entity on a batch of cases with congenital hydronephrosis, by identification of lesional features correlated with cause of disease. The etiology of hydronephrosis in analyzed cases was characterized by heterogeneity: polar inferior artery, horseshoe kidney, extrarenal pelvis, transverse valves of pelviureteral junction (PUJ), adhesion of ureter to PUJ, intrinsic stenosis of PUJ, vesico-ureteral reflux, posterior urethral valves, stenosis of urethral meatus. The way of intervention of urinary obstruction and the uni- or bilateral character of damage were definitory for the macroscopical appearance of the hydronephrotic kidney, renal pelvis demonstrating its role of expansion room for kidney protection. In analyzed cases of congenital hydronephrosis, correlation specific cause-pelvic lesion evidenced histopathological differences related to etiology. Anatomical preparations obtained by injection followed by corrosion have revealed that renal vessels appear elongated, distanced from each other and even reduced in density, which explains the appearance of ischemia accompanying pathogenetic changes of obstructive uropathy. Regardless of etiology, all cases of congenital hydronephrosis were characterized by varying degrees of fibrosis in chorion of renal pelvis, accompanied by active chronic inflammation, observation that support the idea of connection between the two pathological changes. PMID:21424044

  7. Expression of recombinant human granulocyte macrophage-colony stimulating factor (hGM-CSF) in mouse urine.

    PubMed

    Ryoo, Z Y; Kim, M O; Kim, K E; Bahk, Y Y; Lee, J W; Park, S H; Kim, J H; Byun, S J; Hwang, H Y; Youn, J; Kim, T Y

    2001-06-01

    We have generated transgenic mice expressing human granulocyte macrophage-colony stimulating factor (hGM-CSF) in urine. In particular, the expression plasmid DNA containing mouse uroplakin II promoter was used to direct uroepithelium-specific transcription of transgene. In this study, hGM-CSF transcript was detected only in bladder uroepithelium as determined by northern blot analysis. Furthermore, hGM-CSF protein was detected in the suprabasal layer of the uroepithelium and ureter by immunohistochemistry. The hGM-CSF was secreted into urine at high level (up to 180 ng/ml), and enhanced proliferation of hGM-CSF-dependent human acute monocyte leukemic cells, suggesting that transgenic urine-derived hGM-CSF was bioactive. This is the first case of demonstrating biological activity of a cytokine produced in the urine of a transgenic animal. Our results demonstrate that bladder can be used as a bioreactor to produce biologically important substances. In addition, it suggests a potential application of bladder expression system to livestock for high-yield production of pharmaceuticals. PMID:11437276

  8. A guidewire introducer as a ureteral foreign body: A case report

    PubMed Central

    Sener, Tarik Emre; Cloutier, Jonathan; Audouin, Marie; Villa, Luca; Traxer, Olivier

    2015-01-01

    A 63-year-old male, previously treated for a ureteral tumour by a right-sided segmental ureterectomy and end-to-end anastomosis of ureteral segments, was referred to our clinic for endoscopic follow-up. During his follow-up, he was diagnosed with partial right-sided ureteral stricture which eventually progressed to complete obstruction. During the ureteroscopy, as the stenotic segment did not allow passage of an hydrophilic guidewire, an antegrade-retrograde approach was decided. On the antegrade endoscopic view, a near-complete stenosis was diagnosed and a nephrostomy catheter (12 Fr) was placed. A second intervention was planned and from the nephrostomy tract, the ureteroscope was placed into the right pyelocaliceal system. The diagnostic ureteroscopy revealed a foreign object proximal to the stenotic area. Right-sided segmental ureterectomy of the stenotic segment with ureteroneocystostomy and removal of the foreign object was performed. This is the only case in literature to reveal a guidewire introducer as a ureteral foreign body. This case also highlights the importance of the fragility of the ureter, the importance of the equipment, of always being watchful during a surgery, and the importance of checking the integrity of the equipment at the end of each procedure. PMID:26225183

  9. Shrinking the Supply Chain for Implantable Coronary Stent Devices.

    PubMed

    Moore, Sean S; O'Sullivan, Kevin J; Verdecchia, Francesco

    2016-02-01

    Stenting treatments for the management of disease in the heart, arterial and venous systems, biliary ducts, urethras, ureters, oesophageal tract and prostate have made enormous technical advances since their introduction into clinical use. The progression from metallic to polymer based bio-absorbable stents, coupled with the advances in additive manufacturing techniques, present a unique opportunity to completely re-envision the design, manufacture, and supply chain of stents. This paper looks at current stenting trends and proposes a future where the stent supply chain is condensed from ~150 days to ~20 min. The Cardiologist therefore has the opportunity to become a designer, manufacturer and user with patients receiving custom stents specific to their unique pathology that will be generated, delivered and deployed in the Cath-lab. The paper will outline this potentially revolutionary development and consider the technical challenges that will need to be overcome in order to achieve these ambitious goals. A high level overview of the generating eluting stents in situ program-GENESIS-is outlined including some early experimental work. PMID:26438449

  10. Advances in ureteral stents

    PubMed Central

    Brotherhood, Hilary; Lange, Dirk

    2014-01-01

    Ureteral stents are commonly used in urology. Every urologist is familiar with the problems that are associated with stents including infection, encrustation, and bothersome symptoms. These problems limit and affect the use of ureteral stents which are necessary, even in light of the problems they can cause. New designs such as a helically cut ureteral stent which is designed to stretch and conform to the ureter is designed to improve comfort. Drug-eluting designs with an antimicrobial (triclosan) are designed to reduce bacterial adherence to ureteral stents. Chlorhexidine, an antiseptic, has been incorporated into a stent and held in place by a slow release varnish to prevent biofilm formation. Combinations of antibiotics coated directly on the stent and administered systemically have been shown to reduce stent colonization both in vitro and in vivo. Gel-based ureteral stents were also showed to reduce bacterial infection and colonization. Bioabsorbable materials have also been designed to reduce infection, symptoms and prevent the forgotten stent syndrome. Newer designs including stents based on guidewire technology, gels, and a combination of self-expanding wire stents with polymer films are reviewed. There is hope on the horizon that new stents will be able to effectively tackle problems that are often seen with ureteral stents. PMID:26816785

  11. Organ preservation in invasive bladder cancer: Brachytherapy, an alternative to cystectomy and combined modality treatment?

    SciTech Connect

    Pos, Floris

    2005-03-01

    Purpose: To evaluate our long-term results of bladder preservation with brachytherapy in the treatment of bladder cancer. Methods and materials: Between 1987 and 2000, 108 patients with T1-G3 and T2-T3a stages of bladder cancer were treated with a transurethral resection (TUR) and a course of external beam radiotherapy (30 Gy in 15 fractions) followed by brachytherapy (40 Gy). All tumors were solitary lesions with a diameter {<=}5 cm. Median follow-up was 54 months (range, 1-178 months). Results: The 5-year and 10-year overall survival rates were 62% and 50%, respectively. The 5-year and 10-year disease-specific survival rates were 73% and 67%, respectively. The actuarial local control rate was 73% at 5 and 73% at 10 years, respectively. The 5-year and 10-year disease-specific survival rates for patients with a preserved bladder were 68% and 59%, respectively. Of all long-term surviving patients, 90% preserved their native bladders. The treatment was well tolerated. Acute toxicity was mild. Two patients experienced serious late toxicity: 1 patient developed a persisting vesicocutaneous fistula and the other a stricture of the urethra and ureters. Conclusion: For patients with solitary, organ confined invasive bladder cancer {<=}5 cm, bladder preservation with brachytherapy is an excellent alternative to radical cystectomy and combined modality treatment.

  12. Optimal use of 99mtechnetium-glucoheptonate scintigraphy in the detection of pyelonephritic scarring in children: a preliminary report

    SciTech Connect

    Shapiro, E.; Slovis, T.L.; Perlmutter, A.D.; Kuhns, L.R.

    1988-11-01

    Renal scintigraphy represents the optimal modality for the detection of renal scars. 99mTechnetium-glucoheptonate is rapidly accumulated by the kidney through glomerular filtration and active transport by renal tubular cells. This permits rapid visualization of the renal parenchyma in the early phase (1 to 3-minute images) and subsequent imaging of the collecting system and ureters. About 10 to 15 per cent of the injected activity remains in the kidney, labeling the cells of the proximal convoluted tubules (late phase or 1 to 2-hour images). The late phase has been used more commonly to assess renal parenchymal damage. Early and late phase glucoheptonate scanning was performed in 42 children as part of the evaluation of recurrent febrile urinary tract infections with or without a history of vesicoureteral reflux. Inter-observer reliability to interpret glucoheptonate scans was good (early, 83 per cent agreement and late, 93 per cent agreement). The ability of glucoheptonate scanning to detect renal scarring in children with febrile urinary tract infections was equivalent with the early or late phase of the study. In 6 patients renal scarring was detected on only the early phase scan and in 7 scarring was detected only in the late phase. Although the detection rates are equivalent the over-all detection of scarring is improved by using both phases. Therefore, the early phase of the glucoheptonate scan may be a valuable adjunct to conventional glucoheptonate scan methodology used for the detection of renal scarring in children with recurrent urinary tract infections.

  13. Acoustical And Optical Feedback Guidance For Pulsed Laser Lithotripsy And Angioplasty

    NASA Astrophysics Data System (ADS)

    Rosen, David I.; Bhatta, Krishna M.; Dretler, Stephen P.

    1989-09-01

    The feasibility of using acoustic and plasma optical feedback emissions for guidance during pulsed laser lithotripsy and angioplasty procedures was studied in-vitro. A flash-lamp pumped tunable dye laser operating at a wavelength of 504 nm (coumarin green) was used as the laser source. Acoustic signals were recorded with a hydrophone which has a useful frequency response of up to 350 KHz. Plasma optical emissions were transmitted retrograde along the laser fiber and reflected through a beam splitter to an optical detection system consisting of a series of spectral filters (to transmit plasma radiation from 380 to 440 nm and block any 504 nm laser light) and a photomultiplier tube. Measurements of the laser-induced acoustic and the plasma optical emission signals were obtained from urinary and biliary calculi, ex-vivo bovine ureters, blood, blood clots, bile, atheromatous plaque and normal arterial wall. Results of monitoring show that it is possible to know without direct vision whether the laser energy is being discharged in the lumen, on healthy soft tissue, or on calculus or atheromatous plaque. Blood, blood clots, bile produced strong acoustic signals but no plasma signals; calculi and plaque produced strong plasma and strong acoustic signals. Neither plasma nor significant acoustic signals were produced by normal ureteral or arterial wall. These distinctions may allow clinical laser fragmentation of calculi or ablation of plaque to be performed with fewer complications.

