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1

Ectopic Ureter  

MedlinePLUS

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

2

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.

3

Indocyanine green for intraoperative localization of ureter.  

PubMed

Intraurethral injection of indocyanine green (ICG; Akorn, Lake Forest, IL) and visualization under near-infrared (NIR) light allows for real-time delineation of the ureter. This technology can be helpful to prevent iatrogenic ureteral injury during pelvic surgery. Patients were scheduled to undergo robot-assisted laparoscopic sacrocolpopexy. Before the robotic surgery started, the tip of a 6-F ureteral catheter was inserted into the ureteral orifice. Twenty-five milligrams of ICG was dissolved in 10-mL of sterile water and injected through the open catheter. The same procedure was repeated on the opposite side. The ICG reversibly stained the inside lining of the ureter by binding to proteins on urothelial layer. During the course of robotic surgery, the NIR laser on the da Vinci Si surgical robot (Intuitive Surgical, Inc, Sunnyvale, CA) was used to excite ICG molecules, and infrared emission was captured by the da Vinci filtered lens system and electronically converted to green color. Thus, the ureter fluoresced green, which allowed its definitive identification throughout the entire case. In all cases of >10 patients, we were able to visualize bilateral ureters with this technology, even though there was some variation in brightness that depended on the depth of the ureter from the peritoneal surface. For example, in a morbidly obese patient, the ureters were not as bright green. There were no intraoperative or postoperative adverse effects attributable to ICG administration for up to 2 months of observation. In our experience, this novel method of intraurethral ICG injection was helpful to identify the entire course of ureter and allowed a safe approach to tissues that were adjacent to the urinary tract. The advantage of our technique is that it requires the insertion of just the tip of ureteral catheter. Despite our limited cohort of patients, our findings are consistent with previous reports of the excellent safety profile of intravenous and intrabiliary ICG. Intraurethral injection of ICG and visualization under NIR light allows for real-time delineation of the ureter. This technology can be helpful to prevent iatrogenic ureteral injury during pelvic surgery. PMID:24835212

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

2014-10-01

4

COMPASS-based ureter segmentation in CT urography (CTU)  

NASA Astrophysics Data System (ADS)

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

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

2014-03-01

5

Computerized segmentation of ureters in CT urography (CTU) using COMPASS  

NASA Astrophysics Data System (ADS)

We are developing a computerized system for automated segmentation of ureters on CTU, as 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. We propose a COmbined Model-guided Path-finding Analysis and Segmentation System (COMPASS) to track the ureters in CTU. COMPASS consists of three stages: (1) adaptive thresholding and region growing, (2) edge profile extraction and feature analysis, and (3) path-finding and propagation. 114 ureters, filled with IV contrast material, on 74 CTU scans from 74 patients were segmented. On average the ureter occupied 286 CT slices (range:164 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, which served as an input to the COMPASS, to initialize the tracking. The path-finding and segmentation are guided by anatomical knowledge of the 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, 75 (66%) were segmented completely (100%), 99 (87%) were segmented through at least 70% of its length, and 104 (91%) were segmented at least 50%. Previously, without the model-guided approach, 61 (54%) ureters were segmented completely (100%), 80 (70%) were segmented through at least 70% of its length, and 96 (84%) were segmented at least 50%. COMPASS improved the ureter tracking, including regions across ureter lesions, wall thickening and the narrowing of the lumen.

Hadjiiski, Lubomir M.; Chan, Heang-Ping; Niland, Luke; Cohan, Richard H.; Caoili, Elaine M.; Zhou, Chuan; Wei, Jun

2013-03-01

6

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

MedlinePLUS

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

7

Ureter Smooth Muscle Cell Orientation in Rat Is Predominantly Longitudinal  

PubMed Central

In ureter peristalsis, the orientation of the contracting smooth muscle cells is essential, yet current descriptions of orientation and composition of the smooth muscle layer in human as well as in rat ureter are inconsistent. The present study aims to improve quantification of smooth muscle orientation in rat ureters as a basis for mechanistic understanding of peristalsis. A crucial step in our approach is to use two-photon laser scanning microscopy and image analysis providing objective, quantitative data on smooth muscle cell orientation in intact ureters, avoiding the usual sectioning artifacts. In 36 rat ureter segments, originating from a proximal, middle or distal site and from a left or right ureter, we found close to the adventitia a well-defined longitudinal smooth muscle orientation. Towards the lamina propria, the orientation gradually became slightly more disperse, yet the main orientation remained longitudinal. We conclude that smooth muscle cell orientation in rat ureter is predominantly longitudinal, though the orientation gradually becomes more disperse towards the proprial side. These findings do not support identification of separate layers. The observed longitudinal orientation suggests that smooth muscle contraction would rather cause local shortening of the ureter, than cause luminal constriction. However, the net-like connective tissue of the ureter wall may translate local longitudinal shortening into co-local luminal constriction, facilitating peristalsis. Our quantitative, minimally invasive approach is a crucial step towards more mechanistic insight into ureter peristalsis, and may also be used to study smooth muscle cell orientation in other tube-like structures like gut and blood vessels. PMID:24465961

Reesink, Koen D.; Kroon, Wilco; Delhaas, Tammo

2014-01-01

8

Evidence for Alpha Receptors in the Human Ureter  

NASA Astrophysics Data System (ADS)

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

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

2007-04-01

9

Inguinoscrotal hernia of the ureter combined with renal pelvic carcinoma.  

PubMed

Inguinoscrotal herniation of the ureter is a rare finding, with the potential for serious surgical complications. Here we report an extremely rare case of inguinoscrotal hernia of the ureter combined with renal pelvic carcinoma. This 61-year-old man was diagnosed with right renal pelvic tumor, bilateral hydronephrosis with inguinoscrotal hernia of the right ureter, and left ureteral calculus. He was successfully treated with right nephroureterectomy, inguinoscrotal hernia repair, and left ureterolithotomy. Pathologic examinations revealed a high-grade transitional cell carcinoma. PMID:23806411

Tan, Fu-Qing; Yang, Kai; Zheng, Jian-Hong; Chen, Shan-Wen; Xie, Li-Ping

2013-07-01

10

[Cytodiagnosis of pathologic changes in the renal pelvis and ureter].  

PubMed

In 80 cases of roentgenologic filling defects in renal pelvis and ureter, which could be determined exactly preoperatively, we could confirm the diagnostic value of cytology from washings of renal pelvis and ureter (lavage cytology) especially in preoperative diagnosis of carcinoma of renal pelvis and ureter. Twenty of 25 tumors (80%) were detected preoperatively. There were no false positive results. The diagnostic reliability of this method was more accurate than with normal exfoliative urinary cytology from other authors. The results are discussed together with the literature. PMID:489403

Leistenschneider, W; Nagel, R

1979-08-01

11

Transcaval ureter: a rare embryological anomaly causing obstructive uropathy.  

PubMed

A 21-year-old woman presented with a longstanding history of episodic right flank pain related to fluid consumption and recurrent urinary tract infections. On examination, there was right costovertebral angle tenderness. Renal tract ultrasound demonstrated hydronephrosis and CT urography confirmed transcaval ureter. The patient's clinical presentation was likely due to obstruction associated with the right ureter passing through the opening created by the duplicated segment of the inferior vena cava. While asymptomatic transcaval ureter can be managed conservatively, severe symptoms or complications of ureteric obstruction may require surgical treatment. In this case, treatment comprised a laparoscopic ureteroureterostomy with an end-to-end anastomosis between the proximal and distal sections of the right ureter. The patient's postoperative recovery was uneventful and she reported resolution of the flank pain during the one year of follow-up. PMID:25694637

Giddy, Stephanie; Thangasamy, Isaac; Vega Vega, Antonio

2015-01-01

12

Electrical propagation in the renal pelvis, ureter and bladder.  

PubMed

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

Hammad, F T

2015-02-01

13

Peristomal Pagetoid Spread of Urothelial Carcinoma of the Ureter  

PubMed Central

Patients with ostomy including urinary stoma often develop peristomal complications, especially skin damage. The patient in this case was a 69-year old female with a history of urothelial carcinoma of the bladder and left ureter who underwent transurethral resection of a bladder tumor, nephroureterectomy and cystectomy combined with ureterocutaneostomy. Later, she had recurrence of urothelial carcinoma in the remaining ureter that spread to the peristomal epidermis, with a skin appearance resembling Paget’s disease. We report this case based on its clinical significance since we believe it is the first description of this condition in the literature. PMID:24179661

Ito, Fumio; Kihara, Ken; Shiomi, Koh; Ishizaki, Sumiko; Tanaka, Masaru; Aiba, Motohiko; Fujibayashi, Mariko; Nakazawa, Hayakazu

2013-01-01

14

Chronic incomplete obstruction of the ureter: a new experimental model.  

PubMed

To produce a chronic moderate hydronephrosis in dog, a method of partial ureteral occlusion using a specially designed polypropylene obturator was developed. In 11 of 14 dogs undergoing this procedure, excretory urography constantly revealed a moderate degree of hydronephrosis persisting for 7 weeks. Combination of this method in one ureter with the vaginal-cuff cutaneous ureterostomy, previously reported, in the contralateral ureter is a useful model for split renal function study of unilateral chronic hydronephrosis or obstructive nephropathy analogous to that of clinical case. PMID:3824699

Masui, S; Hiratsuka, Y; Ariyoshi, A; Sakamoto, K

1986-01-01

15

Down the tube of obstructive nephropathies: The importance of tissue interactions during ureter development  

Microsoft Academic Search

Congenital obstructive malformations of the ureter are amongst the most common human birth defects. To date, the etiology of these diseases has remained largely unexplored, which has preempted any rational approach for therapeutic intervention. Here, we describe that obstructive ureter defects can arise from genetic insults affecting various subprograms of ureter development including formation and patterning of the ureteric bud,

R Airik; A Kispert

2007-01-01

16

Chronic Incomplete Obstruction of the Ureter: A New Experimental Model  

Microsoft Academic Search

To produce a chronic moderate hydronephrosis in dog, a method of partial ureteral occlusion using a specially designed polypropylene obturator was developed. In 11 of 14 dogs undergoing this procedure, excretory urography constantly revealed a moderate degree of hydronephrosis persisting for 7 weeks. Combination of this method in one ureter with the vaginal-cuff cutaneous ureterostomy, previously reported, in the contralateral

Setsuo Masui; Yoshiharu Hiratsuka; Asami Ariyoshi; Kimitaka Sakamoto

1986-01-01

17

Intracorporeal ileal ureter replacement using laparoscopy and robotics  

PubMed Central

Introduction Ileal ureter is a suitable treatment option for patients with long ureteric strictures. Minimally invasive techniques have been shown to be as safe as open techniques but superior in terms of post–operative recovery. We report our experience using minimally invasive techniques for total intracorporeal ureteral replacement. Material and methods A chart review revealed five patients who underwent intracorporeal ileal ureter using minimally invasive techniques in the preceding 5 years. 4 patients underwent conventional laparoscopic surgery and 1 patient underwent robotic–assisted surgery. Patient's characteristics, perioperative data and functional outcomes as well as a detailed description of surgical technique are reported. In all 5 of these patients, the ileal ureter was performed completely intracorporeally. Results The median age of our patients is 61 (range 42–73). The median operative time was 250 minutes (range 150–320) and median blood loss was 100 ml (range 50–200). The median hospital stay was 8 days (range 6–10) and there were no major perioperative complications reported. At median follow up of 22 months (range 4–38), there were no recurrences of strictures or any other complications. Conclusions We have demonstrated the safety and feasibility of minimally invasive intracorporeal ileal ureter. Numbers are still small but its application is likely to grow further.

Sim, Allen; Todenhöfer, Tilman; Mischinger, Johannes; Halalsheh, Omar; Boettge, Johannes; Rausch, Steffen; Bier, Simone; Aufderklamm, Stefan; Stenzl, Arnulf; Gakis, Georgios

2014-01-01

18

An unusual complication of ischemic injury to upper pole ureter during lower pole heminephroureterectomy.  

PubMed

Lower pole heminephroureterectomy is a common paediatric urology procedure with few reported complications. We report a case of possible vascular ischemic injury to the normal remaining ureter following a lower pole heminephroureterectomy, probably due to both ureters sharing a common blood supply. Extra caution in such procedures is therefore warranted. PMID:24469495

Hurst, Katherine Victoria; Ram, Ashok Daya; Milanovic, Dragan; Lynn, Swe

2013-01-01

19

Evaluation of the tensile strength of the human ureter - Preliminary results.  

PubMed

Introduction: Ureteral injuries such as avulsion are directly related to mechanical damage of the ureter. Understanding the tensile strength of this tissue may assist in prevention of iatrogenic injuries. Few published studies have looked at the mechanical properties of the animal ureter, and of those none have determined the tensile strength of the human ureter. Therefore, the purpose of this work was to determine the tensile strength of the human ureter. Materials and Methods: We harvested 11 human proximal ureters from patients who were undergoing nephrectomy for either kidney tumors or non-functioning kidney. The specimens were then cut into multiple circumferentially and longitudinally-oriented tissue strips for tensile testing. Strips were uniaxially stretched to failure in a tensile testing machine. The corresponding force and displacement were recorded. Finally, stress at failure was noted as the tensile strength of the sample. Circumferential tensile strength was also compared in the proximal and distal regions of the specimens. Results: The tensile strength of the ureter in circumferential and longitudinal orientations was found to be 457.52±33.74 Ncm-2 and 902.43±122.08 Ncm-2, respectively (p<0.001). The circumferential strength in the proximal portion of the ureter was 409.89±35.13 Ncm-2 in comparison to 502.89±55.85 Ncm-2 in the distal portion (p=0.08). Conclusions: The circumferential tensile strength of the ureter was found to be significantly lower than the longitudinal strength. Circumferential tensile strength was also lower with more proximal parts of the ureter. This information may be important for the design of "intelligent" devices and simulators in order to prevent complications. PMID:25222851

Shilo, Yaniv; Pichamuthu, Joseph E; Averch, Timothy D; Vorp, David A

2014-09-15

20

[Lavage-cytology of the renal pelvis and ureter with special reference to tumors (author's transl)].  

PubMed

On 138 patients with radiologic filling defects in the ureter and renal pelvis lavage cytology was done. With this method it was possible to recognize clearly 39 of 47 urothelial tumors of renal pelvis and ureter (81,3%). Lavage cytology failed in patients with hypernephroma. Severe cellular atypias could be seen in patients with urolithiasis and inflammation. The diagnostic reliability of lavage cytology with urothelial tumors of renal pelvis and ureter is far greater than that of exfoliative urinary cytology and reaches results as good as those from brush biopsy. PMID:7043857

Leistenschneider, W; Nagel, R; Al-Abadi, H

1982-03-01

21

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

PubMed

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

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

22

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

Microsoft Academic Search

The aim of this study was to determine the feasibility of using a newly designed polytetrafluoroethylene (PTFE)-covered metallic\\u000a stent in the ureter by comparing its effectiveness with that of the noncovered stent in a canine model. We placed 14 stents\\u000a in the ureters of seven mongrel dogs that weighed 30–40 kg each. The covered and noncovered stents were deployed in

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

2008-01-01

23

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

PubMed Central

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

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

2014-01-01

24

Thulium fiber laser lithotripsy in an in vitro ureter model  

NASA Astrophysics Data System (ADS)

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 167±41 s (n=12). TFL times measured 111±49, 39±11, and 23±4 s, for pulse rates of 150, 300, and 500 Hz, respectively (n=12 each). Mean peak saline irrigation temperatures reached 24±1°C for holmium, and 33±3°C, 33±7°C, and 39±6°C, for TFL at pulse rates of 150, 300, and 500 Hz, respectively. To avoid thermal buildup and provide a sufficient safety margin, TFL lithotripsy should be performed with pulse rates below 500 Hz and/or increased saline irrigation rates. The TFL rapidly fragmented kidney stones due in part to its high pulse rate, high power density, high average power, and observation of reduced stone retropulsion and may provide a clinical alternative to the conventional holmium laser for lithotripsy.

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

2014-12-01

25

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

PubMed

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

Sokolis, Dimitrios P

2014-11-01

26

Fused ureters in patient with horseshoe kidney and aortic abdominal aneurysm  

PubMed Central

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

Obidike, Stephen; Woha, Akeh; Aftab, Fuad

2014-01-01

27

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

PubMed Central

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

Stoica, RA; Enache, T; Iordache, N

2014-01-01

28

[Experiences with lavage cytology from renal pelvis and ureter (author's transl)].  

PubMed

In 41 cases of roentgenologic filling defects in renal pelvis and ureter, which could not be determined exactly preoperatively, we could confirm the diagnostic value of cytology from washings of renal pelvis and ureter (lavage cytology), especially in preoperative diagnosis of carcinoma of renal pelvis and ureter. Ten of fourteen tumors (71%) were detected by this method. The diagnostic reliability increased with tumor-stage and was more accurate than the normal exfoliative urinary cytology. In five cases of hypernephromas invading the renal pelvis lavage cytology was not successful and we had obtained only false negative results. In roentgenologic filling defects that were not tumor-induced especially uric acid stones, inflammatory processes, blood clots and renal cysts, we had no false positive results. Our findings are discussed together with the literature. PMID:898441

Leistenschneider, W; Nagel, R

1977-07-01

29

Metachronous Primary Adenocarcinoma of Distal and Proximal Ureter within Two Years  

PubMed Central

Primary adenocarcinoma of the upper urinary tract, particularly of the ureter, is an extremely rare entity. We are reporting on the first case of metachronous appearance in one patient. The 71-year-old man underwent partial ureterectomy (R0 resection) for primary adenocarcinoma of the left distal ureter. 3 years later, nephroureterectomy had to be performed because of metachronous primary adenocarcinoma of the left proximal ureter. Extensive examinations revealed no evidence for further malignancies at both times. Primary adenocarcinoma of the upper urinary tract is rare but should be kept in mind, especially in patients with chronic inflammation and urinary tract obstruction. Due to the low incidence, there is a lack of data regarding its pathogenesis, diagnosis, and optimal treatment. PMID:24982812

Abt, Dominik; Müllhaupt, Gautier; Mordasini, Livio; Diener, Pierre André; Schmid, Hans-Peter

2014-01-01

30

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

PubMed

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

Obidike, Stephen; Woha, Akeh; Aftab, Fuad

2014-01-01

31

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

PubMed

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

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

2008-01-01

32

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

SciTech Connect

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

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

2008-05-15

33

Lavage of cytology of the renal pelvis and ureter with special reference to tumors.  

PubMed

Lavage cytology was done in 101 patients with radiological filling defects in the ureter and renal pelvis. This simple and inexpensive technique is valuable in the preoperative diagnosis of tumors of the ureter and renal pelvis. In our series it was possible to recognize clearly 29 of 36 such tumors (80.5 per cent) through preoperative lavage cytology. No falsely positive diagnoses were made. Lavage cytology failed in 6 patients with hypernephroma. The diagnostic reliability of lavage cytology with urothelial tumors is far greater than that of exfoliative urine cytology and reaches almost equally good results as brush biopsy. PMID:7452779

Leistenschneider, W; Nagel, R

1980-11-01

34

The interaction of laser energy with ureter tissues in a long-term investigation.  

PubMed

This study investigates tissue responses after laser irradiation of the rabbit ureter, which serves as an experimental model for rectourogenital fistulae of children. Twenty-five rabbit ureters were irradiated intraluminally by a Nd:YAG laser 1320 nm (2 Watt, 20 seconds and 3 Watt, 8 seconds) via an applicator with radialsymmetrical light distribution. Immediately, 2 weeks, 4 weeks, 8 weeks, and 16 weeks after irradiation, the ureters were X-rayed with contrast solution and prepared for light and transmission electron microscopy. For the parameters employed, no apparent morphological differences could be observed. Immediately, the central laser zone showed a transmural thermonecrosis prevailed by cellular destruction, condensed ground substance and occlusion of most vascular lumina. Peripheral laser zones displayed urothelial vacuolations. Between 2 and 16 weeks, urothelial regeneration and ingrowth of granulation tissue caused a luminal stenosis or occlusion followed by transformation into scar tissue. In some peripheral laser zones, a hydroureter with marked luminal dilatation developed. We conclude that the ureter is occluded if the expanding force of the growing scar tissue exceeds the hydrostatic pressure of the obstructed urine. A laser occlusion of rectourogenital fistulae will be easier to achieve since fistula occlusion does not entail an obstruction of the urine flow. PMID:7501993

Stratmann, U; Schaarschmidt, K; Lehmann, R R; Heinze, A; Willital, G H; Unsöld, E

1995-09-01

35

Mechanically evoked responses of afferent fibres innervating the guinea-pig's ureter: an in vitro study.  

PubMed Central

1. Electrophysiological recordings from ureteric mechanosensitive afferent fibres were performed using an in vitro preparation of the guinea-pig ureter and associated nerves. Single-unit recordings were obtained from small ureteric nerves arising from the inferior mesenteric ganglion, the hypogastric nerve or the pelvic plexus. The fibre composition of these ureteric nerves was also examined by electron microscopy. 2. In two ureteric nerve bundles, which were taken as representative of the maximal and minimal size of nerves used in the electrophysiological recordings, the number of nerve fibres was found to be 417 and 48, respectively. In the bigger nerve 12% of the fibres were small myelinated and the rest unmyelinated. The smaller nerve consisted of unmyelinated fibres only. 3. Electrophysiological recordings were made from sixty-seven mechanosensitive afferent fibres. The conduction velocities (CV) of forty-two of them were determined and all were found to be in the C fibre range (mean CV, 0.4 m/s). Of 119 additional fibres which were not further characterized 112 were C fibres (mean CV, 0.51 m/s) and seven were A delta fibres (mean CV, 3.78 m/s). 4. Mechanosensitive units were classified into two groups according to their ability to respond to contractions of the ureter: (i) U-1 units (9% of all mechanosensitive units) responded to contractions of the ureter and did not show on-going activity or after-discharges to mechanical stimulation. They had low thresholds to intraluminal distension (mean, 8 mmHg) and responded with a short latency to pressure stimuli. (ii) U-2 units (91% of all mechanosensitive units) did not respond to contractions of the ureter, had spontaneous activity between 0 and 2.4 Hz and exhibited after-discharges to mechanical stimuli lasting up to several minutes. They responded after a long latency (greater than 3 s) to distensions in the range of 5-30 mmHg. 5. The level of spontaneous activity and the pressure thresholds of the U-2 units were found to be different depending on whether or not the ureter was perfused intraluminally. Thus U-2 units recorded with intraluminal perfusion had a lower rate of on-going activity and higher threshold to intraluminal distension than U-2 units recorded without intraluminal perfusion. 6. Movement of an intraluminal glass bead under the receptive field of the units evoked strong responses in nine of eleven U-2 units tested as soon as their receptive fields were reached. 7. Our results demonstrate the existence of two classes of mechanosensitive afferent fibres in the guinea-pig ureter.(ABSTRACT TRUNCATED AT 400 WORDS) Images Fig. 2 PMID:2600832

Cervero, F; Sann, H

1989-01-01

36

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

PubMed Central

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

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

2009-01-01

37

Total ureterectomy and ileal ureteric replacement for TCC ureter in a solitary kidney  

PubMed Central

Traditional treatment of upper tract transitional cell carcinoma (TCC) is nephroureterectomy with a bladder cuff. This is in keeping with the nature of the disease, in that TCC is a panurothelial disease. However, there are a few rare occasions when this would mean making a subject anephric, as in a TCC in a solitary kidney or bilateral synchronous/metachronous disease. We present a case of a patient with a dysplastic, poorly functioning left kidney and with a TCC of the ureter on the right side. PMID:25553174

Banerji, John S.; George, Arun J.P.

2014-01-01

38

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

PubMed Central

According to previous observations nitric oxide (NO), as well as an unknown nature mediator are involved in the inhibitory neurotransmission to the intravesical ureter. This study investigates the hydrogen sulfide (H2S) role in the neurogenic relaxation of the pig intravesical ureter. We have performed western blot and immunohistochemistry to study the expression of the H2S synthesis enzymes cystathionine ?-lyase (CSE) and cystathionine ?-synthase (CBS), measurement of enzymatic production of H2S and myographic studies for isometric force recording. Immunohistochemical assays showed a high CSE expression in the intravesical ureter muscular layer, as well as a strong CSE-immunoreactivity within nerve fibres distributed along smooth muscle bundles. CBS expression, however, was not consistently observed. On ureteral strips precontracted with thromboxane A2 analogue U46619, electrical field stimulation (EFS) and the H2S donor P-(4-methoxyphenyl)-P-4-morpholinylphosphinodithioic acid (GYY4137) evoked frequency- and concentration-dependent relaxations. CSE inhibition with DL-propargylglycine (PPG) reduced EFS-elicited responses and a combined blockade of both CSE and NO synthase (NOS) with, respectively, PPG and NG-nitro-L-arginine (L-NOARG), greatly reduced such relaxations. Endogenous H2S production rate was reduced by PPG, rescued by addition of GYY4137 and was not changed by L-NOARG. EFS and GYY4137 relaxations were also reduced by capsaicin-sensitive primary afferents (CSPA) desensitization with capsaicin and blockade of ATP-dependent K+ (KATP) channels, transient receptor potential A1 (TRPA1), transient receptor potential vanilloid 1 (TRPV1), vasoactive intestinal peptide/pituitary adenylyl cyclase-activating polypeptide (VIP/PACAP) and calcitonin gene-related peptide (CGRP) receptors with glibenclamide, HC030031, AMG9810, PACAP6–38 and CGRP8–37, respectively. These results suggest that H2S, synthesized by CSE, is involved in the inhibitory neurotransmission to the pig intravesical ureter, through an NO-independent pathway, producing smooth muscle relaxation via KATP channel activation. H2S also promotes the release of inhibitory neuropeptides, as PACAP 38 and/or CGRP from CSPA through TRPA1, TRPV1 and related ion channel activation. PMID:25415381

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

2014-01-01

39

Investigating the Flow Dynamics in the Obstructed and Stented Ureter by Means of a Biomimetic Artificial Model  

PubMed Central

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

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

2014-01-01

40

Outcomes of Surgical Management of Deep Infiltrating Endometriosis of the Ureter and Urinary Bladder  

PubMed Central

Objectives: To report the outcomes of surgical management of urinary tract endometriosis and discuss the choice between conservative and radical surgery. Materials and Methods: We reviewed data concerning women managed for ureteral or bladder deep infiltrating endometriosis in 5 surgical departments participating in the CIRENDO prospective database. Preoperative data, surgical procedure data, and postoperative outcomes were analyzed. Results: Data from 30 women pooled in the database showed 15 women presenting with ureteral endometriosis, 14 women with bladder nodules, and 1 with both types of lesions. Ureterolysis was performed in 14 cases; the ureter was satisfactorily freed in 10 of these. In 4 women over 40 years old, who were undergoing definitive amenorrhea, moderate postoperative ureteral stenosis was tolerated and later improved in 3 cases, while the fourth underwent secondary ureteral resection and ureterocystoneostomy. Primary ureterectomy was carried out in 4 women. Two cases of intrinsic ureteral endometriosis were found in 5 ureter specimens. Four complications were related to surgical procedures on ureteral nodules, and 2 complications followed the removal of bladder endometriosis. Delayed postoperative outcomes were favorable with a significant improvement in painful symptoms and an absence of unpleasant urinary complaints, except for one patient with prolonged bladder denervation. Conclusion: Conservative surgery, in association with postoperative amenorrhea, can be proposed in a majority of cases of urinary tract endometriosis. Although the outcomes are generally favorable, the risk of postoperative complications should not be overlooked, as surgery tends to be performed in conjunction with other complex procedures such as colorectal surgery. PMID:22643496

Rozsnyai, Francisc; Resch, Benoit; Dugardin, Fabrice; Berrocal, Juan; Descargues, Gérôme; Schmied, Remi; Boukerrou, Malik; Marpeau, Loïc

2011-01-01

41

Bilateral Double Ureters with Bladder Neck Diverticulum in a Nigerian Woman Masquerading as an Obstetric Fistula  

PubMed Central

A 43-year-old woman presented with 20-year history of leakage of urine per vaginam. She had one failed repair attempt. Pelvic examination with dye test showed leakage of clear urine suggestive of ureterovaginal fistula. The preoperative intravenous urogram revealed duplex ureter and cystoscopy showed normally cited ureteric orifices with two other ectopic ureteric openings and bladder diverticula. The definitive surgery performed was ureteric reimplantation (ureteroneocystostomy) of the two distal ureteric to 2?cm superiolateral to the two normal orifices and diverticuloplasty. There was resolution of urinary incontinence after surgery. Three months after surgery, she had urodynamic testing done (cystometry), which showed 220?mLs with no signs of instability or leakage during filling phase but leaked on coughing at maximal bladder capacity. This is to showcase some diagnostic dilemma that could arise with obstetric fistula, which is generally diagnosed by clinical assessment. PMID:25587483

Morhason-Bello, Imran O.; Adebayo, Sikiru A.; Abdusalam, Rukiyat A.; Bello, Oluwasomidoyin O.; Odubamowo, Kehinde H.; Lawal, Olatunji O.; Olapade-Olaopa, E. Oluwabunmi; Ojengbede, Oladosu A.

2014-01-01

42

Common site of urinary calculi in kidney, ureter and bladder region.  

PubMed

Urolithiasis is an ancient disease with global distribution. It refers to stones originating anywhere in the urinary system. Urinary calculi or stones are the most common cause of acute urinary system obstruction. The study was aimed with finding out the common site of urinary calculus in kidney ureter bladder (KUB) region. This was a prospective cross-sectional study conducted from June 2012 to September 2012 at Tribhuvan University, Teaching Hospital, Maharajgunj. A total 240 urolitiasis patients were enrolled for plain KUB examination. Site of urinary calculus was identified by observing KUB film of the subjects under the supervision of radiologist. The data were analyzed prospectively with outcome measures of gender & stone location. Out of 240 patients, 138 were male and 102 were female with male to female ratio of 1.35:1. The age ranged from 9 to 83 years. Out of total 240 patients, 71.9% (187) patients belonged to productive age group (20-60 years). Total number of urinary calculi was 345 in which 208 were found in male patients and 137 were found in female patients. Of total 345 calculi, 237 were renal stones, 47 were ureteric stones, 22 of the stones were found in pelviureteric junction (PUJ), 33 of stones were found in vesicoureteric junction (VUJ), and 6 were in bladder. In conclusion, urinary stone disease is a major public health problem in a developing country like Nepal with male and productive age group predominance. Kidney stones are most common. Distal ureter is the most common site of ureteric stone. PMID:24592784

Chand, R B; Shah, A K; Pant, D K; Paudel, S

2013-03-01

43

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

PubMed Central

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

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

2014-01-01

44

Metastatic Prostate Adenocarcinoma Posing as Urothelial Carcinoma of the Right Ureter: A Case Report and Literature Review  

PubMed Central

This is a case report of a 67-year-old patient with distant metastasis of prostate cancer to the right ureter which caused hydronephrosis. At the beginning, both of the cytology of the morning urine and imaging findings were consistent with urothelial carcinoma. Nephroureterectomy was subsequently performed. Interestingly, the pathological examination of the excised ureter revealed that the malignancy was derived from the prostate. No skeletal metastasis was detected. However, after four months of follow-up, several abnormal signal shadows were reported in skeletal scintigraphy and the prostate specific antigen (PSA) was gradually increasing. We present such a case for its unique presentation. A review of the literature is also provided. PMID:25197608

Huang, Tian-bao; Yan, Yang; Liu, Huan; Che, Jian-ping; Wang, Guang-chun; Liu, Min; Zheng, Jun-hua; Yao, Xu-dong

2014-01-01

45

Endoscopic Versus Open Approach of Bladder Cuff and Distal Ureter in the Management of Upper Urinary Tract Transitional Cell Carcinoma  

PubMed Central

Objective: Nephroureterectomy with the removal of the ipsilateral ureteral orifice and bladder cuff en bloc remains the gold standard treatment for upper urinary tract urothelial cancer. The distal ureter can be removed with the open surgical technique or endoscopic approach. We compared the outcomes of the endoscopic approach with those of conventional open surgery on the distal ureter. Materials and Methods: We collected data from the charts of 30 patients who underwent radical nephroureterectomy at our clinic from January 1997 to January 2007 for upper urinary tract urothelial carcinoma. The patients were divided into two groups according to procedure performed on the distal ureter. Group I (n:12) was comprised of patients who underwent an open surgical procedure, and group II (n:18), was comprised of patients who underwent an endoscopic approach. Both groups were compared in terms of operative time, blood loss, transurethral catheter duration and duration of hospital stay. Results: Patient age and tumor location showed no significant differences between the two groups. The operative time was significantly longer in group I than group II (181 versus 128 minutes; p<0.05). On the other hand, the estimated blood loss, transurethral catheter duration and duration of hospital stay were significantly lower in group II (205 mL versus 435 mL, 5 versus 8.5 days and 5.6 versus 9.2 days, respectively; p <0.05). Conclusion: The results of our study show that the endoscopic approach is less invasive than open surgery on the distal ureter. This procedure can easily be performed in the management of upper urinary tract urothelial carcinoma.

Yapanoglu, Turgut; Kocaturk, Huseyin; Polat, Ozkan; Demirel, Azam; Okyar, Guray

2008-01-01

46

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

PubMed Central

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.

Chung, Mee Young; Chae, Su Min

2015-01-01

47

Percutaneous nephrolithotripsy and antegrade ureterolithotripsy in a 10-month-old infant with urinary stones in both kidney and ureter.  

PubMed

The prevalence of urinary tract stones in the pediatric population is lower than that in adults. Although methods of surgery and medical equipment have developed, medical treatments for urinary tract stones are limited for pediatric cases. We report the case of a 10-month-old male infant with urinary stones in the left kidney and ureter who underwent percutaneous nephrolithotripsy and ureterolithotripsy using antegrade insertion of a ureteroscope through the same nephrostomy tract. PMID:25252092

Naitoh, Yasuyuki; Yamada, Yasuhiro; Fujihara, Atsuko; Naya, Yoshio; Hongo, Fumiya; Kamoi, Kazumi; Okihara, Koji; Miki, Tsuneharu

2014-09-23

48

Sarcomatoid carcinoma with a predominant basaloid squamous carcinoma component: the first report of an unusual biphasic tumor of the ureter.  

PubMed

Malignant tumors of the ureter that display biphasic patterns are very rare; they include carcinosarcomas, sarcomatoid carcinomas and carcinomas with pseudosarcomatous stroma. Although the distinction between carcinosarcomas and sarcomatoid carcinomas has been extensively discussed in the past, the recent World Health Organization classification of urinary tract tumors (2004) does not distinguish the two lesions and use the term sarcomatoid carcinoma to represent these biphasic tumors. The epithelial components of previously reported ureteral biphasic tumors comprise transitional cell carcinoma, squamous cell carcinoma, carcinoma in situ, small cell carcinoma and adenocarcinoma. In this paper, we report the first case of sarcomatoid carcinoma of the ureter with a predominant basaloid squamous carcinoma component. A 63-year-old man who had developed asymptomatic gross hematuria was diagnosed with a right ureteral tumor and underwent a right nephroureterectomy. Macroscopic examination of the excised tumor revealed a polypoid mass. Histopathologic examination exposed a tumor with malignant epithelial and sarcomatous components. The malignant epithelial component was predominantly composed of basaloid squamous carcinoma, and the sarcomatous component was mostly composed of undifferentiated spindle cells. A small focus of a chondrosarcomatous component was present. There were also transitional zones between the two components. In addition, the spindle cells of the sarcomatous component were partially positive for cytokeratin 7. We believe that the findings of this case study will increase the morphological diversity used for diagnosing malignant tumors of the ureter. PMID:18057014

Maeda, Daichi; Fujii, Akiko; Yamaguchi, Kazumi; Tominaga, Takashi; Fukayama, Masashi; Mori, Masaya

2007-11-01

49

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

SciTech Connect

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

Boyvat, Fatih, E-mail: fboyvat@baskent-ank.edu.tr, E-mail: boyvatf@yahoo.com; Aytekin, Cuneyt [Baskent University Faculty of Medicine, Department of Radiology (Turkey); Colak, Turan [Baskent University Faculty of Medicine, Department of Nephrology (Turkey); Firat, Ali [Baskent University Faculty of Medicine, Department of Radiology (Turkey); Karakayali, Hamdi; Haberal, Mehmet [Baskent University Faculty of Medicine, Department of General Surgery (Turkey)

2005-04-15

50

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

PubMed Central

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

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

2014-01-01

51

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

PubMed

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

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

2014-07-01

52

Sodium currents in smooth muscle cells freshly isolated from stomach fundus of the rat and ureter of the guinea-pig.  

PubMed Central

1. Inward currents elicited by depolarization from holding potentials of -80 to -10 mV in single smooth muscle cells isolated from stomach fundus of the rat and ureter of the guinea-pig had two components. The initial fast component (Ifi) was activated and mostly inactivated within 1-2 and 10 ms, respectively, at 21 degrees C. The following sustained component (Isi) lasted over 50 and 500 ms in fundus and ureter cells, respectively. Ifi was blocked by tetrodotoxin but not affected by 0.5 microM-mu-conotoxin in both types of cells. Isi was abolished by the substitution of extracellular Ca2+ with Mn2+. 2. The sensitivity of Ifis to TTX was markedly different in fundus and ureter cells. The half-inhibition was obtained at 870 and 11 nM, respectively. The amplitude of Ifi was highly dependent on extracellular Na+ concentration in a solution containing 2.2 mM-Mn2+ and 0 mM-Ca2+ in both cells. It is concluded that Ifis in these cells are TTX-sensitive and mu-conotoxin-insensitive Na+ currents. 3. Some of the kinetics of INa measured at 10 degrees C were markedly different in fundus and ureter cells. The current-voltage relationships for Ifi in fundus and ureter cells had peaks at about -10 and 0 mV, respectively. The voltage dependence of the steady-state inactivation of Ifi was also significantly different in these cell types. The half-inactivation voltages were about -74 and -45 mV, respectively. The recovery time course from inactivation in fundus cells was about 10 times slower than that in ureter at -80 mV, where it was 25 ms. 4. The contribution of Ifi to the rising phase of an action potential was examined using TTX under current clamp mode at 21 degrees C. A fast notch-like potential elicited by a subthreshold stimulus for action potential generation was blocked by TTX in both types of cells. Action potentials elicited by a stimulus around threshold were occasionally suppressed by TTX, whereas an action potential was never observed when extracellular Ca2+ was replaced with Mn2+. 5. In conclusion, the existence of at least two types of Na+ channel currents, which were distinguished by their TTX sensitivity and kinetics, was strongly suggested in smooth muscle cells from the rat fundus and the guinea-pig ureter. INa in these cells may have a physiological role to accelerate the generation of an action potential by triggering a rapid activation of ICa, while not being essential for activation of action potentials. PMID:1665861

Muraki, K; Imaizumi, Y; Watanabe, M

1991-01-01

53

A novel ureter dilatation method for replacing hydromantic perfusion pump during ureteroscopic lithotripsy in patients with ureteral calculi and ibroepithelial polyps  

PubMed Central

This study aimed to evaluate the clinical value of a novel ureter dilatation method during ureteroscopic pneumatic lithotripsy in patients with ureteral calculi and polyps. Clinical information of 86 patients with ureter calculi and polyps who underwent ureteroscopic pneumatic lithotripsy was reviewed. A cavity-distention machine was used in 44 cases to inject normal saline for keeping clear operation view (cavity-distention machine-assisted group). A high handled water bag with artificial water injection (traditional pneumatic lithotripsy group) was used in 42 cases. The total operation time, time of stone removal, stone clearance rate and surgery complications were compared between two groups. All operations were successful with no patients transferred to open surgery. No ureter breakage or avulsion occurred in two groups. Two patients in traditional pneumatic lithotripsy group suffered from ureter perforation. In cavity-distention machine-assisted group and traditional pneumatic lithotripsy group, the total operation time was 30.1±4.8 min and 36.2±6.0 min, respectively (t=-5.22, P<0.01); the time of stone removal was 6.4±1.3 min and 9.3±1.5 min, respectively (t=-9.59, P<0.01); the stone clearance rate was 100% (44/44) and 95.2% (40/42; upper ureter stone immigrated to the renal pelvis in 2, and extraorgan shock wave lithotripsy was performed), respectively. Thus, intraoperative infusion of saline with a cavity-distention machine may replace the hydromantic perfusion pump to maintain a clear operation view and favor the stone removal in lesser time. This method has important clinical value in the treatment of ureteral calculi and polyps. PMID:24753755

Li, Tengcheng; Fang, Youqiang; Wu, Jieying; Zhou, Xiangfu

2014-01-01

54

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

PubMed

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

Viozzi, G P; Gutiérrez, P A

2001-04-01

55

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

SciTech Connect

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

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

2007-10-01

56

[Histology and histochemistry of the kidney and ureters of the Caiman crocodilus yacare (Daudin, 1802)--Crocodilia Reptilia)].  