  14. Eph/ephrin signaling in the kidney and lower urinary tract.

    PubMed

    Weiss, Anna-Carina; Kispert, Andreas

    2016-03-01

    Development and homeostasis of the highly specialized cell types and tissues that constitute the organs of the urinary system, the kidneys and ureters, the bladder, and the urethra, require the tightly regulated exchange of signals in and between these tissues. Eph/ephrin signaling is a bidirectional signaling pathway that has been functionally implicated in many developmental and homeostatic contexts, most prominently in the vascular and neural system. Expression and knockout analyses have now provided evidence that Eph/ephrin signaling is of crucial relevance for cell and tissue interactions in the urinary system as well. A clear requirement has emerged in the formation of the vesicoureteric junction, in urorectal septation and glomerulogenesis during embryonic development, in maintenance of medullary tubular cells and podocytes in homeostasis, and in podocyte and glomerular injury responses. Deregulation of Eph/ephrin signaling may also contribute to the formation and progression of tumors in the urinary system, most prominently bladder and renal cell carcinoma. While in the embryonic contexts Eph/ephrin signaling regulates adhesion of epithelial cells, in the adult setting, cell-shape changes and cell survival seem to be the primary cellular processes mediated by this signaling module. With progression of the genetic analyses of mice conditionally mutant for compound alleles of Eph receptor and ephrin ligand genes, additional essential functions are likely to arise in the urinary system. PMID:25903642

  15. First Report: Robot-Assisted Total Pelvic Exenteration for Locally Advanced Prostate Cancer.

    PubMed

    Castillo, Octavio A; Vidal-Mora, Ivar; Rodriguez-Carlin, Arquimedes; Silva, Andres; Schatloff, Oscar

    2015-07-01

    Pelvic exenteration is used in the treatment of several pelvic cancers, including those of the rectum, uterus, and bladder. We report the first case of robotic pelvic exenteration for the treatment of symptomatic prostate cancer involving the rectum and bladder. A six-port transperitoneal robotic approach was used. Bilateral extended lymphadenectomy up to the inferior mesenteric artery was performed. The rectum and bladder were removed en bloc, and a double-barrel anastomosis was then performed with both ureters being connected to the lower opening of the colostomy. Operative time was 249 minutes, and estimated blood loss was 600?mL. No intraoperative or postoperative complications were recorded. Biopsy of the rectum and bladder showed prostatic adenocarcinoma with a Gleason score of 9 (5+4), and 1 of 17 nodes was positive for cancer. Postoperative prostate-specific antigen level was 1.24?ng/mL. The patient is already 19 months after surgery with optimal quality of life. Thus pelvic exenteration is a feasible alternative for highly symptomatic prostate cancer involving adjacent pelvic organs. PMID:26134069

  16. Nephritis associated with infectious bronchitis virus Cal99 variant in game chickens.

    PubMed

    Frana, M; Woolcock, P R; Yu, M; Jackwood, M W; Shivaprasad, H L

    2011-09-01

    Infectious bronchitis virus (IBV) Cal99 variant was isolated from the kidneys of seven 2-5-mo-old game chickens with nephritis and respiratory disease. IBV Cal99 variant is usually associated with respiratory disease in broiler chickens in California. Macroscopically, the majority of the birds had moderately to severely enlarged and mottled pale kidneys, with increased urates in the ureters. Microscopically, most of the birds had acute nephrosis and interstitial nephritis. The birds also had sinusitis, tracheitis, bronchopneumonia, airsacculitis, salivary gland adenitis, and lymphoid depletion in the thymus and bursa of Fabricius. Immunohistochemistry was strongly positive for IBV antigen in the cytoplasm of tubular epithelial cells in the kidneys and also in the epithelium of the respiratory tract, salivary glands, proventriculus, intestine, and bursa of Fabricius. Infectious bronchitis virus was isolated from the trachea, lungs, kidneys, and cecal tonsils. Sequencing of the hypervariable region of the S1 gene of the kidney IBV isolate, designated IBV/CA99variant/07, revealed that the virus was 98% homologous to the Cal99 serotype of IBV. PMID:22017040

  17. Bitter triggers acetylcholine release from polymodal urethral chemosensory cells and bladder reflexes

    PubMed Central

    Deckmann, Klaus; Filipski, Katharina; Krasteva-Christ, Gabriela; Fronius, Martin; Althaus, Mike; Rafiq, Amir; Papadakis, Tamara; Renno, Liane; Jurastow, Innokentij; Wessels, Lars; Wolff, Miriam; Schtz, Burkhard; Weihe, Eberhard; Chubanov, Vladimir; Gudermann, Thomas; Klein, Jochen; Bschleipfer, Thomas; Kummer, Wolfgang

    2014-01-01

    Chemosensory cells in the mucosal surface of the respiratory tract (brush cells) use the canonical taste transduction cascade to detect potentially hazardous content and trigger local protective and aversive respiratory reflexes on stimulation. So far, the urogenital tract has been considered to lack this cell type. Here we report the presence of a previously unidentified cholinergic, polymodal chemosensory cell in the mammalian urethra, the potential portal of entry for bacteria and harmful substances into the urogenital system, but not in further centrally located parts of the urinary tract, such as the bladder, ureter, and renal pelvis. Urethral brush cells express bitter and umami taste receptors and downstream components of the taste transduction cascade; respond to stimulation with bitter (denatonium), umami (monosodium glutamate), and uropathogenic Escherichia coli; and release acetylcholine to communicate with other cells. They are approached by sensory nerve fibers expressing nicotinic acetylcholine receptors, and intraurethral application of denatonium reflexively increases activity of the bladder detrusor muscle in anesthetized rats. We propose a concept of urinary bladder control involving a previously unidentified cholinergic chemosensory cell monitoring the chemical composition of the urethral luminal microenvironment for potential hazardous content. PMID:24843119

  18. Effect of alkalinization on calcium oxalate monohydrate calculi during extracorporeal shock wave lithotripsy: in vivo experiments.

    PubMed

    Vandeursen, H; De Ridder, D; Demeulenaere, R; Pittomvils, G; Boving, R; Baert, L

    1992-01-01

    Previous in vitro experiments demonstrated the reduced microhardness of calcium oxalate monohydrate (COM) calculi, relative to dry values, when saturated with an alkaline solution (pH = 9.5). Nineteen patients with a COM calculus in the distal ureter which had been resistant to prior extracorporeal shock wave lithotripsy in situ, were treated when the stone was surrounded by alkaline urine. The urine of 14 patients was alkalinized orally by administration of acetazolamine and citrate solution; in 5 other patients direct percutaneous irrigation of sodium bicarbonate via a nephrostomy tube was carried out. The urinary pH just before lithotripsy was greater than or equal to 9 in 17/19 patients. 4,000 shock waves, averaging 18.1 kV generated by the Siemens Lithostar, were delivered onto the calculus. No significant increase of comminution rate was apparent at radiographic control immediately after the treatment and only in half of the cases was evacuation obtained within 3 months. PMID:1316663

  19. Ureteral Metastasis: Uncommon Manifestation in Prostate Cancer.

    PubMed

    Schallier, Denis; Rappe, Bernard; Carprieaux, Marilyn; Vandenbroucke, Frederik

    2015-11-01

    Ureteral metastasis from a primary prostate cancer is a rare event in the initial diagnosis and progression of prostate cancer. We report here the case of a 72- year-old patient who was treated for castration-resistant metastatic prostate cancer involving bone, intra-abdominal lymph nodes, bilateral adrenal glands, and a small distal ureteral lesion with left hydronephrosis considered in remission, with a luteinizing hormone-releasing hormone analog plus abiraterone acetate (AA) and prednisone after initial docetaxel plus prednisone chemotherapy. After an episode of acute left flank pain, the previous left distal intraluminal ureteral mass appeared increased in volume on computed tomographic scan and was compatible with either a metastasis from prostate cancer, transitional cell carcinoma of the ureter, or a collision tumor. After left nephroureterectomy (NU), the mass was confirmed to be of prostatic origin on histopathological examination and the only site of metastatic progression of prostate cancer. Abdominal CT-scan and the operative specimen of the NU showed no direct extension of the abdominal lymph nodes into the ureteral lesion. We speculate that this unique ureteral prostate cancer metastasis was the result of hematogenic spread of prostate cancer, although microscopic spread through the lymphatic system could not be excluded. The transient anti-tumor effect of AA plus prednisone at the level of ureteral metastasis, as far as we are aware of, has never been documented before. PMID:26504069

  20. The cyclic GMP-dependent protein kinase Iα suppresses kidney fibrosis.

    PubMed

    Schinner, Elisabeth; Schramm, Andrea; Kees, Frieder; Hofmann, Franz; Schlossmann, Jens

    2013-12-01

    Cyclic guanosine monophosphate (cGMP) is synthesized by nitric oxide or natriuretic peptide-stimulated guanylyl cyclases and exhibits pleiotropic regulatory functions in the kidney. Hence, integration of cGMP signaling by cGMP-dependent protein kinases (cGKs) might play a critical role in renal physiology; however, detailed renal localization of cGKs is still lacking. Here, we performed an immunohistochemical analysis of cGKIα and cGKIβ isozymes in the mouse kidney and found both in arterioles, the mesangium, and within the cortical interstitium. In contrast to cGKIα, the β-isoform was not detected in the juxtaglomerular apparatus or medullary fibroblasts. Since interstitial fibroblasts play a prominent role in interstitial fibrosis, we focused our study on cGKI function in the interstitium, emphasizing a functional differentiation of both isoforms, and determined whether cGKIs influence renal fibrosis induced by unilateral ureter obstruction. Treatment with the guanylyl cyclase activators YC1 or isosorbide dinitrate showed stronger antifibrotic effects in wild-type than in cGKI-knockout or in smooth muscle-cGKIα-rescue mice, which are cGKI deficient in the kidney except in the renal vasculature. Moreover, fibrosis influenced the mRNA and protein expression levels of cGKIα more strongly than cGKIβ. Thus, our results indicate that cGMP, acting primarily through cGKIα, is an important suppressor of kidney fibrosis. PMID:23760283

  1. Cajal beyond the gut: interstitial cells in the urinary system--towards general regulatory mechanisms of smooth muscle contractility?

    PubMed

    Thornbury, K D; Hollywood, M A; McHale, N G; Sergeant, G P

    2011-12-01

    Interstitial cells of Cajal (ICC), similar to GI pacemakers have been identified throughout the urinary system. Although each part of the system serves a different function, ranging from peristalsis of the ureters, storage of urine by the bladder, and a sphincteric action by the urethra, they share a common mechanism in being able to generate phasic myogenic contractions. Even the urethra, often considered to be a 'tonic' smooth muscle, achieves an apparently sustained contraction by averaging numerous small asynchronous 'phasic' contractions. This activity can occur in the absence of any neural input, implying the presence of an intrinsic pacemaker. Intracellular microelectrode recordings from urethral muscle strips reveal electrical slow waves similar to those of the GI tract. To study this further, we isolated single cells from rabbit urethra and found not only smooth muscle cells (SMC), but a second cell type comprising -10% of the total. The latter cells were branched and non-contractile and closely resembled intestinal ICC. Electrophyiological studies revealed that, while the isolated smooth muscle cells were electrically quiescent, the 'ICC' fired electrical slow waves similar to those observed in the whole tissue. The basis of this difference was the presence of a large pacemaker current involving the activation of calcium-activated Cl channels by spontaneous intracellular Ca2+ waves. These, in turn, have been shown to be modulated by neurotransmitters such as nitric oxide, noradrenaline and ATP, thus providing a possible mechanism whereby neural regulation of the urethra, as well as spontaneous tone, may be mediated via ICC. PMID:22319963

  2. Organization and function of ICC in the urinary tract

    PubMed Central

    McHale, N G; Hollywood, M A; Sergeant, G P; Shafei, M; Thornbury, K T; Ward, S M

    2006-01-01

    ICC are found in both the upper and lower urinary tract. They are not found in the ureter itself but are confined to the lamina propria of the renal pelvis and pelvi-calyceal junction. They do not appear to have a primary pacemaker role (this is ascribed to atypical smooth muscle cells in the same location) but rather conduct and amplify the pacemaker signals generated by the atypical smooth muscle cells. In the bladder, ICC are widely distributed in the sub-urothelial region, in the lamina propria and at the margins of the detrusor smooth muscle bundles. Again they appear not to have a pacemaking role and such evidence as there is would suggest that they have a role in the modulation of signal transduction. The strongest evidence that ICC in the urinary tract act as pacemakers comes from studies of those in the urethra. Isolated ICC show regular spontaneous depolarizations in current clamp which resemble very closely the slow waves recorded from intact tissue. In voltage clamp they show abundant calcium-activated chloride current and spontaneous transient inward currents which can be blocked by chloride channel blockers. However, their role in the modulation of urethral tone has yet to be fully elucidated. PMID:16916908

  3. Organization and function of ICC in the urinary tract.

    PubMed

    McHale, N G; Hollywood, M A; Sergeant, G P; Shafei, M; Thornbury, K T; Ward, S M

    2006-11-01

    ICC are found in both the upper and lower urinary tract. They are not found in the ureter itself but are confined to the lamina propria of the renal pelvis and pelvi-calyceal junction. They do not appear to have a primary pacemaker role (this is ascribed to atypical smooth muscle cells in the same location) but rather conduct and amplify the pacemaker signals generated by the atypical smooth muscle cells. In the bladder, ICC are widely distributed in the sub-urothelial region, in the lamina propria and at the margins of the detrusor smooth muscle bundles. Again they appear not to have a pacemaking role and such evidence as there is would suggest that they have a role in the modulation of signal transduction. The strongest evidence that ICC in the urinary tract act as pacemakers comes from studies of those in the urethra. Isolated ICC show regular spontaneous depolarizations in current clamp which resemble very closely the slow waves recorded from intact tissue. In voltage clamp they show abundant calcium-activated chloride current and spontaneous transient inward currents which can be blocked by chloride channel blockers. However, their role in the modulation of urethral tone has yet to be fully elucidated. PMID:16916908

  4. Effect of Flos carthami Extract and ?1-Adrenergic Antagonists on the Porcine Proximal Ureteral Peristalsis

    PubMed Central

    Wu, San-Yuan; Man, Kee-Ming; Shen, Jui-Lung; Chen, Huey-Yi; Chang, Chiao-Hui; Tsai, Fuu-Jen; Hsieh, Wen-Tsong; Winardi, Daniel; Lee, Yuan-Ju; Tsai, Kao-Sung; Lin, Yu-Ning; Chen, Wen-Chi

    2014-01-01

    Traditional Chinese medicine (TCM) has been proposed to prevent urolithiasis. In China, Flos carthami (FC, also known as Carthamus tinctorius) (Safflower; Chinese name: Hong Hua/??) has been used to treat urological diseases for centuries. We previously performed a screening and confirmed the in vivo antilithic effect of FC extract. Here, ex vivo organ bath experiment was further performed to study the effect of FC extract on the inhibition of phenylepinephrine (PE) (10?4 and 10?3?M) ureteral peristalsis of porcine ureters with several ?1-adrenergic antagonists (doxazosin, tamsulosin, and terazosin) as experimental controls. The results showed that doxazosin, tamsulosin, and terazosin dose (approximately 4.5 10?6 ? 4.5 10?1??g/mL) dependently inhibited both 10?4 and 10?3?M PE-induced ureteral peristalsis. FC extract achieved 6.2% 10.1%, 21.8% 6.8%, and 24.0% 5.6% inhibitions of 10?4?M PE-induced peristalsis at doses of 5 103, 1 104, and 2 104??g/mL, respectively, since FC extract was unable to completely inhibit PE-induced ureteral peristalsis, suggesting the antilithic effect of FC extract is related to mechanisms other than modulation of ureteral peristalsis. PMID:25170340

  5. Effect of Flos carthami Extract and ? 1-Adrenergic Antagonists on the Porcine Proximal Ureteral Peristalsis.

    PubMed

    Wu, San-Yuan; Man, Kee-Ming; Shen, Jui-Lung; Chen, Huey-Yi; Chang, Chiao-Hui; Tsai, Fuu-Jen; Hsieh, Wen-Tsong; Winardi, Daniel; Lee, Yuan-Ju; Tsai, Kao-Sung; Lin, Yu-Ning; Chen, Yung-Hsiang; Chen, Wen-Chi

    2014-01-01

    Traditional Chinese medicine (TCM) has been proposed to prevent urolithiasis. In China, Flos carthami (FC, also known as Carthamus tinctorius) (Safflower; Chinese name: Hong Hua/) has been used to treat urological diseases for centuries. We previously performed a screening and confirmed the in vivo antilithic effect of FC extract. Here, ex vivo organ bath experiment was further performed to study the effect of FC extract on the inhibition of phenylepinephrine (PE) (10(-4) and 10(-3)?M) ureteral peristalsis of porcine ureters with several ? 1-adrenergic antagonists (doxazosin, tamsulosin, and terazosin) as experimental controls. The results showed that doxazosin, tamsulosin, and terazosin dose (approximately 4.5 10(-6) - 4.5 10(-1)??g/mL) dependently inhibited both 10(-4) and 10(-3)?M PE-induced ureteral peristalsis. FC extract achieved 6.2% 10.1%, 21.8% 6.8%, and 24.0% 5.6% inhibitions of 10(-4)?M PE-induced peristalsis at doses of 5 10(3), 1 10(4), and 2 10(4)??g/mL, respectively, since FC extract was unable to completely inhibit PE-induced ureteral peristalsis, suggesting the antilithic effect of FC extract is related to mechanisms other than modulation of ureteral peristalsis. PMID:25170340

  6. The renal scan in pregnant renal transplant patients

    SciTech Connect

    Goldstein, H.A.; Ziessman, H.A.; Fahey, F.H.; Collea, J.V.; Alijani, M.R.; Helfrich, G.B.

    1985-05-01

    With the greater frequency of renal transplant surgery, more female pts are becoming pregnant and carrying to term. In the renal allograft blood vessels and ureter may be compressed resulting in impaired renal function and/or, hypertension. Toxemia of pregnancy is seen more frequently than normal. Radionuclide renal scan monitoring may be of significant value in this high risk obstetrical pt. After being maintained during the pregnancy, renal function may also deteriorate in the post partum period. 5 pregnant renal transplant pts who delivered live babies had renal studies with Tc-99m DTPA to assess allograft perfusion and function. No transplanted kidney was lost during or after pregnancy as a result of pregnancy. No congenital anomalies were associated with transplant management. 7 studies were performed on these 5 pts. The 7 scans all showed the uterus/placenta. The bladder was always distorted. The transplanted kidney was rotated to a more vertical position in 3 pts. The radiation dose to the fetus is calculated at 0.024 rad/mCi administered. This study demonstrates the anatomic and physiologic alterations expected in the transplanted kidney during pregnancy when evaluated by renal scan and that the radiation burden may be acceptable in management of these pts.