PubMed

The elongated kidneys of Caiman crocodilus yacare are found in pairs and have two lobes. Each lobe is crossed lengthwise down the middle by the renal vein and artery along which there are the renal corpuscules in groups of two or four which delimit the medullar renal region. These corpuscules are generally poorly developed and there is a center of connective tissue with few capillary loops. The Bowman capsule is of pavement or cubic epithelium and leads into a narrow, short, non-secretory neck segment composed of cubical cells followed by tubulus contortus with brush borders against the lumen and the distal tubule with cubic epithelium brush borders. In the renal cortical region are the median tubulus with cylindrical and granular epithelium and the smaller collecting canals which flow into larger collecting canals which flow along the renal border. Among the various tubular parenchyma segments there is a network of blood vessels which lead into the renal vein and into a renal afferent vein. Abundant fat granular bodies and lipid droplets are observed in the proximal and median tubules. The collecting canals and ureters show PAS positive granules in their cells. PMID:7569146

Jin, S M; Rodrigues, A M; de Souza, A C

1995-02-01

57

Expression of Rho-kinase (ROCK-1 and ROCK-2) and its substantial role in the contractile activity of the sheep ureter  

PubMed Central

Expression of two isoforms of Rho-kinase (ROCK) and its functional role in the physiological control of smooth muscle contraction in the sheep ureter were investigated. Helical strips of the ureteric smooth muscle were stimulated by electrical field stimulation (EFS, 60 V, 1 mS, 2, 4, 8, 16 and 32 Hz, for 20 S), KCl (80 mM), carbachol (CCh, 10?8–10?4 M) or phenylephrine (Phe, 10?8–10?4 M). EFS produced a reproducible contractile activity, which was abolished by tetrodotoxin (3 × 10?6 M), a Na+ channel blocker. A muscarinic receptor antagonist, atropine (2 × 10?6 M), and an adrenergic neuron blocker, guanethidine (10?5 M), significantly suppressed the contraction induced by EFS. However, this contraction was augmented in the presence of NG-nitro-L-arginine (L-NA, 10?4 M), a nitric oxide synthase inhibitor. Two Rho-kinase inhibitors, Y-27632 (5 × 10?5 M) and fasudil (5 × 10?5 M), markedly attenuated the EFS-elicited contraction. CCh and Phe produced concentration-dependent contraction in the sheep ureter. pD2 values for Phe and CCh were 5.04±0.11 and 5.00±0.22, respectively. Y-27632 (5 × 10?5 M) and fasudil (5 × 10?5 M) also significantly inhibited CCh- and Phe-induced contractions. Moreover, these ROCK inhibitors produced relaxations in the KCl-elicited contraction in a concentration-dependent manner. pD2 values for Y-27632 and fasudil were, respectively, 5.17±0.07 and 4.58±0.08 (P<0.001). Furthermore, the influences of these agents were also tested on spontaneous phasic contractions of the tissue. Among Y-27632, fasudil, TTX, L-NA, guanethidine and atropine, only the ROCK inhibitors (10?6–10?5 M) were able to suppress the spontaneous contractile activity. Western blot analysis has revealed that both isoforms of Rho-kinase (ROCK-1 and ROCK-2) are expressed in the sheep ureter. Densitometric analysis has indicated that these enzymes are less expressed in the sheep ureter than are in the sheep aorta in a significant manner. These results show that a contractile enzyme, Rho-kinase, is expressed, and it mediates agonist- and EFS-induced contractions as well as spontaneous contractile activity of the isolated sheep ureter. Since Y-27632 and fasudil depressed the contractions, it seems plausible to postulate that Rho-kinase inhibitors may be beneficial in the treatment of renal colic. PMID:15351780

Levent, Adnan; Büyükaf?ar, Kansu

2004-01-01

58

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

PubMed Central

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

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

2014-01-01

59

Stromal invasion of the prostate following a complete response to bacillus Calmette-Guerin instillation therapy for carcinoma in situ of the ureter and the bladder.  

PubMed

Bacillus Calmette-Guerin (BCG) instillation therapy is now a standard therapy for high-risk superficial bladder cancer patients. Although the complete response rate is approximately 70%, extra-vesical progression is sometimes observed. In particular, those patients who present a positive urinary cytology even after complete response from bladder lesion should be thoroughly examined. We present two cases of stromal invasion of the prostate after complete remission by BCG therapy of carcinoma in situ of the ureter and bladder found by transrectal prostate biopsy. PMID:15028107

Hara, Isao; Yao, Akihisa; Muramaki, Mototsugu; Hikosaka, Satoko; Yamada, Yuji; Kawabata, Gaku; Kamidono, Sadao

2004-04-01

60

Injury - kidney and ureter  

MedlinePLUS

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

61

Should low-dose computed tomography kidneys, ureter and bladder be the new investigation of choice in suspected renal colic?: A systematic review  

PubMed Central

Introduction: Computed tomography kidneys, ureter and bladder (CTKUB) is the accepted gold standard investigation for suspected renal colic. Dose considerations are particularly pertinent in the context of detecting urolithiasis given the high risk of disease recurrence, which can necessitate multiple radiological examinations over the lifetime of a stone-former. We performed a systematic review of the literature to see whether there was any evidence that reducing the effective radiation dose of a CTKUB compromised the diagnostic accuracy of the scan. Materials and Methods: Relevant databases including MedLine, EMBASE, DARE and the Cochrane Library were searched from inception to October 2012. All English language articles reporting on prospective studies where non-contrast, low-dose CT (LDCT) was used to investigate adults (males and non-pregnant females) presenting with flank pain or suspected urolithiasis were included. LDCT was defined as an effective radiation dose <3 mSv per examination. Results: Our initial search identified 497 records. After removing duplicates, 390 abstracts were screened, of which 375 were excluded, principally because outcomes of interest were not presented. Six papers remained for the final analysis, reporting on a total of 903 patients. Individual studies showed a prevalence of urolithiasis ranging between 36% and 88%, with additional pathologies found in 5-16%. The effective radiation dose of the LDCT techniques used ranged from 0.5 to 2.8 mSv. The sensitivity of LDCT for diagnosing stone disease was 90-97% with a specificity of 86-100%. Conclusions: The sensitivity and specificity of CTKUB for diagnosing urolithiasis remains high, even when the effective radiation dose is lowered. LDCT may miss some small stones (<3 mm), especially in obese patients (>30 kg/m2), but in this group LDCT still identifies most alternative diagnoses. With at least one level 1A and two level 1B studies supporting the use of LDCT, there is Grade A recommendation for its use as the first-line investigation in suspected renal colic in non-obese patients. PMID:24744508

Drake, Tamsin; Jain, Nitin; Bryant, Timothy; Wilson, Iain; Somani, Bhaskar K.

2014-01-01

62

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

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

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

2014-01-01

63

Tumors of the kidney, ureter, and bladder.  

PubMed Central

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

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

1992-01-01

64

The role of dilatation in bilharzial ureters.  

PubMed

Endoscopic dilatation of bilharzial ureteric strictures was carried out in 35 men and four women. The procedure had to be repeated in 10 patients after 2 months and three patients have required regular dilatation every 4 months for the last 2 years. The selection of patients is important since they should have neither an active lesion nor a stenotic calcific one. PMID:3109536

Wishahi, M M

1987-05-01

65

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 ...

66

ATP is released from guinea pig ureter epithelium on distension  

E-print Network

School, London NW3 2PF, United Kingdom; and 2 Department of Pharmacology, School of Medicine, University such as the rat pulmonary vascular bed (25) and rabbit and guinea pig coronary beds (49, 51). ATP is also released from both human and rabbit red blood cells (RBCs) in response to mechanical deforma- tion (48). The ATP

Burnstock, Geoffrey

67

Synchronous tumors in both ureters and left renal pelvis.  

PubMed

A case of bilateral, synchronous ureteral tumors and a tumor in the left renal pelvis is presented. Conservative surgical treatment involved local resection of both ureteral tumors and partial nephrectomy of the left kidney. Multiple urothelial tumors subsequently developed in the bladder which were resected. The patient has had good kidney function and no evidence of disease. PMID:6836808

Maruf, N J; Godec, C J; Kahn, A; Cass, A S

1983-03-01

68

Successful Treatment of Stent Knot in the Proximal Ureter Using Ureteroscopy and Holmium Laser  

PubMed Central

Knotted ureteral stent is rare yet tedious complication that might represent a treatment challenge to the endourologist. Only twelve cases of knotted stent have been reported. Different management options have been reported, including simple traction, ureteroscopy, percutaneous removal, and open surgery. In this paper, we present the successful untying of the knot using ureteroscopy with holmium laser. PMID:21629808

Richards, Masters M.; Khalil, Daniel; Mahdy, Ayman

2011-01-01

69

Minimally Invasive Techniques for Management of the Ureterocele and Ectopic Ureter: Upper Tract Versus Lower Tract Approach.  

PubMed

The optimal management approach for children with ureterocele and complete pyeloureteral duplication, especially in the setting of high-grade ipsilateral vesicoureteral reflux, remains unclear. Trends in surgical management reflect a shift from single-stage open reconstruction toward conservative management and minimally invasive approaches. This article reviews lower tract approaches (endoscopic ureterocele incision and ipsilateral ureteroureterostomy), and upper tract approaches (ureterocele moiety heminephrectomy) in terms of selected operative techniques, patient selection, published outcomes, postoperative care, and follow-up. Current data support endoscopic puncture as a safe and effective treatment of symptomatic children with single-system intravesical ureteroceles. PMID:25455173

Timberlake, Matthew D; Corbett, Sean T

2015-02-01

70

Atlantic cod is a common host for myxosporeans, few reported as pathogens eg. Myxobolus aeglefini Auerbach, 1906 (Kabata, 1957)  

E-print Network

in middle trunk kidney Occlusion of collecting ducts & ureters Ureter in head kidney Collecting duct in posterior kidney Ureter in posterior kidney Massive to the epithelium, discharging into the luminal space Ureter in posterior kidney #12

Kane, Andrew S.

71

MP/H Rules Presentation - Urinary  

Cancer.gov

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

72

Treatment of vesicoureteric reflux by endoscopic injection of Teflon  

Microsoft Academic Search

Thirteen girls with grade III-V vesicoureteric reflux were treated by endoscopic injection of Teflon paste behind the intravesical ureter. Fourteen of the 18 treated ureters showed complete absence of reflux after one injection of Teflon. Three ureters required a second injection of Teflon for successful treatment of the reflux. One ureter with grade IV reflux was converted to grade II

B ODonnell; P Puri

1984-01-01

73

21 CFR 876.4020 - Fiberoptic light ureteral catheter.  

Code of Federal Regulations, 2012 CFR

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

2012-04-01

74

21 CFR 876.4020 - Fiberoptic light ureteral catheter.  

Code of Federal Regulations, 2013 CFR

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

2013-04-01

75

21 CFR 876.4020 - Fiberoptic light ureteral catheter.  

Code of Federal Regulations, 2010 CFR

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

2010-04-01

76

21 CFR 876.4020 - Fiberoptic light ureteral catheter.  

Code of Federal Regulations, 2011 CFR

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

2011-04-01

77

21 CFR 876.4020 - Fiberoptic light ureteral catheter.  

Code of Federal Regulations, 2014 CFR

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

2014-04-01

78

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

Adult Solid Neoplasm; Bladder Carcinoma; Breast Carcinoma; Endometrial Carcinoma; Esophageal Carcinoma; Lung Carcinoma; Malignant Head and Neck Neoplasm; Melanoma; Ovarian Neoplasm; Renal Pelvis and Ureter Urothelial Carcinoma; Testicular Lymphoma; Ureter Carcinoma; Urethral Carcinoma

2015-02-10

79

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

Adult Solid Neoplasm; Bladder Carcinoma; Breast Carcinoma; Endometrial Carcinoma; Esophageal Carcinoma; Lung Carcinoma; Malignant Head and Neck Neoplasm; Melanoma; Ovarian Neoplasm; Renal Pelvis and Ureter Urothelial Carcinoma; Testicular Lymphoma; Ureter Carcinoma; Urethral Carcinoma

2014-12-19

80

Ureterocele  

MedlinePLUS

... diagnostic procedure that uses a combination of large magnets, radiofrequencies and a computer to produce detailed images ... between two segments of the same ureter. ureters: Pair of tubes that carry urine from each kidney ...

81

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

ClinicalTrials.gov

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

2015-01-19

82

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

ClinicalTrials.gov

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

2015-02-10

83

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

ClinicalTrials.gov

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

2014-09-03

84

Ixabepilone in Treating Patients With Advanced Urinary Tract Cancer  

ClinicalTrials.gov

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

2013-01-23

85

Dipping technique for ureteroileal anastomosis in orthotopic ileal neobladder: 20-year experience in 670 patients-no stenosis with preservation of the upper tract.  

PubMed

Objectives. Many techniques were described for ureteroileal anastomosis in orthotopic bladder substitution, ranging from nonrefluxing to refluxing techniques, all aiming at preservation of the upper tract. We describe our technique of dipping the ureter into the ileal pouch, which is simple and had no complications. Patients and Methods. Our technique implies dipping the ureter in the lateral side of the pouch, in right and left corners, with two rows of four sutures fixing the seromuscular layer of the ureter to the seromuscular layer of the ileal pouch. The procedure was applied in both normal ureteric calibre and dilated ureter. Total number of procedures done was 1,340 ureters in 670 patients after radical cystectomy for invasive carcinoma of the bladder of urothelial and nonurothelial cancer. Results. Followup of patients every six months and onward did not show stenosis in the ureteroileal anastomotic site. Filling of the ureter with contrast dye on ascending pouchogram was observed in patients who had considerably dilated ureters at the time of cystectomy. Normal ureter did not show clinical reflux but radiological filling of the ureter when the intravesical pressure exceeded the leak point pressure. Time to perform the dipping technique was 5-7 minutes for each site. Conclusion. Dipping technique for ureteroileal anastomosis in orthotopic ileal neobladder avoids the incidence of stenosis, preserves the upper tract, is a fast procedure, stands the evaluation in long-term followup, and was practiced successfully for twenty years. PMID:23762629

Wishahi, Mohamed M; Elganzoury, Hosam; Elkhouly, Amr; Mehena, Ahmed

2013-01-01

86

Dipping Technique for Ureteroileal Anastomosis in Orthotopic Ileal Neobladder: 20-Year Experience in 670 Patients—No Stenosis with Preservation of the Upper Tract  

PubMed Central

Objectives. Many techniques were described for ureteroileal anastomosis in orthotopic bladder substitution, ranging from nonrefluxing to refluxing techniques, all aiming at preservation of the upper tract. We describe our technique of dipping the ureter into the ileal pouch, which is simple and had no complications. Patients and Methods. Our technique implies dipping the ureter in the lateral side of the pouch, in right and left corners, with two rows of four sutures fixing the seromuscular layer of the ureter to the seromuscular layer of the ileal pouch. The procedure was applied in both normal ureteric calibre and dilated ureter. Total number of procedures done was 1,340 ureters in 670 patients after radical cystectomy for invasive carcinoma of the bladder of urothelial and nonurothelial cancer. Results. Followup of patients every six months and onward did not show stenosis in the ureteroileal anastomotic site. Filling of the ureter with contrast dye on ascending pouchogram was observed in patients who had considerably dilated ureters at the time of cystectomy. Normal ureter did not show clinical reflux but radiological filling of the ureter when the intravesical pressure exceeded the leak point pressure. Time to perform the dipping technique was 5–7 minutes for each site. Conclusion. Dipping technique for ureteroileal anastomosis in orthotopic ileal neobladder avoids the incidence of stenosis, preserves the upper tract, is a fast procedure, stands the evaluation in long-term followup, and was practiced successfully for twenty years. PMID:23762629

Wishahi, Mohamed M.; Elganzoury, Hosam; Elkhouly, Amr; Mehena, Ahmed

2013-01-01

87

SIX1 acts synergistically with TBX18 in mediating ureteral smooth muscle formation.  

PubMed

Dysfunction of the ureter often leads to urine flow impairment from the kidney to the bladder, causing dilation of the ureter and/or renal pelvis. Six1 is a crucial regulator of renal development: mutations in human SIX1 cause branchio-oto-renal (BOR) syndrome and Six1(-/-) mice exhibit renal agenesis, although the ureter is present. It remains unclear whether Six1 plays a role in regulating ureter morphogenesis. We demonstrate here that Six1 is differentially expressed during ureter morphogenesis. It was expressed in undifferentiated smooth muscle (SM) progenitors, but was downregulated in differentiating SM cells (SMCs) and had disappeared by E18.5. In Six1(-/-) mice, the ureteral mesenchymal precursors failed to condense and differentiate into normal SMCs and showed increased cell death, indicating that Six1 is required for the maintenance and normal differentiation of SM progenitors. A delay in SMC differentiation was observed in Six1(-/-) ureters. A lack of Six1 in the ureter led to hydroureter and hydronephrosis without anatomical obstruction when kidney formation was rescued in Six1(-/-) embryos by specifically expressing Six1 in the metanephric mesenchyme, but not the ureter, under control of the Eya1 promoter. We show that Six1 and Tbx18 genetically interact to synergistically regulate SMC development and ureter function and that their gene products form a complex in cultured cells and in the developing ureter. Two missense mutations in SIX1 from BOR patients reduced or abolished SIX1-TBX18 complex formation. These findings uncover an essential role for Six1 in establishing a functionally normal ureter and provide new insights into the molecular basis of urinary tract malformations in BOR patients. PMID:20110314

Nie, Xuguang; Sun, Jianbo; Gordon, Ronald E; Cai, Chen-Leng; Xu, Pin-Xian

2010-03-01

88

Intravenous Pyelogram (IVP)  

MedlinePLUS

... detect problems within the urinary tract resulting from: kidney stones enlarged prostate tumors in the kidney, ureters or urinary bladder surgery ... of the kidneys and surrounding structures nearby the kidneys, ureters and ... Small urinary tract tumors and stones are more easily identified on these ...

89

Correction of experimentally produced vesicoureteric reflux in the piglet by intravesical injection of Teflon  

Microsoft Academic Search

Vesicoureteric reflux was produced in eight piglets by opening their bladders and slitting the anterior intravesical wall of the ureter. Cystography confirmed the presence of bilateral reflux in six piglets and unilateral reflux in two. Six to eight weeks later the bladder was again opened and Teflon paste injected in the space behind the intravesical ureter, thereby creating a support

P Puri; B ODonnell

1984-01-01

90

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

91

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

SciTech Connect

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.

Saad, Wael E. A., E-mail: ws6r@virginia.edu; Kalagher, S.; Turba, U. C.; Sabri, S. S.; Park, A.-W.; Stone, J.; Angle, J. F.; Matsumoto, A. H. [University of Virginia Health System, Department of Radiology and Medical Imaging, Division of Vascular Interventional Radiology (United States)

2013-08-01

92

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

PubMed Central

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.

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

2015-01-01

93

Clinical value of persistent but downgraded vesicoureteral reflux after dextranomer/hyaluronic acid injection in children.  

PubMed

We aimed to investigate the clinical value of persistent but downgraded vesicoureteral reflux (VUR) after dextranomer/hyaluronic acid (Dx/HA) injection in children. The medical records of 128 children (195 ureters) who underwent Dx/HA injections for VUR were reviewed. The incidences of pre- and post-operative febrile urinary tract infections (UTIs) were analyzed in children with or without persistent VUR on voiding cystourethrography (VCUG) 3 months postoperatively. The surgical results of VUR persistent children who underwent a single additional injection were assessed. The VUR resolved completely in 100 ureters (51.3%), was persistent in 95 ureters, and newly developed in 2 ureters. The incidence of pre/post-operative febrile UTIs were 0.35 ± 0.39 per year and 0.07 ± 0.32 per year in VUR resolved children (P < 0.001), and 0.76 ± 1.18 per year and 0.20 ± 0.61 per year in VUR persistent children (P < 0.001). A single additional Dx/HA injection (44 ureters) resolved VUR in 29 ureters (65.9%), and also reduced the VUR to grade I in 7 ureters (15.9%), II in 4 (9.1%), and III in 4 (9.1%). Even in children with persistent VUR after Dx/HA injection, the incidence of febrile UTIs decreased markedly. The VUR grade significantly decreases after single additional Dx/HA injection. PMID:23853490

Baek, Minki; Kang, Min Young; Lee, Hahn-Ey; Park, Kwanjin; Choi, Hwang

2013-07-01

94

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

PubMed Central

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

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

2014-01-01

95

Pazopanib in Treating Patients With Metastatic Urothelial Cancer  

ClinicalTrials.gov

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

2014-05-22

96

A Giant Ureteral Stone without Underlying Anatomic or Metabolic Abnormalities: A Case Report  

PubMed Central

A 28-year old man presented with left flank pain and dysuria. Plain abdominal film and computed tomography showed a left giant ureteral stone measuring 11.5?cm causing ureteral obstruction and other stones 2.5?cm in size in the lower pole of ipsilateral kidney and 7?mm in size in distal part of right ureter. A left ureterolithotomy was performed and then a double J stent was inserted into the ureter. The patient was discharged from the hospital 4 days postoperatively with no complications. Stone analysis was consistent with magnesium ammonium phosphate and calcium oxalate. Underlying anatomic or metabolic abnormalities were not detected. One month after surgery, right ureteral stone passed spontaneously, left renal stone moved to distal ureter, and it was removed by ureterolithotomy. Control intravenous urography and cystography demonstrated unobstructed bilateral ureter and the absence of vesicoureteral reflux. PMID:24324500

Sarikaya, Selcuk; Resorlu, Berkan; Ozyuvali, Ekrem; Bozkurt, Omer Faruk; Oguz, Ural; Unsal, Ali

2013-01-01

97

Ischemic cecal perforation secondary to ESWL of junctional stone in ureterosigmoidostomy (Mainz Pouch II).  

PubMed

We report an unusual case of ischemic cecal perforation after extracorporeal shock wave lithotripsy for an impacted stone at the distal end of the right ureter of a ureterosigmoidostomy in a 78-year-old female patient. PMID:18639326

Cardinaux, C; Tawadros, T; Praz, V; Wisard, M; Treuthardt, C; Jichlinski, P

2009-06-01

98

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. After entering the ...

99

Math. Model. Nat. Phenom. Vol. ?, No. ?, 20??, pp. ?-?  

E-print Network

with the fluid, such as ovum transport in the oviduct or kidney stones in the ureter. In some of these biological contractions in the oviduct and uterus contribute to ovum transport and embryo implantation in the uterus [4

Chrispell, John

100

Afatinib in Advanced Refractory Urothelial Cancer  

ClinicalTrials.gov

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

2014-04-23

101

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 ...

102

Benign (Not Cancerous) Urethral Lesions in Children -- Boys  

MedlinePLUS

... the Ureter F no topics for this letter G no topics for this letter H Hematuria Horseshoe ... medical history, and analyzing any tests performed (e.g., blood tets, urine tests, brain scans, etc.). diverticula: ...

103

Pheochromocytoma  

MedlinePLUS

... the Ureter F no topics for this letter G no topics for this letter H Hematuria Horseshoe ... medical history, and analyzing any tests performed (e.g., blood tets, urine tests, brain scans, etc.). endocrine: ...

104

Kidney (Renal) Abscess  

MedlinePLUS

... the Ureter F no topics for this letter G no topics for this letter H Hematuria Horseshoe ... medical history, and analyzing any tests performed (e.g., blood tets, urine tests, brain scans, etc.). gene: ...

105

Adrenal Gland Disorders  

MedlinePLUS

... the Ureter F no topics for this letter G no topics for this letter H Hematuria Horseshoe ... medical history, and analyzing any tests performed (e.g., blood tets, urine tests, brain scans, etc.). ectopic: ...

106

Bladder Trauma  

MedlinePLUS

... the Ureter F no topics for this letter G no topics for this letter H Hematuria Horseshoe ... medical history, and analyzing any tests performed (e.g., blood tets, urine tests, brain scans, etc.). incision: ...

107

BPH: Medical Management (Benign Prostatic Hyperplasia /Enlarged Prostate)  

MedlinePLUS

... the Ureter F no topics for this letter G no topics for this letter H Hematuria Horseshoe ... desired. Commonly it is an undesirable effect (e.g., nausea, headache, insomnia, acute toxic reaction or drug ...

108

Epididymitis and Orchitis  

MedlinePLUS

... the Ureter F no topics for this letter G no topics for this letter H Hematuria Horseshoe ... medical history, and analyzing any tests performed (e.g., blood tets, urine tests, brain scans, etc.). epididymis: ...

109

BPH: Minimally Invasive Management (Benign Prostatic Hyperplasia/Enlarged Prostate)  

MedlinePLUS

... the Ureter F no topics for this letter G no topics for this letter H Hematuria Horseshoe ... desired. Commonly it is an undesirable effect (e.g., nausea, headache, insomnia, acute toxic reaction or drug ...

110

Renovascular Disease  

MedlinePLUS

... the Ureter F no topics for this letter G no topics for this letter H Hematuria Horseshoe ... medical history, and analyzing any tests performed (e.g., blood tets, urine tests, brain scans, etc.). electrolytes: ...

111

Urethral Diverticulum  

MedlinePLUS

... the Ureter F no topics for this letter G no topics for this letter H Hematuria Horseshoe ... medical history, and analyzing any tests performed (e.g., blood tets, urine tests, brain scans, etc.). distal: ...

112

Benign (Not Cancerous) Urethral Lesions in Children -- Girls  

MedlinePLUS

... the Ureter F no topics for this letter G no topics for this letter H Hematuria Horseshoe ... medical history, and analyzing any tests performed (e.g., blood tets, urine tests, brain scans, etc.). endoscopic: ...

113

Conn's Syndrome (Primary Hyperaldosteronism)  

MedlinePLUS

... the Ureter F no topics for this letter G no topics for this letter H Hematuria Horseshoe ... medical history, and analyzing any tests performed (e.g., blood tets, urine tests, brain scans, etc.). diuretic: ...

114

BPH: Diagnosis (Benign Prostatic Hyperplasia/Enlarged Prostate)  

MedlinePLUS

... the Ureter F no topics for this letter G no topics for this letter H Hematuria Horseshoe ... medical history, and analyzing any tests performed (e.g., blood tets, urine tests, brain scans, etc.). DRE: ...

115

Prostatitis (Prostate Infection)  

MedlinePLUS

... the Ureter F no topics for this letter G no topics for this letter H Hematuria Horseshoe ... medical history, and analyzing any tests performed (e.g., blood tets, urine tests, brain scans, etc.). digital ...

116

Ectopic Kidneys  

MedlinePLUS

... the Ureter F no topics for this letter G no topics for this letter H Hematuria Horseshoe ... medical history, and analyzing any tests performed (e.g., blood tets, urine tests, brain scans, etc.). ectopic: ...

117

Ureteropelvic Junction (UPJ) Obstruction  

MedlinePLUS

... the Ureter F no topics for this letter G no topics for this letter H Hematuria Horseshoe ... medical history, and analyzing any tests performed (e.g., blood tets, urine tests, brain scans, etc.). excretory: ...

118

Kidney (Renal) Failure  

MedlinePLUS

... the Ureter F no topics for this letter G no topics for this letter H Hematuria Horseshoe ... medical history, and analyzing any tests performed (e.g., blood tets, urine tests, brain scans, etc.). dialysis : ...

119

Kidney Cancer in Children  

MedlinePLUS

... the Ureter F no topics for this letter G no topics for this letter H Hematuria Horseshoe ... medical history, and analyzing any tests performed (e.g., blood tets, urine tests, brain scans, etc.). edema: ...

120

MPH Urinary Practicum : Breeze Training Transcript: Feb 20 07  

Cancer.gov

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

121

MPH Urinary Rules: Breeze Training Transcript: Feb 16 07  

Cancer.gov

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

122

21 CFR 876.5900 - Ostomy pouch and accessories.  

Code of Federal Regulations, 2011 CFR

...material or urine following an ileostomy, colostomy, or ureterostomy (a surgically created opening of the small intestine, large intestine, or the ureter on the surface of the body). This generic type of device and its accessories...

2011-04-01

123

21 CFR 876.5900 - Ostomy pouch and accessories.  

Code of Federal Regulations, 2010 CFR

...material or urine following an ileostomy, colostomy, or ureterostomy (a surgically created opening of the small intestine, large intestine, or the ureter on the surface of the body). This generic type of device and its accessories...

2010-04-01

124

21 CFR 876.5900 - Ostomy pouch and accessories.  

Code of Federal Regulations, 2014 CFR

...material or urine following an ileostomy, colostomy, or ureterostomy (a surgically created opening of the small intestine, large intestine, or the ureter on the surface of the body). This generic type of device and its accessories...

2014-04-01

125

21 CFR 876.5900 - Ostomy pouch and accessories.  

Code of Federal Regulations, 2012 CFR

...material or urine following an ileostomy, colostomy, or ureterostomy (a surgically created opening of the small intestine, large intestine, or the ureter on the surface of the body). This generic type of device and its accessories...

2012-04-01

126

21 CFR 876.5900 - Ostomy pouch and accessories.  

Code of Federal Regulations, 2013 CFR

...material or urine following an ileostomy, colostomy, or ureterostomy (a surgically created opening of the small intestine, large intestine, or the ureter on the surface of the body). This generic type of device and its accessories...

2013-04-01

127

Vesicoureteral Reflux  

MedlinePLUS

... of Deflux is injected into the bladder wall near the opening of the ureter. This injection creates ... The Clearinghouse encourages users of this publication to duplicate and distribute as many copies as desired. NIH ...

128

A life of pelvic pain Karen J. Berkley *  

E-print Network

on the uterus. (b) Colon inflammation produces signs of inflammation in the otherwise healthy bladder and uterus crosstalk; Endometriosis; Uterus; Vagina; Bladder; Colon; Ureter; Spinal cord; Pain mechanisms 1

Berkley, Karen J.

129

Ureteric obstruction after dacron vascular replacement.  

PubMed Central

Ureteric obstruction is a recognised complication of aortic bifurcation grafting where the graft material is in close proximity to the ureter as it crosses the common iliac vessels. We have assessed the value of routine postoperative urography in (1) a retrospective 6-year study of ruptured aortic aneurysm repair (11 patients reviewed) and (2) a prospective 18-month study of all patients receiving intra-abdominal dacron grafts (24 assessable patients) in a district general hospital. Renal function was normal in all cases and only 1 ureter was shown at urography to be minimally dilated but not significantly obstructed out of 32 'at risk' ureters in 18 patients in the 2 studies. This complication is uncommon, and no particular advantage can be demonstrated in positioning the ureters either behind or in front of the graft limbs. There is no place for routine urography which should be reserved for the patient with symptoms of ureteric obstruction. Images p[385]-a PMID:6227269

Thomas, J. M.; Mortensen, N. J.; Bayliss, C. R.

1983-01-01

130

Robot-Assisted Pyeloplasty  

Microsoft Academic Search

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

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

131

Palliative Care of Malignant Ureteral Obstruction with Polytetrafluoroethylene Membrane-Covered Self-Expandable Metallic Stents: Initial Experience  

PubMed Central

Purpose We assessed the efficacy and safety of insertion of a polytetrafluoroethylene membrane-covered self-expandable metallic stent (UVENTA stent) for palliation of malignant ureteral obstruction on the basis of our early results. Materials and Methods Eighteen patients underwent UVENTA stent insertion for extrinsic malignant ureteral obstructions of 20 ureters. The UVENTA stents were deployed retrogradely under cystoscopy and fluoroscopy. Candidates for the procedure had preexisting double-J stents that were nonfunctional or caused excessive bladder irritation. We recorded the success and patency rate in addition to any complications associated with the procedure. Results The mean length of obstruction was 10.6 cm (range, 2 to 20 cm). Two ureters were obstructed in the upper ureter, 9 in the lower ureter, and 9 in multiple levels of ureter. Simultaneous balloon dilation was performed in 12 ureters. UVENTA stents were successfully inserted in all patients. No obstruction of the UVENTA stents occurred during the mean follow-up period of 7.3 months (patency rate 100%), but de novo ureteral obstruction developed in 4 ureters. There were no instances of stone formation, hyperplastic reaction, encrustation, or migration. Abnormally elevated serum creatinine decreased to normal levels and hydronephrosis gradually resolved during the 4 weeks after UVENTA insertion. No significant complications developed except for transient and self-limiting hematuria and mild lower abdominal pain. Conclusions UVENTA stents may relieve malignant ureteral obstruction safely and easily. Long-term follow-up is necessary to assess the role of this stent in the treatment of malignant ureteral obstruction. PMID:23061000

Kim, Jae Han; Song, Kanghyon; Jo, Moon Ki

2012-01-01

132

Prevention of orchialgia after left sided laparoscopic donor nephrectomy - A prospective study.  

PubMed

Background: Etiology of orchialgia or testicular pain after laparoscopic donor nephrectomy (LDN) has been found to be related to injury of spermatic plexus during gonadal (testicular) vein (GV) or ureteral ligation. This study was aimed to evaluate and validate the impact of level of ligation of GV & ureter in relation to crossing of iliac vessels (CIV) on incidence of orchialgia. Material and methods: A prospective study was conducted on 70 male who underwent left LDN, during Jan 2008 to Dec 2010 (group A) to determine the correlation between orchialgia and level of ligation of GV & Ureter in respect to CIV; which revealed that the ligation of GV and / or ureter above the level of CIV (level 1, n=40) is less likely to cause orchialgia than ligating them at / or below (level 2, n=30). Subsequently in 45 male patients (group B) for left LDN during Jan 2011 to June 2013, we ensured that clipping of ureter & GV be done above the CIV to validate above findings. Patients with history of scrotal pathology or surgery were excluded. One sided Z-test with pooled variance was used to calculate the sample size Results: In group A, orchialgia was seen in 10 (14.3 %) patients. The clipping of ureter and GV at level 2(orchialgia, n=9) was associated with significantly higher incidence of orchialgia than clipping them at level 1(orchialgia, n=1)(p=0.001,95 % CI= 0.0707 to 0.2471). In group B, 43 patients were finally analyzed and none of them had orchialgia. Conclusion: Level of ligation of GV & ureter has significant impact on the incidence of orchialgia. Ipsilateral testicular pain in patients with left sided LDN is preventable, if ureter and GV are ligated or clipped above the level of iliac vessels bifurcation. PMID:25401724

Sureka, Sanjoy Kumar; Srivastava, Aneesh; Agarwal, Shikhar; Srivastava, Alok; An, Sachin; Singh, Sanjeet; Mittal, Varun; Patidar, Nietsh; Ansari, M S-; Kapoor, Rakesh

2014-11-17

133

Laparoscopic ipsilateral ureteroureterostomy for the management of children with duplication anomalies  

PubMed Central

Aim: Ipsilateral ureteroureterostomy is an established method for the treatment of duplication anomalies in children. With the advent of pediatric laparoscopy, many urologic procedures in children are being performed using minimal access techniques. We present our experience with laparoscopic ipsilateral ureteroureterostomy (LIUU) for duplex anomalies. Patients and Methods: The data of children who underwent LIUU was reviewed for demographic parameters, clinical and operative details, follow-up and results. Results: Over 3 years period, LIUU was performed in eight children (age 6-60 months). Five children had complete ipsilateral duplication with ectopic upper moiety ureter, one child each had ipsilateral incomplete duplication and bilateral duplex systems (with ipsilateral ectopic upper moiety ureter). One child had ipsilateral complete duplex with Grade V vesicoureteric reflux into the lower moiety ureter. Four children had antenatal diagnosis of hydronephrosis; three children had a urinary infection and two children presented with urinary incontinence. The surgical procedure consisted of cystoscopy, retrograde studies and cannulation of the recipient ureter. Then, LIUU was performed using three ports. The ectopic (donor) ureter was divided at the pelvic brim; the recipient ureter was opened and end-to-side LIUU was performed with 5/0 vicryl stitches over a double J (DJ) stent placed in the recipient ureter. Bladder catheter was removed after 2 days, and DJ stent was removed after 4 weeks. At a mean follow-up of 19 months (3-36), all children are asymptomatic and continent, with a significant reduction in hydroureteronephrosis on ultrasound. The cosmetic results were excellent. Conclusion: LIUU is a safe and effective technique in the management of duplication anomalies in children. It could be performed with minimal blood loss, minimal postoperative pain, excellent cosmesis and good success. PMID:25552828

Chandrasekharam, VVS; Jayaram, Harish

2015-01-01

134

Pulmonary Tumor Thrombotic Microangiopathy Induced by Ureteral Carcinoma: A Necropsy Case Report  

PubMed Central

Background Pulmonary tumor thrombotic microangiopathy (PTTM) is a fatal cancer-related pulmonary complication with rapidly progressing dyspnea and pulmonary hypertension that occasionally induces sudden death. We report the first case of PTTM induced by ureter carcinoma. Case Presentation The patient was an 80-year-old Japanese female with chief complaints of dry cough and dyspnea. An echocardiogram revealed severe pulmonary hypertension. A chest radiograph showed ground glass opacity of bilateral lower lung field predominance, and an abdominal computed tomography scan revealed a left ureter mass suggestive of ureter carcinoma. The patient died of respiratory failure on the eighth day of hospitalization. Postmortem examination indicated that the primary lesion was a left ureter cancer with tumor microemboli extending to both lungs through the right side of the heart. The final diagnosis of this case was PTTM induced by ureter carcinoma. Conclusion The pathogenesis and pathophysiology of PTTM remains obscure with no effective management available. In cases of rapidly progressing respiratory failure with pulmonary hypertension, it is necessary to consider PTTM in the differential diagnosis. PMID:25298767

Marumo, Satoshi; Sakaguchi, Masahiro; Teranishi, Takashi; Higami, Yuichi; Koshimo, Yoshiyuki; Kato, Motokazu

2014-01-01

135

Performance of a new vascular xeno prosthesis.  

PubMed

To date no prosthetic vascular prosthesis performs as well as the autologous saphenous vein in diameters of 6 mm and less. The purpose of this study was to compare the in vitro and in vivo performance of a new glutaraldehyde stabilized, narrow diameter (4 mm), vascular prosthesis fashioned from bovine ureters (Flonova) with the saphenous vein and polytetrafluoroethylene (PTFE) prostheses. The methods used for the comparative in vitro analysis of the bovine ureter and saphenous vein were modifications of tests recommended by the American National Standards for Vascular Prostheses. Blood compatibility was evaluated by measuring platelet consumption in an artificial circulation, and heparin uptake was quantified using tritiated heparin. The results indicate that the bovine ureter grafts have an adequate degree of mural integrity and hemocompatible properties comparable to saphenous vein. The in vivo patency in a canine bilateral femoral interposition model was 62.5% (10/16) for the bovine ureters and 43.75% (7/16) for PTFE. Bovine ureter grafts appear to have an excellent potential for use in narrow diameter peripheral and coronary arterial bypass procedures and warrant further investigation. PMID:2597448

Burns, P; Edwards, G A; Roberts, G R; Ketharanathan, V; Hatami-Monazah, H

1989-01-01

136

MDCT urography: retrospective determination of optimal delay time after intravenous contrast administration.  

PubMed

The optimal delay time after intravenous (i.v.) administration of contrast medium (CM) for opacification of the upper urinary tract (UUT) for multidetector computed tomography urography (MDCTU) was investigated. UUT opacification was retrospectively evaluated in 36 four-row MDCTU examinations. Single- (n=10) or dual-phase (n=26) MDCTU was performed with at least 5-min delay after i.v. CM. UUT was divided into four sections: intrarenal collecting system (IRCS), proximal, middle and distal ureter. Two independent readers rated UUT opacification: 1, none; 2, partial; 3, complete. Numbers and percentages of scores, and the 5%, 25%, 50%, 75% and 95% percentiles of delay time were calculated for each UUT section. After removing diseased segments, 344 segments were analysed. IRCS, proximal and middle ureter were completely opacified in 94% (81/86), 93% (80/86) and 77% (66/86) of cases, respectively. Median delay time was 15 min for complete opacification. The distal ureter was completely opacified in 37% (32/86) of cases and not opacified in 26% (22/86). Median delay time for complete opacification was 11 min with 25% and 75% percentiles of 10 and 16 min, respectively. At MDCTU, opacification of the IRCS, proximal and middle ureter was hardly sensitive to delay time. Delay times between 10 and 16 min were favourable in the distal ureter. PMID:16583216

Meindl, Thomas; Coppenrath, Eva; Kahlil, Rami; Müller-Lisse, Ulrike L; Reiser, Maximilian F; Müller-Lisse, Ullrich G

2006-08-01

137

Ureteral quintuplication with renal atrophy in an infant after the 1986 Chernobyl nuclear disaster.  

PubMed

Ureteral duplication is a comparatively frequent urinary tract anomaly. Ureteral triplication is rare, but quadruplication is extremely rare. In this study, we describe a case of ureteral quintuplication, the first such report in the English-language literature. A newborn female baby was diagnosed with left ureteral quintuplication. The left ureter was divided into 5 ureters with 5 renal pelvises within approximately 3 cm of the urinary bladder, and trace parenchyma of the kidney was noted. The patient was born within 60 km of the epicenter of the 1986 Chernobyl disaster, 24 years after the catastrophic nuclear accident, and is currently aged 3 years. PMID:24001707

Jurkiewicz, Beata; Z?bkowski, Tomasz; Shevchuk, Dmitrij

2014-01-01

138

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

PubMed

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

Whyburn, James J; Alizadeh, Ahmadreza

2013-06-01

139

Inguinoscrotal hernias involving urologic organs: A case series.  

PubMed

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

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

2014-05-01

140

Inguinoscrotal hernias involving urologic organs: A case series  

PubMed Central

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

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

2014-01-01

141

Endoluminal release of ureteral ligature after hysterectomy.  

PubMed

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

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

2014-09-17

142

Spontaneous Forniceal Rupture in Pregnancy  

PubMed Central

Forniceal rupture is a rare event in pregnancy. We report a case of a 26-year-old primigravid woman who experienced a forniceal rupture at 23 weeks of gestation with no inciting cause except for pregnancy. Pregnancy is associated with ureteral compression due to increase in pelvic vasculature with the right ureter more dilated due to anatomic reasons. Hormones such as prostaglandins and progesterone render the ureter more distensible to allow for pressure build-up and an obstructive picture at the collecting system. We will discuss physiologic changes in pregnancies that predispose to this uncommon phenomenon and the most up-to-date management strategies. PMID:25648411

Upputalla, Roshni; Moore, Robert M.; Jim, Belinda

2015-01-01

143

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

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

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

2014-01-01

144

Large spectrum of complete urinary collecting system duplication exemplified by cases. Pictorial essay.  

PubMed

Urinary collecting system duplication is a congenital anomaly and can associate various types of urinary tract pathologies. Authors will illustrate by cases some of associated anomalies such as ureterocele, extravesical ectopic ureter, vesicoureteral reflux or reflux nephropathy; one case presented an association between posterior urethral valve and bilateral collecting system duplication. PMID:24286096

Fufezan, Otilia; T?tar, Simona; Dee, Ana Maria; Cramariuc, Radu; As?voaie, Carmen; Co?arc?, Mihaela

2013-12-01

145

Evocation des Travaux Francais sur Latimeria Notamment Depuis 1972  

Microsoft Academic Search

French research on Latimeria published before 1972 is first briefly recalled. After the Anglo--Franco--American Expedition of 1972, the material obtained enabled us to focus attention on the histology of the kidney and ureter and on ultrastructural aspects of the postanal gland. Ovarian eggs of unusual volume have been collected, measured and weighed. Kinematic analysis of the intracranial articulation was carried

J. Anthony

1980-01-01

146

Permeability of the bladder mucosa to thiotepa, adriamycin, and daunomycin in men and rabbits  

Microsoft Academic Search

The permeability of the bladder mucosa to thiotepa and to the anthraquinonic antibiotics, adriamycin and daunomycin, was investigated both in humans and in experimental animals. Instillations in rabbits were performed either in intact males or in animals with ligated ureters. Absorption of thiotepa was significantly higher than that of the antibiotics both in men and in rabbits. Furthermore a qualitative

M. Pavone-Macaluso; N. Gebbia; F. Biondo; S. Bertolini; G. Caramia; F. P. Rizzo

1976-01-01

147

Identification of the Origin of a Vesical Mass Occurring after Cadaveric Renal Transplantation Using Short TandemRepeat Marke rs  

Microsoft Academic Search

We report a case of polypoid cystitis in a 54-year-old female occurring 4 years after cadaveric kidney transplantation. Endoscopic exploration revealed a polypoid tumor near the stoma opened for the transplanted ureter. The diagnosis of polypoid cystitis was confirmed histopathologically. Genotyping of cells from the tumor with polymorphic short tandem repeat (STR) and amelogenin loci revealed that the tumor contained

Naoki Yamamoto; Atsushi Nagai; Manabu Kuriyama; Satoshi Ishihara; Isao Ohya; Takashi Deguchi

2000-01-01

148

Ureteritis cystica: A rare entity in children  

PubMed Central

Ureteritis cystica (UC) is a benign condition. Although it can often be diagnosed with imaging techniques, we report a case of a child for whom we planned nephrectomy and ureteral augmentation cystoplasty, but abandoned the cystoplasty due to extensive UC in the ureter. PMID:25378828

Dönmez, M. ?rfan; Beksaç, A. Tuna; Do?an, H. Serkan; Koni, Artan; Baydar, Dilek Ertoy; Tekgül, Serdar

2014-01-01

149

[Magnetic resonance imaging as the primary diagnostic method for ectopic discharging ureteral insertion of a dysplastic kidney].  

PubMed

Ectopic ureters associated with dysplastic kidneys remain a diagnostic dilemma. Ultrasound, endoscopy as well as intravenous urography do not always show correct urinary tract morphology and function. We report the case of a 6-year-old girl with continuous urine dribbling to demonstrate the diagnostic value of MR urography. PMID:15205740

Rebmann, S; Strauss, A; Vosshenrich, R; Zöller, G

2004-08-01

150

Radionuclide Cystogram (Bladder Scan)  

MedlinePLUS

... filter wastes from the blood and discharge these waste products in urine. The kidneys are located on either side at the level of the 12th ribs toward the back. The kidneys send urine to the bladder through tubes called ureters. radioactive: Relating to or making use of radioactive substances ...

151

Robotization of a ureteroscope for efficient semi-automatic vaporization of kidney stones  

E-print Network

Robotization of a ureteroscope for efficient semi-automatic vaporization of kidney stones Benoit Rosa, Pierre Mozer, and J´er^ome Szewczyk Email : firstname.name@isir.upmc.fr I. INTRODUCTION Kidney pass the ureter and therefore must be treated inside the kidney. The operation process is the following

Paris-Sud XI, Université de

152

Unilateral hydronephrosis  

MedlinePLUS

... depends on the cause of the kidney swelling. Treatment may include: A ureteral stent (tube that allows the ureter to drain into the bladder) A nephrostomy tube (allows the blocked urine to drain ... treatment. People who have long-term hydronephrosis may need ...

153

Treatment of Ureteral Lithiasis with Tamsulosin: Literature Review and Meta-Analysis  

Microsoft Academic Search

Objective: Ninety percent of ureteral calculi <4 mm are expelled over a period of 3 months; if they are >6 mm the elimination possibilities are reduced to 30%. Presently, investigations in the treatment of ureteral lithiasis have the objective of modifying ureter contractibility with the aid of calcium antagonist and ?-blocking drugs. The objective of this study is to analyze

Miguel Arrabal-Martin; Francisco Valle-Diaz de la Guardia; Miguel Angel Arrabal-Polo; Francisco Palao-Yago; Jose Luis Mijan-Ortiz; Armando Zuluaga-Gomez

2010-01-01

154

21 CFR 876.4620 - Ureteral stent.  

Code of Federal Regulations, 2012 CFR

...inserted into the ureter to provide ureteral rigidity and allow the passage of urine. The device may have finger-like protrusions or hooked ends to keep the tube in place. It is used in the treatment of ureteral injuries and ureteral obstruction. (b)...

2012-04-01

155

21 CFR 876.4620 - Ureteral stent.  

Code of Federal Regulations, 2010 CFR

...inserted into the ureter to provide ureteral rigidity and allow the passage of urine. The device may have finger-like protrusions or hooked ends to keep the tube in place. It is used in the treatment of ureteral injuries and ureteral obstruction. (b)...

2010-04-01

156

21 CFR 876.4620 - Ureteral stent.  

Code of Federal Regulations, 2014 CFR

...inserted into the ureter to provide ureteral rigidity and allow the passage of urine. The device may have finger-like protrusions or hooked ends to keep the tube in place. It is used in the treatment of ureteral injuries and ureteral obstruction. (b)...

2014-04-01

157

21 CFR 876.4620 - Ureteral stent.  

Code of Federal Regulations, 2013 CFR

...inserted into the ureter to provide ureteral rigidity and allow the passage of urine. The device may have finger-like protrusions or hooked ends to keep the tube in place. It is used in the treatment of ureteral injuries and ureteral obstruction. (b)...

2013-04-01

158

21 CFR 876.4620 - Ureteral stent.  

Code of Federal Regulations, 2011 CFR

...inserted into the ureter to provide ureteral rigidity and allow the passage of urine. The device may have finger-like protrusions or hooked ends to keep the tube in place. It is used in the treatment of ureteral injuries and ureteral obstruction. (b)...

2011-04-01

159

Influence of stone size, location and impaction on the success of ureteroscopic pneumolithotripsy.  

PubMed

This study was conducted on 336 patients that had undergone ureteroscopic pneumolithotripsy for ureteric stones between August 2005 and June 2008. Patient data were analyzed with respect to stone localization, size and impaction. All ureterorenoscopic procedures were performed under general anesthesia using a 9.5F rigid ureteroscope. A plain film of the kidney ureter bladder was performed on the first postoperative day and week 4 to evaluate treatment efficacy. Patient age was 42, 63+/-15 (14-77) yr. Mean stone size for all groups was 9.77+/-4mm (5-20 mm). A total of 336 patients were treated with ureteroscopic pneumolithotripsy, 129 female and 207 male. The overall initial success rate was 85.71%. The success rate of ureteroscopic pneumolithotripsy, proximal, middle and distal ureter, for Stone location, 76.54%, 85.48%, 90.74%, for Stone size (>10 mm) 54%, 77%, 88 % and for Stone impaction; 50%, 75,6%, 85,4% respectively. There was a statistically significant difference between stone free rates with respect to the proximal ureter stone, increasing stone size (>10 mm) and stone impaction (p<0.05) and a positive correlation with the operative complication rate. It is concluded that it is possible to achieve high success and low complication rates in pneumolithotripsy for distal ureteric stones. Nevertheless, the success rate decreases and complication rate increases with stone locations close to the proximal ureter. Complication rate increases with increasing stone size and/or impacted ureteral stones. PMID:20622268

Ciftci, H; Savas, M; Altunkol, A; Yeni, E; Verit, A; Celepkolu, B

2010-06-01

160

Ureteroscopic treatment of urological calculi under sacral block anesthesia.  

PubMed

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

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

2012-08-01

161

Ovarian remnant syndrome: a case report.  

PubMed

A case is reported of ureteral obstruction due to retained corpus luteum. The patient had previously undergone a hysterectomy and salpingo-ovariectomy with incomplete removal of ovarian tissue on both sides. The ureteral obstruction was treated by the excision of the mass and the reimplantation of the obstructed ureter into the bladder hitched to psoas muscle. PMID:2141720

Visentini, E; Bondavalli, C; Pegoraro, C; Schiavon, L; Dall'Oglio, B; Parma, A

1990-03-01

162

Malignant paraganglioma in a cougar (Puma concolor).  

PubMed

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

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

2014-12-01

163

Sites of renal pain processing in the rat spinal cord. A c- fos study using a percutaneous method to perform ureteral obstruction  

Microsoft Academic Search

The sites of renal pain processing in the rat spinal cord were studied by mapping the spinal cord neurons expressing c-fos after acute ureteral distension due to obstruction. A new experimental model is presented. A nylon knot was loosely placed around the ureter and the ends of the thread exteriorized through the retroperitoneal wall. Eight days later, when all c-fos

António Avelino; Francisco Cruz; Antonio Coimbra

1997-01-01

164

Losartan attenuates renal vasoconstriction in response to acute unilateral ureteral occlusion in pigs  

Microsoft Academic Search

Unilateral ureteral obstruction in pigs is associated with an enhanced, de novo generation of angiotensin II from the ipsilateral kidney. In order to further investigate the role of this system during unilateral ureter obstruction, the renal hemodynamic response to the non-peptide angiotensin II antagonist losartan was investigated. Danish land race pigs were operated on under general anesthesia. Catheters were placed

Jan J. Hvistendahl; Thomas S. Pedersen; Jens C. Djurhuus; Erling B. Pedersen; Jørgen Frøkiær

2002-01-01

165

Cystoscopy - Women  

MedlinePLUS Videos and Cool Tools

... causing severe pain. If a stone or a tumor is blocking urine flow from the kidney to the bladder, the doctor can treat this ... the obstruction. Damage to the urethra, bladder, ureters, kidneys, and other abdominal ... especially if a tumor was taken out. Some burning during urination is ...

166

Bladder Diverticulum  

MedlinePLUS

... bladder stones, backwards flow of urine into the kidneys ( reflux ), bladder tumors or difficulty urinating. For those patients with diverticula ... bladder into the ureters and occasionally into the kidneys, raising the risk of infection. ... formed in an organ. tumor: An abnormal mass of tissue or growth of ...

167

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

Microsoft Academic Search

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

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

2002-01-01

168

What I need to know about My Child's Urinary Tract  

E-print Network

Services NATIONAL INSTITUTES OF HEALTH National Kidney and Urologic Diseases Information Clearinghouse #12 Services NATIONAL INSTITUTES OF HEALTH National Kidney and Urologic Diseases Information Clearinghouse #12 includes two kidneys, two ureters, a bladder, and a urethra. The kidneys are a pair of bean- shaped organs

Baker, Chris I.

169

Kidney Dysplasia National Kidney and Urologic Diseases Information Clearinghouse  

E-print Network

Kidney Dysplasia National Kidney and Urologic Diseases Information Clearinghouse U.S. Department of Health and Human Services NATIONAL INSTITUTES OF HEALTH What is kidney dysplasia? The kidneys are a pair the kidneys to the bladder through tubes called ureters. Kidney dysplasia is a condition that can occur

Baker, Chris I.

170

Kidney stone treatment http://www.sciencephoto.com/media/282652/view[19/06/2012 14:38:20  

E-print Network

Kidney stone treatment http://www.sciencephoto.com/media/282652/view[19/06/2012 14:38:20] Kidney/SCIENCE PHOTO LIBRARY Caption: Kidney stone treatment. Medical researcher testing a method for monitoring kidney stone treatment. Kidney stones are deposits of calcium and other minerals in the kidneys and ureters

Sóbester, András

171

Fuzzy signal detection theory: analysis of human and machine performance in air traffic control, and analytic considerations  

Microsoft Academic Search

This paper applies fuzzy SDT (signal detection theory) techniques, which combine fuzzy logic and conventional SDT, to empirical data. Two studies involving detection of aircraft conflicts in air traffic control (ATC) were analysed using both conventional and fuzzy SDT. Study 1 used data from a preliminary field evaluation of an automated conflict probe system, the User Request Evaluation Tool (URET).

ANTHONY MASALONIS; RAJA PARASURAMAN

2003-01-01

172

Mucosal folding in upper urinary pathways following ureterolithiasis.  

PubMed

Mucosal folds in the ureter or renal pelvis were demonstrated in 2 children and 27 adults with urolithiasis. It appeared from the sequence of events observed in these cases that the folds occurred in a redundant mucosa following an episode of mural stretching. Urinalysis, including bacterial culture in the majority of cases, showed infection in only 3 of the adults. PMID:983762

Theander, G; Wehlin, L

1976-09-01

173

Uroplakins in urothelial biology, function, and disease  

Microsoft Academic Search

Urothelium covers the inner surfaces of the renal pelvis, ureter, bladder, and prostatic urethra. Although morphologically similar, 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

Xue-Ru Wu; Xiang-Peng Kong; Angel Pellicer; Gert Kreibich; Tung-Tien Sun

2009-01-01

174

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

PubMed Central

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

2013-01-01

175

Development of Fetal Lamb Lung and Kidney in Obstructive Uropathy: A Preliminary Report  

Microsoft Academic Search

Oligohydramnios, whatever the cause, results in lungs that are ‘hypoplastic’ or at least smaller than normal. The fine structure in such lungs has not been reported previously. Three fetal lambs had both ureters ligated at 60, 72 and 58 days of gestation. They were sacrificed at 117, 143 and 142 days of gestation. The lungs were fixed by tracheal perfusion

K. C. Pringle; S. M. Bonsib

1988-01-01

176

Diagnostic value of diuretic-enhanced excretory MR urography in patients with obstructive uropathy  

Microsoft Academic Search

Purpose: Ultrasonography and conventional intravenous urography are most common methods in diagnosis of obstructive uropathies. The disadvantage of ultrasonography is inability of visualizing middle and lower one thirds of ureter, while intravenous urography is using radiation, also functionally extra loading effect on kidneys. In this study, the diagnostic value of MR urography on obstructive uropathy were investigated. Materials and methods:

Aydin Karabacakoglu; Serdar Karakose; Ozlem Ince; Osman Ege Cobankara; Giray Karalezli

2004-01-01

177

Expression of Adhesion Molecules in Kidney with Experimental Chronic Obstructive Uropathy: The Pathogenic Role of ICAM-1 and VCAM-1  

Microsoft Academic Search

Background: Chronic obstructive uropathy induced by maintained unilateral ureter ligation in the rat is characterized morphologically by interstitial inflammation, interstitial fibrosis, and tubular atrophy. Infiltrating mononuclear inflammatory cells, particularly T lymphocytes and macrophages, may contribute to the progression of this lesion by mediating tubular injury and by the activation of interstitial fibroblasts, with resultant tubular atrophy and interstitial fibrosis, respectively.

Scott B. Shappell; Leonardo H. Mendoza; Tayfun Gurpinar; C. Wayne Smith; Wadi N. Suki; Luan D. Truong

2000-01-01

178

Feasibility of CT scan studies with triple split bolus intravenous contrast medium technique and reduced radiation dose for potential kidney donors Viabilidade do estudo tomográfico com triplo fracionamento do contraste endovenoso e redução da dose de radiação para candidatos a doadores renais  

Microsoft Academic Search

Objective: To show that it is possible to reduce the radiation dose in the examination of potential kidney donors by splitting the contrast injection followed by a single scanning, enabling evaluation of vascular structures, renal parenchyma and collecting system\\/ ureters, using computed tomography protocols with reduced mAs. Methods : Twenty-six potential donors were evaluated based on the following criteria: image

Bruna Schmitz Serpa; Ronaldo Hueb Baroni; Adriano Tachibana; Marcelo Buarque de Gusmão

2009-01-01

179

Viabilidade do estudo tomográfico com triplo fracionamento do contraste endovenoso e redução da dose de radiação para candidatos a doadores renais Feasibility of CT scan studies with triple split bolus intravenous contrast medium technique and reduced radiation dose for potential kidney donors  

Microsoft Academic Search

objective: To show that it is possible to reduce the radiation dose in the examination of potential kidney donors by splitting the contrast injection followed by a single scanning, enabling evaluation of vascular structures, renal parenchyma and collecting system\\/ ureters, using computed tomography protocols with reduced mAs. Methods : Twenty-six potential donors were evaluated based on the following criteria: image

Bruna Schmitz Serpa; Ronaldo Hueb Baroni; Adriano Tachibana; Marcelo Buarque de Gusmão

2009-01-01

180

CE Certificate - Urinary Bladder online training  

Cancer.gov

Certificate of Attendance The Participant is hereby granted 2 CEUs for attending the Multiple Primary and Histology Coding Rules Bladder, Ureter, Renal Pelvis and Other Urinary - Breeze online training NCRA Event Number 2006-246 VtÜÉÄ [t{Ç ]É{ÇáÉÇ

181

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. ...

182

Complication of Clorpactin WCS90 therapy for interstitial cystitis.  

PubMed

A case of ureteral fibrosis complicating Clorpactin WCS90 treatment for interstitial cystitis in a patient with vesicoureteral reflux is presented. The results of a laboratory experiment designed to study the effects of Clorpactin WCS90 on refluxing ureters are discussed. PMID:219578

Messing, E M; Freiha, F S

1979-04-01

183

Treatment of vesicoureteral reflux in children by endoscopic injection of Teflon  

Microsoft Academic Search

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

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

1991-01-01

184

Bifunctional irrigation liquid as an ideal energy converter for laser lithotripsy with nanosecond laser pulses  

Microsoft Academic Search

The intracorporal lithotripsy of ureter stones using laser pulses with a duration of 8 to 20 ns is carried out by means of energy converters. These devices have the purpose to transform the optical energy of the laserlight into mechanical energy of shockwaves, which cause the intended stone fragmentation. Therefore this method is independent of any optical property of the

Erich Reichel; Heinz Schmidt-Kloiber; Guenther Paltauf; Karl Groke

1991-01-01

185

Uterus retrieval in cadaver: technical aspects.  

PubMed

The authors describe uterus retrieval in cadavers. Uterine retrieval with its vasculature could be successfully achieved in four of the presented cases. Special attention was given to dissection of bilateral ureters and hypogastric vasculature. Uterine retrieval with its vasculature and supporting sacrouterine,vesicouterine peritoneal folds is an anatomically feasible procedure in preparation for uterus transplantation. PMID:24992779

Akar, M Erman; Ozkan, O; Ozekinci, M; Sindel, M; Yildirim, F; Oguz, N

2014-01-01

186

Complete laparoscopic nephroureterectomy with intravesical lockable clip  

PubMed Central

Introduction We present a cohort of patients with low-stage pelviureteric neoplastic disease who underwent complete laparoscopic nephroureterectomy (CLNUE) with intravesical lockable clip (IVLC). Due to the absence of a standard technique of NUE, the study was not randomized. Materials From 1/2010 to 1/2012, 21 patients were subjected to CLNUE-IVLC. The first step was transurethral excision of the ureterovesical junction with Collin's knife deep into the paravesical adipose tissue. The ureter was grasped with biopsy forceps and the distal end of the ureter was occluded with lockable clip. The applicator was introduced through a 5 mm port inserted as an epicystostomy. The patients were rotated to flank position and CLNUE followed. The endoscopically introduced clip on the distal ureter is proof of completion of the total ureterectomy. Results The mean operation time was 161 (115-200) min. In four (19.0%), the application of the clip failed and CLNUE was completed with non-occluded ureter. In three cases, subsequent laparoscopic nephrectomy was converted to open surgery. In two cases, the distal ureterectomy was completed with pluck technique through a lower abdominal incision that was also used for extraction of the specimen. There were four complications (Clavien II 2x, IIIb, V). Follow-up was available for all – mean 10.6 (range: 0-25) months. One died of disease generalization within 11 months. Conclusion CLNUE-IVLC is fast and safe. If needed, the endoscopic phase can be switched to open NUE. Disadvantages include: the need to change the position of the patient, the risk of inability to apply the clip on the distal ureter, and the risk of an unclosed defect of the urinary bladder. PMID:24578933

Eret, Viktor; Ürge, Tomáš; Kle?ka, Ji?í; Trávní?ek, Ivan; Hes, Ond?ej; Petersson, Fredrik; Stránský, Petr

2012-01-01

187

Cascade Bioassay Evidence for the Existence of Urothelium-Derived Inhibitory Factor in Guinea Pig Urinary Bladder  

PubMed Central

Our aim was to investigate whether guinea pig urothelium-derived bioactivities compatible with the existence of urothelium-derived inhibitory factor could be demonstrated by in vitro serial bioassay and whether purinergic P1 receptor agonists, nitric oxide, nitrite or prostaglandins might explain observed activities. In a cascade superfusion system, urothelium-denuded guinea pig ureters were used as bioassay tissues, recording their spontaneous rhythmic contractions in presence of scopolamine. Urothelium-intact or -denuded guinea pig urinary bladders were used as donor tissues, stimulated by intermittent application of carbachol before or during the nitric oxide synthase inhibitor NG-nitro-L-arginine methyl ester (L-NAME), the adenosine/P1 nucleoside receptor antagonist 8-(p-sulfophenyl)theophylline (8-PST) or the cyclo-oxygenase inhibitor diclofenac infused to bath donor and bioassay tissues. The spontaneous contractions of bioassay ureters were unaltered by application of carbachol 1–5 µM in the presence of scopolamine 5–30 µM. When carbachol was applied over the urothelium-denuded bladder, the assay ureter contraction rate was unaltered. Introducing carbachol over the everted urothelium-intact bladder significantly inhibited the contraction frequency of the assay ureter, suggesting the transfer of an inhibitory activity from the bladder to the assay ureter. The transmissible inhibitory activity was not markedly antagonized by L-NAME, 8-PST or diclofenac, while L-NAME nearly abolished nitrite release from the urothelium-intact bladder preparations. We suggest that urothelium-derived inhibitory factor is a transmissible entity over a significant distance as demonstrated in this novel cascade superfusion assay and seems less likely to be nitric oxide, nitrite, an adenosine receptor agonist or subject to inhibition by administration of a cyclo-oxygenase inhibitor. PMID:25084114

Guan, Na N.; Thor, Anna; Hallén, Katarina; Wiklund, N. Peter; Gustafsson, Lars E.

2014-01-01

188

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

PubMed Central

Objectives Ureteral reimplantation (UR) is the gold standard for the surgical treatment of vesicoureteral reflux (VUR) but few studies have documented its long-term results. We reviewed late cystography (LC) results following successful UR. Methods We performed a retrospective chart review of all children with primary VUR who underwent successful open UR (grade 0 VUR into the reimplanted ureter(s) on initial cystogram) at our institution from January 1990 – December 2002. We identified successful UR patients who underwent LC ? 1 year after UR and reviewed the results for the presence of recurrent VUR into the reimplanted ureter(s). Results 794 patients underwent successful open UR for primary VUR, of whom 60 (7.6%) had a subsequent LC. Preoperative VUR grade was ?II in 20 (34.5%), ?III in 38 (65.5%). Median age at UR was 3.5 years (IQR: 1.3–6.2 years); 51 (85%) were female. UR was intravesical in 45 (75%) and bilateral in 19 (32%). LC was performed at a median of 38.7 months after UR (IQR: 19.6–66.1 months). Indication for LC was febrile UTI in 16 (27%), non-febrile UTI’s in 15 (25%), follow-up of contralateral VUR in 16 (27%) and other clinical indications in 13 (21%). The recurrence rate was 0%; of the 79 reimplanted ureters, 100% (95% CI: 95.4–100) had no VUR (grade 0). Conclusions Among children who underwent successful open UR for primary VUR, there was no VUR recurrence on extended follow-up. This suggests that the late durability of open anti-reflux surgery is excellent. PMID:22245304

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

2013-01-01

189

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

PubMed

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

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

2012-12-01

190

Role of external radiation therapy in urinary cancers.  

PubMed

Invasive urinary tumors are relatively rare and their treatment may cause important changes in urinary, sexual, and social functions. A systematic review of external radiation therapy studies in urinary cancers has been carried out. This synthesis of the literature is based on data from meta-analysis, randomized and prospective trials, and retrospective studies. There are few controlled clinical trials using adjuvant or radical radiotherapy +/- chemotherapy in kidney, ureter, and urethra cancers; there are several reports of muscle-invasive bladder cancer using multimodality treatment: intravesical surgery and neo-adjuvant chemotherapy to radiotherapy or concomitant radiochemotherapy with organ preservation. The conclusions reached for renal cancer are controversial; urethra and ureter cancers data are few and inconclusive; sufficient data now exist in literature to demonstrate that conservative management with organ preservation, for muscle-invasive bladder cancer, is a valid alternative to radical cystectomy, viewed as the gold standard. PMID:17591812

Parisi, S; Troiano, M; Corsa, P; Raguso, A; Cossa, S; Piazzolla, E E; Munafò, T; Sanpaolo, G; Natuno, A; Maiello, E

2007-06-01

191

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

PubMed

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

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

2014-05-01

192

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

PubMed

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

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

2014-01-01

193

[Morbus Ormond (idiopatic retroperitoneal fibrosis)].  

PubMed

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

Michaligová, A; Plank, L; Jezíková, A; Manka, V; Makovický, P; Mokán, M

2011-05-01

194

A unique case of kidney’s collecting system MALT lymphoma  

PubMed Central

Low-grade B cell lymphomas of mucosa-associated lymphoid tissue (MALT lymphomas) are mostly seen in the gastrointestinal tract. MALT lymphomas involving kidney are extremely rare. We report on a case of MALT lymphomas of the kidney. A 74-year-old woman presented with an episode of gross hematuria and right flank pain. In renal sonography, we found a hypoecho lesion measuring 61 × 58 × 44 mm in the lower pole of right kidney. A computed tomography scan revealed an enlarged hypodense soft tissue measuring 62 × 42 × 37 mm within the pelvic brim of the right kidney, with extension to the proximal portion of the ipsilateral ureter and engulfed it. The patient underwent a right radical nephrectomy. The pathology specimen indicated a lymphoprolifrative disorder involving the kidney and ureter. To obtain a definitive diagnosis, we used an immunohistochemistry, which confirmed the diagnosis of a MALT lymphoma. PMID:24678358

Asgari, Seyed Alaeddin; Aval, Hamidreza Baghani; Asgari, Seyed Ali; Kheradmand, Keyvan

2014-01-01

195

Squamous cell carcinoma in a duplicated renal pelvis  

PubMed Central

We report an extremely rare case of squamous cell carcinoma (SCC) of the renal pelvis associated with an incompletely duplicated renal pelvis and ureter. A 71-year-old woman presented with left lower back pain and gross hematuria. Urinary cytology showed atypical squamous cells. Computed tomography, magnetic resonance imaging and retrograde pyelography revealed left incompletely duplicated renal pelvis and ureter and a mass in the left upper renal pelvis. A clinical diagnosis of left renal pelvic cancer was made and the patient underwent total nephroureterectomy. Histological examination of the resected specimen revealed SCC with marked keratinization in the upper renal pelvis. The tumor had invaded the renal parenchyma and perinephric fat. There was no urothelial carcinoma component. The pathological stage was pT4 N0. There was no evidence of recurrence 6 months postoperatively. Because the prognosis of SCC of the upper urinary tract is poor, urologists and pathologists should be aware that SCC may develop in duplicated urinary systems.

Ogawa, Makiko; Morikawa, Teppei; Toyoshima, Toyoaki; Fukayama, Masashi

2014-01-01

196

Holmium Laser Lithothripsy of Ureteral Calculi: Our Initial Experience  

Microsoft Academic Search

Aim: To evaluate effectiveness and safety of intracorporeal holmium:YAG (Ho:YAG) laser lithotripsy of ureteral calculi. Patients and Methods: Between October 2003 and September 2005, 45 patients (age range 27–74, mean age 51.5 years) with 49 ureteral stones (measuring 4–28 mm in size) were treated with Ho:YAG laser lithotripsy. The locations of the stones in the ureter were: 6 in the

A. Triantafyllidis; C. Kalaitzis; S. Giannakopoulos; A. G. Papatsoris; T. Pantazis; A. Papathanasiou; S. Touloupidis

2007-01-01

197

Diffuse Large B-Cell Lymphoma in an Adolescent Male Presenting as Ureteral Stricture  

PubMed Central

Lymphoma may affect the ureter in cases of retroperitoneal involvement. We present a case of an adolescent male found to have non-Hodgkin lymphoma initially presenting as ureteral stricture evident on imaging. He was treated and responded to multiagent chemotherapy with resolution of both the lymphoma and the ureteral stricture. Although rare, non-Hodgkin lymphoma should be included in the differential diagnosis of pediatric patients with noncalculous, idiopathic ureteral strictures. PMID:25093138

Jaeger, Christopher D.; McAlvany, Kelly L.; Zingula, Shannon N.; Kramer, Stephen A.; Granberg, Candace F.

2014-01-01

198

Dilatation of the collecting system during pregnancy: physiologic vs obstructive dilatation  

Microsoft Academic Search

.   Dilatation of the collecting system is a classical phenomenon during pregnancy, due to hormonal and extrinsic compressive\\u000a factors. Imaging has to differentiate a physiological dilatation and a pathological obstruction due to urolithiasis. Presently,\\u000a sonography, using both, B-mode and color Doppler, has the potential to demonstrate the physiological compression of ureters\\u000a at the level of the pelvic brim. A pathological

N. Grenier; J. L. Pariente; H. Trillaud; C. Soussotte; C. Douws

2000-01-01

199

[Application of alpha1-adrenoblockers in treatment of ureteral calculi].  

PubMed

The results of evaluation of the efficacy of alpha1-adrenoblockers in treatment of ureteral calculi are presented. Comparative, prospective, placebo-uncontrolled nonrandomized single-center study was performed, which included 118 patients with solitary diagnosed calculi in various parts of ureter. After the pain relief, all the patients underwent conservative therapy aimed at spontaneous discharge of concretions. The maximum duration of conservative treatment was 28 days. Ultrasound monitoring was performed every week in all patients. The control group of patients received only Drotaverinum 40 mg three times a day, and analgesics. The main group received alpha1-adrenoblocker tamsulosin at a standard dose of 0.4 mg once a day along with Drotaverinum and analgesics. The overall probability of a discharge of concrements localized in the distal ureter was significantly (P = 0.02) higher in the patients treated with alpha1-adrenoblockers. Treatment regimen in main group of patients allowed better control of pain during all periods of observation, even if the discharge of concretions was not registered. The overall probability of migration of concrements from the proximal to the distal ureter in main group of patients was 52% versus 32% in controls (P = 0.17). The frequency of adverse effects was comparable in both groups. Vertigo, postural hypotension, and weakness were significantly more frequent in the main group of patients. Univariate and multivariate analyses of the proportional hazards model have demonstrated that the administration of alpha1-adrenoblocker increased the likelihood of a discharge of concrement from the distal ureter. It is shown that the nature of the applied therapy has directly influence on the risk of an earlier discharge of concretions. Inclusion of alpha1-adrenoblockers in the treatment scheme increased the probability of discharge of concrements at 4.11 times. PMID:23342609

Dutov, V V; Popov, D V; Rumiantsev, A A; Pashchenko, V B

2012-01-01

200

Fluid-electrolyte and renal pelvic pressure changes during ureteroscopic lithotripsy.  

PubMed

Abstract The objective of the study was to evaluate fluid-electrolyte and renal pelvic pressure (RPP) changes during ureteroscopic lithotripsy. Fifteen patients were detected with residual ureteral calculi after minimally invasive percutaneous nephrolithotomy (MPCNL), distal ureter calculi in three, midureter calculi in four, proximal calculi in eight. RPP was measured via the percutaneous nephrostomy tube by urodynamic study at irrigation pressures of 50, 100 and 200 mmHg. Haemoglobin (Hb), haematocrit (Hct), blood urea mitrogen (BUN), creatinine (Cre), serum sodium (Na(+)), potassium (K(+)), chlorine (Cl(-)) were recorded before and after ureteroscopic lithotripsy. There were no significant differences between Hb, Hct, BUN, Cre, Na(+), K(+), Cl(-) values. Baseline RPP was (16.37 ± 3.14) cmH(2)O, RPPs were 46.06 ± 6.85 cmH(2)O, 99.07 ± 14.62 cmH(2)O and 166.27 ± 33.08 cmH(2)O at irrigation pressures of 50, 100 and 200 mmHg, they were much higher than baseline RPP (p < 0.0001). RPP in the proximal ureter was much higher than in the distal and middle ureter, 50.98 ± 4.52 cmH(2)O versus 40.44 ± 4.07 cmH(2)O (p = 0.0004), 110.26 ± 2.39 cmH(2)O versus 86.29 ± 11.60 cmH(2)O (p = 0.0014), 193.21 ± 5.88 cmH(2)O versus 135.47 ± 20.95 cmH(2)O (p = 0.0002) at irrigation pressures of 50, 100 and 200 mmHg. There were no significant changes in fluid-electrolyte. RPP was significantly increased during ureteroscopic lithotripsy, it was correlated with the irrigation pressure and the position in the ureter. PMID:21745133

Shao, Yi; Shen, Zhi-Jie; Zhu, Yi-Yong; Sun, Xiao-Wen; Lu, Jun; Xia, Shu-Jie

2012-07-01

201

Danazol in the management of ureteral obstruction secondary to endometriosis  

SciTech Connect

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.

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

1985-08-01

202

Surgical views: Surgical treatment of urethral sphincter mechanism incompetence in dogs.  

PubMed

Urinary incontinence--loss of voluntary control over the retention and expulsion of urine--is a common medical problem in small animal patients. Incontinence occur when pressure within the bladder exceeds urethral pressure. Incontinence may result from a variety of etiologies, including congenital anatomic abnormalities of the lower urinary and reproductive systems (ureter, bladder, bladder neck, urethra, vagina,vestibule) as well as neurologic, neoplastic, infectious, and inflammatory disease. PMID:19866443

McLoughlin, Mary A; Chew, Dennis J

2009-08-01

203

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

PubMed Central

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.

Blewniewski, Mariusz; Ró?a?ski, Waldemar

2015-01-01

204

Deletion (11)(q14.1q21)  

SciTech Connect

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.