  7. AB100. Laparoscopic ureteral reimplantation underneath broad ligament tunnel for female vesicoureteral stenosis: a technical innovation

    PubMed Central

    Xu, Chuanliang; Zeng, Shuxiong; Zhang, Zhensheng; Lu, Xin; Wei, Rongchao; Zhao, Junjie; Li, Huizhen; Yang, Bo; Sun, Yinghao

    2014-01-01

    Purpose In order to anatomically reconstruct the ureteral stenosis, we present a novel technique for laparoscopic ureteral reimplantation. Patients and methods Three young females, who were diagnosed as hydroureteronephrosis caused by congenital vesicoureteral junction obstruction, were treated by laparoscopic ureteral reimplantation with a tunnel underneath the broad ligament. Results Surgery was performed successfully without conversion to open surgery. No major intraoperative or postoperative complications occurred. The mean postoperative follow-up was 38, 33 and 26 months respectively. The operative time was between 220 and 260 minutes. The mean estimated blood loss was less than 20 mL. Subsequent imaging performed 3 months after surgery revealed relief of hydroureteronephrosis for all patients. Patients all gave birth to healthy neonates and showed normal urinary tract sonogram and urine analysis during gestation period. Conclusion Laparoscopic ureteral reimplantation with a tunnel underneath the broad ligament tunnel is safe, effective, allowing for anatomical reconstruction of ureter defects, however. A larger clinical sample and longer follow-up period will be needed for fully validation of this technique.

  8. Methodological Standardization for the Preclinical Evaluation of Renal Sympathetic Denervation

    PubMed Central

    Sakakura, Kenichi; Ladich, Elena; Edelman, Elazer R.; Markham, Peter; Stanley, James R.L.; Keating, John; Kolodgie, Frank D.; Virmani, Renu; Joner, Michael

    2015-01-01

    Transcatheter ablation of renal autonomic nerves is a viable option for the treatment of resistent arterial hypertension; however, structured preclinical evaluation with standardization of analytical procedures remains a clear gap in this field. Here we discuss the topics relevant to the preclinical model for the evaluation of renal denervation (RDN) devices and report methodologies and criteria towards standardization of the safety and efficacy assessment, including histopathological evaluations of the renal artery, peri-arterial nerves, and associated peri-adventitial tissues. The preclinical swine renal artery model can be used effectively to assess both the safety and efficacy of RDN technologies. Assessment of the efficacy of RDN modalities primarily focuses on the determination of the depth of penetration of treatment-related injury (eg, necrosis) of the peri-arterial tissues and its relationship (ie, location and distance) and affect on the associated renal nerves and the correlation thereof with proxy biomarkers including renal norepinephrine concentrations and nerve-specific immunohistochemical stains (eg, tyrosine hydroxylase). The safety evaluation of RDN technologies involves assessing for adverse effects on tissues local to the site of treatment (ie, on the arterial wall) as well as tissues at a distance (eg, soft tissue, veins, arterial branches, skeletal muscle, adrenal gland, ureters). Increasing experience will help to create a standardized means of examining all arterial beds subject to ablative energy and in doing so enable us to proceed to optimize development and assessment of these emerging technologies. PMID:25240550

  9. Pathophysiology of kidney, gallbladder and urinary stones treatment with herbal and allopathic medicine: A review

    PubMed Central

    Alok, Shashi; Jain, Sanjay Kumar; Verma, Amita; Kumar, Mayank; Sabharwal, Monika

    2013-01-01

    Medicinal plants have been known for millennia and are highly esteemed all over the world as a rich source of therapeutic agents for the prevention of various ailments. Today large number of population suffers from kidney stone, gall stone and urinary calculi. Stone disease has gained increasing significance due to changes in living conditions i.e. industrialization and malnutrition. Changes in prevalence and incidence, the occurrence of stone types and stone location, and the manner of stone removal are explained. Medicinal plants are used from centuries due to its safety, efficacy, cultural acceptability and lesser side effects as compared to synthetic drugs. The present article deals with measures to be adopted for the potential of medicinal plants in stone dissolving activity. The problem of urinary stones or calculi is a very ancient one and many remedies have been employed during the ages these stones are found in all parts of the urinary tract, the kidney, the ureters and the urinary bladder and may vary considerably in size. In the present article, an attempt has been made to emphasis on herbal option for urinary stone.

  10. A Nanostructured Degradable Ureteral Stent Fabricated by Electrospinning for Upper Urinary Tract Reconstruction.

    PubMed

    Wang, Xiaoqing; Zhang, Long; Chen, Qihui; Hou, Yuchuan; Hao, Yuanyuan; Wang, Chunxi; Shan, Hongli

    2015-12-01

    A degradable polycaprolactone(PCL)/poly(lactic-co-glycolic acid, LA:GA = 80:20) (PLGA) ureter tubular stent was fabricated by electrospinning. The structure and properties of the stents were investigated by the mechanical property testing, scanning electron microscopy (SEM), degradability test in vitro and MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) assay. The stent was transplanted to the dorsal muscle of rabbit to evaluate its tissue compatibility. It was shown that the stent has the nano-structure. The mechanical test showed that with the increase in PCL concentration, the mechanical properties of the stent gradually increased, and it could meet the demands of a urethral stent. The collapse time of different concentration of PCL/PLGA (5%, 15%, and 25%) was 28, 42, and 56 days, respectively. These results provide strong evidence that the degradation time can be increased with the increase in PCL concentration. The results of the MTT assay show that the PCL/PLGA stent had no cytotoxicity. In muscle implantation tests, acute tissue reactions due to operation trauma were seen in all specimens at 1 week. After four weeks, the number of inflammatory cells had decreased significantly. Only a few inflammatory cells were seen in the PCL/PLGA stent group after 12 weeks, and the foreign body reaction was more severe in the control group. Animal orthotopic transplantation experiments of these ureteral stents will be done to evaluate its degradable model and tissue compatibility. PMID:26682432

  11. Diagnostic accuracy of magnetic resonance voiding cystourethrography for detecting vesico-ureteral reflux in children and adolescents

    PubMed Central

    Hekmatnia, Ali; Merrikhi, Alireza; Farghadani, Maryam; Barikbin, Roozbeh; Hekmatnia, Farzaneh; Nezami, Nariman

    2013-01-01

    Background: The purpose of the present study is to determine the accuracy of magnetic resonance voiding cystourethrography (MRVCUG) for diagnosis of vesicoureteral reflux (VUR) in children and adolescents with recurrent urinary tract infection (UTI). Materials and Methods: During the cross-sectional study from May 2009 to June 2011, 30 patients’ (60 kidney-ureter units) MRVCUG findings by 1.5 T magnetic resonance imaging (MRI) were compared with voiding cystourethrography (VCUG) findings in patients with urinary tract infection. The sensitivity, specificity, positive and negative predictive values for MRVCUG were calculated. Findings: The sensitivity, specificity, positive and negative predictive values and accuracy for MRVCUG for detecting VUR were respectively 92.68% (95% CI: 80.57-97.48%), 68.42% (95% CI: 46.01-84.64%), 86.36% (95% CI: 71.95-94.33%), 81.25% (95% CI: 53.69-95.02%), and 85% (95% CI: 80.40-89.60%. The level of agreement between MRVCUG and VCUG findings for diagnosis VUR was very good (P < 0.001, according to Cohen's kappa value = 0.638). Studying correlation of low grade VUR (grade I and II) and high grade VUR (grade III-V) showed a very good agreement between MRVCUG and VCUG findings (P < 0.001, Cohen's kappa value = 0.754). Conclusion: MRVCUG could accurately reveal the presence and severity of VUR, especially in cases with high-grade (grade III-V) VUR in both children and adolescents. PMID:23900240

  12. T-type Ca2+ channels and the urinary and male genital tracts.

    PubMed

    Fry, C H; Jabr, R I

    2014-04-01

    T-type Ca(2+) channels are widely expressed throughout the urinary and male genital tracts, generally alongside L-type Ca(2+) channels. The use of pharmacological blockers of these channels has suggested functional roles in all regions, with the possible exception of the ureter. Their functional expression is apparent not just in smooth muscle cells but also in interstitial cells that lie in close proximity to muscle, nerve and epithelial components of these tissues. Thus, T-type Ca(2+) channels can contribute directly to modulation of muscle function and indirectly to changes of epithelial and nerve function. T-type Ca(2+) channel activity modulates phasic contractile activity, especially in conjunction with Ca(2+)-activated K(+) channels, and also to agonist-dependent responses in different tissues. Upregulation of channel density occurs in pathological conditions associated with enhanced contractile responses, e.g. overactive bladder, but it is unclear if this is causal or a response to the pathological state. Moreover, T-type Ca(2+) channels may have a role in the development of prostate tumours regulating the secretion of mitogens from neuroendocrine cells. Although a number of selective channel blockers exist, their relative selectivity over L-type Ca(2+) channels is often low and makes evaluation of T-type Ca(2+) channel function in the whole organism difficult. PMID:24463704

  13. Small bowel obstruction secondary to strangulation through a defect in the falciform ligament after blunt abdominal trauma in a pediatric patient.

    PubMed

    Sykes, Joseph A; Norton, Karen I; Bhattacharya, Nishith; Stombaugh, Lauretta

    2010-06-01

    Obstruction caused by strangulation internal hernia secondary to incarceration within the falciform ligament, although rare, has been previously reported in the literature. These cases, however, were unrelated to trauma. We report on the first case in the pediatric literature of a strangulated internal hernia secondary to incarceration in the falciform ligament precipitated by blunt abdominal trauma. A 12-year-old girl presented to the emergency room less than 24 hours after sustaining a kick to the right upper quadrant. She described sharp, nonradiating, right-upper-quadrant abdominal pain, which was associated with nausea and vomiting. A KUB (kidney, ureter, bladder) view showed a paucity of bowel in the right upper quadrant with distended adjacent bowel. An ultrasound showed a small amount of abdominal ascites and a prominent liver. Computed tomography scan revealed a linear hypodensity at the tip of the right lobe of the liver, suggestive of a laceration. Moderate abdominal and pelvic ascites and multiple collapsed small-bowel loops with diffuse wall thickening and poor enhancement were seen in the right upper quadrant. Significantly, pneumatosis was noted, raising the question of obstruction/volvulus and/or bowel ischemia. An exploratory laparotomy revealed incarcerated small bowel herniated into a defect in the falciform ligament, which was resected. The defect was repaired. Seemingly trivial trauma may play a precipitating role in strangulation in a patient who already has a defect in the falciform ligament. PMID:20531130

  14. Percutaneous ureteral stent placement for the treatment of a benign ureteral obstruction in a Sumatran tiger (Panthera tigris sumatrae).

    PubMed

    Delk, Katie W; Wack, Raymund F; Burgdorf-Moisuk, Anne; Palm, Carrie A; Zwingenberger, Allison; Glaiberman, Craig B; Ferguson, Kenneth H; Culp, William T N

    2015-01-01

    A 15-year-old, 113 kg intact male Sumatran tiger (Panthera tigris sumatrae) was evaluated for weight loss, polydipsia, and intermittent hematuria. The tiger was immobilized for diagnostic testing including blood work, urinalysis, and abdominal ultrasound. Laboratory testing demonstrated macro- and microhematuria, azotemia, and an increased urine protein:creatinine ratio. Abdominal ultrasound revealed bilateral ureterolithiasis as well as hydronephrosis and ureteral dilation. Ultrasonography performed 5 months later revealed worsening of the right-sided hydronephrosis and hydroureter and a decrease in the severity of dilation on the left side presumably from passage of the left-sided ureteral calculi. Nephroureteral decompression via the placement of a stent was elected. A pigtail ureteral catheter (8.2 French diameter) was placed in the right ureter via an antegrade percutaneous approach utilizing ultrasound and fluoroscopic-guidance. Following stent placement, macrohematuria resolved although microhematuria was noted in opportunistic urine samples. Five months after stent placement, the azotemia had mildly progressed, the urine protein:creatinine ratio was improved, the right hydronephrosis and hydroureter had completely resolved, and the ureteral stent remained in the appropriate position. The tiger had clinically improved with a substantial increase in appetite, weight, and activity level. Ureteral stenting allowed for nephroureteral decompression in the captive large felid of this report, and no complications were encountered. Ureteral stenting provided a minimally invasive method of managing ureteral obstruction in this patient and could be considered in future cases due to the clinical improvement and low morbidity. PMID:25653150

  15. ARA290, a non-erythropoietic EPO derivative, attenuates renal ischemia/reperfusion injury

    PubMed Central

    2013-01-01

    Background In contrast with various pre-clinical studies, recent clinical trials suggest that high dose erythropoietin (EPO) treatment following kidney transplantation does not improve short-term outcome and that it even increases the risk of thrombotic events. ARA290 is a non-erythropoietic EPO derivative and does not increase the risk of cardiovascular events, but potentially has cytoprotective capacities in prevention of renal ischemia/reperfusion injury. Methods Eight female Dutch Landrace pigs were exposed to unilateral renal ischemia for 45 minutes with simultaneous cannulation of the ureter of the ischemic kidney. ARA290 or saline was administered by an intravenous injection at 0, 2, 4 and 6 hours post-reperfusion. The animals were sacrificed seven days post-reperfusion. Results ARA290 increased glomerular filtration rate during the observation period of seven days. Furthermore, ARA290 tended to reduce MCP-1 and IL-6 expression 15 minutes post-reperfusion. Seven days post-reperfusion ARA290 reduced interstitial fibrosis. Conclusions The improvement in renal function following renal ischemia/reperfusion and reduced structural damage observed in this study by ARA290 warrants further investigation towards clinical application. PMID:23302512

  16. [Clinical effects of allylestrenol on benign prostatic hypertrophy by double-blind method].

    PubMed

    Shida, K; Koyanagi, T; Kawakura, K; Nishida, T; Kumamoto, Y; Orikasa, S; Sato, S; Takeda, M; Yamanaka, H; Shimazaki, J

    1986-04-01

    A double blind comparative clinical trial was performed with allylestrenol (AE) and chlormadinone acetate (CMA) to investigate the clinical efficacy of AE on prostatic hypertrophy. Both drugs were administered orally for 12-16 weeks in a daily dose of 50 mg. With both drugs marked improvement of disorders of micturition and a slight decrease in the size of the hypertrophied prostatic node were observed. No significant difference was observed between the two drugs in the overall efficacy of the treatments. Significant improvement of practically all parameters used for evaluation of results was observed with both drugs following treatment. Ultrasonotomographic examination revealed diminution of the size of the prostatic node and x-ray examination of the ureter showed improvement in elevation of the fundus of the bladder. These improvements were better after CMA treatment than after AE treatment. With all other parameters used no significant difference was observed between the two drugs. Mild adverse effects such as loss of sexual desire and potency were observed in a few cases. The incidence of side-effects was lower following AE treatment, and the incidence of loss of sexual desire and potency was significantly lower after AE than after CMA. Taking into consideration efficacy and safety of the treatments, no significant difference was observed in usefulness between the two drugs, and we were able to confirm the usefulness of AE for the conservative treatment of prostatic hypertrophy. PMID:2426932

  17. Endoscopic surgery and telemedicine in microgravity: developing contingency procedures for exploratory class spaceflight

    NASA Technical Reports Server (NTRS)

    Jones, J. A.; Johnston, S.; Campbell, M.; Miles, B.; Billica, R.

    1999-01-01

    OBJECTIVES: The risk of a urinary calculus during an extended duration mission into the reduced gravity environment of space is significant. For medical operations to develop a comprehensive strategy for the spaceflight stone risk, both preventive countermeasures and contingency management (CM) plans must be included. METHODS: A feasibility study was conducted to demonstrate the potential CM technique of endoscopic ureteral stenting with ultrasound guidance for the possible in-flight urinary calculus contingency. The procedure employed the International Space Station/Human Research Facility ultrasound unit for guide wire and stent localization, a flexible cystoscope for visual guidance, and banded, biocompatible soft ureteral stents to successfully stent porcine ureters bilaterally in zero gravity (0g). RESULTS: The study demonstrated that downlinked endoscopic surgical and ultrasound images obtained in 0g are comparable in quality to 1g images, and therefore are useful for diagnostic clinical utility via telemedicine transmission. CONCLUSIONS: In order to be successful, surgical procedures in 0g require excellent positional stability of the operating surgeon, assistant, and patient, relative to one another. The technological development of medical procedures for long-duration spaceflight contingencies may lead to improved terrestrial patient care methodology and subsequently reduced morbidity.

  18. Dero (Allodero) lutzi Michaelsen, 1926 (Oligochaeta: Naididae) associated with Scinax fuscovarius (Lutz, 1925) (Anura: Hylidae) from Semi-deciduous Atlantic Rain Forest, southern Brazil.

    PubMed

    Oda, F H; Petsch, D K; Ragonha, F H; Batista, V G; Takeda, A M; Takemoto, R M

    2015-01-01

    Amphibians are hosts for a wide variety of ecto- and endoparasites, such as protozoans and parasitic worms. Naididae is a family of Oligochaeta whose species live on a wide range of substrates, including mollusks, aquatic macrophytes, sponges, mosses, liverworts, and filamentous algae. However, some species are known as endoparasitic from vertebrates, such as Dero (Allodero) lutzi, which is parasitic of the urinary tracts of frogs, but also have a free-living stage. Specimens in the parasitic stage lack dorsal setae, branchial fossa, and gills. Here we report the occurrence of D. (A.) lutzi associated with anuran Scinax fuscovarius from Semi-deciduous Atlantic Rain Forest in southern Brazil. The study took place at the Caiu Ecological Station, Diamante do Norte, Paran, southern Brazil. Seven specimens of S. fuscovarius were examined for parasites but only one was infected. Parasites occurred in ureters and urinary bladder. Previous records of this D. (A.) lutzi include the Brazilian States of Santa Catarina, So Paulo, Rio de Janeiro, and Minas Gerais, as well as Cuba and North America. This is a new locality record for this species in Brazil. Reports of Dero (Allodero) lutzi are rare, due to difficulty of observation, and such events are restricted only the fortuitous cases. It is important to emphasize the necessity of future studies, which are fundamental to the understanding of biological and ecological aspects of this species. PMID:25945624

  19. Dose audit for patients undergoing two common radiography examinations with digital radiology systems

    PubMed Central

    İnal, Tolga; Ataç, Gökçe

    2014-01-01

    PURPOSE We aimed to determine the radiation doses delivered to patients undergoing general examinations using computed or digital radiography systems in Turkey. MATERIALS AND METHODS Radiographs of 20 patients undergoing posteroanterior chest X-ray and of 20 patients undergoing anteroposterior kidney-ureter-bladder radiography were evaluated in five X-ray rooms at four local hospitals in the Ankara region. Currently, almost all radiology departments in Turkey have switched from conventional radiography systems to computed radiography or digital radiography systems. Patient dose was measured for both systems. The results were compared with published diagnostic reference levels (DRLs) from the European Union and International Atomic Energy Agency. RESULTS The average entrance surface doses (ESDs) for chest examinations exceeded established international DRLs at two of the X-ray rooms in a hospital with computed radiography. All of the other ESD measurements were approximately equal to or below the DRLs for both examinations in all of the remaining hospitals. Improper adjustment of the exposure parameters, uncalibrated automatic exposure control systems, and failure of the technologists to choose exposure parameters properly were problems we noticed during the study. CONCLUSION This study is an initial attempt at establishing local DRL values for digital radiography systems, and will provide a benchmark so that the authorities can establish reference dose levels for diagnostic radiology in Turkey. PMID:24317331

  20. Arsenic in Drinking Water, Transition Cell Cancer and Chronic Cystitis in Rural Bangladesh.

    PubMed

    Mostafa, Mohammad Golam; Cherry, Nicola

    2015-11-01

    In earlier analyses, we demonstrated dose-response relationships between renal and lung cancer and local arsenic concentrations in wells used by Bangladeshi villagers. We used the same case-referent approach to examine the relation of arsenic to biopsy confirmed transition cell cancer (TCC) of the ureter, bladder or urethra in these villagers. As the International Agency for Research on Cancer (IARC) has conclude that arsenic in drinking water causes bladder cancer, we expected to find higher risk with increasing arsenic concentration. We used histology/cytology results from biopsies carried out at a single clinic in Dhaka, Bangladesh from January 2008 to October 2011. We classified these into four groups, TCC (n = 1466), other malignancies (n = 145), chronic cystitis (CC) (n = 844) and other benign (n = 194). Arsenic concentration was estimated from British Geological Survey reports. Odds ratios were calculated by multilevel logistic regression adjusted for confounding and allowing for geographic clustering. We found no consistent trend for TCC with increasing arsenic concentration but the likelihood of a patient with benign disease having CC was significantly increased at arsenic concentrations >100 g/L. We conclude that the expected relationship of TCC to arsenic was masked by over-matching that resulted from the previously unreported relationship between arsenic and CC. We hypothesize that CC may be a precursor of TCC in high arsenic areas. PMID:26516891

  1. How can we predict ureteral obstruction after gynecological surgery? The changes in Doppler resistive index and plasma creatinine and magnesium concentrations after surgical, unilateral ureteral obstruction in a rabbit model.