Stratton, R.F.; Lazarus, K.H.; Ritchie, E.J.L. [Southwest Texas Methodist Hospital, San Antonio, TX (United States); Bell, A.M. [Nichols Institute, Los Angeles, CA (United States)

1994-02-01

205

Epithelial transformation of metanephric mesenchyme in the developing kidney regulated by Wnt4  

Microsoft Academic Search

THE kidney has been widely exploited as a model system for the study of tissue inductions regulating vertebrate organogenesis1,2. Kidney development is initiated by the ingrowth of the Wolfian duct-derived ureteric bud into the presumptive kidney mesenchyme. In response to a signal from the ureter, mesenchymal cells condense, aggregate into pretubular clusters and undergo an epithelial conversion generating a simple

Kevin Stark; Seppo Vainio; Galya Vassileva; Andrew P. McMahon

1994-01-01

206

Congenital giant megaureter.  

PubMed

We have seen 21 patients with unilateral congenital giant megaureter. Age ranged from 2 months to 8 years. This condition is characterized by giant focal segmental ureteral dilatation producing an elongated and distorted ureter; distally there may be congenital ureteral stenosis or atresia, or a ureter of approximately normal caliber. They usually have a dysplastic and disorganized muscular coat, lined with a columnar epithelial mucosa rather than the usual transitional epithelium. The associated kidney or moiety was hypoplastic, dysplastic, or the site of comparatively mild hydronephrosis associated with atrophic renal parenchyma. Function and volume of the bladder was normal. Twelve of 21 patients had a duplex collecting system on the affected side. One patient had four pelves and proximal ureters opening into a single lower ureter, which was the site of a giant cyst. One of eight simple giant megaureters was suspected of being associated with a solitary kidney. Depending on whether the giant segmental ureteral dilatation was multiple or single, these cases have presented either with marked protruberance of the mid and lower abdomen, which was distended by transverse elongated cysts, or with a round cyst mass in the lower abdomen. Nineteen patients treated by excision of the giant megaureter and the associated kidney or moiety were free of symptoms postoperatively. One 4-month-old infant with multiple congenital abnormalities and urinary tract infections died soon after operation. Another 4-month-old infant with suspected solitary kidney was treated by ureterostomy and was discharged in a critical condition without follow-up. PMID:3559867

Huang, C J

1987-03-01

207

Sulfasalazine reduces inflammatory renal injury in unilateral ureteral obstruction  

Microsoft Academic Search

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

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

2007-01-01

208

RENAL AUTOTRANSPLANTATION IN SHEEP—PREPARATION AND PHYSIOLOGY  

Microsoft Academic Search

A novel procedure for renal autotransplantation in sheep is described. The operative procedure involved two preliminary operations for preparation of carotid artery and jugular vein loops and of a Wright-type parotid fistula. At transplantation the renal artery and vein were anastomosed end-to-end to carotid artery and jugular vein and the ureter was anastomosed end-to-end to the parotid duct. The cranial

JG McDougall; JP Coghlan; DA Denton; KJ Hardy; SJ Potocnik; BA Scoggins

1982-01-01

209

Myocyte apoptosis in the pathogenesis of ureteral damage in rats with obstructive uropathy  

Microsoft Academic Search

Objectives. To elucidate the role of signal apoptosis in the pathogenesis of ureteral damage during the course of obstructive uropathy and to investigate the cell proliferation in the smooth muscle layer of ligated ureter.Methods. The apoptotic cells were detected with the method of in situ end-labeling of DNA fragments. The expression of Fas, tumor necrosis factor receptor 1 (TNF-R1), and

Yen-Hwang Chuang; Wan-Long Chuang; Chun-Hsiung Huang

2001-01-01

210

Excretory System Activity  

NSDL National Science Digital Library

This activity from Darcy Hartley-Pinard will help elementary school teachers demonstrate the structures and process of the excretory system. The class will use a diagram of a human body and everyday items including straws, uncooked spaghetti, yarn and kidney beans to recreate the veins, arteries, kidneys, ureters, bladder and urethra. This activity is useful for younger students to visualize and connect with the processes that take place in their own bodies.

2012-06-12

211

Agenesis of the urinary bladder with cutaneous ectopic ureteric orifice and multiple birth defects.  

PubMed

This is to our knowledge the first case in the world literature of a liveborn baby with a tubular colonic duplication, agenesis of the urinary bladder, urethral atresia, and a single pelvic kidney with its ureter opening directly onto the skin in the region of the natal cleft. A brief review of the embryology is included and an attempt is made to explain the embryologic basis for this anomaly. PMID:9035215

Bhagwat, A D; Samuel, K V; Kulkarni, M S; Kapur, V R

1997-01-01

212

Management of incurable urinary fistulas by percutaneous ureteral occlusion.  

PubMed

Women with large urinary tract fistulas in the presence of advanced incurable gynecologic cancer are a difficult problem. In the past, treatment has usually been either inadequate or highly morbid. We have palliated three women with large incurable urinary tract fistulas by occluding the distal ureters with isobutyl-2-cyanoacrylate (Bucrylate) and implanting permanent bilateral percutaneous nephrostomies. This technique is easily performed and effective, and has few complications. PMID:3684136

Stern, J L; Maroney, T P; Lacey, C G

1987-12-01

213

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

PubMed

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

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

2012-04-01

214

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

PubMed Central

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

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

2012-01-01

215

An update on lower urinary tract tuberculosis  

Microsoft Academic Search

Tuberculosis of the genitourinary tract presents with atypical manifestations. Only 20% to 30% of patients with genitourinary\\u000a tuberculosis have a history of pulmonary infection. Tuberculosis often affects the lower genitourinary system rather than\\u000a the kidney. Tuberculosis of the lower genitourinary tract most commonly affects the epididymis and the testis, followed by\\u000a bladder, ureter, prostate, and penis. Use of bacillus Calmette-Guérin

Gilbert J. Wise; Alex Shteynshlyuger

2007-01-01

216

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

ClinicalTrials.gov

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

2014-12-12

217

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

PubMed Central

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

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

2012-01-01

218

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

PubMed

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

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

2012-01-01

219

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

NASA Astrophysics Data System (ADS)

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

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

2005-07-01

220

Syntactic methods of shape feature description and its application in analysis of medical images  

NASA Astrophysics Data System (ADS)

The paper presents specialist algorithms of morphologic analysis of shapes of selected organs of abdominal cavity proposed in order to diagnose disease symptoms occurring in the main pancreatic ducts and upper segments of ureters. Analysis of the correct morphology of these structures has been conducted with the use of syntactic methods of pattern recognition. Its main objective is computer-aided support to early diagnosis of neoplastic lesions and pancreatitis based on images taken in the course of examination with the endoscopic retrograde cholangiopancreatography (ERCP) method and a diagnosis of morphological lesions in ureter based on kidney radiogram analysis. In the analysis of ERCP images, the main objective is to recognize morphological lesions in pancreas ducts characteristic for carcinoma and chronic pancreatitis. In the case of kidney radiogram analysis the aim is to diagnose local irregularity of ureter lumen. Diagnosing the above mentioned lesion has been conducted with the use of syntactic methods of pattern recognition, in particular the languages of shape features description and context-free 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 into diagrams of widths of the examined structures.

Ogiela, Marek R.; Tadeusiewicz, Ryszard

2000-02-01

221

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

NASA Astrophysics Data System (ADS)

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.

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

2003-06-01

222

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

PubMed Central

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

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

2015-01-01

223

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

USGS Publications Warehouse

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

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

2003-01-01

224

Lower urinary tract development and disease  

PubMed Central

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

Rasouly, Hila Milo; Lu, Weining

2013-01-01

225

An active membrane model for peristaltic pumping: Part I--Periodic activation waves in an infinite tube.  

PubMed

A model for the coupled problem of wall deformation and fluid flow, based on thin-shell and lubrication theories, and driven by a propagating wave of smooth muscle activation, is proposed for peristaltic pumping in the ureter. The model makes use of the available experimental data on the mechanical properties of smooth muscle and accounts for the soft material between the muscle layer and the vessel lumen. The main input is the activation wave of muscular contraction. Equations for the time-dependent problem in tubes of arbitrary length are derived and applied to the particular case of periodic activation waves in an infinite tube. Mathematical (small amplitude) and numerical analyses of this case are presented. Predictions on phase-lag in wall constriction with respect to peak activation wave, lumen occlusion due to thickening lumen material with contracting smooth muscle, and the general bolus shape are in qualitative agreement with observation. Some modifications to the mechanical, elastic, and hydrodynamic properties of the ureter that will make peristalsis less efficient, due for example to disease, are identified. In particular, the flow rate-pressure rise relationship in linear for weak to moderate activation waves, but as the lumen is squeezed shut, it is seen to be nonlinear in a way that increases pumping efficiency. In every case a ureter whose lumen can theoretically be squeezed shut is the one for which pumping is most efficient. PMID:9083851

Carew, E O; Pedley, T J

1997-02-01

226

Comparison of the effects of ureteral calculosis and occlusion on muscular sensitivity to painful stimulation in rats.  

PubMed

An animal model of muscular hyperalgesia was developed. In humans, this disorder follows painful crises due to ureteral calculosis. Changes in vocalization thresholds to electrical stimulation of the obliquus externus muscle of both sides were studied in a group of rats with chronically implanted muscles before and after the production of a stone in one ureter. In another group of rats with implanted muscles, it had been verified preliminarily that these thresholds did not vary widely from day to day. On the contrary, a significant lowering in threshold (max 31%) in the muscle ipsilateral to the implanted ureter appeared the day after the production of the stone and persisted for the subsequent 10 days of observation, although less pronounced during the last 5 days. Hypersensitivity to manual pressure was also observed, mainly in the ipsilateral muscle, in most rats during the same period. In order to differentiate between the effects due to the presence of the stone in the ureteral lumen and those due to the spontaneous occlusion which frequently occurred in the implanted ureter, 2 other groups of rats were studied. In one, a unilateral ureteral ligature was performed; in the other, the production of a stone was combined with a ligature (placed distally to the stone). Ligature alone never induced any hyperalgesic effect. Stone plus ligature produced a marked hyperalgesia (max 39%) in the ipsilateral muscle, which lasted for only 5 days. It is concluded that the ureteral stone is the factor responsible for the appearance of muscular hyperalgesia. PMID:2087333

Giamberardino, M A; Vecchiet, L; Albe-Fessard, D

1990-11-01

227

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

SciTech Connect

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

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

2008-09-15

228

Ureteral Reconstruction With Bowel Segments: Experience With Eight Patients in a Single Institute  

PubMed Central

Purpose Although replacement of the ureter with a bowel segment is indicated for large ureteral defects, it is still a challenging technique for urologists. We present our experience and outcome of ureteral reconstruction using bowel segments. Materials and Methods Ureteral reconstruction with bowel segments was performed in eight patients in our institute between 1969 and 2009. We investigated the position and length of the ureteral defect and methods of reconstruction as well as the patients' backgrounds, postoperative complications, and clinical outcomes. Results Five patients underwent ureteral replacement with isolated ileal segments alone. In one patient, the ureter was reconstructed by using the Yang-Monti procedure with the ileum. A colon segment was used in two patients who required bladder augmentation for tuberculous contracted bladder at the same time. Metabolic acidosis occurred in three patients having a solitary kidney and the ureter had to be replaced by a relatively long intestinal segment. Two patients who received preoperative radiation therapy were required to undergo additional operations. Long-term cancer-free survival was achieved in one patient who underwent ileal substitution for low-grade renal pelvic cancer. Conclusions Although ureteral replacement with a bowel segment is a challenging and useful procedure, attention must be paid to the possibility of metabolic acidosis, which is likely to occur in patients having a solitary kidney with renal insufficiency or in patients requiring a long intestinal segment for reconstruction. In addition, preoperative radiation therapy for the pelvic organs may cause postoperative complications. PMID:25405017

Takeuchi, Motoi; Tsukamoto, Taiji

2014-01-01

229

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

PubMed

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

Grewal, Sundeep Singh

2013-09-01

230

Endoscopic Management of Vesicoureteral Reflux in Children in Kosova  

PubMed Central

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

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

2014-01-01

231

Possible Complications of Ureteroscopy in Modern Endourological Era: Two-Point or “Scabbard” Avulsion  

PubMed Central

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

Gaizauskas, Sergejus; Zelvys, Arunas

2014-01-01

232

Smad4 Regulates Ureteral Smooth Muscle Cell Differentiation during Mouse Embryogenesis  

PubMed Central

Proper formation of ureteral smooth muscle cells (SMCs) during embryogenesis is essential for ureter peristalsis that propels urine from the kidney to the bladder in mammals. Currently the molecular factors that regulate differentiation of ureteral mesenchymal cells into SMCs are incompletely understood. A recent study has reported that Smad4 deficiency reduces the number of ureteral SMCs. However, its precise role in the ureteral smooth muscle development remains largely unknown. Here, we used Tbx18:Cre knock-in mouse line to delete Smad4 to examine its requirement in the development of ureteral mesenchyme and SMC differentiation. We found that mice with specific deletion of Smad4 in Tbx18-expressing ureteral mesenchyme exhibited hydroureter and hydronephrosis at embryonic day (E) 16.5, and the mutant mesenchymal cells failed to differentiate into SMCs with increased apoptosis and decreased proliferation. Molecular markers for SMCs including alpha smooth muscle actin (?-SMA) and smooth muscle myosin heavy chain (SM-MHC) were absent in the mutant ureters. Moreover, disruption of Smad4 significantly reduced the expression of genes, including Sox9, Tbx18 and Myocardin associated with SMC differentiation. These findings suggest that Smad4 is essential for initiating the SMC differentiation program during ureter development. PMID:25127126

Yan, Jianyun; Zhang, Lu; Xu, Jinshu; Sultana, Nishat; Hu, Jun; Cai, Xiaoqiang; Li, Jun; Xu, Pin-Xian; Cai, Chen-Leng

2014-01-01

233

Location of the ureteral openings in the cloacas of tinamous, some ratite birds, and crocodilians: a primitive character.  

PubMed

Cloacas of 67 avian species, of both sexes, from various habitats and differing dietary habits, were examined macro- and microscopically to investigate possible variation in the location of the ureteral openings. Differing from most birds studied, in adult male Rhea americana and several tinamous species the ureters were found to open into the coprodeum. In these species the urodeum receives only the vas deferens or oviduct. Similarly, in crocodiles Caiman crocodilus yacare, but not in lizards Tropidurus montanus and snakes Crotalus durissus terrificus, the ureters empty into the coprodeum. This similarity between ancient birds (ratites and tinamous) and crocodiles may indicate a primitive character linking reptiles and birds. This unusual position of the ureteral orifice can represent an adaptation to facilitate urine collection into the coprodeum and large intestine. Another possibility is that this variation in ureter position is a male reproductive strategy to avoid the mixture of urine and semen in the cloaca. There were no evident correlations between the location of the ureteral openings and the birds' habitat, diet, or histology of the coprodeal mucosa. The occurrence of a phallus in eight species of birds was detected, as well as a peculiar vascularization related to the coprodeal epithelium of anseriformes. Together, these data add to the scarce information about the morphophysiology of the avian cloaca, and also contribute to clarify avian phylogenetic linkages. PMID:15108162

Oliveira, Cleida Aparecida; Silva, Renata Mageste; Santos, Marcileida Maria; Mahecha, Germán Arturo Bohórquez

2004-05-01

234

Spontaneous ureteric rupture secondary to an invasive desmoid tumour  

PubMed Central

INTRODUCTION Spontaneous ureteric rupture is a rare entity that presents as an extravasation of urine from the ureter without previous surgery, ureteric manipulation and external trauma of the ureter. We report the case of a desmoid tumour presenting as spontaneous ureteric rupture which was managed in our institution. PRESENTATION OF CASE A 28 years old healthy male presented with a four day history of generalised abdominal pain secondary to spontaneous right ureteric rupture. Patient was initially managed via insertion of nephrostomy tube and antibiotics. After unsuccessful attempts of retrograde and antegrade ureteric stent insertion, patient was subsequently managed via elective surgical intervention. The excised specimen revealed desmoid tumour as cause of the ureteric rupture. DISCUSSION Desmoid tumours are rare benign tumours arising from fascial or musculoaponeurotic structures that do not metastasise, but tend to invade locally. It is often initially managed medically prior to undertaking a definitive surgical intervention. To our knowledge this is the first reported case of ureteric perforation secondary to a desmoid tumour of the mesentery. CONCLUSION Spontaneous rupture of the ureter is often misdiagnosed as other conditions. History taking and examination can be unreliable, hence a high level of suspicion and further investigations should be utilised. Once the diagnosis is made, treatment can be individualised based on aetiology. PMID:25460442

Yoon, Peter Daechul; Ahmadi, Nariman; Strahan, Stephen; Wang, Audrey

2014-01-01

235

Lower urinary tract development and disease.  

PubMed

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 anomaliesc 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 (PUVs). 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, the bladder, and the urethra, and different genes and signaling pathways controlling these developmental processes. Human genetic disorders that affect the ureter, the bladder and the urethra and associated gene mutations are also presented. As we are entering the postgenomic 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

Rasouly, Hila Milo; Lu, Weining

2013-01-01

236

[Treatment of ureteral lithiasis in situ with an EDAP LT01 lithotriptor].  

PubMed

Herein we present the results of 237 ureteral calculi that had been treated, without previous manipulation, with piezoelectric extracorporeal lithotripsy (PEL) using the EDAP LT01 lithotriptor. The lumbar ureter was divided into UP1 and UP2, the segments above or below the inferior border of the kidney, respectively. Forty-seven calculi were located in UP1 and 19 in UP2. The pelvic segment of the ureter was divided into UD1 and UD2, the segment above the sciatic notch and the remaining portion of the pelvic ureter, respectively. Fifty-seven calculi were located in UD1 and 114 in UD2. Treatment was performed in 246 sessions. Localization of the calculi was achieved without difficulty in 56.9%, with difficulty in 35.3% and this could not be achieved in 7.7%. Localization became more difficult as we moved further away from the kidney and urinary bladder. The overall success rate was 83.5%. No correlation was observed between stone size and success. Most of the calculi (62%) were 6 to 10 mm in size. The incidence of satisfactory resolution of calculi increased with the operator's experience. PEL is an effective alternative in the treatment of ureteral calculi in situ. In our setting, it is our first approach in the management of calculi, fundamentally in those cases without a markedly obstructive component. PMID:1807211

Páramo de Santiago, P; Díez-Yanguas Yza, J; Burgos Revilla, F J; Platas, A; Mayayo Dehesa, T

1991-11-01

237

[In situ treatment of ureteral lithiasis with an EDAP LT01 lithotriptor].  

PubMed

Herein we present the results of 237 ureteral calculi that had been treated, without previous manipulation, with piezoelectric extracorporeal lithotripsy (PEL) using the EDAP LT01 lithotriptor. The lumbar ureter was divided into UP1 and UP2, the segments above or below the inferior border of the kidney, respectively. Fourty-seven calculi were located in UP1 and 19 in UP2. The pelvic segment of the ureter was divided into UD1 and UD2, the segment above the sciatic notch and the remaining portion of the pelvic ureter, respectively. Fifty-seven calculi were located in UD1 and 114 in UD2. Treatment was performed in 246 sessions. Localization of the calculi was achieved without difficulty in 56.9%, with difficulty in 35.3% and this could not be achieved in 7.7%. Localization became more difficult as we moved further away from the kidney and urinary bladder. The overall success rate was 83.5%. No correlation was observed between stone size and success. Most of the calculi (62%) were 6 to 10 mm in size. The incidence of satisfactory resolution of calculi increased with the operator's experience. PEL is an effective alternative in the treatment of ureteral calculi in situ. In our setting, it is our first approach in the management of calculi, fundamentally in those cases without a markedly obstructive component. PMID:1953069

Páramo de Santiago, P; Díez-Yanguas Yza, J; Burgos Revilla, F J; Platas, A; Mayayo Dehesa, T

1991-09-01

238

Salt adaptation in Bufo bufo  

PubMed Central

1. The capacity of adaptation of toads (Bufo bufo) to environments of high salinity was studied and the relative importance of skin, kidney and urinary bladder in controlling the balance of water and salt was assessed. 2. Toads were kept in NaCl solutions of 20, 50, 110, 150 and 220 mM and studied in their fourth week of adaptation. A group of animals considered as `control' was kept in wet soil with free access to water. Plasma, ureter urine, and bladder and colon contents were analysed for sodium, potassium, chloride and osmolality, and total body sodium and water were determined. Absorption of water and 22Na through the skin, and water flow and sodium excretion through the ureter, of intact animals was studied. Hydrosmotic water transport through the isolated urinary bladder of `control' and adapted animals was determined. The effects of pitressin and aldosterone on the water and sodium balance are described. 3. The survival rates of toads kept in saline concentrations up to 150 mM were identical to that of `control' animals, but half of the animals kept in 220 mM died within 4 weeks. 4. There is a linear correlation between the sodium concentrations and osmolality of plasma and of the external media. 5. The sodium concentration in colon contents rose with rising external concentrations, up to values higher than the values in plasma. 6. Sodium concentrations and osmolalities of ureter and bladder urine increased in adapted animals, the values for bladder urine becoming much higher than those for ureter urine in animals adapted to 110, 150 and 220 mM. 7. Total body water, as a percentage of total weight was kept within very narrow limits, although the total body sodium increased with adaptation. 8. Absorption of water through the skin for the same osmotic gradients was smaller in adapted than in `control' animals. 9. The ureteral output of water of toads adapted to 110 and 150 mM-NaCl was larger than the water absorption through the skin. 10. Skin absorption of sodium was lower in animals adapted to concentrated saline solutions than in `control' animals. 11. Sodium output by the ureter was identical to skin absorption in `control' animals adapted to 20, 50 and 110 mM-NaCl but was higher in animals adapted to 150 mM-NaCl. 12. Aldosterone increased the absorption of sodium in `control' and adapted toads, but at all dose levels absorption by control was greater than by adapted animals. 13. The stimulation of water absorption by vasopressin in vivo or in isolated bladders was not modified in animals adapted to high salinities. PMID:4633911

Ferreira, H. G.; Jesus, C. H.

1973-01-01

239

[Salvage laparoscopic pyeloplasty in the worst case scenario: after failed open repair and endoscopic salvage.  

PubMed

Objectives: We present the video of a laparoscopic correction of a left ureteropelvic junction obstruction in a patient who has already undergone previous surgical open pyeloplasty and subsequent acucise for failure of the first surgery. At 8 years after the second surgery, the patient showed a recurrence of the obstruction of the left ureteropelvic junction.?It was decided to perform the retroperitoneal laparoscopic correction of the obstruction.?Materials and methods: With the patient placed in a 90° flank position, 4 trocars are placed in the retroperitoneum space by the Hasson tecnique.?After the creation of the retroperitoneum space, the Gerota's fascia is opened. The posterior layer of the Gerota's fascia appears very thickened at the level of the lower pole of the kidney and is very adherent with the surrounding structures, in particular the psoas muscle.?Gerota's fascia is incised and removed from the previous surgery and the psoas muscle is identified. The distal lumbar ureter is tenaciously anchored to the psoas muscle. The lower pole of the kidney is freed from the adhesions of the previous surgery. The proximal ureter is hardly isolable for the presence of fibrosis. The renal pelvis is fixed to the psoas due to fibrotic tissue that is cut with scissors. Once the pelvis and the ureter are separated from the psoas, the surgery proceeds with the liberation of the pelvis from the adipose tissue and fibrosis that surround it. The pieloureteral obstruction is not easily identifiable. The renal pelvis is opened at the level of the ureteral junction, the ureter is spatulated on its medial side. The scar tissue is removed until well vascularized tissue is seen. The anastomosis between the ureter and pelvis is performed with 2 semicontinuous running sutures. Once the anterior plate of the anastomosis is completed a cystoscopic retrograde DJ ureteral stent insertion is performed. The procedure ends with the packaging of the posterior plate of the anastomosis with the second running suture.?Results: The operation lasted 180 minutes. The postoperative course was uneventful, the drain was removed on the second day and the bladder catheter on the 4th. The patient was discharged on the 5th day and the DJ ureteral stent was removed on the 21st post-operative day.?Discussion: The laparoscopic reoperation in patients with previous open surgery interventions is definitely difficult. This kind of surgery has to be carried out after having gained considerable laparoscopy experience. Specifically, the reoperation of laparoscopic pyeloplasty after 2 previous intervention poses the following difficulties: the creation of appropriate space, dissection of the ureter and pelvis from the psoas muscle, appropriate mobilization of the lower pole of the kidney to get a "tension free" anastomosis, liberation of the pelvis and ureter from the tenaciously adherent fibrotic tissue, identification of the stenotic ureteropelvic junction.?Conclusions: Laparoscopic pyeloplasty after failure of past interventions remains a difficult procedure that should only be performed after major laparoscopic experience. In experienced hands, redo laparoscopic pyeloplasty provides high success rates. PMID:24665025

Parma, Paolo; Samuelli, Alessandro; Luciano, Marco; Dall'oglio, Bruno

2014-03-01

240

Which one is safer – performing a laparoscopic hysterectomy with a tissue fusion device involving diagnostic cystoscopy or traditional abdominal hysterectomy with ureteral dissection?  

PubMed Central

Introduction It still remains an unanswered question whether, in the absence of gynecological malignancy and under elective conditions, to perform abdominal hysterectomy (AH), offering a safer approach, or to perform a laparoscopic hysterectomy (LH) procedure. Aim We aimed to compare LH operations performed with a tissue fusion device accompanied by intraoperative diagnostic cystoscopy with traditional AH operations involving bilateral ureteral dissection. Material and methods The integrity of the ureters, ureteral peristalsis and the diameter of the ureters were examined during AH by inspection. At the end of LH, the bladder wall was systematically evaluated by cystoscopy and a jet of urine spurting was noted from both ureteral orifices. Results The operation time was longer in patients who underwent LH + CYS (p = 0.0001). The decline in hematocrit and hemoglobin levels in the postoperative period was significantly higher in patients who underwent AH + UD (p = 0.0001 and p = 0.002, respectively). No significant difference was found between the two groups in terms of ureteral injury, bowel injury or bladder injury (p = 0.378, p = 1.000 and p = 1.000, respectively). There was no statistically significant difference between the two groups in terms of mean body temperature and postoperative blood transfusion requirements (p = 0.051 and p = 0.210, respectively). Mean parenteral analgesic requirement and length of hospital stay were significantly different between the groups (p = 0.005 and p = 0.0001). No statistically significant difference was found between the two groups in terms of postoperative cardiopulmonary complications, re-operation rate or occurrence of genitourinary fistula (p = 1.000, p = 1.000 and p = 1.000, respectively). Conclusions We concluded that LH performed with a tissue fusion device involving diagnostic cystoscopy yields major and minor complication rates similar to safely performed AH operations preserving ureters. PMID:24501597

Yildiz, Gazi; Ça?lar, Mete; Alt?nta?, Ra?it; Dilbaz, Serdar; Yildiz, Pinar; Kumru, Selahattin; Üstün, Yusuf

2013-01-01

241

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

NASA Astrophysics Data System (ADS)

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

Ogiela, Marek R.; Tadeusiewicz, Ryszard

2000-04-01

242

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

PubMed Central

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 Sihler’s and HE techniques. Fifteen human bladders were adopted by Sihler’s staining, using 10% formaldehyde to fix 12 weeks, 7 by HE dyeing fixes 24 hours. Results indicated that man’s bladder was triangularpyramid-shaped. While dog’s 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 dog’s bladder was transparent jelly, the nerve was purple color, enter bladder at the ureter-bladder junction with different forms. Man’s 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 dog’s 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 man’s bladder wall, the situations is opposite on the dog’s. 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.

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

2014-01-01

243

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

PubMed Central

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

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

2014-01-01

244

A murine model of irreversible and reversible unilateral ureteric obstruction.  

PubMed

Obstruction of the kidney may affect native or transplanted kidneys and results in kidney injury and scarring. Presented here is a model of obstructive nephropathy induced by unilateral ureteric obstruction (UUO), which can either be irreversible (UUO) or reversible (R-UUO). In the irreversible UUO model, the ureter may be obstructed for variable periods of time in order to induce increasingly severe renal inflammation and interstitial fibrotic scarring. In the reversible R-UUO model the ureter is obstructed to induce hydronephrosis, tubular dilation and inflammation. After a suitable period of time the ureteric obstruction is then surgically reversed by anastomosis of the severed previously obstructed ureter to the bladder in order to allow complete decompression of the kidney and restoration of urinary flow to the bladder. The irreversible UUO model has been used to investigate various aspects of renal inflammation and scarring including the pathogenesis of disease and the testing of potential anti-inflammatory or anti-fibrotic therapies. The more challenging model of R-UUO has been used by some investigators and does offer significant research potential as it allows the study of inflammatory and immune processes and tissue remodeling in an injured and scarred kidney following the removal of the injurious stimulus. As a result, the R-UUO model offers investigators the opportunity to explore the resolution of kidney inflammation together with key aspects of tissue repair. These experimental models are of relevance to human disease as patients often present with obstruction of the renal tract that requires decompression and are commonly left with significant residual kidney impairment that has no current treatment options and may lead to eventual end stage kidney failure. PMID:25549273

Hesketh, Emily E; Vernon, Madeleine A; Ding, Peng; Clay, Spike; Borthwick, Gary; Conway, Bryan; Hughes, Jeremy

2014-01-01

245

Double pigtail ureteral stenting and renal pelvic lavage for renal-sparing treatment of obstructive pyonephrosis in dogs: 13 cases (2008-2012).  

PubMed

Objective-To describe the technical aspects and clinical outcome of endoscopic- and fluoroscopic-guided ureteropelvic lavage and ureteral stent placement for treatment of obstructive pyonephrosis in dogs. Design-Retrospective case series. Animals-13 client-owned dogs (14 obstructed ureters). Procedures-All patients with obstructive pyonephrosis were treated with a ureteral stent. Medical records were reviewed for history, clinical signs, pre- and postprocedural clinical and imaging data, and short- and long-term outcomes. Results-13 dogs (14 ureters) had unilateral or bilateral ureteral obstructions and pyonephrosis due to ureterolithiasis (n = 13) or a suspected ureteral stricture (1). Eleven dogs had positive results of bacteriologic culture of urine obtained from the bladder, renal pelvis, or both. Ten were thrombocytopenic, and 8 were azotemic. Stents were placed fluoroscopically with endoscopic (n = 11) or surgical (3) assistance. Median hospitalization time was 48 hours (range, 6 to 260 hours). Median follow-up time was 480 days (range, 2 to 1,460 days). Intraoperative complications occurred in 2 patients (stent occlusion from shearing of a guide wire, and wire penetration of the ureter at the location of a stone). Short-term complications included a bladder hematoma (n = 1) and transient dysuria (1). Long-term complications included stent encrustation (n = 1), stent migration (1), and tissue proliferation at the ureterovesicular junction (5), which had no clinical implications. Recurrent urinary tract infections were documented in 7 dogs. Conclusions and Clinical Relevance-Ureteral stenting was a successful renal-sparing treatment for obstructive pyonephrosis in dogs and could often be performed in a minimally invasive manner. There were few major complications. This technique may be considered as an effective treatment option for this condition in dogs. PMID:25554938

Kuntz, Jodi A; Berent, Allyson C; Weisse, Chick W; Bagley, Demetrius H

2015-01-15

246

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

PubMed Central

Purpose Success rates of ureteral reimplantation for primary vesicoureteral reflux (VUR) are high. Few studies document the natural history of children with persistent VUR. We reviewed their clinical outcomes and long-term resolution. Materials and Methods We performed a retrospective review of all children with persistent VUR (grade?1) into the reimplanted ureter(s) on initial cystogram after reimplantation for primary VUR at our institution from January 1990 - December 2002. We evaluated subsequent cystograms (graded on the 3-point radionuclide cystogram scale), surgery, and urinary tract infection (UTI). We performed survival analyses of time to resolution of persistent (grade?1) and clinically significant (grade?2) VUR in patients with >1 postoperative cystogram. Results Of 965 patients, 59 (94 ureters) had persistent VUR (6.1%): 19 grade 1/3, 29 grade 2/3 and 11 grade 3/3. Median age at reimplantation was 1.9 years; 62.7% were female. Preoperative VUR grade was 2/3 in 42.4% and 3/3 in 57.6%; 30.5% had ureteral tapering. Median follow-up was 47.1 months (IQR 19.3–65.3). 26/36 (72.2%) patients resolved; median time to resolution was 20.4 months. 21/32 with grade ? 2 on postoperative cystogram (65.6%) resolved; median time to resolution was 20.4 months. 10 had persistent VUR at last cystogram; grade 1 or 2 in 9 patients and 3/3 in 1 patient. One had repeat reimplantation for persistent VUR. 7 patients (13%) had postoperative febrile UTI at a median of 37 months postoperatively (IQR 1.7–64.4). Conclusions Persistent VUR after reimplantation resolves spontaneously in most children and can be managed non-operatively with good long-term outcomes. PMID:22906647

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

2013-01-01

247

Holmium Laser Lithotripsy with Semi-Rigid Ureteroscopy: A First-Choice Treatment for Impacted Ureteral Stones in Children?  

PubMed Central

Background We aimed to assess the effectiveness of semi-rigid ureteroscopy and holmium laser lithotripsy in the treatment of impacted ureteral stones in children. Material/Methods We evaluated a total of 32 children under the age of 18 years treated with ureteroscopic holmium laser lithotripsy for impacted ureteral stones between January 2005 and July 2013. Their stone-free state was defined as the absence of any residual stone on radiologic evaluation performed 4 weeks postoperatively. Complications were evaluated according to the modified Clavien classification. Result The mean patient age was 9.5±5.1 years (range 1–18 years). Seven (21.8%) of the stones were located in the proximal ureter, 9 (28.2%) were in the mid-ureter, and 16 (50%) were in the distal ureter. The mean stone size was calculated as being 10.46±3.8 mm2 (range 5–20). The stone-free rate was 93.75% (30/32 patients) following primary URS. Additional treatment was required for only 2 (6.25%) of the patients. After the procedure, a D-J stent was placed in all the patients. The total complication rate was 15.6% (5 patients). The 10 total complications in these 5 patients were 5 (15.6%) Grade I, 1 (3.1%) Grade II, 2 (6.25%) Grade IIIa, and 2 (6.25%) Grade IIIb. The mean follow-up period was 16.5 months (range 3–55). Conclusions For the treatment of impacted ureteral stones in children, holmium laser lithotripsy with semi-rigid ureteroscopy, with its low retreatment requirement and acceptable complication rates, is an effective and reliable method in experienced and skilled hands as a first-choice treatment approach. PMID:25415256

Adanur, Senol; Aydin, Hasan Riza; Ozkaya, Fatih; Ziypak, Tevfik; Polat, Ozkan

2014-01-01

248

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

PubMed Central

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

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

2014-01-01

249

Characteristics of Calculi in the Urinary Tract  

PubMed Central

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

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

2014-01-01

250

[Mechanisms of synergism of the autonomic nervous system compartments].  

PubMed

The realization mechanisms of phenomena of sympathetic nerve potentiation of vagal stimulation of motor activity of duodenal and jejunal intestine, urinary bladder and ureters, uterus and tubes, vas deference and mechanism of sympathetic nerve potentiation of vagal cardioinhibitory action were studied. There were demonstrated that these phenomena were realized with participation of preganglionic serotoninergic nerve fibers transmitting an excitation on ganglionary serotoninergic neurons. It was found an existence of increasing cranio-caudal and decreasing ventro-dorsal gradients of serotoninergic innervation of visceral organs. PMID:16522004

Lychkova, A E

2006-01-01

251

[Cecocystoplasty. Apropos of 14 cases].  

PubMed

Cystoplasty is the ideal method of bringing back normal urinary flow after cystectomy, and the authors have used this procedure in fourteen cases. The cecum is mobIlized with its vascular pedicle. Bowel continuity is readily and safely restored with the aid of suturing forceps (TA 55, GIA). The cecum is carefully cleaned of all fecal matter. Two UCN join the ureters and the cecum, to which the trigone, the cervix vesicae, or the prostatic or membranous urethra is anastomosed, depending on the case. Three benign cystopathies, four recurrent diffuse papillomatoses and seven vesical carcinomas were treated in this way, with excellent results. PMID:4026209

Rampal, M; Ivaldi, A; Coulange, C; Lacoste, J; Gauvin, C

1985-01-01

252

Ureteritis Cystica: A Radiologic Pathologic Correlation  

PubMed Central

Ureteritis cystica (UC) is a benign condition that commonly affects the ureter and can mimic other conditions such as transitional cell carcinoma, blood clots, air bubbles, radiolucent stones, fibroepithelial polyps, and sloughed renal papillae. Radiographically, UC is characterized by multiple small, round, lucent defects, which cause scalloping of the ureteral margins when seen in profile. The scalloping is produced by the projection of the submucosal cysts into the lumen and represents an important differential feature of this disease. We present a case of UC with a radiological pathological correlation. PMID:21966620

Rothschild, Jennifer G; Wu, Guan

2011-01-01

253

A rare case of plasmacytoid urothelial carcinoma of bladder: Diagnostic dilemmas and clinical implications  

PubMed Central

Plasmacytoid urothelial carcinoma is an uncommon and aggressive variant of urothelial carcinoma associated with late presentation and poor prognosis. We discuss here the first reported case from India of a 54-year-old male who presented with hematuria. Cystoscopy showed edematous and ulcerated mucosa throughout the bladder. A transurethral biopsy revealed urothelial carcinoma with plasmacytoid appearance. He underwent a radial cystectomy which on histopathology showed plasmacytoid urothelial carcinoma of the bladder of high stage with involvement up to bladder serosa and adventitial walls of the ureter. The diagnostic dilemmas of this unusual variant of urothelial malignancy and its clinical impact are discussed. PMID:21716882

Rahman, Khaliqur; Menon, Santosh; Patil, Asawari; Bakshi, Ganesh; Desai, Sangeeta

2011-01-01

254

Untitled  

Cancer.gov

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

255

Percutaneous Radiofrequency Ablation of a Small Renal Mass Complicated by Appendiceal Perforation  

SciTech Connect

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

Boone, Judith, E-mail: j.boone@amc.uva.nl [Antoni van Leeuwenhoek Hospital, Department of Radiology, Netherlands Cancer Institute (Netherlands); Bex, Axel, E-mail: a.bex@nki.nl [Antoni van Leeuwenhoek Hospital, Department of Urology, Netherlands Cancer Institute (Netherlands); Prevoo, Warner, E-mail: w.prevoo@nki.nl [Antoni van Leeuwenhoek Hospital, Department of Radiology, Netherlands Cancer Institute (Netherlands)

2012-06-15

256

Semen quality after extracorporeal shockwave lithotripsy for the management of lower ureteric stones: a review of the literature.  

PubMed

Extracorporeal Shockwave Lithotripsy has long been an important tool in the urologists' armamentarium for the treatment of distal ureteric stones. Several studies have been conducted on the morbidity and adverse effects of ESWL on human tissues but the effect of lithotripsy on semen and testes remains inconclusive. Impact on semen analysis and testes is important because the seminal vesicles and testes are exposed to the shock waves due to their anatomical proximity to the distal ureter. This article has reviewed all the published literature in English language on semen analysis after lithotripsy. PMID:21443655

Gulur, Dev Mohan; Philip, Joe

2011-10-01

257

Intracorporal Alexandrite-laser lithotripsy in the treatment of ureteral calculi  

NASA Astrophysics Data System (ADS)

Extracorporal shock wave lithotripsy (ESWL) is the standard therapy in the treatment of urinary calculi. the high rate of fragmentation and simultaneous stone selectivity makes laser lithotripsy an alternative method in the treatment of obstructing ureteral calculi. In comparison to the success rate of ESWL, laser lithotripsy as a minimally invasive endoscopic procedure seems to be superior in disintegrating calculi in the distal ureter. Together with the advance of miniaturized semiflexible endoscopes, intracorporal laser lithotripsy presents a new aspect in the treatment of urinary calculi.

Zumbe, Juergen; Fischer, Hermann; Kimont, Hans-Georg; Kierfeld, Gerd

1994-02-01

258

Urgent ureteroscopy as first-line treatment for ureteral stones: a meta-analysis of 681 patients.  

PubMed

There are various recent studies on the use of ureteroscopy and debate on whether this should be the first-line treatment for patients with ureteral stones. The aim of this meta-analysis was to understand the role of this surgical procedure in the emergency setting as first-line treatment and to compare the immediate procedure with a delayed one in terms of stone-free rate and complications. A bibliographic search covering the period from January 1980 to March 2010 was conducted in PubMed, MEDLINE and EMBASE. This analysis is based on the six studies found that fulfilled the predefined inclusion criteria. A total of 681 participants were included. The number of participants in each of the studies considered ranged from 27 to 244 (mean 113). Stone-free rates were 81.9% (72.0-91.8) for the proximal ureter, 87.3% (82.6-92.0) for the mid-ureter, 94.9% (92.1-97.6) for the distal ureter and 89.5% (86.5-92.5) overall according to the logistic regression applied. These values are not statistically significantly different from those reported in the AUA and EAU guidelines. The stone diameter seems to affect the stone-free rate. An increase of the stone diameter of 1 mm beyond 8 mm corresponded to a reduction of stone-free rate of 5% (2.4-8.0) and 8.1% (3.8-12.1) for the distal and proximal ureters, respectively. There is a complete lack of information in international guidelines on the ureteroscopic management of ureteral stones in an emergency setting and the currently available results are dispersed in a few studies in the literature. The rationale for using emergency ureteroscopy is more rapid stone clearance and relief from colic pain. According to our meta-analysis, immediate ureteroscopy for ureteral stone colic seems to be a safe treatment with a high success rate. This evidence will be validated by further randomized studies, with larger series of patients. PMID:22367457

Picozzi, Stefano C M; Ricci, Cristian; Gaeta, Maddalena; Casellato, Stefano; Stubinski, Robert; Bozzini, Giorgio; Pace, Gianna; Macchi, Alberto; Carmignani, Luca

2012-10-01

259

Automatic segmentation of medical images for renal calculi and analysis.  

PubMed

Development of an automated system to identify renal calculi based on its physical characteristics is proposed. Calculi are due to abnormal collection of certain chemicals like oxalate, phosphate and uric arid. Renal calculi may be present in kidney, ureter or in urinary bladder. An algorithm is proposed to detect calculus using its shadow. The system also extracts the properties of calculi such as size, shape and location, which are vital for reliable diagnosis. This method has been implemented in the MATLAB/IDL platform and a considerable success rate is obtained. PMID:11347425

Sridhar, S; Kumaravel, N

2001-01-01

260

Laparoscopic Treatment of Ovarian Retention Pathology  

PubMed

We define ovarian retention pathology as the complications (cystic, degenerative, adhesions, endometriosis, pain, etc.) attributed to ovaries deliberately retained at the time of hysterectomy. We established a protocol for laparoscopy in these women. During 14 laparoscopic procedures for ovarian retention pathology, only one intraoperative complication occurred, a small bowel injury requiring minilaparotomy. One woman required repeat surgery for ovarian remnant syndrome. Published experience with laparotomy suggests that significant injuries to or resections of bowel, bladder, or ureters can occur, but the limited experience with laparoscopic surgery has not shown significant complications. PMID:9074105

Dionisi; Dionisi; Dionisi

1996-08-01

261

Assessment of local structural disorders of the bladder wall in partial bladder outlet obstruction using polarized light imaging  

PubMed Central

Partial bladder outlet obstruction causes prominent morphological changes in the bladder wall, which leads to bladder dysfunction. In this paper, we demonstrate that polarized light imaging can be used to identify the location of obstruction induced structural changes that other imaging modalities fail to detect. We induced 2-week and 6-week partial outlet obstruction in rats, harvested obstructed bladders, then measured their retardances while distended to high pressures and compared them to controls. Our results show that the retardance of the central part of the ventral side (above the ureters) closer to the urethra can be used as a potential metric of the distending bladder obstruction. PMID:24575354

Alali, Sanaz; Aitken, Karen J.; Schröder, Annette; Gribble, Adam; Bagli, Darius J.; Vitkin, I. Alex

2014-01-01

262

Losartan attenuates renal vasoconstriction in response to acute unilateral ureteral occlusion in pigs.  

PubMed

Unilateral ureteral obstruction in pigs is associated with an enhanced, de novo generation of angiotensin II from the ipsilateral kidney. In order to further investigate the role of this system during unilateral ureter obstruction, the renal hemodynamic response to the non-peptide angiotensin II antagonist losartan was investigated. Danish land race pigs were operated on under general anesthesia. Catheters were placed in both renal veins by x-ray and ultrasonic flow probes were mounted on the renal arteries. Losartan (2 mg/kg/h) was administered intravenously to an experimental group ( n=9) continuously over 8 h of unilateral ureteral occlusion. This group was then compared to a matched control group which received only saline ( n=6). Ipsilateral pelvic pressure, renal blood flow using ultrasound transit time, glomerular filtration rate, mean arterial pressure and heart rate were measured. Renal handling of angiotensin II was examined by determining the renal extraction and secretion rates of immunoreactive angiotensin II. The anticipated reduction in ipsilateral renal blood flow after the onset of obstruction was attenuated in the losartan treated pigs, but the ipsilateral glomerular filtration rate was unaffected as compared with the controls. In the losartan group, the increase in renal vascular resistance was significantly reduced compared with un-treated controls (141+/-25% vs 217+/-24%, P<0.05). Plasma immunoreactive angiotensin II increased significantly from all three sample locations in both groups after the onset of obstruction, being more pronounced in the losartan treated group in which immunoreactive angiotensin II from the ipsilateral renal vein increased from 5.1+/-0.5 pmol/l to 41.6+/-19.6 pmol/l, P=0.027. In the controls immunoreactive angiotensin II increased from 2.7+/-0.3 pmol/l to 24.8+/-10.2 pmol/l. Furthermore, plasma aldosterone was significantly reduced after losartan administration (from 80.4 pmol/l to 36.0 pmol/l, P=0.005), indicating effective blockade of the angiotensin II type-1 receptor. The results from the present study suggest that continuous intravenous administration of losartan blocks the angiotensin II receptor mediated effects in the pig. Losartan is able to reduce ipsilateral vasoconstriction in the obstructed kidney during unilateral ureter obstruction supporting the view that angiotensin II is an important mediator of vasoconstriction during unilateral ureter obstruction in the pig model with acute unilateral occlusion of the ureter. PMID:12111180

Hvistendahl, Jan J; Pedersen, Thomas S; Djurhuus, Jens C; Pedersen, Erling B; Frøkiaer, Jørgen

2002-07-01

263

Model of orthotopic renal transplantation in the rabbit.  

PubMed

A microsurgical method of orthotopic renal allotransplantation in the rabbit is described, and the results of 179 consecutive procedures are presented. There were 10 (5.5%) deaths within 1 week of transplantation. Early complications included vascular thrombosis (4.4%), and obstruction (6.7%) and fistula formation (0.6%) at the uretero-ureteric anastomosis. This method of end-to-end vascular and ureteric anastomoses is straightforward and, in contrast to other models, does not require occlusion of the recipient inferior vena cava or aorta, use of a long segment of donor ureter, or operation on the recipient bladder. PMID:2327907

Francis, D M; Millar, R J; Dumble, L J; Clunie, G J

1990-01-01

264

Bilateral ureteropelvic junction stenosis causing hydronephrosis and renal failure in an adult cat.  

PubMed

A 3.5-year-old male neutered cat was presented for investigation of renomegaly appreciated during a routine physical examination. Marked renomegaly due to bilateral hydronephrosis was detected and further testing identified International Renal Interest Society stage 2, non-hypertensive, non-proteinuric chronic kidney disease. Ten months later the cat was evaluated for acute lethargy; severe azotemia with oliguria was documented. Medical therapy failed to result in clinical improvement and the cat was euthanased. Necropsy revealed bilateral marked hydronephrosis secondary to a tortuous proximal ureter consistent with proximal ureteropelvic junction stenosis. This is the first report of this disorder leading to progressive renal failure in a cat. PMID:22914571

Foster, Jonathan D; Pinkerton, Marie E

2012-12-01

265

Endovascular Management of Ureteroarterial Fistula: A Rare Potentially Life Threatening Cause of Hematuria  

PubMed Central

Ureteroarterial fistula is a rare, potentially life-threatening cause of hematuria characterized by an abnormal channel between a ureter and artery. The rarity of this condition, complexity of predisposing risk factors and intermittence of symptoms may delay or obscure its diagnosis. With a high index of suspicion and careful angiographic evaluation, embarking on this condition is not only possible but sets the stage for curative intervention. We report a case of a ureteroarterial fistula presenting with intermittent hematuria, successfully diagnosed at angiography and managed with endovascular stent graft placement. PMID:25426238

Copelan, Alexander; Chehab, Monzer; Cash, Charles; Korman, Howard; Dixit, Purushottam

2014-01-01

266

Unilateral ureteric stone associated with gross hydronephrosis and kidney shrinkage: a cadaveric report  

PubMed Central

Ureteric stones are a common cause of obstruction of the urinary tract, usually presenting with characteristic signs and symptoms, such as acute ureteric colic and hematuria. Occasionally, stones may present with non-specific symptoms such as low back pain and remain unidentified, leading to stone growth, chronic ureteric obstruction and complications such as hydronephrosis and renal damage. Here, we report a large ureteric stone in a cadaver with complete obstruction at the left ureterovesical junction, resulting in severe dilatation of the left ureter and renal pelvis. PMID:25548725

Tay, Ern-Wei; Bay, Boon-Huat

2014-01-01

267

The use of adhesion barrier film as an alternative to omental wrap in open ureterolysis.  

PubMed

Retroperitoneal fibrosis (RPF) is a rarely occurring disease process characterized by the development of fibrous plaques that encase retroperitoneal organs and major vessels. The most common sequelae is obstructive uropathy secondary to ureteral compression. Ureterolysis with intraperitoneal transposition and omental wrapping has historically been a popularized means to relieve ureteral obstruction. We present the case of a 47-year-old man with bilateral hydronephrosis secondary to RPF. Due to insufficient length of omentum, we report the first documented use of SurgiWrap to wrap the ureters to minimize the future possibility of recurrent/continued fibrosis, compression, and ureteral obstruction. PMID:24331350

Hartman, Robert J; Helfand, Brian T; Lin, William W

2013-12-01

268

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

PubMed Central

A 10-yr-old boy visited Minoh City Hospital complaining of gross hematuria. Laboratory investigations revealed hypercalcemia, hypophosphatemia, and elevated serum levels of parathyroid hormone. A stone was found in the right ureter with drip infusion pyelography. A parathyroid adenoma was successfully diagnosed with computed tomography, ultrasonography, and methoxy-2-isobutyl isonitrile (MIBI) scintigraphy. Multiple endocrine neoplasia was ruled out by normal results of endocrine laboratory examinations. Extracorporeal shock wave lithotripsy was performed to treat the urolithiasis, and the parathyroid adenoma was surgically removed. Primary hyperparathyroidism is rare in childhood; however, this case suggests that gross hematuria is an important sign of hyperparathyroidism. PMID:24790339

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

2007-01-01

269

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

PubMed Central

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

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

2014-01-01

270

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

PubMed

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

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

2014-04-01

271

Stereoselective synthesis of a novel 2-aza-7-oxabicyclo[3.3.0]octane as neurokinin-1 receptor antagonist.  

PubMed

A novel neurokinin-1 receptor antagonist, (+/-)-(1R( *),3S( *),4S( *),5S( *))-4-[(N-(2-methoxy-5-trifluoromethoxybenzyl)amino]-3-phenyl-2-aza-7-oxabicyclo[3.3.0]octane (1), was synthesized stereoselectively using Padwa's intramolecular 1,3-dipolar cycloaddition methodology as the key step. Compound (+/-)-1 showed high affinity for the NK-1 receptors in human IM-9 cells with an IC(50) value of 0.22 nM. This new structural scaffold demonstrated significant in vivo antagonistic activity in the guinea pig ureter capsaicin-induced plasma extravasation model with an ED(50) value of 1-10mg/kg, po. PMID:17967540

Shishido, Yuji; Ito, Fumitaka; Morita, Hiromasa; Ikunaka, Masaya

2007-12-15

272

Stereoselective synthesis of a novel 2-aza-7-oxabicyclo[3.3.0]octane as neurokinin-1 receptor antagonist  

Microsoft Academic Search

A novel neurokinin-1 receptor antagonist, (±)-(1R?,3S?,4S?,5S?)-4-[(N-(2-methoxy-5-trifluoromethoxybenzyl)amino]-3-phenyl-2-aza-7-oxabicyclo[3.3.0]octane (1), was synthesized stereoselectively using Padwa’s intramolecular 1,3-dipolar cycloaddition methodology as the key step. Compound (±)-1 showed high affinity for the NK-1 receptors in human IM-9 cells with an IC50 value of 0.22nM. This new structural scaffold demonstrated significant in vivo antagonistic activity in the guinea pig ureter capsaicin-induced plasma extravasation model with an

Yuji Shishido; Fumitaka Ito; Hiromasa Morita; Masaya Ikunaka

2007-01-01

273

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

PubMed Central

Ureteropelvic junction (UPJ) obstruction describes various causes of impaired drainage at the UPJ. Regardless of the cause, the end result is the same: impedance in the normal flow of urine from the renal pelvis into the proximal ureter, resulting in caliectasis and hydronephrosis. This may lead to progressive deterioration of renal function and, thus, often requires intervention to relieve the obstruction and restore the normal flow of urine. Defining the pertinent anatomy, the degree of obstruction, and differential renal function is key to determining whether and when intervention is necessary. PMID:16985690

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

2001-01-01

274

Hydronephrosis in a woman undergoing in vitro fertilization.  

PubMed

Obstruction of a ureter secondary to tumor, fibrosis, or inflammation has been well documented in published reports. A review of English studies revealed no reported cases of hydronephrosis of a native kidney resulting from hyperstimulation of an ovary. We report a case of hydronephrosis in a woman undergoing ovarian stimulation for in vitro fertilization. Her presentation was prompted by symptoms of flank pain with nausea and vomiting. Management with ureteral stent placement was successful in relieving the obstructive symptoms. This case demonstrates the importance of imaging and close monitoring of symptoms in women undergoing in vitro fertilization. PMID:17320689

Califano, John A; Confer, Stephen D; Galati, Vincenzo; Oguejiofor, Ikechukwu; Manatt, C Scott; Hansen, Karl R; Culkin, Daniel J

2007-02-01

275

[Classification and natural history of bladder tumors].  

PubMed

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

Allory, Yves

2014-12-01

276

Influence of Saline on Temperature Profile of Laser Lithotripsy Activation.  

PubMed

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??m 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

Molina, Wilson R; Silva, Igor N; Donalisio da Silva, Rodrigo; Gustafson, Diedra; Sehrt, David; Kim, Fernando J

2014-10-10

277

Chronic prostatitis, cystitis, pyelonephritis, and balanoposthitis in a cat.  

PubMed

An adult, intact male domestic shorthair presented for preputial swelling and urinary incontinence. A caudal abdominal mass was palpated. A transabdominal ultrasound examination showed severe prostatomegaly with abnormal tissue extending along the urethra. The cat was euthanized due to the owner's financial constraints and the veterinarians' suspicion of a poor long-term prognosis. Biopsies showed chronic active inflammation of the prostate, bladder, kidneys, ureters, penis, and prepuce most consistent with a chronic infectious process. Reports of feline prostatic disease of any kind are rare. Chronic prostatitis may have a more favorable prognosis than feline prostatic adenocarcinoma, currently the most commonly reported disease of the feline prostate. PMID:21673330

Pointer, Emmy; Murray, Louise

2011-01-01

278

Postoperative distal ureteric and bladder cuff recurrence in a Grade I renal transitional cell carcinoma diagnosed and restaged by fluorodeoxyglucose positron emission tomography-computed tomography  

PubMed Central

A 56-year-old male having Grade I transitional cell carcinoma (TCC) of left kidney, postleft nephrectomy and upper 1/3rd ureterectomy presented with painless hematuria. Restaging fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) revealed abnormal linear FDG uptake in the lower 2/3rd of the left ureter and in the bladder adjacent to the left vesicoureteric junction, no locoregional adenopathy nor distant metastases (Figures 1 and 2- left column). Patient underwent left lower ureterectomy with partial cystectomy. Postoperative histopathology was TCC. Instillation of Bacillus Calmette-Guérin injection in the bladder was done postoperatively. A follow-up FDG PET/CT scan performed 3 months postoperatively was revealed no abnormal focal FDG uptake in the whole body revealing disease free status. FDG PET was helpful in diagnosing tumor recurrence in the distal remnant ureter. This case attempts to highlight the role of FDG PET/CT in follow-up, residual and recurrence evaluation. PMID:25400371

Sonavane, Sunita; Rani, Deepa; Asopa, Ramesh; Upadhye, Trupti; Pawar, Dilip

2014-01-01

279

Candida albicans Fungaemia following Traumatic Urethral Catheterisation in a Paraplegic Patient with Diabetes Mellitus and Candiduria Treated by Caspofungin  

PubMed Central

A 58-year-old paraplegic male, with long-term indwelling urethral catheter, developed catheter block. The catheter was changed, but blood-stained urine was drained intermittently. A long segment of the catheter was seen lying outside his penis, which indicated that the balloon of Foley catheter had been inflated in urethra. The misplaced catheter was removed and a new catheter was inserted correctly. Gentamicin 160?mg was given intravenously; meropenem 1 gram every eight hours was prescribed; antifungals were not given. Twenty hours later, this patient developed distension of abdomen, tachycardia, and hypotension; he was not arousable. Computed tomography of abdomen revealed inflamed uroepithelium of right renal pelvis and ureter, 4?mm lower ureteric calculus with gas in right ureter proximally, and vesical calculus containing gas in its matrix. Urine and blood culture yielded Candida albicans. Identical sensitivity pattern of both isolates suggested that the source of the bloodstream infection was most likely urine. Both isolates formed consistently high levels of biofilm formation in vitro as assessed using a biofilm biomass stain, and high levels of resistance to voriconazole were observed. Both amphotericin B and caspofungin showed good activity against the biofilms. HbA1c was 111?mmol/mol. This patient was prescribed human soluble insulin and caspofungin 70?mg followed by 50?mg daily intravenously. He recovered fully from candidemia. PMID:24223316

Vaidyanathan, Subramanian; Soni, Bakul; Hughes, Peter; Singh, Gurpreet

2013-01-01

280

Small Cell Neuroendocrine Carcinoma of the Urinary Tract Successfully Managed with Neoadjuvant Chemotherapy  

PubMed Central

Introduction. Small cell neuroendocrine carcinomas of the urinary tract is an extremely rare entity and very few cases have been reported in the literature. Small cell neuroendocrine carcinoma of the urinary tract (SCC-UT) is the association between bladder and urinary upper tract-small cell carcinoma (UUT-SCC). It characterized by an aggressive clinical course. The prognosis is poor due to local or distant metastases, and usually the muscle of the bladder is invaded. Case Presentation. We report a rare case of a 54-year-old Arab male native of moroccan; he is a smoker and was referred to our institution for intermittent hematuria. Following a diagnosis of small cell neuroendocrine carcinomas of the ureter and the bladder, thoracoabdominal-pelvic CT was done, and the staging of the tumor was done in the bladder (T2N0M0) and (T1N0M0) in the ureter. Neoadjuvant alternating doublet chemotherapy with ifosfamide/doxorubicin and etoposide/cisplatin was realized, and nephroureterectomy associated to a cystoprostatectomy was carried out. After 24 months of followup, no local or distant metastasis was detected. Conclusion. The purpose of this review is to present a rare case of pure small cell neuroendocrine carcinoma of the urinary tract and review the literature about the place of neoadjuvant chemotherapy in this rare tumors. PMID:24024065

Ahsaini, Mustapha; Riyach, Omar; Tazi, Mohammed Fadl; El Fassi, Mohammed Jamal; Farih, My Hassan; Elfatmi, Hind; Amarti, Afaf

2013-01-01

281

Small cell neuroendocrine carcinoma of the urinary tract successfully managed with neoadjuvant chemotherapy.  

PubMed

Introduction. Small cell neuroendocrine carcinomas of the urinary tract is an extremely rare entity and very few cases have been reported in the literature. Small cell neuroendocrine carcinoma of the urinary tract (SCC-UT) is the association between bladder and urinary upper tract-small cell carcinoma (UUT-SCC). It characterized by an aggressive clinical course. The prognosis is poor due to local or distant metastases, and usually the muscle of the bladder is invaded. Case Presentation. We report a rare case of a 54-year-old Arab male native of moroccan; he is a smoker and was referred to our institution for intermittent hematuria. Following a diagnosis of small cell neuroendocrine carcinomas of the ureter and the bladder, thoracoabdominal-pelvic CT was done, and the staging of the tumor was done in the bladder (T2N0M0) and (T1N0M0) in the ureter. Neoadjuvant alternating doublet chemotherapy with ifosfamide/doxorubicin and etoposide/cisplatin was realized, and nephroureterectomy associated to a cystoprostatectomy was carried out. After 24 months of followup, no local or distant metastasis was detected. Conclusion. The purpose of this review is to present a rare case of pure small cell neuroendocrine carcinoma of the urinary tract and review the literature about the place of neoadjuvant chemotherapy in this rare tumors. PMID:24024065

Ahsaini, Mustapha; Riyach, Omar; Tazi, Mohammed Fadl; El Fassi, Mohammed Jamal; Farih, My Hassan; Elfatmi, Hind; Amarti, Afaf

2013-01-01

282

Pseudotumoral tuberculous ureteritis: a case report  

PubMed Central

Introduction Tuberculosis is still endemic in Morocco and the urogenital form is common. This form is characterized by clinical polymorphism. However, the isolated ureteric form is very rare. The differential diagnosis might be raised in tumoral cases while undertaking surgical excision which is the realistic choice. Hence, we report an isolated ureteric tuberculosis case, and we discuss the clinical, imaging, diagnostic and therapeutical features. Case presentation A 30-year-old Moroccan man consulted us for left back pain associated with urinary frequency and a few macroscopic episodes of hematuria for the past six months. A computed tomography urography revealed a left hydronephrosis and hydroureter secondary to focal wall thickening of the left lumbar ureter. Hence, we had diagnosed a ureteral tumor. However, a clinical examination showed irritative voiding symptoms and epididymal disorders associated with prostate infection suggesting a Koch’s bacillus assessment of the patient’s urine of which the results proved strongly positive. The treatment consisted of establishing a double-J ureteric stent to drain the left kidney, followed by antituberculous antibiotics. Conclusion Urogenital tuberculosis is common in endemic countries, however isolated ureter affection is rare. It is important to consider a ureteral tuberculosis diagnosis whenever ureteral thickening is revealed in a patient living in a country in which tuberculosis is endemic. PMID:23414595

2013-01-01

283

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

SciTech Connect

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.

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

1984-10-01

284

Nephric duct insertion requires EphA4/EphA7 signaling from the pericloacal mesenchyme.  

PubMed

The vesico-ureteric junction (VUJ) forms through a complex developmental program that connects the primordium of the upper urinary tract [the nephric duct (ND)] with that of the lower urinary tract (the cloaca). The signals that orchestrate the various tissue interactions in this program are poorly understood. Here, we show that two members of the EphA subfamily of receptor tyrosine kinases, EphA4 and EphA7, are specifically expressed in the mesenchyme surrounding the caudal ND and the cloaca, and that Epha4(-/-);Epha7(+/-) and Epha4(-/-);Epha7(-/-) (DKO) mice display distal ureter malformations including ureterocele, blind and ectopically ending ureters with associated hydroureter, megaureter and hydronephrosis. We trace these defects to a late or absent fusion of the ND with the cloaca. In DKO embryos, the ND extends normally and approaches the cloaca but the tip subsequently looses its integrity. Expression of Gata3 and Lhx1 and their downstream target Ret is severely reduced in the caudal ND. Conditional deletion of ephrin B2 from the ND largely phenocopies these changes, suggesting that EphA4/EphA7 from the pericloacal mesenchyme signal via ephrin B2 to mediate ND insertion. Disturbed activity of this signaling module may entail defects of the VUJ, which are frequent in the spectrum of congenital anomalies of the kidney and the urinary tract (CAKUT) in human newborns. PMID:25139858

Weiss, Anna-Carina; Airik, Rannar; Bohnenpoll, Tobias; Greulich, Franziska; Foik, Anna; Trowe, Mark-Oliver; Rudat, Carsten; Costantini, Frank; Adams, Ralf H; Kispert, Andreas

2014-09-01

285

Retrograde Positive Contrast Urethrocystography of the Fish Urogenital System  

PubMed Central

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

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

2014-01-01

286

Nephroliths and ureteroliths: a new stone age.  

PubMed

Nephroliths may obstruct the renal pelvis or ureter, predispose to pyelonephritis, or result in compressive injury of the renal parenchyma leading to progressive chronic kidney disease. Indications for removal of nephroliths in dogs include obstruction, recurrent infection, progressive nephrolith enlargement, presence of clinical signs (renal pain), and patients with nephroliths in a solitary functional kidney. The most common indication for removal of upper tract uroliths in cats is ureteral obstruction caused by ureteroliths. Nonobstructive nephroliths in cats are not usually treated unless they move into the ureter resulting in ureteral obstruction. The treatment approach to nephroliths and ureteroliths is different for dogs versus cats. Surgical removal of nephroliths or ureteroliths by nephrotomy and ureterotomy respectively is associated with potential for complications in more than 30% of cats treated by ureterotomy; therefore, minimally invasive options should also be considered. Extracorporeal shock wave lithotripsy (ESWL) treatment of nephroliths results in small "passable" stone fragments in most dogs, whereas ESWL does not work effectively in cats. Ureteral stents are effective for relief of ureteral obstruction by ureteroliths in both dogs and cats. Ureteral stents may be left in place long-term to relieve ureteral obstruction by ureteroliths. Post-operative morbidity and mortality are substantially lower for ureteral stent placement compared to open surgical ureterotomy in cats. PMID:23484823

Adams, L G

2013-07-01

287

Management of iatrogenic ureteral injury  

PubMed Central

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

Burks, Frank N.

2014-01-01

288

Considerations in Minimally Invasive Surgery for Renal and Ureteric Calculi: A Bicenter Quality Control Study  

PubMed Central

Background The use of minimally invasive surgery is increasing. Evaluating the quality of care brings new sights in the optimization of operating techniques. Methods We included all procedures performed in two hospitals during 2010 and 2011. A total of 264 patients were included in the ureterorenoscopy (URS) group and 77 patients in the percutaneous nephrolitholapaxy (PCNL) group. Data were gathered by retrospectively reviewing medical records. Results Mean stone diameter in the URS group was 9 mm. Patients suffered from a single stone in 79% of the cases. Calculi in the distal ureter, defined as the part of the ureter below the lower border of the sacroiliac joint, were most likely to be removed. A stone-free status was reached in 69% of the cases using URS. Mean stone diameter in the PCNL group was 23 mm. PCNL was successful in 70% of the cases in Haga Hospital versus 53% in Medisch Centrum Haaglanden. Incidence of complications was comparable between the hospitals (p = 0.5). Outcome and quality of both PCNL and URS was not influenced by sex, age or body mass index. Conclusion The clinical results were comparable with results in the literature. Further improvement can be made by optimization of technical aspects and centralization of treatment by urologists experienced in minimally invasive techniques. PMID:24917772

Weltings, Saskia; Roshani, Hossain; Leenarts, Joost; Pelger, Rob

2014-01-01

289

Noncontrast multidetector-row computed tomography scanning for detection of radiolucent calculi in acute renal insufficiency caused by bilateral ureteral obstruction of ceftriaxone crystals.  

PubMed

Noncontrast computed tomography (CT) has great advantage with higher sensitivity and more clear modalities in detecting urinary tract radiolucent calculi in patients with acute renal insufficiency (ARI) compared to other image diagnosis approaches. We report two cases (female, 28 years old; male, 39 years old) with persistent flank pain and acute anuria after the administration of ceftriaxone (4.0 g daily) for 2 days intravenously. No abnormality was found in the kidney-ureter- bladder (KUB) areas with plain abdomen X-rays. A diagnosis of bilateral hydronephrosis was made by ultrasound examination in both cases. Serum creatinine levels reached up to 257 and 810 ? mol/L (normal serum creatinine level is 40-130 ? mol/L), respectively. Vague density spots were noticed in the pelvis with noncontrast multidetector-row CT (MDCT) scanning. However, distinguishable clusters of high-density shadows were seen in pelvic areas with maximum intensity projections (MIP, CT values in 30-128 HU). Ceftriaxone crystal calculi were found on both sides of distal ureters under endoscopy. Renal function recovered in both patients after double-J ureteral stents were installed. Out results demonstrated that noncontrast MDCT scanning and MIP reconstruction as an effective diagnostic tool could provide clear images in detection of radiolucent calculi in urinary tract when conventional X-rays image are not suitable in the patients with obstructive anuria and ARI of unknown origin. PMID:22398584

Lu, Xiongbing; Wu, Rongpei; Huang, Xiaoning; Zhang, Yuanyuan

2012-01-01

290

Spontaneous Ureteral Rupture Diagnosis and Treatment  

PubMed Central

Rupture of the urinary collecting system associated with perinephric or retroperitoneal extravasation of the urine is an unusual condition and it is commonly associated with renal obstructing disease. Perforation could occur at any level from the calix to the bladder but it is usually seen at the fornices and upper ureter. It may lead to several serious consequences including urinoma, abscess formation, urosepsis, infection, and subsequent irreversible renal impairment. We report a case of a 69-year-old woman who presented at the emergency department of our institution with severe abdominal pain. Due to symptomatology worsening, complete laboratory evaluation was performed and the patient underwent abdominal contrast enhanced computed tomography (CT) evaluation which showed contrast agent extravasation outside the excretory system without any evidence of renal calculi at basal acquisition. It was decided to perform a double-J stent placement which was followed by complete healing of the ureter and its removal was performed 8 weeks later. Diagnosis and therapeutic approaches are discussed. PMID:24455381

Pampana, E.; Altobelli, S.; Morini, M.; Ricci, A.; D'Onofrio, S.; Simonetti, G.

2013-01-01

291

Laparoscopic nephrectomy in children for benign conditions: indications and outcome  

PubMed Central

Aim: To analyze the indications and outcome of laparoscopic nephrectomy for benign non-functioning kidneys in children. Materials and Methods: The data of all patients operated over a 10 year period was retrospectively analyzed. Results: There were 56 children, aged 4 months to 12 years with a male: female ratio of 2.3:1. The most common presentation in boys and girls was urinary tract infection (UTI) (61.5% and 47.05% respectively). Incontinence due to ectopic ureter was a close second in girls (41.17%). The most common underlying conditions were vesico-ureteric reflux (42.85%) and multicystic dysplastic kidney (23.2%). There were 6 nephrectomies, 4 heminephroureterectomies and the remaining nephroureterectomies. All children tolerated the surgery well. One patient underwent a concomitant cholecystectomy. The post-operative problems encountered were UTI (1), urine retention (1), pyonephrosis in the opposite kidney and development of contra-lateral reflux (1). All others had resolution of pre-operative symptoms with good cosmesis. Conclusions: As per available literature, this appears to be the largest Indian series of pediatric laparoscopic nephrectomies for benign non-functioning kidneys. Laparoscopic approach gives excellent results provided pre-operative investigations rule out other causes for the symptoms with which the patient presents. Often it is not the kidney but the dilated dysplastic ureter which is the seat of stasis and infection or pain and therefore should be completely removed. PMID:24604980

Menon, Prema; Handu, Abhilasha T; Rao, Katragadda Lakshmi Narasimha; Arora, Suman

2014-01-01

292

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

PubMed Central

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

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

2014-01-01

293

A nipple-valve technique for ureteroneocystostomy in pediatric kidney transplantation.  

PubMed

The ureteroneocystostomy in kidney transplantation can be performed with a variety of techniques. Over a 20-yr period, we utilized a technique of nipple-valve ureteroneocystostomy for the pediatric kidney transplants performed at our institution. The distal ureter is everted upon itself and anchored in place with four interrupted sutures to create a nipple valve, which is then inserted into the bladder and sewn mucosa-to-mucosa with the same sutures. The muscularis layer is closed around the ureter without tunneling and without routine ureteral stenting. After 109 transplants, patient survival was 97.2, 97.2, and 86.9% at one, five, and 10 yr, respectively. Graft survival was 91.7, 71.7, and 53.9% at one, five, and 10 yr, respectively. The most common cause of graft loss was acute or chronic rejection, seen in 75% of those experiencing graft loss. Two patients (1.8%) developed pyelonephritis in the transplanted kidney. Nipple-valve ureteroneocystostomy in pediatric kidney transplantation is a safe and simple method for performing the ureterovesical anastomosis with a low rate of pyelonephritis after transplantation. PMID:25400105

Van Arendonk, Kyle J; Goldstein, Seth D; Salazar, Jose H; Kumar, Komal; Lau, Henry T; Colombani, Paul M

2015-02-01

294

OCT-aided anastomosis platform study in the rodent model  

NASA Astrophysics Data System (ADS)

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

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

2014-02-01

295

The predictive value of Tc-99m DTPA renography in obstructive uropathy using animal model.  

PubMed

There is no simple analytical test. Radionuclide diuretic renography (RDR), being a dynamic imaging study reflecting the function of the kidney and the urodynamics of the urinary tracts, has the potential to predict the outcome of surgery in obstructive uropathy. In 12 sheep, we occluded one ureter for a maximum of seven weeks and followed up for a maxim of five weeks after release of occlusion. Repeated Tc-99m DTPA diuretic renography studies were performed and the results were correlated with the duration of complete ureteric occlusion. The renal uptake percentage and the extraction slope of the time activity curve (TAC) showed progressive and steady decrease over the period of the occlusion. By the fifth week there was very low uptake (less than 18%) and the TAC was almost flat, suggestive of severe nephropathy. The parenchymal transit time index (PTTI) showed immediate rise after occlusion but with no progressive increase in its value. By the fifth week it dropped down to normal. After release, the recovery of function showed good correlation with the renal uptake percentage and extraction slope of TAC before release of occlusion. Therefore both these parameters, rather than PTTI, can be used to predict the outcome of surgery before the release of complete obstruction of the ureter. PMID:2285520

Bahar, R H; Elgazzar, A H; Abu-Zidan, F M; Sabha, M; Francis, I M; Kouris, K; Awdeh, M; Abdel-Dayem, H M; Nilsson, T; Britton, K E

1990-01-01

296

Percutaneous ureteral occlusion with use of Gianturco coils and gelatin sponge. Part I. Swine model.  

PubMed

An animal model was developed to study ureteral occlusion produced by steel coils and gelatin sponge. A coil nest was formed in the ureter, and in all but one pig, gelatin sponge pledgets were incorporated in the coil nest. Animals were killed at 2 hours, 1 week, 1 month, and 2 months. High-grade obstruction was present immediately following the procedure in all animals and was documented to be persistent by means of antegrade nephrostograms obtained just prior to death. At gross examination after death, ureteral thickening and strictures were evident. Histologic studies helped confirm the presence of acute and chronic inflammatory changes. In the in vivo model, gelatin sponge was not found necessary for acute ureteral occlusion. However, in an ancillary in vitro study in which a rigid plastic tube was used, gelatin sponge was necessary in addition to coil occlusion to provide acute total obstruction. The authors' findings suggest that in a compliant ureter, coil occlusion alone produces sufficient mechanical occlusion. Long-term obstruction is probably due to mechanical obstruction and stricture formation. PMID:1627879

Bing, K T; Hicks, M E; Figenshau, R S; Wick, M; Picus, D; Darcy, M D; Clayman, R V

1992-05-01

297

Sites of renal pain processing in the rat spinal cord. A c-fos study using a percutaneous method to perform ureteral obstruction.  

PubMed

The sites of renal pain processing in the rat spinal cord were studied by mapping the spinal cord neurons expressing c-fos after acute ureteral distension due to obstruction. A new experimental model is presented. A nylon knot was loosely placed around the ureter and the ends of the thread exteriorized through the retroperitoneal wall. Eight days later, when all c-fos expression due to nociceptive input from the abdominal wound and the manipulation of the intestines had disappeared, the nylon ends were pulled to produce ureteral occlusion. C-fos activation occurred at spinal segments T10-L4 with a peak at L1-L2. The activated neurons were concentrated in laminae I, lateral IV-V, medial VII and X. While in lamina I nearly all Fos-immunoreactive cells were ipsilateral, in the deeper laminae taken together 60% cells were ipsilateral and 40% contralateral to the distended ureter. It is suggested that renal nociceptive input giving rise to conscious pain perception is transmitted through ipsilateral lamina I, whereas input triggering autonomic reflexes may be mainly processed, ipsi- and contralaterally, in the deep laminae. PMID:9470145

Avelino, A; Cruz, F; Coimbra, A

1997-12-01

298

Laparoscopic infrared imaging.  

PubMed

A system was developed to determine the potential role of infrared imaging as a tool for localizing anatomic structures and assessing tissue viability during laparoscopic surgical procedures. A camera system sensitive to emitted energy in the midinfrared range (3-5 micron) was incorporated into a two-channel visible laparoscope. Laparoscopic cholecystectomy, dissection of the ureter, and assessment of bowel perfusion were performed in a porcine model with the aid of this infrared imaging system. Inexperienced laparoscopists were asked to localize and differentiate structures before dissection using the visible system and then using the infrared system. Assessment of bowel perfusion was also conducted using each system. Infrared imaging proved to be useful in differentiating between blood vessels and other anatomic structures. Differentiation of the cystic duct and arteries and transperitoneal localization of the ureter were successful in all instances using the infrared system when use of the visible system had failed. This system also permitted assessment of bowel perfusion during laparoscopic occlusion of mesenteric vessels. These initial studies demonstrate that infrared imaging may improve the differentiation and localization of anatomic structures and allow assessment of physiologic parameters such as perfusion not previously attainable with visible laparoscopic techniques. It may thus potentially be a powerful adjunct to laparoscopic surgery. PMID:9373300

Roberts, W W; Dinkel, T A; Schulam, P G; Bonnell, L; Kavoussi, L R

1997-12-01

299

Combined endoscopic surgery in the prone-split leg position for successful single-session removal of an encrusted ureteral stent: a case report  

PubMed Central

Introduction Although encrusted stents may lead to some unwanted complications including urinary tract obstruction, urinary sepsis, and potential loss of kidney function, there is currently no consensus on the most efficient method for managing stents that are intentionally left in situ. This is the first report describing the management of an encrusted stent using combined endoscopic surgery in the prone split-leg position in a single session. Case presentation A 47-year-old Asian man presented with left flank pain and macrohematuria. The patient had undergone left ureteral stenting three years previously for the treatment of left ureteral stones and hydronephrosis; however, he was lost to follow-up before the treatment for the ureter stones was completed. Therefore, the ureteral stent and stones were not removed. An abdominal radiograph and a noncontrast computed tomography scan showed encrustation along the retained stent with stone burdens in the kidney and ureter. The ureteral stent could not be removed by cystoscopy after shock wave lithotripsy of the left ureteral stones. Therefore, endoscopic lithotripsy combined with flexible ureteroscopy and miniature nephroscopy was performed with the patient in the prone split-leg position. All the stones and the encrusted ureteral stent were successfully removed in a single session. Conclusions In this case, percutaneous nephrolithomy in addition to flexible ureteroscopy was preferred because severe encrustation of the proximal stent and ureteral stones complicated the therapeutic strategy. Combined endoscopic techniques in the prone split-leg position can achieve successful and safe management of encrusted stents. PMID:24742133

2014-01-01

300

Ureteral complications after renal transplant in children: timing of presentation, and their open and endoscopic management.  