    PubMed

    Terek, M C; Tamsel, S; Aygul, S; Akman, L; Irer, S V; Itil, I M; Alper, G

    2006-01-01

    The aim of this study is to evaluate the changes in Doppler resistive index (RI) and plasma creatinine and magnesium concentrations after unilateral ureteral obstruction in a rabbit model. Fourteen adult female rabbits were used in this study. In seven rabbits, the left ureter was ligated with silk suture, and the control group was sham operated. Before surgery and on the second and seventh days after surgery, blood samples were obtained to measure plasma creatinine and magnesium concentrations. Doppler RIs of both kidneys were also measured before surgery and on the second and seventh days after the surgical procedure. With regard to magnesium levels, there was a significant within-subjects sessions difference [F(2, 20) = 15.21, P= 0.001] indicating a decrease through sessions. Magnesium concentrations decreased significantly at the postoperative second and seventh days compared to preoperative baseline levels (P= 0.003 and P= 0.001, respectively). Multifactorial analysis of variance was applied for each session separately with laterality, and groups as factors. The Doppler RI and the creatinine level did not show any significant differences or interactions for all sessions (P > 0.05). The decreasing plasma magnesium concentration after surgery may indicate ureteral injury; however, Doppler studies and creatinine levels may not be useful as well. PMID:16445661

  2. Treatment of urinary tract stones.

    PubMed Central

    Wickham, J E

    1993-01-01

    Replacement of open surgery with minimally invasive techniques for treating stones in the renal tract has greatly reduced patients' morbidity and mortality and the period of hospitalisation and convalescence. Extracorporeal shockwave lithotripsy does not require anaesthesia and requires little analgesia so that treatment can be given on an outpatient basis, and there is no wound to heal. Only a small puncture site is needed for percutaneous endoscopic lithotomy, and with the advent of prophylactic antibiotics there are few complications. Of renal stones, about 85% can now be successfully treated by extracorporeal lithotripsy alone, and almost all of the stones too large or hard for lithotripsy can be treated endoscopically, with ultrasonic or electrohydraulic probes being used to fragment the stone. Stones in the upper and lower thirds of the ureter can be treated by extracorporeal lithotripsy, but stones in the middle third, which cannot normally be visualised to allow focusing of the shockwaves, usually require ureteroscopy. Nearly all bladder stones can be treated by transurethral endoscopy with an electrohydraulic probe. Only the largest renal tract stones still require open surgery. Images FIG 10 p1415-a p1415-b p1416-a p1416-b p1417-a PMID:8274898

  3. Damage of Stone Baskets by Endourologic Lithotripters: A Laboratory Study of 5 Lithotripters and 4 Basket Types

    PubMed Central

    Brinkmann, Ralf; Jocham, Dieter

    2013-01-01

    Background. In some cases, the ureteral stone is simultaneously stabilized by a stone basket when endourologic lithotripsy is performed. This stabilization can be either on purpose or by accident. By accident means that an impaction in the ureter occurs by an extraction of a stone with a basket. A stabilization on purpose means to avoid a retropulsion of the stone into the kidney during lithotripsy. At this part of the operation, stone baskets have been frequently damaged. This severing of wires can lead to ureteral trauma because of hook formation. Material and Methods. In a laboratory setting, the time and the pulse numbers were measured until breaking the wires from four different nitinol stone baskets by using five different lithotripsy devices. The endpoint was gross visibledamage to the wire and loss of electric conduction. Results. The Ho:YAG laser and the ultrasonic device were able to destroy almost all the wires. The ballistic devices and the electrohydraulic device were able to destroy thin wires. Conclusion. The operating surgeon should know the risk of damagefor every lithotripter. The Ho:YAG-laser and the ultrasonic device should be classified as dangerous for the basket wire with all adverse effects to the patient. PMID:24288527

  4. Therapeutic role of template-based lymphadenectomy in urothelial carcinoma of the upper urinary tract.

    PubMed

    Kondo, Tsunenori; Takagi, Toshio; Tanabe, Kazunari

    2015-12-10

    Lymphadenectomy for urothelial carcinoma of the upper urinary tract has attracted the attention of physicians. The mapping study of lymphatic spread has shown that a relatively wide area should comprise the regional nodes for tumors of the right renal pelvis or the right upper two-thirds of the ureter. A prospective study showed that an anatomical template-based lymphadenectomy significantly improved patient survival in tumors of the renal pelvis. This benefit was more evident for patients with pT2 stage tumors or higher. The risk of regional node recurrence is significant reduced by template-based lymphadenectomy, which is likely to be associated with improved patient survival. The removal of lymph node micrometastases is assumed to be the reason for therapeutic benefit following lymphadenectomy. The number of resected lymph nodes can be used to assess the quality of lymphadenectomy, but not to determine the extent of lymphadenectomy. The guidelines currently recommend lymphadenectomy for patients with muscle-invasive disease, even though the current recommendation grades are still low. The present limitation of lymphadenectomy is the lack of standardization of the extent of lymphadenectomy and the randomized trials. Further studies are warranted to collect the evidence to support lymphadenectomy. PMID:26677437

  5. Percutaneous Nephroscopic Surgery

    PubMed Central

    2010-01-01

    With the development of techniques for percutaneous access and equipment to disintegrate calculi, percutaneous nephroscopic surgery is currently used by many urologists and is the procedure of choice for the removal of large renal calculi and the management of diverticula, intrarenal strictures, and urothelial cancer. Although it is more invasive than shock wave lithotripsy and retrograde ureteroscopic surgery, percutaneous nephroscopic surgery has been successfully performed with high efficiency and low morbidity in difficult renal anatomies and patient conditions. These advantages of minimal invasiveness were rapidly perceived and applied to the management of ureteropelvic junction obstruction, calyceal diverticulum, infundibular stenosis, and urothelial cancer. The basic principle of endopyelotomy is a full-thickness incision of the narrow segment followed by prolonged stenting and drainage to allow regeneration of an adequate caliber ureter. The preferred technique for a calyceal diverticulum continues to be debated. Excellent long-term success has been reported with percutaneous, ureteroscopic, and laparoscopic techniques. Each approach is based on the location and size of the diverticulum. So far, percutaneous ablation of the calyceal diverticulum is the most established minimally invasive technique. Infundibular stenosis is an acquired condition usually associated with inflammation or stones. Reported series of percutaneously treated infundibular stenosis are few. In contrast with a calyceal diverticulum, infundibular stenosis is a more difficult entity to treat with only a 50-76% success rate by percutaneous techniques. Currently, percutaneous nephroscopic resection of transitional cell carcinoma in the renal calyx can be applied in indicated cases. PMID:20495691

  6. Renal uptakes of 99mTc-MAG3, 99mTc-DTPA, and 99mTc-DMSA in rabbits with unilateral ureteral obstruction.

    PubMed

    Lee, Won Guk; Kim, Joong-Hyun; Kim, Jong Min; Shim, Kyung Mi; Kang, Seong Soo; Chae, Hong In; Choi, Seok Hwa

    2010-01-01

    Renal function measurements using (99m)Tc-DTPA and (99m)Tc-MAG(3) dynamic scintigraphs were compared to those obtained using (99m)Tc-DMSA static scintigraphy. Eighteen experimental rabbits were randomly divided into (99m)Tc-DTPA-, (99m)Tc-MAG(3)-, and (99m) Tc-DMSA-injected groups. Experimental unilateral renal damage was induced by ligating a unilateral right ureter in 18 rabbits. Scintigraphic images were obtained at 2 and 5 h after intravenous injection of (99m)Tc-DMSA, or immediately after administration of (99m)Tc-DTPA or (99m)Tc-MAG(3). For the dynamic images using (99m)Tc-DTPA and (99m)Tc-MAG(3), rapid sequential images were obtained every 2 s for 30 images up to 1 min. The three groups presented different relative renal functions between the left normal and the right abnormal kidneys at 1, 2, 3, and 4 weeks post-ligation (p<0.05). However, the between-group comparisons showed no significant differences at any time. These results suggest that dynamic images of (99m)Tc-DTPA and (99m)Tc-MAG(3) can be used to measure the relative renal function in place of the static image of (99m)Tc-DMSA. PMID:20363984

  7. Myocardin is required for maintenance of vascular and visceral smooth muscle homeostasis during postnatal development.