PubMed

We retrospectively reviewed the records of 24 consecutive patients undergoing treatment for ureteral complications after RTx in the period 2001-2012 to determine the timing of presentation of the complications, and their open or endoscopic management. Three patients (12%) had a necrosis of the transplanted ureter soon after RTx. All required open urinary diversion in a native ureter. Ten cases (42%) developed ureteral obstruction. Time of presentation was variable mainly in relation to the underlying cause. Endoscopic treatment was successful in two cases with urinary stones and open surgery in two with mid-ureteral obstruction. Six patients had VUJ stenosis, three underwent open reimplantation, whereas temporary double-J stent placement was successfully performed in the remainder. Eleven patients (46%) had VUR. It seldom presented in the first year after RTx. Endoscopic treatment was attempted in all and was successful in all the six cases without vs. only one of the five with lower urinary tract pathology (p = 0.01). Endoscopic treatment is an option in patients with VUR in the absence of lower urinary tract pathology. It is an option also for the treatment of stones and can be attempted in case of VUJ stenosis. Ureteral necrosis always requires open treatment. PMID:24373057

Castagnetti, Marco; Angelini, Lorenzo; Ghirardo, Giulia; Zucchetta, Pietro; Gamba, Piergiorgio; Zanon, GiovanniFranco; Murer, Luisa; Rigamonti, Waifro

2014-03-01

301

[Urothelial carcinoma after renal transplantation : a case report].  

PubMed

We report a case of urothelial carcinoma (UC) in a 69-year-old man that occurred after renal transplantation. He had started receiving hemodialysis therapy in 2004 due to diabetic nephropathy and underwent living related renal transplantation from his brother in 2005. He was referred to our hospital in May 2009 with asymptomatic microscopic hematuria. Cystoscopy findings revealed multiple bladder tumors, and transurethral resection of bladder tumor (TUR-BT) followed by intravesical instillation of pirarubicin was performed. Histopathological findings revealed UC (G1>G2, pTa). Cytology findings after the operation did not become negative; urine specimen from the native right ureter was positive, and abdominal computed tomography (CT) demonstrated a right pelvic tumor. In January 2010, a laparoscopic right nephroureterectomy was performed and pathological examination findings revealed UC in the right pelvis (G3>G2, INF?, pT3). In March 2010, recurrence of the bladder tumor was demonstrated as carcinoma in situ (CIS) of the bladder and left native ureter. In June 2010, a radical cystectomy with left nephroureterectomy and ileal conduit diversion were performed. One week after that operation, laboratory results revealed abnormal hepatic function and CT showed multiple liver metastases. The patient died in August 2010, 2 months after surgery. PMID:23552755

Nakazawa, Shigeaki; Imamura, Ryoichi; Hayashi, Takuji; Yamamoto, Yoshiyuki; Tanigawa, Go; Fujita, Kazutoshi; Hosomi, Masahiro; Fushimi, Hiroaki; Yamaguchi, Seiji

2013-02-01

302

Endoscopic Rendezvous Procedure for Ureteral Iatrogenic Detachment: Report of a Case Series with Long-Term Outcomes.  

PubMed

Abstract Background and Purpose: Injury to the ureter is the most common urologic complication of pelvic surgery, with an incidence that ranges from 1% to 10%. Most cases of ureteral injuries are related to gynecologic procedures. The ureter is particularly vulnerable to detachment or ligation during hysterectomy because of its position from the lateral edge of the cervix. We report a case series of female patients who underwent the ureteral rendezvous procedure for ureteral detachment. Patients and Methods: Between January 2009 and April 2013, 18 ureteral rendezvous procedures were performed for patients with complete detachment. We assessed the operative and clinical outcomes of these patients over a mean follow-up duration of 26.5 months and describe the three most representative cases. Results: The endoscopic rendezvous technique was performed in all cases to manage ureteral detachment. CT urography at discharge and 6 and 12 months after discharge confirmed the restoration of ureteral integrity without any leakage in 66% (12/18) patients, indicated ureteral stenosis in 22% (4/18) patients, and indicated ureteral leakage in 12% (2/18) patients. The overall long-term success rate for all 18 patients was 78% (14/18) at a mean follow-up of 26.5 months. Conclusions: The endoscopic rendezvous procedure reduces the need for invasive open surgical repair and represents the optimal initial option in patients with iatrogenic ureteral lesions before invasive procedures with higher morbidity are attempted. PMID:25226409

Pastore, Antonio Luigi; Palleschi, Giovanni; Silvestri, Luigi; Leto, Antonino; Autieri, Domenico; Ripoli, Andrea; Maggioni, Cristina; Al Salhi, Yazan; Carbone, Antonio

2014-11-18

303

[A case of locally advanced sigmoid colon cancer treated with neoadjuvant chemoradiotherapy].  

PubMed

The patient was a 38-year-old woman who visited our hospital complaining of nausea and abdominal pain. A colonoscopy revealed an advanced cancer in the sigmoid colon. A computed tomography (CT) scan showed left hydronephrosis and lymph node metastasis to the left iliopsoas muscle and left ureter. No distant metastasis was found. Since the surgical margins were likely to be positive with a one-stage resection, 3 cycles of FOLFOX4 (folinic acid, fluorouracil, and oxaliplatin)were administered after creating a transverse loop colostomy. Although the tumor decreased in size, the surgical margins were still suspected to be positive. For further regional tumor control, radiotherapy (1.8 Gy/day for 25 days) to the medial region of the left iliac bone and oral UFT/LV (uracil and tegafur/Leucovorin)were administered. A partial response(PR)was determined in accordance with the Response Evaluation Criteria in Solid Tumors(RECIST). Sigmoidectomy with partial resection of the left ureter was performed by laparotomy. The histologic response was assessed as Grade 2 and all surgical margins were negative. Preoperative chemoradiotherapy may be an effective therapeutic option for locally advanced colon cancer resistant to conventional preoperative chemotherapy. PMID:25248907

Yoshitomi, Mami; Hashida, Hiroki; Nomura, Akinari; Ueda, Shugo; Terajima, Hiroaki; Osaki, Nobuhiro

2014-09-01

304

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

PubMed Central

Background.?Ureters are fundamental for keeping kidneys free from uropathogenic Escherichia coli (UPEC), but we have shown that 2 strains (J96 and 536) can subvert this role and reduce ureteric contractility. To determine whether this is (1) a widespread feature of UPEC, (2) exhibited only by UPEC, and (3) dependent upon type 1 fimbriae, we analyzed strains representing epidemiologically important multilocus sequence types ST131, ST73, and ST95 and non-UPEC E. coli. Methods.?Contractility and calcium transients in intact rat ureters were compared between strains. Mannose and fim mutants were used to investigate the role of type 1 fimbriae. Results.?Non-UPEC had no significant effect on contractility, with a mean decrease after 8 hours of 8.8%, compared with 8.8% in controls. UPEC effects on contractility were strain specific, with decreases from 9.47% to 96.7%. Mannose inhibited the effects of the most potent strains (CFT073 and UTI89) but had variable effects among other UPEC strains. Mutation and complementation studies showed that the effects of the UTI89 cystitis isolate were fimH dependent. Conclusions.?We find that (1) non-UPEC do not affect ureteric contractility, (2) impairment of contractility is a common feature of UPEC, and (3) the mechanism varies between strains, but for the most potent UPEC type 1 fimbriae are involved. PMID:23002447

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

2012-01-01

305

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

PubMed Central

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 NIR–guided angiography; moreover, perfusion angiography of tissue flaps, NIRF visualization of ureters, NIR–guided 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 NIR–guided 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

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

2014-01-01

306

Urgent shock wave lithotripsy as first-line treatment for ureteral stones: a meta-analysis of 570 patients.  

PubMed

The rationale for the use of immediate shock wave lithotripsy (SWL) after a renal colic episode is to obtain maximum stone clearance in the shortest possible time with associated early detection of lithotripsy failures which can be treated with auxiliary procedures. The aim of this meta-analysis is to understand the role of this treatment option in the emergency setting as first-line treatment and to compare such an immediate procedure to a delayed one in terms of stone-free and complication rates. A bibliographic search covering the period from January 1995 to September 2010 was conducted in PubMed, MEDLINE and EMBASE. Database searches yielded 48 references. This analysis is based on the seven studies that fulfilled the predefined inclusion criteria. A total of 570 participants were included. The number of participants in each survey ranged from 16 to 200 (mean 81.42). Six studies were published after 2000 and one in the 1990s. All studies reported participants' age with mean of 40.9 years, and range between 11 and 88 years. All patients presented with unilateral lithiasis, as such the number of total stones treated was 570. Mean stone diameter ranged between 6.38 and 8.45 mm. According to the logistic regression applied stone-free rates were 79 % (61-95) for the proximal ureter, 78 % (69-88) for the mid ureter, 79 % (74-84) for the distal ureter and 78 % (75-82) for overall. Stone-free rates do not evidence a statistically significant difference compared to those described in the AUA and EAU guidelines for elective management. SWL management of ureteral stones in an emergency setting is completely lacking in the international guidelines and they results disperse in the literature in few works. According to our meta-analysis, immediate SWL for a stone-induced acute renal colic seems to be a safe treatment with high success rate. This evidence will be validated by further randomized studies, with a larger series of patients. PMID:22699356

Picozzi, Stefano C M; Ricci, Cristian; Gaeta, Maddalena; Casellato, Stefano; Stubinski, Robert; Ratti, Dario; Bozzini, Giorgio; Carmignani, Luca

2012-12-01

307

The Effect of Tamsulosin on Pain and Clearance According to Ureteral Stone Location After Shock Wave Lithotripsy?  

PubMed Central

Background Medical expulsion therapy has shown encouraging results in facilitating spontaneous clearance of ureteral stones after extracorporeal shock wave lithotripsy. However, no other study has yet determined the benefit of medical expulsion therapy for stones in different ureteral locations. Objective The aim of the study was to evaluate tamsulosin as adjunctive therapy to extracorporeal shock wave lithotripsy (SWL) in terms of pain clearance of stones in the upper, middle, and lower ureter. Methods Between June 2008 and July 2011, patients with a solitary ureteral stone that was ?6 mm up to 15 mm and located in the upper, middle, or lower ureter undergoing SWL were evaluated. The patients were randomly allocated to a conservative treatment (group 1) and a tamsulosin treatment group (group 2). Administration of the drug was started immediately after SWL and was continued for a maximum of 28 days. Patients were evaluated for stone clearance, time to stone clearance, and number of SWL sessions. The pain intensity was evaluated by visual analog scale. Results There were 64 patients in the control group and 59 in the tamsulosin group. The average stone sizes were 10.70 (3.20) mm and 11.40 (3.01) mm (P = 0.24). Group 1 and group 2 received 2507 (984) and 2759 (775) shock waves (P = 0.86), 1.53 (0.8) and 1.49 (0.75) sessions (P = 0.85), respectively. Mean visual analog scale scores and times to clearance were 3.81 (2.74) and 2.73 (2.28) (P = 0.00) and 12.59 (8.63) days and 8.34 (7.60) days (P = 0.00), respectively, for all stones in groups 1 and 2. Only the clearance time of upper ureteral stones between groups showed statistical significance (13.54 [8.32] days vs 7.10 [6.40] days; P = 0.00). Conclusions Tamsulosin may help in the treatment of all ureteral stones after SWL, particularly stones in the upper ureter, with a shorter time to clearance and less need for analgesic drugs. PMID:24385155

Basri Cak?roglu; Sinanoglu, Orhun; Mahmure Uraz

2013-01-01

308

Characterization of nitric oxide synthase activity in sheep urinary tract: functional implications.  

PubMed Central

1. To define further the role of nitric oxide (NO) in urinary tract function, we have measured the presence of nitric oxide synthase (NOS) activity, and its relationship with functional NO-mediated responses to electrical field stimulation (EFS) in the urethra, the detrusor and the ureter from sheep. NOS activity was assayed by the conversion of L-[14C]-arginine to L-[14C]-citrulline. Endogenous production of citrulline was confirmed by thin layer chromatography. 2. NOS enzymatic activity was detected in the cytosolic fraction from tissue homogenates with the following regional distribution (pmol citrulline mg-1 protein min-1): urethra (33 +/- 3.3), detrusor (13.1 +/- 1.1) and ureter (1.5 +/- 0.2). No activity was detected in the particulate fraction of any region. 3. NOS activity was dependent on Ca(2+)-calmodulin and required exogenously added NADPH and tetrahydrobyoptein (BH4) for maximal activity. Exclusion of calmodulin from the incubation mixture did not modify NOS activity, but it was significantly reduced in the presence of the calmodulin antagonist, calmidazolium, suggesting the presence of enough endogenous calmodulin to sustain the observed NOS activity. 4. NOS activity was inhibited to a greater extent by NG-nitro-L-arginine (L-NOARG) and its methyl ester (L-NAME) than by NG-monomethyl-L-arginine (L-NMMA), while 7-nitroindazole (7-NI) was a weak inhibitor and L-cannavine had no effect. 5. Citrulline formation could be inhibited by superoxide dismutase in an oxyhaemoglobin-sensitive manner, suggesting feedback inhibition of NOS by NO. 6. EFS induced prominent NO-mediated relaxations in the urethra while minor or no responses were observed in the detrusor and the ureter, respectively. Urethral relaxations to EFS were inhibited by NOS inhibitors with the rank order of potency: L-NOARG = L-NAME > 7-NI > L-NMMA. 7. In conclusion, we have demonstrated the presence of NO-synthesizing enzymatic activity in the sheep urinary tract which shows similar characteristics to the constitutive NOS isoform found in brain. We suggest that the enzymatic activity measured in the urethral muscle layer may account for the NO-mediated urethral relaxation during micturition whereas regulation of detrusor and ureteral motor function by NOS containing nerves is less likely. Images Figure 4 Figure 5 PMID:8799561

García-Pascual, A.; Costa, G.; Labadia, A.; Persson, K.; Triguero, D.

1996-01-01

309

Marked hydronephrosis and hydroureter after distigmine therapy in an adult male patient with paraplegia due to spinal cord injury: a case report  

PubMed Central

Introduction Distigmine, a long-acting anti-cholinesterase, is associated with side effects such as Parkinsonism, cholinergic crisis, and rhabdomyolysis. We report a spinal cord injury patient, who developed marked hydronephrosis and hydroureter after distigmine therapy, which led to a series of complications over subsequent years. Case presentation A 38-year-old male developed T-9 paraplegia in 1989. Intravenous urography, performed in 1989, showed normal kidneys, ureters and bladder. He was prescribed distigmine bromide orally and was allowed to pass urine spontaneously. In 1992, intravenous urography showed bilateral marked hydronephrosis and hydroureter. Distigmine was discontinued. He continued to pass urine spontaneously. In 2006, intravenous urography showed moderate dilatation of both pelvicalyceal systems and ureters down to the level of urinary bladder. This patient was performing self-catheterisation only once a day. He was advised to do catheterisations at least three times a day. In December 2008, this patient developed haematuriawhich lasted for nearly four months.. He received trimethoprim, then cephalexin, followed by Macrodantin, amoxicillin and ciprofloxacin. In February 2009, intravenous urography showed calculus at the lower pole of left kidney. Both kidneys were moderately hydronephrotic. Ureters were dilated down to the bladder. Dilute contrast was seen in the bladder due to residual urine. This patient was advised to perform six catheterisations a day, and take propiverine hydrochloride 15 mg, three times a day. Microbiology of urine showed Klebsiella oxytoca, Pseudomonas aeruginosa, and Enterococcus faecalis. Cystoscopy revealed papillary lesions in bladder neck and trigone. Transurethral resection was performed. Histology showed marked chronic cystitis including follicular cystitis and papillary/polypoid cystitis. There was no evidence of malignancy. Conclusion Distigmine therapy resulted in marked bilateral hydronephrosis and hydroureter. Persistence of hydronephrosis after omitting distigmine, and presence of residual urine in bladder over many years probably predisposed to formation of polypoid cystitis and follicular cystitis, and contributed to prolonged haematuria, which occurred after an episode of urine infection. This case illustrates the dangers of prescribing distigmine to promote spontaneous voiding in spinal cord injury patients. Instead of using distigmine, spinal cord injury patients should be advised to consider intermittent catheterisation together with oxybutynin or propiverine to achieve complete, low-pressure emptying of urinary bladder. PMID:19918519

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

2009-01-01

310

Retroperitoneal fibrosis.  

PubMed

Retroperitoneal fibrosis (RPF) is a rare disease that is marked by systemic inflammation and the development of a periaortic fibroinflammatory mass. The fibroinflammatory infiltration can encase the abdominal aorta, ureters, and other abdominal organs. The clinical presentation often includes constitutional symptoms, abdominal pain, and signs of renal insufficiency or renal failure related to ureteral obstruction. Less frequently, RPF may present with vascular complications, such as venous thrombosis or claudication. The idiopathic form of RPF is most common but secondary forms have been described and are associated with malignancy and a variety of different medications. The pathophysiology is uncertain, but RPF has been linked with periaortitis and IgG4-related disease. Treatment centers on the relief of symptoms and complications associated with mass effects. Corticosteroids and other immunosuppressant therapies can improve constitutional symptoms, reduce infiltrate mass, and achieve disease remission, but a chronic relapsing course is not uncommon. PMID:25161213

Tzou, Martha; Gazeley, David J; Mason, Peter J

2014-10-01

311

Idiopathic and secondary forms of retroperitoneal fibrosis: A diagnostic approach.  

PubMed

Retroperitoneal fibrosis (RPF) is an uncommon disease characterized by a fibrous reaction that takes place in the peri-aortic retroperitoneum and often entraps the ureters causing obstructive uropathy. RPF is idiopathic in the majority of cases, but can also be secondary to malignancies, infections, drugs, radiotherapy, and rare histiocytic disorders such as Erdheim-Chester disease. Idiopathic RPF is an immune-mediated disease, which can either be isolated, associated with other autoimmune diseases, or arise in the context of a multifocal fibro-inflammatory disorder recently renamed as IgG4-related disease. The differential diagnosis between idiopathic, IgG4-related and secondary RPF is crucial, essentially because the therapeutic approaches - especially of idiopathic vs. secondary RPF - can be dramatically different. This review focuses on the clinical, laboratory and imaging features of the different RPF forms, and also provides an overview of the available treatment options. PMID:25455951

Urban, M L; Palmisano, A; Nicastro, M; Corradi, D; Buzio, C; Vaglio, A

2015-01-01

312

[Pyonephrosis due to xanthine stones in a bitch treated with allopurinol].  

PubMed

A 2-year-old, neutered, crossbreed bitch was presented as an emergency with painful abdomen, fever and vomiting. The cause of the acute abdomen was a pyonephrosis of the left kidney, caused by four xanthine stones, which had blocked the ureter. After surgical removal of the heavily altered left kidney, the bitch recovered rapidly. Because of a leishmaniasis the bitch had been treated with allopurinol over an extended period, the xanthine stone formation is likely to have resulted from allopurinol usage. Because there were additionally small concrements in the right kidney, the medication was stopped. Subsequently, the dog has received a low purine diet, and the leishmaniasis titer and renal function have been monitored regularly. PMID:24518947

Maier, R; Lutter, F X; Lohss-Baumgärtner, E

2014-01-01

313

Laparoscopic management of a small bowel herniation from an ileal conduit: report of a case and review of the literature.  

PubMed

Bladder carcinoma can be treated with cystectomy and urinary diversion. Ileal conduit is a popular technique, originally performed with closure of all mesenteric and peritoneal defects to minimize internal herniation. Recent advances in laparoscopic and robotic techniques often leave these defects open. We present a case of a 75-year-old gentleman with a small bowel entrapment underneath an intraperitoneal ileal conduit and ureter causing obstruction. This internal hernia occurred 2 months after undergoing a DaVinci robotic-assisted laparoscopic cystoprostatectomy with an ileal conduit. Bowel obstruction is an important complication associated with the need for reoperation and patient mortality. Historical review shows a precedent for closure of the mesenteric defect, obliterating the peritoneal defect in the right lumbar gutter, and suturing the ileal conduit to the posterior peritoneum to prevent potential internal hernias. The literature involving ileal conduits is examined for consensus on the preferred method of treating these potential spaces. PMID:23579536

Coughlin, Lisa M; Orr, Dennis P

2013-04-01

314

A Cause of Renal Dysfunction: A Giant Bladder Stone  

PubMed Central

Bladder stones are frequently seen in elderly men and account for 5% of all urinary stones. They develop secondary to infravesical obstructions, such as prostatic hyperplasia and neurogenic bladder. A 56-year-old patient with frequent and painful urination, dysuria, and minor complaints of suprapubic pain was referred to our clinic. He was diagnosed with bladder stones by non-contrast abdominopelvic computerized tomography, kidney-ureter-bladder radiography, and urinary system ultrasonography. Cystolithotomy was applied on a giant stone measuring 11×6.5×10 cm that filled the intravesical cavity nearly completely. Here, we present this case of a giant bladder stone causing renal dysfunction within the context of findings in the literature. PMID:25610281

Ofluoglu, Yilmaz; Aydin, Hasan Riza; Kocaaslan, Ramazan; Adanur, Senol; Ziypak, Tevfik

2013-01-01

315

Elderly patient with ureteric colic: suspect leaking aneurysm  

PubMed Central

Described below is a case of a 72-year-old man with an abdominal aortic aneurysm (AAA) presenting with symptoms of renal colic. This case illustrates the hazards of making a diagnosis of renal colic in an elderly patient without considering the diagnosis of a leaking AAA. The diagnosis of an AAA can be challenging and renal colic is the single most common misdiagnosis. The patient's initial presentation can be misleading as symptoms fit the features of renal colic or a leaking AAA. Despite normal haemoglobin, microscopic haematuria and a dilated ureter on intravenous urogram (IVU); a leaking AAA should still have been considered. An ultrasound or CT (rather than an IVU) scan would have confirmed the appropriate diagnosis. A high degree of suspicion, early identification and surgical intervention can help reduce the high incidence of mortality in such cases. PMID:23420732

Sinha, Yashashwi

2013-01-01

316

Laparoscopic management of sacral nerve root schwannoma with intractable vulvococcygodynia: report of three cases and review of literature.  

PubMed

Herein we report the feasibility of laparoscopic resection of schwannomas of the sacral nerves roots in 3 women with intractable vulvodynia and coccygodynia. Laparoscopic en bloc resection of the sacral schwannomas was performed, with primary control of the tumor blood supply and with exposure and sparing of the sacral nerve roots. In all 3 patients, laparoscopy was successful, with minimal blood loss and without complications. Histologic examination confirmed the diagnosis of schwannoma without malignant transformation in all 3 women. At mean follow-up of 27.66 months, no patient reported recurrence or worsening of symptoms. All patients are able to walk normally without gait aids. Primary control of the tumor blood supply during laparoscopic surgery to resect deep sacral masses reduces considerably the risk of operative hemorrhage. Compared with classic neurosurgical approaches, laparoscopic exposure of the rectum, ureters, and sacral nerve roots renders the procedure safer and easier, with less risk of postoperative functional morbidity. PMID:23522662

Possover, Marc; Kostov, Plamen

2013-01-01

317

Laparoscopic resection of a retroperitoneal pelvic schwannoma  

PubMed Central

Schwannomas are rarely located in the pelvis. A 54-year-old woman was found incidentally to have a tumor in the abdomen. Abdominal computed tomography and magnetic resonance imaging revealed a well-defined, heterogeneous tumor, 5 cm in diameter, in the pelvic cavity. With a diagnosis of a mesenteric tumor, a laparoscopic procedure was performed. Intra-operatively, an elastic tumor was identified in the pelvis adjacent to the right internal iliac vein and ureter. The tumor was dissected free from adjacent structures using Liga-Sure and blunt maneuvers. A complete laparoscopic excision was performed. Histopathological examination revealed a benign schwannoma. The patient had an uneventful post-operative course, and was discharged on the fourth post-operative day. Laparoscopic treatment is useful and feasible for retroperitoneal pelvic schwannoma, with minimal invasiveness and an early post-operative recovery. Thus, this procedure may be the first-choice surgical procedure for retroperitoneal pelvic schwannomas. PMID:24876325

Okuyama, Takashi; Tagaya, Nobumi; Saito, Kazuyuki; Takahashi, Shuhei; Shibusawa, Hiroyuki; Oya, Masatoshi

2014-01-01

318

Primary Pleomorphic Undifferentiated Sarcoma—a Rare Renal Localization: A Case Report  

PubMed Central

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

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

319

Ultrasonographic abdominal screening of atomic bomb-exposed subjects.  

PubMed

Abdominal ultrasonographic screening for cancer was performed in 6,001 Hiroshima and Nagasaki A-bomb exposed and comparison subjects, all members of the Adult Health Study of the Radiation Effects Research Foundation, formerly the Atomic Bomb Casualty Commission. This study yielded 20 cancers, including 7 hepatocellular, 3 gastric, 3 renal and 2 urinary bladder cancers; one cancer each of the ovary, pancreas, colon and ureter; and one cancer metastatic to the liver, whose primary was unknown. Seventeen of these 20 subjects manifested no symptoms or signs of their disease. A variety of additional tumors, unproven and probably benign, including uterine myomata, and other abnormalities were also detected. Abdominal ultrasonographic screening greatly assisted in the detection of cancers, most of which neither the patients nor their physicians were aware. In this screened fixed population sample the cancer detection rate was 0.33%, exceeding any such rates previously reported in the medical literature. PMID:8172742

Russell, W J; Higashi, Y; Fukuya, T; Hosoda, Y; Murakami, J; Kawashima, A; Murayama, S; Ohuchida, T; Mihara, F; Takagi, M

1994-03-01

320

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

NASA Astrophysics Data System (ADS)

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.

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

2000-05-01

321

[Application of rowatinex in the perioperative period in the extracorporeal shock wave lithotripsy].  

PubMed

Despite the high efficacy and safety of ESWL used to disintegrate stones in pyelocaliceal system and upper ureter, the issue of further reduction of the risk of complications of this procedure remains unresolved. The inclusion ofphytopreparations with anti-inflammatory and lithokinetic properties in the scheme of perioperative treatment is one of the ways for prevent complications of ESWL. The effect of the drug Rowatinex on the process of discharge of calculi fragments after ESWL is evaluated. The frequency and intensity of qualitative changes of urine after appointment this drug were assessed. It is concluded that Rowatinex has positive impact on the final result of ESWL in the case of its inclusion in the complex medical treatment, which manifests in terms of reducing the time of discharge of fragments, mitigation of subjective symptoms, as well as reducing the frequency of subclinical bacteriuria and severe complications. PMID:24956667

Popkov, V M; Bliumberg, B I; Osnovin, O V; Shatylko, T V

2014-01-01

322

Primary localized amyloidosis of the urinary tract frequently mimics neoplasia: a clinicopathologic analysis of 11 cases  

PubMed Central

Localized urinary tract amyloidosis (UTA) is a rare disease that mimics neoplasia clinically, cystoscopically, and radiologically. We report eleven cases of isolated UTA from the urinary bladder (n=7) and upper urinary tract including the ureter (n=2) and renal pelvis (n=2). All cases clinically presented as mass lesions prior to histologic examination and clinically suggested a neoplastic process. The amyloid composition in most cases was mixed Kappa and Lambda light chains. All cases were cured after surgical excision except one case which was diagnosed as plasmacytosis/plasmacytoma six months later. Localized amyloidosis of the urinary tract usually has a benign clinical course and simple resection is recommended after systemic disease is ruled out. PMID:25374907

Zhou, Fang; Lee, Peng; Zhou, Ming; Melamed, Jonathan; Deng, Fang-Ming

2014-01-01

323

Extra-adrenal paraganglioma of the prostate  

PubMed Central

Extra-adrenal pheochromocytomas, or paragangliomas, are rare tumours that may develop from extra-adrenal chromaffin cells, and most occur in the organ of Zuckerkandl. Extra-adrenal paraganglioma of the prostate is extremely rare. We report a 53-year-old man with hypertension and lower urinary tract symptoms, who was initially diagnosed with benign prostate hyperplasia. Computed tomography (CT) showed a large heterogenously enhancing mass in the prostate, imprinting the right distal ureter and urinary bladder. Before surgical intervention, CT-guided biopsy of the prostatic mass was performed and the result of histologic examination confirmed extra-adrenal paraganglioma. He underwent radical prostatectomy, partial cystectomy and right ureteroneocystostomy. The patient recovered and his blood pressure returned within normal range after surgical removal of the prostate tumour. In this article, we stress that the rarity of prostatic paraganglioma, preoperative localization and imaging-guided biopsy were useful in determining the surgical strategy. PMID:23766843

Wang, Hong-Hau; Chen, Yen-Lin; Kao, Hao-Lun; Lin, Shih-Chung; Lee, Chiao-Hua; Huang, Guo-Shu; Chang, Wei-Chou

2013-01-01

324

Primary localized amyloidosis of the urinary tract frequently mimics neoplasia: a clinicopathologic analysis of 11 cases.  

PubMed

Localized urinary tract amyloidosis (UTA) is a rare disease that mimics neoplasia clinically, cystoscopically, and radiologically. We report eleven cases of isolated UTA from the urinary bladder (n=7) and upper urinary tract including the ureter (n=2) and renal pelvis (n=2). All cases clinically presented as mass lesions prior to histologic examination and clinically suggested a neoplastic process. The amyloid composition in most cases was mixed Kappa and Lambda light chains. All cases were cured after surgical excision except one case which was diagnosed as plasmacytosis/plasmacytoma six months later. Localized amyloidosis of the urinary tract usually has a benign clinical course and simple resection is recommended after systemic disease is ruled out. PMID:25374907

Zhou, Fang; Lee, Peng; Zhou, Ming; Melamed, Jonathan; Deng, Fang-Ming

2014-01-01

325

Embryonic Stem Cells Proliferate and Differentiate when Seeded into Kidney Scaffolds  

PubMed Central

The scarcity of transplant allografts for diseased organs has prompted efforts at tissue regeneration using seeded scaffolds, an approach hampered by the enormity of cell types and complex architectures. Our goal was to decellularize intact organs in a manner that retained the matrix signal for differentiating pluripotent cells. We decellularized intact rat kidneys in a manner that preserved the intricate architecture and seeded them with pluripotent murine embryonic stem cells antegrade through the artery or retrograde through the ureter. Primitive precursor cells populated and proliferated within the glomerular, vascular, and tubular structures. Cells lost their embryonic appearance and expressed immunohistochemical markers for differentiation. Cells not in contact with the basement membrane matrix became apoptotic, thereby forming lumens. These observations suggest that the extracellular matrix can direct regeneration of the kidney, and studies using seeded scaffolds may help define differentiation pathways. PMID:19729441

Williams, Matthew J.; Hamazaki, Takashi; Terada, Naohiro; Clapp, William L.; Adin, Christopher; Ellison, Gary W.; Jorgensen, Marda; Batich, Christopher D.

2009-01-01

326

Urological applications of single-site laparoscopic surgery  

PubMed Central

Single-port, single-incision laparoscopy is part of the natural development of minimally invasive surgery. Refinement and modification of laparoscopic instrumentation has resulted in a substantial increase in the use of laparoendoscopic single-site surgery (LESS) in urology over the past 2 years. Since the initial report of single-port nephrectomy in 2007, the majority of laparoscopic procedures in urology have been described with a single-site approach. This includes surgery on the adrenal, ureter, bladder, prostate, and testis, for both benign and malignant conditions. In this review, we describe the current clinical applications and results of LESS in Urological Surgery. To date this evidence comes from small case series in centres of excellence, with good results. Further well-designed prospective trials are awaited to validate these findings. PMID:21197251

Symes, Andrew; Rane, Abhay

2011-01-01

327

Bladder Neck Rupture Following Perineal Bull Horn Injury: A Surgical Challenge  

PubMed Central

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

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

328

[A case of genital Chlamydia trachomatis infection with acute post renal failure].  

PubMed

A 29-year-old woman presented with bilateral hydronephroses concomitant with acute renal failure. Retrograde pyelography demonstrated bilateral ureteral strictures located at the lower segment of ureters. Computed tomography revealed inflammation of the left ovary and severe colon adhesion. She received the operation, i.e. left ovariectomy and colon adhesiotomy, because of a possibility of gynecological disease including endometriosis and malignant tumors. Clinical and pathological findings showed non-specific inflammation in the pelvis and ovary. A pelvic inflammatory disease due to a genital Chlamydia trachomatis was highly suspected and she was treated with targeted antibiotics. There have been no signs of hydronephroses or renal failure during six years' follow-up after the treatment. We discus this rare case of bilateral hydronephroses due to genital Chlamydia trachomatis. PMID:18516926

Hirayama, Takahiro; Matsumoto, Kazumasa; Song, Shigehiro; Matsushita, Kazuhito; Satoh, Takefumi; Iwamura, Masatsugu; Baba, Shiro

2008-04-01

329

The first use of Resonance® metallic ureteric stent in a case of obstructed transplant kidney  

PubMed Central

INTRODUCTION To date, double JJ stent is the mainstay ureteric stent used in a transplant kidney. We herein report the first use of Resonance® metallic ureteric stent to manage ureteric obstruction in a transplant kidney. PRESENTATION OF CASE A 45-year-old lady underwent an uneventful living related donor renal transplantation. Due to post-operative pelvi-ureteric obstruction and recurrent obstruction following multiple distal stent migration and expulsion necessitated frequent nephrostomy insertion and antegrade stenting, she underwent challenging but successful retrograde insertion of a 12 centimetres long and size 6.0 French Cook Resonance® metallic ureteric stent which was performed under general anaesthesia. DISCUSSION Metallic ureteric stents are a fairly recent introduction to modern urology and they have been successfully used in the management of benign and malignant obstruction of ureter. CONCLUSION This is the first case of therapeutic metallic ureteric stent insertion in a transplant kidney. PMID:24858983

Abdulmajed, Mohamed I.; Jones, Vaughan W.; Shergill, Iqbal S.

2014-01-01

330

Successful Removal of an Intravesical Electrical Wire Cable  

PubMed Central

A few previous reports have described cases wherein electrical wire cables were inserted into the male urethra and bladder. Electrical wire cables are available at home and are easy to insert. However, after they coil in the patient's bladder, they are difficult to remove. In February 2013, a 30-year-old man presented to the emergency room of SMG-SNU Boramae Medical Center with a urethral foreign body. He had inserted an electrical wire cable into his urethra for the purpose of masturbation, despite having a regular sex partner and no underlying disease. A kidney-ureter-bladder radiography showed a tangled wire in his bladder and urethra. On the next day, we tried to remove the wire cystoscopically, but this proved to be impossible because of complex coiling and the slippery surface of the wire. A Pfannenstiel incision was made to remove the foreign body. No postoperative complications were noted. PMID:25237664

Ahn, Hyunsoo

2014-01-01

331

Ovarian remnant syndrome: diagnostic dilemma and surgical challenge.  

PubMed

The ovarian remnant syndrome, an unusual complication of bilateral oophorectomy, usually presents with pelvic pain with or without a mass. From 1980-1985, 31 patients were seen with this diagnosis, which was confirmed by excision of ovarian tissue. Various adhesion-producing conditions leading to retention of ovarian tissue, such as endometriosis, pelvic inflammatory disease, or inflammatory bowel disease, were present at the original procedure. The increase in diagnosis of this condition during the past five years may represent a greater awareness of the potential condition, combined with wider use of ultrasonography and computed tomography scanning. Twenty of the 31 patients were found to have a tender palpable mass of thickening. In 11 patients, a mass was found only on ultrasonography. Surgical correction required dissection and mobilization of the ureter throughout its entire pelvic course to facilitate resection of the specimen. The complications were minor, and symptoms were relieved. PMID:3281076

Pettit, P D; Lee, R A

1988-04-01

332

Evaluation of normal and pathologic ureteral dynamics: comparison of a radioisotopic method with ureteral pressure/flow perfusion study.  

PubMed

The ureteral pressure/flow perfusion study has lately been repopularized and its use demonstrated in many forms of suspected obstructive uropathy. The present study was undertaken to compare the ureteral pressure/flow perfusion study with a radioisotopic method of investigating ureteral obstruction. The 2 methods were evaluated with a mongrel canine laboratory model. Both diagnostic modalities were employed concomitantly on intact renoureteral units; first with the ureter unobstructed, then after submission to varying degrees of ureteral occlusion. Analysis of data from these studies shows that the curve pattern produced by the computer generated 99mTc-DTPA renogram is as accurate as ureteral pressure/flow perfusion study in determining the presence and degree of ureteral obstruction. PMID:7045396

Braren, V; Bauriedel, J K; Jones, W B; Goddard, J

1982-05-01

333

Evaluation of normal and pathologic ureteral dynamics: comparison of a radioisotopic method with ureteral pressure/flow perfusion study  

SciTech Connect

The ureteral pressure/flow perfusion study has lately been repopularized and its use demonstrated in many forms of suspected obstructive uropathy. The present study was undertaken to compare the ureteral pressure/flow perfusion study with a radioisotopic method of investigating ureteral obstruction. The 2 methods were evaluated with a mongrel canine laboratory model. Both diagnostic modalities were employed concomitantly on intact renoureteral units; first with the ureter unobstructed, then after submission to varying degrees of ureteral occlusion. Analysis of data from these studies shows that the curve pattern produced by the computer generated 99mTc-DTPA renogram is as accurate as ureteral pressure/flow perfusion study in determining the presence and degree of ureteral obstruction.

Braren, V.; Bauriedel, J.K.; Jones, W.B.; Goddard, J.

1982-05-01

334

Peristaltic pumping of solid particles immersed in a viscoelastic fluid  

NASA Astrophysics Data System (ADS)

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.

Chrispell, John; Fauci, Lisa

2010-11-01

335

Pyelonephritis xanthogranulomatosa in a 7-year-old girl  

PubMed Central

Xanthogranulomatous pyelonephritis (XGPN) is rare form of chronic, usually unilateral, renal infection that involves damage to the renal glomeruli and periglomerular tissue and destruction of the renal parenchyma. Nephrectomy is usually necessary and the prognosis is good if XGPN is unilateral and treated early. XGPN typically affects middle-aged females and is extremely rare in children. We report one case of XGPN in a seven-year-old girl who was operated on at our institution be-cause of lower urinary tract dysfunction and renal insufficiency – the left kidney was removed and the bladder was augmented by means of the remaining ureter. The histopathological evaluation of the removed kidney showed chronic XGPN. PMID:24578955

Apozna?ski, Wojciech; Szyde?ko, Tomasz; Patkowski, Dariusz

2012-01-01

336

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

PubMed

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

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

2014-09-01

337

About a case report of giant hydronephrosis.  