    PubMed

    Huang, Jianhe; Wang, Tao; Wright, Alexander C; Yang, Jifu; Zhou, Su; Li, Li; Yang, Jisheng; Small, Aeron; Parmacek, Michael S

    2015-04-01

    Myocardin is a muscle-restricted transcriptional coactivator that activates a serum response factor (SRF)-dependent gene program required for cardiogenesis and embryonic survival. To identify myocardin-dependent functions in smooth muscle cells (SMCs) during postnatal development, mice harboring a SMC-restricted conditional, inducible Myocd null mutation were generated and characterized. Tamoxifen-treated SMMHC-Cre(ERT2)/Myocd(F/F) conditional mutant mice die within 6 mo of Myocd gene deletion, exhibiting profound derangements in the structure of great arteries as well as the gastrointestinal and genitourinary tracts. Conditional mutant mice develop arterial aneurysms, dissection, and rupture, recapitulating pathology observed in heritable forms of thoracic aortic aneurysm and dissection (TAAD). SMCs populating arteries of Myocd conditional mutant mice modulate their phenotype by down-regulation of SMC contractile genes and up-regulation of extracellular matrix proteins. Surprisingly, this is accompanied by SMC autonomous activation of endoplasmic reticulum (ER) stress and autophagy, which over time progress to programmed cell death. Consistent with these observations, Myocd conditional mutant mice develop remarkable dilation of the stomach, small intestine, bladder, and ureters attributable to the loss of visceral SMCs disrupting the muscularis mucosa. Taken together, these data demonstrate that during postnatal development, myocardin plays a unique, and important, role required for maintenance and homeostasis of the vasculature, gastrointestinal, and genitourinary tracts. The loss of myocardin in SMCs triggers ER stress and autophagy, which transitions to apoptosis, revealing evolutionary conservation of myocardin function in SMCs and cardiomyocytes. PMID:25805819

  8. Radiation-induced endometriosis in Macaca mulatta

    SciTech Connect

    Fanton, J.W.; Golden, J.G. )

    1991-05-01

    Female rhesus monkeys received whole-body doses of ionizing radiation in the form of single-energy protons, mixed-energy protons, X rays, and electrons. Endometriosis developed in 53% of the monkeys during a 17-year period after exposure. Incidence rates for endometriosis related to radiation type were: single-energy protons, 54%; mixed-energy protons, 73%; X rays, 71%; and electrons, 57%. The incidence of endometriosis in nonirradiated control monkeys was 26%. Monkeys exposed to single-energy protons, mixed-energy protons, and X rays developed endometriosis at a significantly higher rate than control monkeys (chi 2, P less than 0.05). Severity of endometriosis was staged as massive, moderate, and minimal. The incidence of these stages were 65, 16, and 19%, respectively. Observations of clinical disease included weight loss in 43% of the monkeys, anorexia in 35%, space-occupying masses detected by abdominal palpation in 55%, abnormal ovarian/uterine anatomy on rectal examination in 89%, and radiographic evidence of abdominal masses in 38%. Pathological lesions were endometrial cyst formation in 69% of the monkeys, adhesions of the colon in 66%, urinary bladder in 50%, ovaries in 86%, and ureters in 44%, focal nodules of endometrial tissue throughout the omentum in 59%, and metastasis in 9%. Clinical management of endometriosis consisted of debulking surgery and bilateral salpingo-oophorectomy combined in some cases with total abdominal hysterectomy. Postoperative survival rates at 1 and 5 years for monkeys recovering from surgery were 48 and 36%, respectively.

  9. Origin of Parietal Podocytes in Atubular Glomeruli Mapped by Lineage Tracing

    PubMed Central

    Schulte, Kevin; Berger, Katja; Boor, Peter; Jirak, Peggy; Gelman, Irwin H.; Arkill, Kenton P.; Neal, Christopher R.; Kriz, Wilhelm; Floege, Jrgen; Smeets, Bart

    2014-01-01

    Parietal podocytes are fully differentiated podocytes lining Bowmans capsule where normally only parietal epithelial cells (PECs) are found. Parietal podocytes form throughout life and are regularly observed in human biopsies, particularly in atubular glomeruli of diseased kidneys; however, the origin of parietal podocytes is unresolved. To assess the capacity of PECs to transdifferentiate into parietal podocytes, we developed and characterized a novel method for creating atubular glomeruli by electrocoagulation of the renal cortex in mice. Electrocoagulation produced multiple atubular glomeruli containing PECs as well as parietal podocytes that projected from the vascular pole and lined Bowmans capsule. Notably, induction of cell death was evident in some PECs. In contrast, Bowmans capsules of control animals and normal glomeruli of electrocoagulated kidneys rarely contained podocytes. PECs and podocytes were traced by inducible and irreversible genetic tagging using triple transgenic mice (PEC- or Pod-rtTA/LC1/R26R). Examination of serial cryosections indicated that visceral podocytes migrated onto Bowmans capsule via the vascular stalk; direct transdifferentiation from PECs to podocytes was not observed. Similar results were obtained in a unilateral ureter obstruction model and in human diseased kidney biopsies, in which overlap of PEC- or podocyte-specific antibody staining indicative of gradual differentiation did not occur. These results suggest that induction of atubular glomeruli leads to ablation of PECs and subsequent migration of visceral podocytes onto Bowmans capsule, rather than transdifferentiation from PECs to parietal podocytes. PMID:24071005

  10. Ureteroscopy-assisted retrograde nephrostomy (UARN) without ureteral access sheath (UAS)

    PubMed Central

    Kawahara, Takashi; Ito, Hiroki; Terao, Hideyuki; Uemura, Hiroji; Yao, Masahiro; Matsuzaki, Junichi

    2015-01-01

    Introduction We previously described ureteroscopy assisted retrograde nephrostomy (UARN). In UARN, it is possible to continuously visualize the dilation of the ureter from puncture to insertion of the nephroaccess sheath with minimal complication. But in the course of making nephrostomy, UARN requires ureteral access sheath (UAS). UAS has a potential risk of ureteral stricture. Herein, we report the first case of UARN without the use of UAS. Presentation of case A 53-year-old female was referred to our hospital for treatment of her right renal stone. Because her stone burden was 27mm, we planned to perform percutaneous nephrolithotomy (PCNL) using UARN without UAS. Discussion UAS facilitates a decrease in the intrarenal pressure due to irrigation, and it makes controlling the URS easier. However, in terms of the risk of ureteral stricture, unnecessary insertion of a UAS should be avoided. Conclusion We describe the first case of a renal stone successfully treated by PCNL using the UARN method without the use of a UAS. PMID:25813125

  11. Regeneration and Experimental Orthotopic Transplantation of a Bioengineered Kidney

    PubMed Central

    Song, Jeremy J; Guyette, Jacques; Gilpin, Sarah; Gonzalez, Gabriel; Vacanti, Joseph P; Ott, Harald C

    2013-01-01

    Over 100,000 individuals in the United States currently await kidney transplantation, while 400,000 individuals live with end-stage kidney disease requiring hemodialysis. The creation of a transplantable graft to permanently replace kidney function would address donor organ shortage and the morbidity associated with immunosuppression. Such a bioengineered graft must have the kidneys architecture and function, and permit perfusion, filtration, secretion, absorption, and drainage of urine. We decellularized rat, porcine, and human kidneys by detergent perfusion, yielding acellular scaffolds with vascular, cortical and medullary architecture, collecting system and ureters. To regenerate functional tissue, we seeded rat kidney scaffolds with epithelial and endothelial cells, then perfused these cell-seeded constructs in a whole organ bioreactor. The resulting grafts produced rudimentary urine in vitro when perfused via their intrinsic vascular bed. When transplanted in orthotopic position in rat, the grafts were perfused by the recipients circulation, and produced urine via the ureteral conduit in vivo. PMID:23584091

  12. Calculus-related ureteral intussusception: A case report and literature review

    PubMed Central

    Sewell, James; Blecher, Gideon; Tsai, Ken; Bishop, Conrad

    2015-01-01

    Introduction Ureteral intussusception is a rarely reported condition, primarily as a complication of ureteric tumours. Fewer than 30 case reports have been made. This case represents the first reported case, to our knowledge, of ureteral intussusception caused by a ureteric calculus. Presentation of case We present the case of a 70 year old man with a history of conservatively managed renal calculi, in whom obstructive ureterolithiasis was incidentally detected. Retrograde pyelography and ureteroscopy revealed intussusception of the ureter around a calculus. Extensive biopsies revealed no evidence of tumour, and the intussusception resolved following stone clearance. Discussion Literature review of previously reported cases of ureteral intussusception revealed 26 cases, of which 22 were secondary to tumour and 4 were secondary to surgical procedures. We propose a mechanism by which calculus-related ureteral intussusception may occur, and suggest treatment for this condition. Conclusion Calculus-related ureteral intussusception is a rare condition, of which this represents the only case report. Management of the condition should involve excluding the presence of tumour, and then clearing the stone, avoiding the use of a basket for retrieval of fragments. PMID:26011803

  13. Mllerianosis: a rare cause of acute renal colic

    PubMed Central

    Ndokera, Rufaro; Brewster, Simon; Dhar, Sunanda

    2012-01-01

    A 50-year-old woman presented to the urology department with an acute history suggestive of left-sided renal colic. There were no other associated symptoms, but urine dipstick revealed non-visible haematuria. CT-KUB revealed a soft tissue mass at the left vesico-ureteric junction. Flexible cystoscopy demonstrated a mass intruding into the posterior bladder. A transurethral resection of the bladder tumour was undertaken, and it was noted that the mass was not macroscopically consistent with transitional cell carcinoma. Histology demonstrated Mllerianosis, a rare lesion characterised by locally invasive growth of tissue originating from the Mllerian (paramesonephric) duct. The patient was seen by gynaecologist who initiated hormone treatment with an lutenising hormone - releasing hormone (LH-RH) analogue. Urological follow-up 3?months later highlighted ongoing pelvic pain but no further colicky loin pain. Repeat cystoscopy showed the mass had become smaller and the left ureter was laterally displaced. Further gynaecological input is planned if symptoms are ongoing. PMID:23097575

  14. Diagnosis, treatment and follow-up of 25 patients with melamine-induced kidney stones complicated by acute obstructive renal failure in Beijing Children's Hospital.