PubMed

Introduction. Our objective is to report a case of an infrequent entity as the giant hydronephrosis. Case Report. We report the case of an 82-syear-old male referred for a poor general condition. A radiological study revealed a great left hydronephrosis secondary to an urothelial carcinoma. The patient died due to his poor general condition. A histological diagnosis revealed a transitional cell carcinoma of renal pelvis and ureter and atrophic renal parenchyma. Conclusion. Giant hydronephrosis represents a very often entity to be taken into account in cases with big cystic abdominal masses in absence of unilateral or bilateral kidney. Simple nephrectomy is the treatment of choice in most cases. Nevertheless, in cases of nonsubsidiary surgery, percutaneous drainage may be necessary. PMID:24191226

Mediavilla, Enrique; Ballestero, Roberto; Correas, Miguel Angel; Gutierrez, Jose Luis

2013-01-01

338

Morphology and SSU rDNA sequences of Ortholinea orientalis (Shul'man and Shul'man-Albova, 1953) (Myxozoa, Ortholineidae) from Clupea harengus and Sprattus sprattus (Clupeidae) from Denmark.  

PubMed

Ortholinea orientalis (Shul'man and Shul'man-Albova 1953) Shul'man 1956 is redescribed from Clupea harengus L. and Sprattus sprattus (L.) (Teleostei, Clupeidae) from the northern Øresund, Denmark. S. sprattus is a new host record. Polysporic plasmodia and most myxospores were found in the ureters of both hosts. The myxospores have external valvular ridges, which were not observed in the original description. The presence of this character causes us to consider Ortholinea clupeidae Aseeva 2000 as a likely synonym of O. orientalis. Ortholinea antipae Moshu and Trombitsky, 2006 from a Black Sea clupeid is also similar and represent a possible synonym. Sequence comparisons and phylogenetic analysis of partial SSU rDNA sequences of O. orientalis reveal closest affinity (82-86% identity) to members of the 'Freshwater Urinary Bladder Clade' sensu Fiala (2006), a clade among the Platysporina containing members of the myxosporean genera Myxobilatus, Hoferellus, Myxidium, Zschokkella and Chloromyxum from freshwater fishes. PMID:21301876

Karlsbakk, Egil; Køie, Marianne

2011-07-01

339

[Complications of the treatment of renal calculi by extracorporeal lithotripsy. Prospective evaluation of 80 treated kidneys].  

PubMed

The acute effects of extracorporeal shock wave lithotripsy (ESWL) on morphology and function of the kidney were prospectively evaluated by abdominal radiography, ultrasonography and contrast-enhanced computed tomography, in 80 treated kidneys. Two types of complications were demonstrated: 1. Obstruction of the ureter by stone fragments in 25% of cases. Relief procedures became necessary in 5 patients (6% of the 80 cases). 2. Limited injuries of the kidney and perirenal spaces in 44% of cases: parenchymatous abnormalities 17.5%; subcapsular hematoma 12.5%; perirenal fluid collection 24%. No treatment was necessary and morphologic abnormalities disappeared in one or two months post-ESWL. Severe ureteral obstruction after ESWL seems to be related to stone size. No definitive evidence that kidney's injury was related to the number of shock waves applied to the kidney was found. PMID:3323486

Blangy, S; Folinais, D; Sibert, A; Delmas, V; Moulonguet, A; Benacerraf, R

1987-10-01

340

Anterior pelvic reconstruction with ileum after cancer treatment.  

PubMed Central

Ileum has been used to reconstruct the lower urinary tract in 15 patients (10 women, five men) after treatment for bladder or gynaecological cancer. Seven patients had previously received radical pelvic irradiation. Four methods were used: group 1 (five patients): bladder patch after partial cystectomy or bladder augmentation after clam cystotomy for bladder contracture; group 2 (four patients): bladder replacement after subtotal (supratrigonal) cystectomy; group 3 (two patients): ureteric replacement for lower ureteric obstruction or fistula, and group 4 (four patients): complete replacement of bladder and lower ureters after anterior pelvic exenteration, with creation of neovagina from caecum in the two female patients. Review of the results indicates that ileum provides a versatile and safe material for anterior pelvic reconstruction in cancer patients even after previous pelvic irradiation. Images Figure 1. Figure 2. Figure 4. Figure 5. Figure 6. PMID:1774743

Hendry, W F; Christmas, T J; Shepherd, J H

1991-01-01

341

Schistosoma haematobium infection in the opossom (Didelphis marsupialis): involvement of the urogenital system*  

PubMed Central

Investigations of experimental schistosomiasis haematobia have suffered for want of satisfactory mammals in which schistosome infections would establish host—parasite situations more or less comparable with those seen in man. As a consequence, mammals representing different major groups have been exposed to infection by Schistosoma haematobium (Iran strain) to determine their potential use as models for more detailed investigations. In preliminary studies, 8 American opossums (Didelphis marsupialis) were exposed to 1000 or 2000 cercariae. Macroscopic involvement of the urogenital tract was noted in 3 animals, one of which had a 1-cm fibrous plaque in the bladder. In another animal, multiple transitional cell papillomas were present in the bladder and in one ureter. ImagesFig. 3Fig. 4Fig. 7Fig. 8Fig. 5Fig. 6Fig. 2 PMID:5316850

Kuntz, Robert E.; Myers, Betty June; Cheever, Allen W.

1971-01-01

342

CEUS Retrograde Cystography Is Helpful in Percutaneous Drainage of Complex Posttransplant Lymphocele  

PubMed Central

After monolateral dual kidney transplantation, a 69 years old male patient developed symptomatic lymphocele with mild hydroureteronephrosis, impaired renal function, and right inferior limb oedema. A percutaneous ultrasound-guided drainage of the fluid collection was planned, but the complex mutual relations between the collection and the renal hilus did not allow to identify a suitable route for a safe drainage insertion during conventional ultrasound examination. A retrograde cystography using echographic contrast agent was, therefore, performed, and it clarified the position of both ureters and the renal vessels, permitting an harmless ultrasound-guided percutaneous lymphocele drainage. In conclusion contrast-enhanced ultrasound retrograde cystography may be helpful in percutaneous drainage of complex posttransplant lymphocele. PMID:22606639

Di Domenico, Stefano; Patti, Valentina; Fazio, Federico; Moggia, Elisabetta; Fontana, Iris; Valente, Umberto

2012-01-01

343

Multiple primary malignancies: a report of two cases  

PubMed Central

The diagnosis of multiple primary malignancies (MPMs) in a patient has been reported rather frequently during the past decade. Here we present two cases with three synchronous primary malignant tumors. The first patient is a 66-year-old male with synchronous colorectal cancer, renal cell carcinoma (RCC) and non-small cell lung cancer (NSCLC). The second patient is a 64-year-old female with breast cancer, transitional cell carcinoma of the ureter and endometrial cancer. MPMs seem to be diagnosed in a higher incidence than that predicted only by the influence of hazard and, whenever found, they raise questions regarding not only possible common etiologic factors or same pathogenetic mechanisms but also they cause a lot of troubles to both clinicians and patients because the therapeutic options usually become limited. PMID:24826064

Peroukides, Stavros; Iconomou, Gregoris; Boumpoucheropoulos, Sotirios; Kalofonos, Haralabos

2014-01-01

344

Familial visceral myopathy: a family with at least six involved members.  

PubMed Central

A family with at least six members affected by hollow organ visceral myopathy is described. Patients in the first or second decades of life developed symptoms which included weight loss, nausea and vomiting, abdominal pain and distension, constipation and diarrhoea, and urinary symptoms. The radiological features of the disease consisted of oesophageal aperistalsis, megaduodenum, and variable dilatation of the small and large bowel. Four patients had urinary tract involvement with dilatation of the ureters and/or incomplete bladder emptying. Two patients were severely affected and needed home parenteral nutrition and surgical treatment; others were symptomatic but remained well. The characteristic pathological abnormality was vacuolar degeneration predominantly affecting the longitudinal muscle. The disease in this family appears to be transmitted by autosomal dominant mode of inheritance. Images Fig. 2 Fig. 5 Fig. 6 Fig. 7 PMID:2806997

Rodrigues, C A; Shepherd, N A; Lennard-Jones, J E; Hawley, P R; Thompson, H H

1989-01-01

345

An Unusual Extremely Distant Noncommunicating Uterine Horn with Myoma and Adenomyosis Treated with Laparoscopic Hemihysterectomy  

PubMed Central

A 41-year-old woman referred to us with dysmenorrhea and severe pelvic pain although she was previously submitted to right laparotomic adnexectomy for ovarian endometrioma and to a subsequent operative laparoscopy for pelvic adhesions. After ultrasound examination, the patient underwent diagnostic hysteroscopy and operative laparoscopy which confirmed the clinic suspect of an unicornuate uterus. However, it was very unusual to see an extremely distanced right horn, without communication with uterus, without adnexa, and with a small myoma belonging to it. Moreover, omentum and bowel were attached to fundus of right horn and thick adhesions fixed it to rectum and right pelvic wall. Therefore, identification of anatomical structures was difficult, as it was extremely arduous to isolate the ureter, which was involved inside the adhesions surrounding the right uterine horn. Nevertheless, laparoscopic right hemihysterectomy was successfully performed and right horn was sent to our pathologist who recognized hypotrophic endometrium and adenomyosis. PMID:24109532

Morelli, Michele; Mocciaro, Rita; Lico, Daniela; Zullo, Fulvio

2013-01-01

346

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

PubMed

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

Cone, D K; Anderson, R C

1977-08-01

347

Therapeutic effect of dienogest on adenosarcoma arising from endometriosis: a case report.  

PubMed

Dienogest is a novel synthesized progestin used for treatment of endometriosis. This is the first case report describing a therapeutic effect of dienogest on a gynecologic malignancy. The patient was a 44-year-old woman with advanced adenosarcoma arising from the endometriosis in the rectovaginal space and infiltrating the left pelvic wall, left ureter, rectum and vagina. The residual tumor after tumor debulking surgery was resistant to both chemotherapy and radiotherapy. Dienogest was used as a substitute for medroxyprogesterone acetate because of the presence of deep vein thrombosis. Based on the RECIST criteria, partial response was obtained with oral dienogest therapy at six months and the serum CA125 level also decreased from 70 U/ml to 16 U/ml. The tumor remained stable up to 21 months. Thromboembolism or other adverse effects did not occur during the dienogest therapy. Dienogest may be useful for the treatment of adenosarcoma arising from endometriosis. PMID:24324925

Tasaka, Nobutaka; Matsumoto, Koji; Satoh, Toyomi; Minaguchi, Takeo; Onuki, Mamiko; Ochi, Hiroyuki; Tanaka, Yumiko O; Sakata, Akiko; Noguchi, Masayuki; Yoshikawa, Hiroyuki

2013-01-01

348

[Treatment of ureteral lithiasis with laser].  

PubMed

We present our experience in the treatment of ureteral lithiasis with pulsed dye lasertripsy (Pulsolith)**. Evaluation of the results achieved in 67 cases of lithiasis that had been treated from January, 1990 to March, 1991 revealed a success rate of 93%. The remaining cases required the use of other complementary energy to achieve stone fragmentation. The approach, the endoscopic technique using the Olympus ureteroscopes (7.2F-9F) and complementary maneuvers are described. The complications were minimal. We consider this to be the procedure of choice for calculi in the pelvic ureter. Furthermore, we discuss the cost/benefit of this therapeutic option within the context of a lithotripsy unit with a high endoscopic dedication and the possibility of using fine caliber ureteroscopes (Olympus) as well as other options for stone fragmentation (shock wave, ultrasound and electrohydraulic energy). PMID:1586214

Iglesias, J I; Mancebo, J M; Massarra, J; Carbonero, M; Pérez-Castro, E

1992-01-01

349

The Klippel-Feil syndrome: a constellation of deformities.  

PubMed

The clinical triad, described by Klippel and Feil in 1912 and consisting in a short neck, a low dorsal hairline and restricted neck mobility, is the result of synostosis of several cervical vertebrae, which may or may not be deformed. In recent years, however, even more attention has been given to associated urological, neurological, cardiopulmonary and locomotor deformities, which significantly increase the morbidity. A multidisciplinary approach and treatment are therefore required. We have studied 18 patients and examined 6 additional records. Of these 24 cases, 18 showed associated deformities. In 14 cases surgery was necessary, including cervical fusion for hypermobility in 3 cases, fusion to treat scoliosis in 5 cases, one cervical rib resection and one Sprengel deformity correction. In addition 3 patients needed cardiac surgery and one patient had a ureter reinserted because of vesico-ureteral reflux. PMID:2801071

Van Kerckhoven, M F; Fabry, G

1989-01-01

350

Bidirectional inhibitory interactions between the embryonic chicken metanephros and lumbosacral nerves in vitro.  

PubMed

During chicken embryonic development the metanephros forms from the uretic duct at embryonic day (E) 7. As the metanephric tissue develops between E7 and E10, it comes into close apposition with lumbosacral nerves. Coculturing of metanephric and nerve explants demonstrated that the Schwann cells of the sciatic nerve inhibit the migration of metanephric cells in a contact-dependent manner. Conversely, metanephric cells inhibit dorsal root ganglion axon extension in a contact-dependent manner. However, metanephric cells are not inhibited by contact with growth cones or axons. Dorsal root ganglion growth cones become sensitive to the inhibitory signals on the surfaces of metanephric cells around E8, a time when the metanephros is expanding into the territory occupied by nerves in vivo. These observations demonstrate inhibitory bidirectional tissue-tissue interactions in vitro and provide a novel model system for the study of contact-based guidance of both neuronal and non-neuronal cell migration. PMID:15305299

Silver, Lee; Qiang, Liang; Loudon, Robert; Gallo, Gianluca

2004-09-01

351

Update on Vesicoureteral Reflux: Pathogenesis, Nephropathy, and Management  

PubMed Central

Clinical reflux was first visualized over 100 years ago. In the 1950s and early 1960s, the assumption was that surgery to relieve bladder neck obstruction would have a positive effect on bladder function and reflux. By the early 1970s it was understood that the underlying structural problems leading to primary reflux were congenitally abnormal distal ureters and orifices. Researchers in the 1960s and 1970s demonstrated the connection between reflux and renal scarring. More recently, reflux nephropathy in the absence of urinary tract infections has been observed, leading researchers to investigate an association between bladder dysfunction and reflux with resulting nephropathy. The cornerstone of management of the child with vesicoureteral reflux is antibiotic prophylaxis; treatment regimens for various grades of reflux are reviewed. Indications for surgical treatment of reflux are also discussed. Controversies regarding vesicoureteral reflux, including duration of prophylactic treatment, remain to be resolved. PMID:16985715

Decter, Ross M

2001-01-01

352

Micro-optical force distribution sensing suitable for lump/artery detection.  

PubMed

Surgeons performing robotic-assisted surgical tasks need to establish the density and constituency of hidden tissue structures using only surgical tools. This is possible by integrating a miniaturized sensor into the end-effectors of robotic surgical systems. In this present work, optical microsystems technology is utilized to develop a miniature force-distribution sensor that can be integrated into surgical end-effectors. The sensing principle of the sensor is based on the mechanism of splice coupling. Since the device is fully optical, the sensor is magnetic-resonance compatible and is also electrically passive. The experimental results performed on the developed sensor confirm its ability to measure the distributed force information. Such information is used to detect different tissue structures such as lumps, arteries, or ureters during robotic-assisted surgical tasks. PMID:25653070

Ahmadi, Roozbeh; Arbatani, Siamak; Packirisamy, Muthukumaran; Dargahi, Javad

2015-02-01

353

Onset of hydronephrosis and lower urinary tract symptoms in a previously healthy young man: Phyllodes tumour of the prostate as a potential diagnosis  

PubMed Central

We report the case of a 50-year-old healthy man with early onset of micturition symptoms associated with an elevated total prostate-specific antigen. On physical examination, we found an enlarged prostate; a first-line ultrasound of the urinary tract revealed local disease which covered the entire small pelvis. A computed tomography scan confirmed the presence of a 12.5 × 11.0 × 9.5-cm multicystic prostatic mass, compressing the bladder and pelvic ureters, associated with right hydronephrosis. Renal function was preserved and prostatic biopsies was negative for malignant disease. The mass was completely removed through transvesical approach and histological analysis diagnosed a low-grade phyllodes tumour of the prostate. The patient was free of local recurrence and metastasis 36 months after surgery. PMID:25210565

Ferrari, Matteo; Capitanio, Umberto; Rizzo, Nathalie; Freschi, Massimo; Montorsi, Francesco; Rigatti, Patrizio

2014-01-01

354

Necropsy findings in a fetus with a 46,XY,dic t(X;21)(p11.1;p11.1).  

PubMed Central

We report the findings in a fetus terminated because of multiple abnormalities diagnosed on ultrasound, including asymmetry of the limbs, a hypoplastic diaphragm, unilateral duplex kidney with a double ureter, unilateral cystic kidney, and congenital heart disease including total pulmonary atresia. Cytogenetic studies showed an unbalanced translocation of the long arm of the X chromosome to chromosome 21, resulting in a 46,XY,dic t(X;21)(p11.1;p11.1) karyotype. The cytogenetics were confirmed by non-isotopic in situ hybridisation using probes specific to pericentric alphoid repeats. Parental chromosomes were normal indicating this to be a de novo translocation. It is suggested that the inactivation of the long arm of the X chromosome has resulted in an effective monosomy for chromosome 21. Images PMID:1640434

Smith, N M; Fernandez, H; Chambers, H M; Callen, D F

1992-01-01

355

Modern management of stone disease in patients with a solitary kidney  

PubMed Central

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

Tkocz, Micha?; Ziaja, Damian

2011-01-01

356

Urinary bladder incarceration and infarction by an intra-abdominal fat pad in a Virginia opossum (Didelphis virginiana).  

PubMed

A 2.5-year-old, female opossum had acute stranguria. Based on radiography and ultrasonographic examination a cystic structure was identified in the caudal abdomen associated with bilateral hydroureter and hydronephrosis. This structure contained a neutrophilic fluid, determined to be urine. There was a neutrophilic leukocytosis. Serum chemistry values were within normal limits. The opossum was euthanized. An intra-abdominal fat pad incarceration of the urinary bladder above the trigone was present, resulting in complete obstruction of the urinary bladder and partial obstruction of the ureters. Vessels to the bladder were involved in the incarceration which resulted in vascular compromise and infarction of the bladder. Mild to moderate hydroureter and hydronephrosis were present. PMID:15373255

De Voe, Ryan S; Spaulding, Kathy A; Rotstein, Jack; Rotstein, David S

2004-01-01

357

Intestinal type villous adenoma of the renal pelvis  

PubMed Central

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

Hudson, Jill; Arnason, Thomas; Merrimen, Jennifer L.O.; Lawen, Joseph

2013-01-01

358

The induction of rat bladder cancer by 2-naphthylamine  

PubMed Central

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

Hicks, R. M.; Wright, R.; Wakefield, J. St J.

1982-01-01

359

Treatment outcomes of semirigid ureterorenoscopy and intracorporeal lithotripsy in pregnant women with obstructive ureteral calculi.  

PubMed

The purpose of the study is to evaluate the outcomes of semirigid ureterorenoscopy and intracorporeal lithotripsy as a definitive treatment in pregnant women with obstructive ureteral calculi. A retrospective analysis was performed of 16 pregnant patients referred to gynecology department with ureteral obstruction from 2007 to 2009. The mean age was 25 years, and mean gestation period was 30 weeks. Of the 16 patients; 50% had fever, 100% flank pain, 56% dysuria, 25% gross hematuria, 50% positive urine culture, and 75% pyuria and microscopic hematuria. Abdominal ultrasonography was the principle diagnostic test used. The mean stone size was 9.45 mm. Eleven of the 16 patients, 54% had stones located in the distal ureter and 46% proximal ureter. The stones were fragmented using a swiss pneumatic lithoclast through 9.5 F semirigid ureteroscope by 0.035 mm safety guidewire with the patient under general anesthesia. Eleven patients had obstruction due to the ureteral calculi. Eight of 11 patients had complete fragmentation of the calculi by ureteroscopy as a primary treatment. Push-back was performed in the other three patients. By applying Dj catheter, and performing eswl after giving birth, the patient became stone-free. Dj catheter was applied peroperative to all 16 patients. No complications were recorded, and all patients completed the full term of pregnancy. The results of our study have shown that semirigid ureteroscopy to diagnose ureteral calculi and treat them with intracorporeal pneumatic lithotripsy and ureteral stent insertion, as indicated, is the most efficient and definitive treatment modality in pregnant women. PMID:21448707

Polat, Fazl?; Ye?il, Süleyman; K?raç, Mustafa; Biri, Hasan

2011-12-01

360

Efficacy of extracorporeal shockwave lithotripsy using Dornier SII in different levels of ureteral stones  

PubMed Central

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

Elkholy, Mohamed M.; Ismail, Hassan; Abdelkhalek, Mohamed A.; Badr, Mohamad M.; Elfeky, Mohamed M.

2014-01-01

361

Intracorporeal lithotripsy with the holmium:YAG laser  

NASA Astrophysics Data System (ADS)

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.

Denstedt, John D.; Razvi, Hassan A.; Chun, Samuel S.; Sales, Jack L.

1995-05-01

362

Does tamsulosin change the management of proximally located ureteral stones?  

PubMed

The objective of this study is to assess the efficacy of an alpha-1 adrenergic receptor blocking agent on the spontaneous passage of proximal ureteral calculi < or =10 mm. 92 patients having single radio-opaque proximal ureteral stone < or =10 mm were randomized into two groups. Group 1 patients (n = 50) were followed with classical conservative approach and patients in Group 2 (n = 42) additionally received tamsulosin, 0.4 mg/day during 4 weeks follow-up. The stone passage rates, stone expulsion time, VAS score, change in colic episodes, and hospital re-admission rates for colicky pain were compared. The patients were furthermore stratified according to stone diameters <5 and 5-10 mm. The data of these subgroups were also compared. Stone expulsion rates showed statistically significant difference between tamsulosin receivers and non-receivers (35.7 vs 30%, p = 0.04). Time to stone expulsion period was also shortened in those receiving tamsulosin (8.4 +/- 3.3 vs 11.6 +/- 4.1 days, p = 0.015). Likewise, the mean VAS score and renal colic episodes during follow-up period were significantly diminished in Group 2 patients (4.5 +/- 2.3 vs 8.8 +/- 2.9, p < 0.01 and 66.6 vs 36%, p = 0.001, respectively). Among the stones <5 mm, tamsulosin receiving patients had higher spontaneous passage rate (71.4 vs 50%, p < 0.001). The prominent effect of tamsulosin on the 5-10 mm stones was the relocation of the stones to a more distal part of ureter (39.3 vs 18.7%, p = 0.001). Administration of tamsulosin in the medical management of proximal ureteral calculi can facilitate the spontaneous passage rate in the stone <5 mm and the relocation of the stones between 5 and 10 mm to more distal part of the ureter. PMID:20182703

Yencilek, Faruk; Erturhan, Sakip; Canguven, Onder; Koyuncu, Hakan; Erol, Bulent; Sarica, Kemal

2010-06-01

363

Ureteroscope-assisted double-J stenting following laparoscopic ureterolithotomy.  

PubMed

The aim of this study was to examine the feasibility of ureteroscope-assisted double-J stenting following laparoscopic ureterolithotomy and to evaluate the effects of retrograde ureteroscopic access exerted on the sutured ureterotomy site. From January 2002 to December 2011, 30 patients with proximal ureteral stone underwent ureteroscopic double-J stenting of the ureter following retroperitoneal laparoscopic ureterolithotomy. Patient demographics and perioperative parameters, including the degree of hydronephrosis, urine leakage, and drainage time, were retrospectively reviewed. These data were compared with those of 30 consecutive patients who received open ureterolithotomy and intracorporeal ureteral double-J stenting. In addition, a PubMed search was conducted and the related literature on the placement of a ureteral stent was reviewed. Twenty-eight patients successfully underwent ureteral double-J stenting with ureteroscopic access. No malposition of the ureteral stent was identified in the ureteroscopic group, but two patients in the intracorporeal group required postoperative adjustment of the stent. Residual stone fragments were found during stent placement in three patients in the ureteroscopic group and holmium:yttrium-aluminum-garnet laser lithotripsy was immediately performed. There was no significant difference in postoperative outcomes or complication rates between the two groups. Ureteroscope-assisted ureteral double-J stenting is a simple and safe alternative allowing intraluminal navigation along the entire ureter, correct stent placement, and prompt treatment of residual stone fragments, without radiation exposure. In addition, ureteral disruption and urinary extravasation may not be concerns for ureteroscopic access with continuous normal saline irrigation. PMID:24751387

Chen, I-Hsuan; Tsai, Jeng-Yu; Yu, Chia-Cheng; Wu, Tony; Huang, Jong-Khing; Lin, Jen-Tai

2014-05-01

364

Essential fatty acid deficiency reduces the inflammatory cell invasion in rabbit hydronephrosis resulting in suppression of the exaggerated eicosanoid production.  

PubMed

The rabbit hydronephrotic kidney (HNK) is a model of renal inflammation characterized by a marked increase in arachidonic acid metabolism which is temporally associated with an inflammatory cell influx into the injured tissue. The HNK exhibits an exaggerated elaboration of eicosanoids ex vivo in response to inflammatory agonists (bradykinin and the chemotactic peptide, n-formyl-methionyl-leucyl-phenylalanine). Essential fatty acid (EFA) deficiency [i.e., deprivation of (n-6) fatty acids] attenuated markedly the ex vivo elaboration of eicosanoids and prevented the enhancement of the microsomal cyclooxygenase and thromboxane synthase activity associated with 3 days of ureter occlusion. In contrast, postobstructive release prevented the ex vivo elaboration of eicosanoids by the HNK. When the HNK was assessed morphologically by electron microscopy, both EFA deficiency and postobstructive release markedly reduced the population of interstitial macrophages normally seen in the HNK. Apparently, EFA deficiency blocked the influx of macrophages whereas postobstructive release resulted in the efflux of macrophages from the HNK. Because EFA deficiency has been shown to inhibit the synthesis of leukotriene B4, a potential chemotaxin, it was hypothesized that EFA deficiency might prevent the influx of macrophages due to an inhibition of leukotriene B4 synthesis. Indeed, EFA deficiency suppressed the synthesis of this eicosanoid in blood whereas prostaglandin E2 and thromboxane A2 production were unaffected. In summary, this study demonstrates that EFA deficiency prevents the influx of macrophages into the HNK and prevents the enhanced arachidonate metabolism which normally occurs after ureter obstruction. A potential role for leukotriene B4 as a chemotactic agent in this model of renal inflammation also is suggested. PMID:3133463

Spaethe, S M; Freed, M S; De Schryver-Kecskemeti, K; Lefkowith, J B; Needleman, P

1988-06-01

365

Non-canonical Wnt5a/Ror2 signaling regulates kidney morphogenesis by controlling intermediate mesoderm extension.  

PubMed

Congenital anomalies of the kidney and urinary tract (CAKUT) affect about 1 in 500 births and are a major cause of morbidity in infants. Duplex collecting systems rank among the most common abnormalities of CAKUT, but the molecular basis for this defect is poorly understood. In mice, conditional deletion of Wnt5a in mesoderm results in bilateral duplex kidney and ureter formation. The ureteric buds (UBs) in mutants emerge as doublets from the intermediate mesoderm (IM)-derived nephric duct (ND) without anterior expansion of the glial cell line-derived neurotrophic factor (Gdnf) expression domain in the surrounding mesenchyme. Wnt5a is normally expressed in a graded manner at the posterior end of the IM, but its expression is down-regulated prior to UB outgrowth at E10.5. Furthermore, ablation of Wnt5a in the mesoderm with an inducible Cre at E7.5 results in duplex UBs, whereas ablation at E8.5 yields normal UB outgrowth, demonstrating that Wnt5a functions in IM development well before the formation of the metanephros. In mutants, the posterior ND is duplicated and surrounding Pax2-positive mesenchymal cells persist in the nephric cord, suggesting that disruption of normal ND patterning prompts the formation of duplex ureters and kidneys. Ror2 homozygous mutants, which infrequently yield duplex collecting systems, show a dramatic increase in incidence with the additional deletion of one copy of Wnt5a, implicating this receptor in non-canonical Wnt5a signaling during IM development. This work provides the first evidence of a role of Wnt5a/Ror2 signaling in IM extension and offers new insights into the etiology of CAKUT and possible involvement of Wnt5a/Ror2 mutations. PMID:25082826

Yun, Kangsun; Ajima, Rieko; Sharma, Nirmala; Costantini, Frank; Mackem, Susan; Lewandoski, Mark; Yamaguchi, Terry P; Perantoni, Alan O

2014-12-20

366

Shock wave lithotripsy outcomes for lower pole and non-lower pole stones from a university teaching hospital: Parallel group comparison during the same time period  

PubMed Central

Introduction: Shock wave lithotripsy (SWL) is a treatment option for all locations of renal and ureteric stones. We compared the results of SWL for lower pole renal stones with all other non-lower pole renal and ureteric stones during the same time period. Material and Methods: All SWL procedures were carried out as day case procedures by a mobile lithotripter from January 2012 to August 2013. The follow-up imaging was a combination of KUB X-ray or USS. Following SWL treatment, the stone free rate (SFR) was defined as ?3 mm fragments. Results: A total of 148 patients with a mean age of 62 years underwent 201 procedures. Of the 201 procedures, 93 (46%) were for lower pole stones. The non-lower pole stones included upper pole (n = 36), mid pole (n = 40), renal pelvis (n = 10), PUJ (n = 8), mid ureter (n = 3), upper ureter (n = 5) and a combination of upper, middle and/or lower pole (n = 6). The mean stone size for lower pole stones (7.4 mm; range: 4-16 mm) was slightly smaller than non-lower pole stones (8 mm; range: 4-17 mm). The stone fragmentation was successful in 124 (62%) of patients. However, the SFR was statistically significantly better (P = 0.023) for non-lower pole stones 43 (40%) compared to lower pole stones 23 (25%). There were 9 (4%) minor complications and this was not significantly different in the two groups. Conclusions: Although SWL achieves a moderately high stone fragmentation rate with a low complication rate, the SFR is variable depending on the location of stone and the definition of SFR, with lower pole stones fairing significantly worse than stones in all other locations.

Geraghty, Robert; Burr, Jacob; Simmonds, Nick; Somani, Bhaskar K.

2015-01-01

367

Treatment of ureteral calculus obstruction with laser lithotripsy in an Atlantic bottlenose dolphin (Tursiops truncatus).  

PubMed

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

Schmitt, Todd L; Sur, Roger L

2012-03-01

368

The feasibility of ureteral tissue engineering using autologous veins: an orthotopic animal model with long term results  

PubMed Central

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

2014-01-01

369

Efficiency of percutaneous nephrolithotomy in pediatric patients using adult-type instruments.  

PubMed

To evaluate the efficiency of percutaneous nephrolithotomy using adult-type instruments in children with kidney stones. Between September 2004 and October 2009, 18 children (19 renal units) underwent percutaneous nephrolithotomy using adult-type instruments. Following percutaneous access under fluoroscopy, 20-30F tract dilatation was performed (1,92,427F), and lithotripters were used. Postoperatively, kidney-ureter-bladder X-ray and antegrade pyelography were performed to evaluate residual stones and contrast passage to the bladder. 8 boys and 10 girls with a mean age of 9.8 ± 4.56 years were evaluated. Mean stone burden was 338 ± 196.21 mm². Stones were located in the left and right kidneys in 16 (84.2%) and 3 (16.8%) patients, respectively. Horse-shoe kidney was present in one patient. Mean operation (including cystoscopy) and fluoroscopy times were 106 ± 49.60 and 5.2 ± 2.14 min, respectively. Postoperatively, 10(52.6%) patients were stone free and 4 (21.1%) patients had clinically insignificant stones. Saline extravasation developed in three patients and surgery was aborted in one patient. Stone fragments migrated into the ureter in two patients and managed by additional endourological interventions. Nephrostomy catheters were kept for a mean of 2.6 ± 1.12 days. Four patients required blood transfusion due to bleeding. Postoperative fever of <39°C developed in five patients and >39°C in one patient. Mean hospitalization time was 5.3 ± 3.12 days. Overall, 73.7% of our patients were stone free, including patients with clinically insignificant stones. Particularly in children with a high-stone burden, the use of adult-type instruments might have a positive impact on stone-free rate, operation time and fluoroscopy time without increasing the complication rate. PMID:21814769

Dogan, Bayram; Atmaca, Ali Fuat; Canda, Abdullah Erdem; Isgoren, Abidin Egemen; Akbulut, Ziya; Balbay, Mevlana Derya

2012-06-01

370

Uroplakins in Urothelial Biology, Function and Disease  

PubMed Central

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

Wu, Xue-Ru; Kong, Xiang-Peng; Pellicer, Angel; Kreibich, Gert; Sun, Tung-Tien

2013-01-01

371

The Dornier Lithotripter U 30: first clinical experience.  

PubMed

Since August 1993, the Dornier Lithotripter U 30 has been used at the Department of Urology of the Katharinenhospital in Stuttgart. The machine consists of an endourologic table with an X-ray unit mounted on a C-arm and an electromagnetic shockwave source equipped with an inline ultrasound scanner and oblique shockwave coupling with a water cushion. Stone location can be performed with fluoroscopy or simultaneous ultrasound scanning. Until December 1994, 1092 stones had been treated, requiring 1533 sessions: 497 stones (45.5%) were situated in a calix, 426 (39%) in the renal pelvis, 130 (11.9%) in the upper ureter, and 39 (3.6%) in the distal ureter. Auxiliary measures were necessary before SWL in 245 patients (16%): double-J stent placement in 184 patients (12%), percutaneous lithotripsy in 43 patients (2.8%), and percutaneous nephrostomy in 15 patients (1%). The mean number of shockwaves was 3018, ranging from 250 to 3750. The time needed for positioning ranged from 1 to 10 minutes (mean 3 minutes). The mean treatment time was 30.5 minutes (range 10-50 minutes). There were 26 treatments (1.7%) performed without analgetic medication. In 1359 cases (88.6%), analgetics were utilized, and in 108 cases (7.0%), a sedative was added. In 40 patients (2.6%), general anesthesia was necessary. Complete stone disintegration was achieved in 94%. Auxiliary measures after SWL were ureteroscopy in 8.4% and percutaneous nephrostomy in 1.3%. Perirenal hematomas were found in 10 patients (0.6%). Colic pain necessitating analgetic medication was reported by 247 patients (16.1%). Body temperature above 38 degrees C occurred after 20 treatments (1.3%). At 3 months' follow-up, 110 patients of 128 patients (85.9%) were stone free. The Dornier Lithotripter U 30 has proven highly effective for SWL of renal and ureteral stones, radiolucent and radiopaque, and can be used as a full endourologic work-station. PMID:8580932

Schmidt, A; Volz, C; Eisenberger, F

1995-10-01

372

Use of drug therapy in the management of symptomatic ureteric stones in hospitalized adults (SUSPEND), a multicentre, placebo-controlled, randomized trial of a calcium-channel blocker (nifedipine) and an ?-blocker (tamsulosin): study protocol for a randomized controlled trial  

PubMed Central

Background Urinary stone disease is common, with an estimated prevalence among the general population of 2% to 3%. Ureteric stones can cause severe pain and have a significant impact on quality of life, accounting for over 15,000 hospital admissions in England annually. Uncomplicated cases of smaller stones in the lower ureter are traditionally treated expectantly. Those who fail standard care or develop complications undergo active treatment, such as extracorporeal shock wave lithotripsy or ureteroscopy with stone retrieval. Such interventions are expensive, require urological expertise and carry a risk of complications. Growing understanding of ureteric function and pathophysiology has led to the hypothesis that drugs causing relaxation of ureteric smooth muscle, such as the selective ?-blocker tamsulosin and the calcium-channel blocker nifedipine, can enhance the spontaneous passage of ureteric stones. The use of drugs in augmenting stone passage, reducing the morbidity and costs associated with ureteric stone disease, is promising. However, the majority of clinical trials conducted to date have been small, poor to moderate quality and lacking in comprehensive economic evaluation. This trial aims to determine the clinical and cost-effectiveness of tamsulosin and nifedipine in the management of symptomatic urinary stones. Methods/design The SUSPEND (Spontaneous Urinary Stone Passage ENabled by Drugs) trial is a multicentre, double-blind, randomized controlled trial evaluating two medical expulsive therapy strategies (nifedipine or tamsulosin) versus placebo. Patients aged 18 to 65 with a ureteric stone confirmed by non-contrast computed tomography of the kidney, ureter and bladder will be randomized to receive nifedipine, tamsulosin or placebo (400 participants per arm) for a maximum of 28 days. The primary clinical outcome is spontaneous passage of ureteric stones at 4 weeks (defined as no further intervention required to facilitate stone passage). The primary economic outcome is a reduction in the incremental cost per quality-adjusted life years, determined at 12 weeks. The analysis will be based on all participants as randomized (intention to treat). The trial has 90% power with a type I error rate of 5% to detect a 10% increase in primary outcome between the tamsulosin and nifedipine treatment groups. Trial registration ISRCTN69423238; EudraCT number: 2010-019469-26 PMID:24947817

2014-01-01

373

Retrieval methods for urinary stones.  

PubMed

This paper attempts to assess the current status of the various modalities of available treatment for urinary stone disease in the Kerala scenario. A total of 300 patients who attended the stone clinic with urinary stone disease and had stones retrieved by different means were selected for the study. Their clinical symptoms, demographic profile, size, number and position of stones, metabolic profiles, retrieval modalities and end result of treatment in terms of stone clearance were assessed. Instances of failure, incomplete clearance and complication events were noted. Based on the experiences, a flowchart was created for appropriate decision-making in urinary stone management. The modalities of retrieval included nephrectomy, nephrolithotomy, pyelo-nephrolithotomy, extended pyelolithotomy, pyelolithotomy, ureterolithotomy, cystolithotomy, urethrolithotomy, ESWL, PCNL, URS, cystolithotripsy, urethrolithotripsy and spontaneous passage. The clearance rate of stone was maximum in open surgery. The extent of stone clearance by ESWL depended on various factors. PCNL was mostly limited by the difficulties in achieving puncture at the stone site. Availability of a variety of flexible nephroscopes also altered the success rate of the procedure. There were good success rates in pushing stones from the ureter to the pelvis followed by PCNL. In patients who had successful PCNL, postoperative morbidity was significantly reduced in terms of the number of days of hospitalization, time taken for return to work, absence of urinary leak, site infection, urinoma formation and urinary tract infection. URS was performed in many patients and stones retrieved. However, the indication for the procedure remains doubtful as the size of most of the stones thus retrieved was less than 6 mm. These would have passed out spontaneously or with chemotherapeutic support. URS, lithotripsy and basketting were confronted by upward migration of stones to the kidney, requiring further procedures for retrieval. Introduction of double J stents helped in relieving urinary obstruction, particularly in patients presenting with anuria, but retained stents, forgotten stents and failed stone retrieval were common following the procedure. The procedure of URS was simplified by the presence of dilated ureter in spontaneous stone passers or those with distal obstruction and proximal dilatation. It is concluded from the study that open surgery still remains the sheet anchor of treatment of urinary stones in many patients in Kerala. Newer lesser invasive procedures should be ethically selected. Decisions should be patient based, taking into consideration the economic feasibility for the procedure proposed. PMID:19834701

Marickar, Y M Fazil; Nair, Nandu; Varma, Gayathri; Salim, Abiya

2009-12-01

374

In vitro results with special plastics for biodegradable endoureteral stents.  