    PubMed

    Sun, Qiang; Shen, Ying; Sun, Ning; Zhang, Gui Ju; Chen, Zhi; Fan, Jian Feng; Jia, Li Qun; Xiao, Hong Zhan; Li, Xu Ran; Puschner, Birgit

    2010-04-01

    A total of 25 Chinese patients aged 6 to 36 months hospitalised at Beijing Children's Hospital due to melamine-induced kidney stones complicated by acute obstructive renal failure in 2008 were included in a study in order to diagnose and treat these special cases more effectively. Feeding history, clinical presentation, ultrasound findings, treatments and effects were summarised. Twelve to seventeen months follow-up was reported also. Ultrasound examination showed that calculi were located at the kidney and ureters. Stones were composed of both uric acid and melamine in a molar ratio of 1.2:1 to 2.1:1. Treatments providing liquid plus alkalisation of urine proved to be effective in helping the patients pass the stones. Surgical intervention was needed in severe cases. Renal function returned to normal in all 25 patients after various durations of therapy. Sixty-eight percent of the patients expelled all of the calculi within 3 months, 90% in 6 months and 95% in 9 months, without sequelae till now. Melamine-contaminated milk formula can cause kidney stones in infants, which should be diagnosed by feeding history, clinical symptoms and ultrasound examination. Composition of the stones was not only of melamine but also uric acid. Providing liquid orally or intravenously plus alkalisation of urine proved to promote the removal of the stones. Follow-up of 12 to 17 months after discharge showed no sequelae. PMID:19841939

  15. Urothelial Signaling

    PubMed Central

    Andersson, Karl-Erik

    2013-01-01

    The urothelium, which lines the inner surface of the renal pelvis, the ureters, and the urinary bladder, not only forms a high-resistance barrier to ion, solute and water flux, and pathogens, but also functions as an integral part of a sensory web which receives, amplifies, and transmits information about its external milieu. Urothelial cells have the ability to sense changes in their extracellular environment, and respond to chemical, mechanical and thermal stimuli by releasing various factors such as ATP, nitric oxide, and acetylcholine. They express a variety of receptors and ion channels, including P2X3 purinergic receptors, nicotinic and muscarinic receptors, and TRP channels, which all have been implicated in urothelial-neuronal interactions, and involved in signals that via components in the underlying lamina propria, such as interstitial cells, can be amplified and conveyed to nerves, detrusor muscle cells, and ultimately the central nervous system. The specialized anatomy of the urothelium and underlying structures, and the possible communication mechanisms from urothelial cells to various cell types within the bladder wall are described. Changes in the urothelium/lamina propria (mucosa) produced by different bladder disorders are discussed, as well as the mucosa as a target for therapeutic interventions. PMID:23589830

  16. Ultrasonographic diagnosis of renal disease in small animals.

    PubMed

    Cartee, R E; Selcer, B A; Patton, C S

    1980-03-01

    Real-time ultrasonography was found to be useful in the diagnosis of hydronephrosis, renal calculi, and renal neoplasia in the dog and cat. One dog with hydronephorsis, one with renal calculi, and a cat with a renal neoplasm were scanned with a real-time ultrasonic scanner. Abnormal enlargement due to fluid accumulation was determined by ultrasonographic imaging in the case of hydronephrosis. The location and mobility of the renal calculus were observed during ultrasonography. An uneven contour and parenchymal masses in the neoplastic kidney were detected by ultrasonographic imaging of the cat. The findings were confirmed either by radiography or by postmortem examination. Previously, hydronephrosis could be diagnosed only by radiography, especially by excretory urography. Ultrasonography offers a noninvasive method for diagnosis of hydronephrosis. Localization of a urinary calculus at either the proximal end of the ureter or within the renal pelvis may be difficult by radiography. The ability of real-time ultrasonography to detect motion of the calculi within the pelvis offers an improved diagnostic capability to the veterinarian. The inability of radiography to determine the cause of renal enlargement is contrasted with the ability of ultrasonography to detect changes in tissue density that might be compatible with renal neoplasms PMID:7358560

  17. Macrophage epoxygenase determines a pro-fibrotic transcriptome signature

    PubMed Central

    Behmoaras, Jacques; Srivastava, Prashant; Montoya, Alex; Faull, Peter; Webster, Zoe; Moyon, Ben; Pusey, Charles D.; Abraham, David J.; Petretto, Enrico; Cook, Terence H.; Aitman, Timothy J

    2015-01-01

    Epoxygenases belong to the cytochrome P450 family and they generate epoxyeicosatrienoic acids (EETs) known to have anti-inflammatory effects but little is known about their role in macrophage function. By high-throughput sequencing of RNA (RNA-seq) in primary macrophages derived from rodents and humans, we establish the relative expression of epoxygenases in these cells. Zinc-finger nuclease-mediated targeted gene deletion of the major rat macrophage epoxygenase Cyp2j4 (orthologue of human CYP2J2), resulted in reduced EET synthesis. Cyp2j4−/− macrophages have relatively increased PPARγ levels and show a pro-fibrotic transcriptome, displaying over-expression of a specific subset of genes (260 transcripts) primarily involved in extracellular matrix, with fibronectin being the most abundantly expressed transcript. Fibronectin expression is under the control of epoxygenase activity in human and rat primary macrophages. In keeping with the in vitro findings, Cyp2j4−/− rats show up-regulation of type I collagen following unilateral ureter obstruction (UUO) of the kidney and quantitative proteomics analysis (LC-MS/MS) showed increased renal type I collagen and fibronectin protein abundance resulting from experimentally induced crescentic glomerulonephritis in these rats. Taken together, these results identify the rat epoxygenase Cyp2j4 as a determinant of a pro-fibrotic macrophage transcriptome that could have implications in various inflammatory conditions depending on macrophage function. PMID:25840911

  18. Macrophage epoxygenase determines a profibrotic transcriptome signature.

    PubMed

    Behmoaras, Jacques; Diaz, Ana Garcia; Venda, Lara; Ko, Jeong-Hun; Srivastava, Prashant; Montoya, Alex; Faull, Peter; Webster, Zoe; Moyon, Ben; Pusey, Charles D; Abraham, David J; Petretto, Enrico; Cook, Terence H; Aitman, Timothy J

    2015-05-15

    Epoxygenases belong to the cytochrome P450 family. They generate epoxyeicosatrienoic acids, which are known to have anti-inflammatory effects, but little is known about their role in macrophage function. By high-throughput sequencing of RNA in primary macrophages derived from rodents and humans, we establish the relative expression of epoxygenases in these cells. Zinc-finger nuclease-mediated targeted gene deletion of the major rat macrophage epoxygenase Cyp2j4 (ortholog of human CYP2J2) resulted in reduced epoxyeicosatrienoic acid synthesis. Cyp2j4(-/-) macrophages have relatively increased peroxisome proliferator-activated receptor-γ levels and show a profibrotic transcriptome, displaying overexpression of a specific subset of genes (260 transcripts) primarily involved in extracellular matrix, with fibronectin being the most abundantly expressed transcript. Fibronectin expression is under the control of epoxygenase activity in human and rat primary macrophages. In keeping with the in vitro findings, Cyp2j4(-/-) rats show upregulation of type I collagen following unilateral ureter obstruction of the kidney, and quantitative proteomics analysis (liquid chromatography-tandem mass spectrometry) showed increased renal type I collagen and fibronectin protein abundance resulting from experimentally induced crescentic glomerulonephritis in these rats. Taken together, these results identify the rat epoxygenase Cyp2j4 as a determinant of a profibrotic macrophage transcriptome that could have implications in various inflammatory conditions, depending on macrophage function. PMID:25840911

  19. Mechanism of Accumulation of the Antitumor Protein Antibiotic Neocarzinostatin in Bladder Tissue: Intravenous Administration, Urinary Excretion, and Absorption into Bladder Tissue

    PubMed Central

    Maeda, Hiroshi; Sakamoto, Sadaaki; Ogata, Jiro

    1977-01-01

    Some aspects of the absorption, distribution, and excretion of neocarzinostatin (NCS), a proteinous antitumor antibiotic, were studied in rabbits. NCS was given intravenously (i.v.) via the auricular vein, or [14C]NCS was instilled directly into the cavity of the bladder by tubing. In both groups, ureterostomy was performed, so that the drug excreted in the urine did not pass through the bladder. The results showed extremely rapid renal clearance; namely, two-thirds of the total recovered was excreted in the first 5 min. It was also shown that drug infused into the bladder cavity could be recovered in urine from the ureterostomized ureter. Also, the level of biological activity of NCS in bladder tissues after i.v. administration is significantly lower when ureterostomy is performed. Thus, evidence is presented for the absorption of NCS into bladder tissue from the lumen of the bladder. The high levels of NCS in bladder tissue are due to this effect as well as to accumulation via the iliac artery. These data should encourage further trials of NCS in bladder cancer. A study of urine containing NCS derived from i.v. administration showed an increase in antibacterial activity upon incubation, followed by a decrease. These effects are probably due to proteolysis, as shown by the appearance of a low-molecular-weight fragment and by the absence of such an increase in the presence of inhibitors of proteolysis. PMID:141906

  20. Construction of a tubular scaffold that mimics J-shaped stress/strain mechanics using an innovative electrospinning technique.

    PubMed

    Rapoport, Harry Scott; Fish, Jeff; Basu, Joydeep; Campbell, Jonathon; Genheimer, Christopher; Payne, Richard; Jain, Deepak

    2012-08-01

    Soft tissues such as blood vessel, lung, ureter, skin, etc., possess mechanical behavior characterized by a "J"-shaped curve on a stress-strain diagram with a low-stiffness highly elastic zone giving rise to a high-stiffness zone. This mechanical behavior may be adaptive and protective against aneurysm formation in tissues whose primary loading is pressure-based. "J"-shaped behavior arises from the synergistic interplay of two main structural proteins: collagen and elastin. An innovative electrospinning technique has been utilized to form tubular scaffold composites with structural features reminiscent of the corrugated laminae seen in blood vessels. In doing so, tubular scaffolds have been fabricated with complex "J"-shaped behavior through the use of elastic polyurethane and reinforcing poly-glycolic acid (PGA) woven mesh. In these studies, corrugated laminae were formed on the 175 ?m and 1.5 mm scale. Initial moduli were 0.50.17 MPa (meanstandard deviation) giving rise to stiffer moduli of 36.096.72 MPa at a strain of 1.310.15. Burst pressures were physiologically relevant at 30951016 mmHg. The toughness of these prototypes was 6.31.9 MJ/m(3). The ability to employ different materials and different formation parameters utilizing this technique promises the ability to match complex stress-strain behaviors in soft tissues with a high degree of fidelity. PMID:22250785