PubMed

Internal ureteral stents are widely used in urologic practice for temporary urinary diversion, but all double-J catheters to date exhibit the same disadvantage; that is, they have to be removed endoscopically, necessitating further intervention. We tested different materials (designated G100X-15xLB and G100X-20xLB) to develop a biodegradable (biodissolvable) endoureteral stent that can be held in place without functional loss yet could be dissolved by changing the environment. The principle of the biochemical background is based on the physiological milieu of the urine. The plastics tested are stable in acidic and dissolve in alkaline conditions. In a first step, specimens of two polymers were placed in artificial urine of different pH over a period of 60 days and monitored for integrity (solution trial). In a second step, artificial urine was set in motion (744 mL/24 hours) an infusion pump (Volumed microVP 5000; Fresenius AG, Bad Homburg vdH, Germany) through an infusion set in which a 30-cm piece of the materials to test had been placed (ureter model). Below the inserted specimen, the lumen of the infusion tube was minimized to make obstruction by fragments more possible. In the solution trial, all specimens remained stable under physiologic conditions (pH 5.2) over a period of at least 30 days. The specimens dissolved completely when the pH was adjusted to an alkaline one (pH 7.9). In the ureter model, with pH values of 7.9, all specimens were decomposed after 20 hours, and no occlusion of the model occurred. Using acidic artificial urine, the specimens remained stable with a smooth consistent surface. The dissolution was not a standard chemical one; the materials broke into microscopically small pieces, with fragments of G100X-20xLB being smaller than those of G100X-15xLB. Our first in vitro results show that the tested materials are suitable for further development of biodissolvable endoureteral stents, dissolution of which can be steered by changing the urinary pH. PMID:9847069

Schlick, R W; Planz, K

1998-10-01

375

Mechanism of transmission and modulation of renal pain in cats; effects of transcutaneous electrical nerve stimulation on renal pain.  

PubMed

Transcutaneous electrical nerve stimulation (TENS) has widely been employed as a method of obtaining analgesia in medical practice. The mechanisms of pain relief by TENS are known to be associated with the spinal gate control mechanism or descending pain inhibitory system. However, most of the studies concerning the analgesic effects and their mechanisms for TENS have dealt with somatic pain. Thus, in this experiment, we investigated the analgesic effects of TENS on renal pain as a model of visceral pain, and the characteristics of the dorsal horn cells with renal inputs. The renal pain was induced by acute occlusion of the ureter or renal artery. The main results are summarized as follows: 1) The renal nerve was composed of A beta, A delta and C fiber groups; the thresholds for each group were 400-800 mV, 1.1-1.5 V, and 2.1-5.8 V, respectively. 2) The dorsal horn cells tested received A and/or C afferent fibers from the kidney, and the more C inputs the dorsal horn cells had, the greater was the response to the stimuli that elicited the renal pain. 3) 94.9% of cells with renal input had the concomitant somatic receptive fields on the skin; the high threshold (HT) and wide dynamic range (WDR) cells exhibited a greater responses than low threshold (LT) cells to the renal pain-producing stimuli. 4) TENS reduced the C-responses of dorsal horn cells to 38.9 +/- 8.4% of the control value and the effect lasted for 10 min after the cessation of TENS. 5) By TENS, the responses evoked by acute occlusion of the ureter or renal artery were reduced to 37.5 +/- 9.7% and 46.3 +/- 8.9% of the control value, respectively. This analgesic effects lasted 10 min after TENS. 6) The responses elicited by squeezing the receptive fields of the skin were reduced to 40.7 +/- 7.9% of the control value and the effects lasted 15 min after TENS. These results suggest that most of dorsal horn cells with renal inputs have the concomitant somatic inputs and TENS can alleviate the renal pain as well as somatic pain. PMID:7618365

Nam, T S; Baik, E J; Shin, Y U; Jeong, Y; Paik, K S

1995-05-01

376

Effect of vesicoureteric reflux on renal growth in children with urinary tract infection  

PubMed Central

Renal growth was studied for periods ranging from 2 to 22 years (average 9·4) in 70 children who presented between 2 weeks and 12 years of age with urinary tract infection and who were found to have vesicoureteric reflux. They were managed on a conservative regimen of continuous prophylaxis and regular, complete voiding. Renal growth over the entire period of observation was normal in relation to the child's growth in height in 100 of the 111 kidneys originally drained by refluxing ureters. During the time that reflux was known to be still present, renal growth was within normal limits in 101 kidneys. Renal growth was impaired in 11 kidneys. Ten of them were exposed to a recurrence of urinary tract infection. The eleventh child had an unproved symptomatic infection. Seven of these kidneys were also already scarred and 4 had gross reflux. In 2 of these children a fresh scar developed, one in a previously normal kidney. Because of the tendency for reflux to disappear, the renal growth during the first 2 years of observation was also analysed. A significant association was found between impaired growth and, independently, infection and renal scarring. No independent association was found between impaired growth and the severity of reflux. Small kidneys tended to grow at the expected rate. If growth was compared in pairs of kidneys with unilateral reflux, no difference in rate could be found if the kidneys were unscarred, but a significant difference was found if the refluxing ureter drained a scarred kidney; this tended to grow slowly, and the unscarred non-refluxing kidney tended to accelerate in growth. The small group of kidneys which grew least well had established severe scarring associated with severe persisting vesicoureteric reflux and each had a further infection during the period of observation, although no rise in plasma creatinine concentration was observed in any of these children. It is in such children that the results of a controlled comparison of medical and surgical management will be of greatest value. PMID:7271299

Smellie, Jean M; Edwards, David; Normand, I C S; Prescod, Nina

1981-01-01

377

Uretheral invagination of multilocular cystic nephroma; a case report of a new pathologic variant  

PubMed Central

Background: The multilocular cystic nephroma (MLCN) is a unilateral cystic neoplasm of the kidney exhibiting benign biological behavior. The etiology and histopathogenesis of the disease is controversial (dysplastic/hamartomous/neoplastic). MLCNs show bimodal age distribution, with peak incidence occurring at 2-4 years of age and between the fourth and sixth decades. The male to female ratio in patients aged below 4 years is 3:1, which reverses to 1:8 between the fourth and sixth decades. Patients and methods: A 59-year-old female patient presented with left flank pain and abdominal pain. Ultrasound (US) revealed 220×109×82 mm multiple septated hyperechoic kidney cysts with a semi-solid appearance. MRI showed a 245×119×98 mm multilocular cystic renal mass in the left kidney with hypointense appearance in T1-weighted images and hyperintense in T2-weighted images, and multicystic appearance in ureter projection, the largest portion measuring 17 mm in diameter. Radical nephrectomy was planned with the pre-diagnosis of multilocular cystic nephroma or multicystic renal cell carcinoma. Results: The patient underwent transperitoneal radical nephroureterectomy. The immunohistopathological examination revealed MLCN with ureteral invagination. Conclusion: The etiology, pathogenesis, and genetic basis of multilocular cystic nephroma are currently unknown. This tumor is confused with cystic partially differentiated nephroblastoma and cystic Wilms tumor in childhood, and multilocular cystic renal cell carcinoma, clear cell papillary renal cell carcinoma, and tubulocystic carcinoma in adults. The association of this tumor with pleuropulmonary blastoma in children exhibits genetic inheritance. US control is particularly recommended in siblings of these children. Albeit rare, the disease can occur as a bilateral synchronous or metachronous lesion. There are four reports of cases with recurrence in the literature. The laparoscopic partial nephrectomy is the recommended treatment method in patients with sufficient renal reserve that are found to be free of malignancy in the frozen section examination. The symptoms of hematuria and flank pain can be associated with invagination of the cysts into the pelvis and intrarenal rupture of the cysts. The invagination of cysts into the pelvis has been previously described. The authors consider that this was the first case of MLCN in the literature exhibiting invagination into the ureter. PMID:25197409

Ozturk, Hakan; Karaaslan, Serap

2014-01-01

378

Sigmoido-gluteal fistula--a rare complication in clinically asymptomatic chronic diverticulitis.  

PubMed

Chronic colonic diverticulitis may be associated with typical complications such as local abscesses, stenosis, bleeding, intraperitoneal bowel perforations or fistulas to other organs. Most commonly, fistulas exist between the colon and the bladder; nevertheless, they may also extend to the small intestine, other areas of the colon, ureter, uterus, salpinx, vagina, abdominal wall, portal- and mesenterial venous system, pleura, urachus, biliary system and the hip. We report on a patient with chronic colonic diverticulitis having an unusual sigmoido-gluteal fistula along the sacrum, the piriformis muscle and sciatic nerve. The patient presented with sciatic nerve symptoms and recurrent gluteal abscess formation, but no other clinical symptoms leading to an abdominal pathology. Initially, that fact caused an unsuccessful local treatment under the differential diagnosis of a local gluteal abscess for about a year. Finally, a sigmoid colon resection with end-to-end anastomosis and a proximal diverting stoma was performed. The colostomy was closed electively five months later without any complication. PMID:21954740

Fehmer, T; Citak, M; Schildhauer, T A

2011-01-01

379

Urothelial signaling.  

PubMed

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

Birder, Lori; Andersson, Karl-Erik

2013-04-01

380

Axial Wall Motion can have a Dramatic Effect on Peristaltic Pumping Force  

NASA Astrophysics Data System (ADS)

The classic models of peristaltic pumping apply the lubrication theory approximations, where inertia and axial velocity gradients in the frictional force are neglected. Another approximation, generally made without comment, is purely radial motion of wall particles during peristalsis. In reality, small axial motions occur either from local elongation of material elements or, in muscle-driven systems such as the ureter and GI tract, by active local shortening of longitudinal muscle. We have studied the effects of local axial motion on peristaltic pumping by generalizing the surface boundary condition in lubrication models, and through an asymptotic theory for axially driven peristalsis with small radial wall deformations. The asymptotic theory predicts that peristalsis driven by axial wall motion induces local circulatory flow much lower in strength than the primary flow driven by radial peristaltic deformations. Thus, the effect on pumping is negligible. However, the generalized model shows that the contractile force required to maintain radial peristaltic deformations are dramatically influenced by even low levels of local axial peristaltic motion coordinated with radial peristalsis. In particular, the "closure pressure' can be reduced by over 50relatively little axial motion. The implications to muscle-induced peristalsis in the human body can be profound. *Supported by NIH

Schiffner, Bj; Pal, A.; Brasseur, Jg

2003-11-01

381

Use of the holmium:YAG laser in urology.  

PubMed

The tissue effects of a holmium:YAG (Ho:YAG) laser operating at a wavelength of 2.1 mu with a maximum power of 15 watts (W) and 10 different energy-pulse settings was systematically evaluated on kidney, bladder, prostate, ureteral, and vasal tissue in the dog. In addition, various urologic surgical procedures (partial nephrectomy, transurethral laser incision of the prostate, and laser-assisted vasovasostomy) were performed in the dog, and a laparoscopic pelvic lymph node dissection was carried out in a pig. Although the Ho:YAG laser has a strong affinity for water, precise tissue ablation was achieved in both the contact and non-contact mode when used endoscopically in a fluid medium to ablate prostatic and vesical tissue. Using the usual parameters for tissue destruction (blanching without charring), the depth of thermal injury in the bladder and ureter was kept superficial. In performing partial nephrectomies, a 2-fold reduction in the zone of coagulative necrosis was demonstrated compared to the use of the continuous wave Neodymium:YAG laser (Nd:YAG). When used through the laparoscope, the Ho:YAG laser provided precise cutting and, combined with electrocautery, allowed the dissection to proceed quickly and smoothly. Hemostatic control was adequate in all surgical procedures. Although the results of these investigations are preliminary, our initial experience with the Ho:YAG laser has been favorable and warrants further investigations. PMID:1386643

Johnson, D E; Cromeens, D M; Price, R E

1992-01-01

382

Retroperitoneal fibrosis: role of imaging in diagnosis and follow-up.  

PubMed

Retroperitoneal fibrosis (RPF) encompasses a range of diseases characterized by proliferation of aberrant fibroinflammatory tissue, which usually surrounds the infrarenal portion of the abdominal aorta, inferior vena cava, and iliac vessels. This process may extend to neighboring structures, frequently entrapping and obstructing the ureters and eventually leading to renal failure. The idiopathic form of RPF accounts for more than two-thirds of cases; the rest are secondary to factors such as drug use, malignancies, or infections. If promptly diagnosed and treated, idiopathic and most other benign forms of RPF have a good prognosis. In contrast, malignant RPF, which accounts for up to 10% of cases, has a poor prognosis. Therefore, the most important diagnostic challenge is differentiation of benign from malignant RPF. Imaging plays a key role in diagnosis of RPF. Cross-sectional imaging studies, particularly multidetector computed tomography (CT) and magnetic resonance (MR) imaging, are considered the imaging modalities of choice. Imaging features may help distinguish between benign and malignant RPF, but in some cases histopathologic examination of the retroperitoneal tissue is needed for definitive diagnosis. CT and MR imaging, along with positron emission tomography with fluorine 18 fluorodeoxyglucose, also play an important role in management and follow-up of idiopathic RPF. PMID:23479712

Caiafa, Rafael Oliveira; Vinuesa, Ana Sierra; Izquierdo, Rafael Salvador; Brufau, Blanca Paño; Ayuso Colella, Juan Ramón; Molina, Carlos Nicolau

2013-01-01

383

Predictive Value of Clinicopathological Markers for the Metachronous Bladder Cancer and Prognosis of Upper Tract Urothelial Carcinoma  

PubMed Central

Upper tract urothelial carcinoma (UTUC) is rare but aggressive with poor prognosis. We aimed to find effective predictive markers for recurrence and prognosis in UTUC patients. In this retrospective study, we included 88 UTUC patients treated with radical neprhoureterectomy (RNU) and analyzed their clinicopathological parameters. For study of incidence of metachronous bladder tumor, models were adjusted with inclusion of prophylactic intravesical instillation chemotherapy. The mean follow-up was 28.59 months (2 to 82 mo). Lack of gross hematuria (RR 0.060, 95%CI 0.008–0.468), tumor located at ureter (RR 0.037, 95%CI 0.004–0.378), advanced stage and higher p53 expression were independent factors for worse survival. Recurrence of bladder cancer occurred 20% of patients at median follow-up of 37.65 months (5 to 82 mo). Higher tumor grade (RR 5.998, 95%CI 1.359–26.479) and presence of ipsilateral non-functioning kidney at diagnosis (RR 5.982, 95%CI 1.338–26.750) were predictors for recurrence. The present study identified several parameters with predictive value in the prognosis and intravesicle recurrence in UTUCand shed light on the better monitoring and management of the disease. PMID:24500328

Feng, Chenchen; Wang, Lujia; Ding, Guanxiong; Ding, Qiang; Zhou, Zhongwen; Jiang, Haowen; Wu, Zhong

2014-01-01

384

Smooth muscle cell calcium activation mechanisms  

PubMed Central

Smooth muscle cell (SMC) contraction is controlled by the Ca2+ and Rho kinase signalling pathways. While the SMC Rho kinase system seems to be reasonably constant, there is enormous variation with regard to the mechanisms responsible for generating Ca2+ signals. One way of dealing with this diversity is to consider how this system has been adapted to control different SMC functions. Phasic SMCs (vas deferens, uterus and bladder) rely on membrane depolarization to drive Ca2+ influx across the plasma membrane. This depolarization can be induced by neurotransmitters or through the operation of a membrane oscillator. Many tonic SMCs (vascular, airway and corpus cavernosum) are driven by a cytosolic Ca2+ oscillator that generates periodic pulses of Ca2+. A similar oscillator is present in pacemaker cells such as the interstitial cells of Cajal (ICCs) and atypical SMCs that control other tonic SMCs (gastrointestinal, urethra, ureter). The changes in membrane potential induced by these cytosolic oscillators does not drive contraction directly but it functions to couple together individual oscillators to provide the synchronization that is a characteristic feature of many tonic SMCs. PMID:18787034

Berridge, Michael J

2008-01-01

385

Bilateral ureteral obstruction revealing a benign prostatic hypertrophy: a case report and review of the literature  

PubMed Central

Introduction Prostatic hyperplasia is the most frequent tumor in men older than 50 years of age. Bilateral hydronephrosis secondary to benign prostatic hypertrophy is a rare condition most often due to vesicoureteral reflux. Herein we report a case of a patient with bilateral hydronephrosis with distal ureter obstruction caused by detrusor hypertrophy due to prostatic hyperplasia, our analysis of the clinical data and a review of the relevant published literature. Case presentation We report a case of a 65-year-old Berber man with clinically significant storage, bladder-emptying symptoms and bilateral low back pain with renal biologic failure and bilateral ureterohydronephrosis, distal ureteral stenosis, detrusor hypertrophy and prostate hyperplasia without significant post-void residual urine volume visualized by abdominal sonography. The patient underwent bilateral JJ stent insertion with transurethral resection of the prostate. The patient was discharged 3 days after surgery without any obvious complications. At his 3-month follow-up examination, the JJ stent was removed and the patient had comfortable urination without renal failure. Conclusion This is an extremely rare condition that has important diagnostic considerations because of the possibility of comorbid severe obstructive uropathy and chronic renal failure. PMID:24513237

2014-01-01

386

A Biomechanical Model of Artery Buckling  

PubMed Central

The stability of arteries under blood pressure load is essential to the maintenance of normal arterial function and the loss of stability can lead to tortuosity and kinking that are associated with significant clinical complications. However, mechanical analysis of arterial bent buckling is lacking. To address this issue, this paper presents a biomechanical model of arterial buckling. Using a linear elastic cylindrical arterial model, the mechanical equations for arterial buckling were developed and the critical buckling pressure was found to be a function of the wall stiffness (Young’s modulus), arterial radius, length, wall thickness, and the axial strain. Both the model equations and experimental results demonstrated that the critical pressure is related to the axial strain. Arteries may buckle and become tortuous due to reduced (sub-physiological) axial strain, hypertensive pressure, and a weakened wall. These results are in accordance with, and provide a possible explanation to the clinical observations that these changes are the risk factors for arterial tortuosity and kinking. The current model is also applicable to veins and ureters. PMID:17689541

Han, Hai-Chao

2010-01-01

387

Tomographic quantification of branching morphogenesis and renal development.  

PubMed

Branching morphogenesis is a central process in renal development, but imaging and quantifying this process beyond early organogenesis presents challenges due to growth of the kidney preventing ready imaging of the complex structures. Current analysis of renal development relies heavily on explant organ culture and visualization by confocal microscopy, as a more developmentally advanced native tissue is too thick for conventional microscopic imaging. Cultured renal primordia lack vascularization and a supportive matrix for normal growth, resulting in tissue compression and distortion of ureteric branching. To overcome this, we used optical projection tomography to image and reconstruct the branching ureter epithelium of ex vivo embryonic kidneys and developed software to quantify these three-dimensional (3D) data. Ureteric branching was assessed by measuring tree and terminal branch length, tip number, branching iterations, branch angles, and inter-tip distances in 3D space. To validate this approach for analyzing genetic influences on renal development, we assessed branching and organ morphology in Tgfbeta2(+/-) embryos from E12.5 through E15.5. We found decreased branching, contrary to previous findings using organ culture, and quantified a primary defect in renal pelvic formation. Our approach offers many advantages from improved throughput, analysis, and observation of in vivo branching states, and has demonstrated its utility in studying the basis of renal developmental disease. PMID:20200502

Short, Kieran M; Hodson, Mark J; Smyth, Ian M

2010-06-01

388

The usefulness of stone density and patient stoutness in predicting extracorporeal shock wave efficiency: Results in a North African ethnic group  

PubMed Central

Introduction: We determine the role of stone density and skin-to-stone distance (SSD) by non-contrast computed tomography of the kidneys, ureters and bladder (CT-KUB) in predicting the success of extracorporeal shock wave lithotripsy (ESWL). Methods: We evaluated 89 patients who received ESWL for renal and upper ureteric calculi measuring 5 to 20 mm, over a 12-month period. The mean stone density in Hounsfield units (HU) and mean SSD in mm was determined on pre-treatment CT-KUB at the CT workstation. ESWL was successful if post-treatment residual stone fragments were ?3 mm. Results: ESWL success was observed in 68.5% of patients. Mean stone densities were 505 ± 153 and 803 ± 93 HU in the ESWL successful and failure groups, respectively (p < 0.001, student’s t-test). The mean SSD were 10.6 ± 2.0 and 11.2 ± 2.6 cm in ESWL successful and failure groups, respectively; this was not statistically significant. Conclusions: This study shows that stone density can help to predict the outcome of ESWL. We propose that stone density <500 HU are highly likely to result in successful ESWL. Conversely, stone densities >800 HU are less likely to be successful. PMID:25210567

Abdelaziz, Hamdoune; Elabiad, Yassine; Aderrouj, Ilyas; Janane, Abdellatif; Ghadouane, Mohamed; Ameur, Ahmed; Abbar, Mohamed

2014-01-01

389

From the archives of the AFIP: Inflammatory and nonneoplastic bladder masses: radiologic-pathologic correlation.  

PubMed

Although the vast majority of bladder tumors are epithelial neoplasms, a variety of nonneoplastic disorders can cause either focal bladder masses or diffuse mural thickening and mimic malignancy. Some of these entities are rare and poorly understood such as inflammatory pseudotumor, which produces ulcerated, bleeding polypoid bladder masses. These masses may be large and have an extravesical component. Bladder endometriosis manifests as submucosal masses with characteristic magnetic resonance imaging features consisting of hemorrhagic foci and reactive fibrosis. Nephrogenic adenoma has no typical features, and pathologic evaluation is required for diagnosis. Although imaging features of malacoplakia are also nonspecific, characteristic Michaelis-Gutmann bodies are found at pathologic evaluation. The various types of cystitis (cystitis cystica, cystitis glandularis, and eosinophilic cystitis) require pathologic diagnosis. Bladder infection with tuberculosis and schistosomiasis produces nonspecific bladder wall thickening and ulceration in the acute phase and should be suspected in patients who are immunocompromised or from countries where these infections are common. The diagnosis of chemotherapy cystitis and radiation cystitis should be clinically evident, but imaging may be used to determine severity and to assess complications. Extrinsic inflammatory diseases such as Crohn disease and diverticulitis may be associated with fistulas to the bladder and focal bladder wall abnormality. The extravesical findings allow the diagnosis to be made easily. Finally, extrinsic masses arising from the prostate or distal ureter may cause filling defects, which can be confused with intrinsic bladder masses. PMID:17102055

Wong-You-Cheong, Jade J; Woodward, Paula J; Manning, Maria A; Davis, Charles J

2006-01-01

390

Primary paraganglioma of seminal vesicle?  

PubMed Central

INTRODUCTION Paragangliomas are rare tumors arising from neural crest tissue located outside the adrenal gland. Primary seminal vesicle paraganglioma is extremely rare entity. PRESENTATION OF CASE A 26-year-old male patient presented with symptoms and signs of acute appendicitis where a CT of abdomen and pelvis showed an inflamed appendix and incidental finding of left seminal vesicle mass. The patient underwent uneventful laparoscopic appendectomy followed by transrectal ultrasound (TRUS) guided seminal vesicle biopsies. Histopathology revealed a neuroendocrine neoplasm consistent with paraganglioma. Surgical excision of the left seminal vesicle was carried out. DISCUSSION Paraganglioma of genitourinary tract is rare. The urinary bladder is the most common site, followed by the urethra, pelvis and ureter. Seminal vesicle paragangliomas were reported in association with other genitourinary organ involvement such as bladder and prostate. Isolated seminal vesicle paraganglioma is extremely rare and surgical excision remains the standard treatment for localized paraganglioma. CONCLUSION Primary tumors of seminal vesicle are rare and represent a diagnostic challenge. Differential diagnosis includes a list of benign and malignant tumors. Primary seminal vesicle paraganglioma is a rare but important diagnosis to be included in the differential diagnosis. PMID:23959408

Alharbi, Badr; Al-Ghamdi, Abdullah

2013-01-01

391

Nanoparticles for urothelium penetration and delivery of the histone deacetylase inhibitor belinostat for treatment of bladder cancer  

PubMed Central

Nearly 40% of patients with non-invasive bladder cancer will progress to invasive disease despite locally-directed therapy. Overcoming the bladder permeability barrier (BPB) is a challenge for intravesical drug delivery. Using the fluorophore coumarin (C6), we synthesized C6-loaded poly(lactide-co-glycolide) (PLGA) nanoparticles (NPs), which were surface modified with a novel cell penetrating polymer, poly(guanidinium oxanorbornene) (PGON). Addition of PGON to the NP surface improved tissue penetration by 10-fold in intravesically-treated mouse bladder and ex vivo human ureter. In addition, NP-C6-PGON significantly enhanced intracellular uptake of NPs compared to NPs without PGON. To examine biological activity, we synthesized NPs that were loaded with the histone deacetylase (HDAC) inhibitor belinostat (NP-Bel-PGON). NP-Bel-PGON exhibited a significantly lower IC50 in cultured bladder cancer cells, and sustained hyperacetylation, when compared to unencapsulated belinostat. Xenograft tumors treated with NP-Bel-PGON showed a 70% reduction in volume, and a 2.5-fold higher intratumoral acetyl-H4, when compared to tumors treated with unloaded NP-PGON. PMID:23764660

Martin, Darryl T.; Hoimes, Christopher J.; Kaimakliotis, Hristos Z.; Cheng, Christopher J.; Zhang, Ke; Liu, Jingchun; Wheeler, Marcia A.; Kelly, W. Kevin; Tew, Greg N.; Saltzman, W. Mark; Weiss, Robert M.

2013-01-01

392

The Role of Ureteral Stents for All Ureteroneocystostomies in Kidney Transplants  

PubMed Central

Background: Despite significant advancements in renal transplantation, certain basic surgical practices such as the routine use of ureteral stents (US) remain controversial. A recent met-analysis of ureteral stenting concluded that the routine use of US resulted in improved outcomes. In contrast, the indiscriminate use of US can lead to adverse complications. Objective: To better define this question, we reviewed our single center experience in which US were placed selectively. Methods: 301 patients were eligible to be enrolled. 55 living donor and 246 deceased-donor charts were analyzed for donor and recipient clinical characteristics, immunosuppressive therapy and outcomes. Results: 28 US were placed for either small bladder capacity (n=7), unhealthy appearing bladder tissue (n=8) or for an uncertain vascular supply to the ureter (n=13). Patients with US did not develop urinary leaks, 8 (28%) developed complications including obstruction, encrustation, and urinary tract infections. 12 (4.3%) non-stented patients developed a clinically significant urinary leak. Risk factors for urinary leaks included dual and en-bloc pediatric donor kidney transplants, extended criteria donors and the use of single U stitch technique for ureteral anastomoses. Conclusion: Our results demonstrate that the majority of patients can be successfully transplanted without the routine use of US. Selective use of US should be reserved for high-risk situations. PMID:25013597

Laftavi, M. R.; Chaudhry, Q.; Kohli, R.; Feng, L.; Said, M.; Paolini, K.; Dayton, M.; Pankewycz, O.

2011-01-01

393

Laparoscopic surgery in endometriosis.  

PubMed

Endometriosis (the presence of endometrial glands and stroma outside of the uterine cavity) is a common gynecologic problem affecting 10% of women in the general population, 40% of women with infertility and 60% of women with chronic pelvic pain. Laparoscopy has revolutionized management of women with endometriosis. Diagnosis of endometriosis depends on visualization of endometriotic lesions and histologic confirmation. Endometriotic implants have a multitude of appearances: powder burns, red, blue-black, yellow, white, clear vesicular and peritoneal windows. Diagnostic laparoscopy is often combined with operative procedures to treat manifestations and symptoms of endometriosis. This often includes removal or laser vaporization of endometriotic implants, lysis of adhesions, restoration of normal anatomy and removal or fulguration of ovarian endometriomas (conservative surgery). Severe incapacitating endometriosis, recurrent endometriosis following conservative surgery and symptomatic endometriosis in women not desiring more children is often treated by laparoscopic unilateral or bilateral salpingo-oophorectomy or laparoscopically-assisted vaginal hysterectomy with bilateral salpingo-oophorectomy (radical surgery). Endometriosis affecting the appendix, ureters, bladder wall and rectosigmoid colon could be treated with laparoscopic appendectomy, excision of endometriotic implants or laparoscopic colectomy and anastomosis, respectively. Hydrodis-section and use of CO2 super pulsed laser aid in removal of adherent endometriotic implants without damage to normal underlying structures. Robotic-assisted laparoscopic surgery promises to provide advantages in the management of women with severe endometriosis secondary to 3-dimensional visualization, decreasing surgeon's fatigue and hand tremors and improving surgical precision. PMID:18560348

Eltabbakh, G H; Bower, N A

2008-08-01

394

Pathophysiology of kidney, gallbladder and urinary stones treatment with herbal and allopathic medicine: A review  

PubMed Central

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.

Alok, Shashi; Jain, Sanjay Kumar; Verma, Amita; Kumar, Mayank; Sabharwal, Monika

2013-01-01

395

Optically triggered solid state driver for shock wave therapy  

NASA Astrophysics Data System (ADS)

Shock wave lithotripsy (SWL) represents one of several first-line therapies for the treatment of stones located in the kidneys and ureters. Additional applications for shock wave therapy are also under exploration, including non-urinary calculi, orthopedics, and neovascularization. Except for the elimination of a large water bath in which the treatment is performed, current procedures remain largely unchanged, with one of the original commercial devices (the Dornier HM3) still considered a gold standard for comparison. To accelerate research in this area, Coleman, et al. published an experimental electrohydraulic shock wave generator capable of simulating the acoustic field generated by the HM3. We propose a further update of this system, replacing the triggered spark gap with an optically triggered solid state switch. The new system has better reliability, a wider operating range, and reduced timing jitter allowing synchronization with additional acoustic sources under exploration for improving efficacy and reducing injury. Originally designed for exciting electrohydraulic spark electrodes, the system can also be adapted for driving piezoelectric and electromagnetic sources.

Duryea, Alexander P.; Roberts, William W.; Cain, Charles A.; Hall, Timothy L.

2012-10-01

396

Rat Urinary Bladder Carcinogenesis by Dual-Acting PPAR? + ? Agonists  

PubMed Central

Despite clinical promise, dual-acting activators of PPAR? and ? (here termed PPAR?+? agonists) have experienced high attrition rates in preclinical and early clinical development, due to toxicity. In some cases, discontinuation was due to carcinogenic effect in the rat urothelium, the epithelial layer lining the urinary bladder, ureters, and kidney pelvis. Chronic pharmacological activation of PPAR? is invariably associated with cancer in rats and mice. Chronic pharmacological activation of PPAR? can in some cases also cause cancer in rats and mice. Urothelial cells coexpress PPAR? as well as PPAR?, making it plausible that the urothelial carcinogenicity of PPAR?+? agonists may be caused by receptor-mediated effects (exaggerated pharmacology). Based on previously published mode of action data for the PPAR?+? agonist ragaglitazar, and the available literature about the role of PPAR? and ? in rodent carcinogenesis, we propose a mode of action hypothesis for the carcinogenic effect of PPAR?+? agonists in the rat urothelium, which combines receptor-mediated and off-target cytotoxic effects. The proposed mode of action hypothesis is being explored in our laboratories, towards understanding the human relevance of the rat cancer findings, and developing rapid in vitro or short-term in vivo screening approaches to faciliate development of new dual-acting PPAR agonist compounds. PMID:19197366

Oleksiewicz, Martin B.; Southgate, Jennifer; Iversen, Lars; Egerod, Frederikke L.

2008-01-01

397

Lipocalin 2 Imparts Selective Pressure on Bacterial Growth in the Bladder and Is Elevated in Women with Urinary Tract Infection  

PubMed Central

Competition for iron is a critical component of successful bacterial infections, but the underlying in vivo mechanisms are poorly understood. We have previously demonstrated that lipocalin 2 (LCN2) is an innate immunity protein that binds to bacterial siderophores and starves them for iron, thus representing a novel host defense mechanism to infection. In the present study we show that LCN2 is secreted by the urinary tract mucosa and protects against urinary tract infection (UTI). We found that LCN2 was expressed in the bladder, ureters, and kidneys of mice subject to UTI. LCN2 was protective with higher bacterial numbers retrieved from bladders of Lcn2-deficient mice than from wild-type mice infected with the LCN2-sensitive Escherichia coli strain H9049. Uropathogenic E. coli mutants in siderophore receptors for salmochelin, aerobactin, or yersiniabactin displayed reduced fitness in wild-type mice, but not in mice deficient of LCN2, demonstrating that LCN2 imparts a selective pressure on bacterial growth in the bladder. In a human cohort of women with recurrent E. coli UTIs, urine LCN2 levels were associated with UTI episodes and with levels of bacteriuria. The number of siderophore systems was associated with increasing bacteriuria during cystitis. Our data demonstrate that LCN2 is secreted by the urinary tract mucosa in response to uropathogenic E. coli challenge and acts in innate immune defenses as a colonization barrier that pathogens must overcome to establish infection. PMID:25398327

Steigedal, Magnus; Marstad, Anne; Haug, Markus; Damås, Jan K.; Strong, Roland K.; Roberts, Pacita L.; Himpsl, Stephanie D.; Stapleton, Ann; Hooton, Thomas M.; Mobley, Harry L. T.; Hawn, Thomas R.

2014-01-01

398

Retroperitoneal laparoscopic technique in treatment of complex renal stones: 75 cases  

PubMed Central

Background In most hospitals, several options for the management of renal stones are available: shockwave lithotripsy, endourologic treatment, or surgery. Choice of treatment is based on the anatomic characteristics of the patient, and the location and size of the stones. In this study we assessed a retroperitoneal laparoscopic technique for treatment of complex renal stones. Methods Seventy-five patients, including 53 men and 22 women with a mean age of 47.8 years (range 18–74 y), underwent retroperitoneal laparoscopy for the treatment of complex renal stones between July 2006 and November 2012 in our hospital. Results The retroperitoneal laparoscopic procedures for treatment of complex renal stones were completely successful in 73 cases, while 2 cases converted to open surgery. The operative time was 85–190 min with a mean of 96 min. The estimated blood lost was 20–400 mL with a mean of 80 mL. After the operation 7 patients experienced urinary leakage. Ultrasonography, x-ray of the kidney, ureter and bladder, and intravenous urography were reviewed at post-procedural follow-up at 6–82 months. No hydronephrosis aggravation was found, and there was no calculus recurrence. Conclusion The merits of retroperitoneal laparoscopy for the treatment of complex renal stones include sparing the nephron, less bleeding, short hospitalization, quick postoperative recovery, and controllable procedure after training Success depends on the experience of surgeons and judicious selection of cases. PMID:24491207

2014-01-01

399

Renal function, protein excretion, and pathology of Balkan endemic nephropathy. III. Light and electron microscopic studies.  

PubMed

This study was performed to evaluate histomorphological features of BEN in 50 kidney biopsies from patients who met the epidemiologic, clinical and laboratory criteria for BEN. This is the first such study reported in detail. The patients were divided into three groups based on the DTPA clearance values: group 1, greater than 99 ml/min, group 2, 51 to 99 ml/min, and group 3, 29 to 50 ml/min. All patients in all groups had an increase in proteinuria consisting of proteins less than 25,000 daltons. Multifocal interstitial sclerosis spreading from the superficial into the deep cortex was found in 49 (98%), tubular atrophy in 48 (96%), and global glomerular sclerosis with microvascular hyalinosis/sclerosis of sclerotic and atrophic changes were significantly increased when compared to age-related standards. An accelerated aging process may be assumed to occur in BEN. More peculiar additional findings with much lower incidence and extent included multifocal vascular and glomerular capillary changes resembling the chronic form of thrombotic microangiopathy group of diseases. These findings, together with the presence of arteriolar hyalinosis and tubulointerstitial sclerosis seen in patients with cyclosporine nephrotoxicity suggest that the mechanism of toxicity may be similar to BEN. We conclude that the histopathology is predominantly tubulointerstitial sclerosis without infiltrates. The combination of the histology, tubular proteinuria, geographic distribution, familial occurrence, and the remarkable association with papillary transitional cell carcinoma of the renal pelvis and ureters, qualifies BEN as a unique disease. PMID:1762337

Ferluga, D; Hvala, A; Vizjak, A; Trnacevi?, S; Halilbasi?, A

1991-11-01

400

Sciaticum majus foramen and sciaticum minus foramen as the path of SWL in the supine position to treat distal ureteral stone.  

PubMed

The purpose of the study is to evaluate the efficacy and safety of shock wave lithotripsy (SWL) using sciaticum majus foramen and sciaticum minus foramen as the path to treat distal ureteral stone in supine position. Between December 2006 and November 2008, 243 cases of distal urinary calculi were treated in our department using SWL or ureteroscopy. 189 cases for SWL were treated in supine position. The shockwave target on the stone in distal ureter via sciaticum majus foramen and sciaticum minus foramen, avoiding the sacroiliac joint. 54 cases were underwent ureteroscopy combined with holmium:YAG laser lithotripsy. The stone-free rate and the efficacy quotient (EQ) for SWL and ureteroscopy was 81.5%, 0.68; 94.4%, 0.78; respectively (p = 0.02). The retreatment rate for SWL and ureteroscopy was 14.6%, 0, respectively. The number of the shocks ranged from 600 to 3,000 (mean 2,566.3 ± 378.8). The energy per pulse of SWL ranged from 8 to 12 kV (mean 10.7). SWL in the supine position using sciaticum majus foramen and sciaticum minus foramen as the path is a choice of the treatment of distal ureteral stones with an excellent success rate and low side effect. PMID:20625895

Lu, Jianlin; Sun, Xizhao; He, Lei

2010-12-01

401

Does a Retrograde Pyelography prior to Ureteroscopy Influence Stone-Free Rates and Complication Rates in Ureteral Calculi.  

PubMed

Objectives: To evaluate the impact of retrograde pyelography (RPG) in patients treated with ureteroscopy (URS) for ureteral calculi. Methods: Retrospective analysis of patients treated with and without RPG prior to URS at a single institution from 2010 to 2013. Assessment of stone-free rates and intraoperative complications. Results: Out of 469 URS, 211 (45%) were done with and 258 (55%) without RPG. Complete stone removal was achieved in 86.8% without RPG compared to 73% with RPG (p = 0.0001). Partial stone removal rates were similar in both groups (p = 0.77). Stone removal was not achieved in 9.3 vs. 22.7% (p = 0.0001), with concordant findings in the distal (7.4 vs. 16.9%, p = 0.007) and the proximal ureter (14.5 vs. 38.6%, p = 0.002). Patients with RPG had a threefold higher chance of an unsuccessful URS (OR 3.05, 1.71-5.43, p < 0.0001) and were less likely of having a complete stone removal (OR 0.37, 0.22-0.61, p < 0.0001). Ureteral avulsions (0%) and ureteral perforation rates were similar (4.7 vs. 3.8%, p = 0.65). Conclusions: Patients treated with an RPG prior to URS had significantly inferior stone-free rates. RPG was identified as an independent risk factor for inferior results. RPG neither facilitates nor diminishes complication rates during URS. © 2014 S. Karger AG, Basel. PMID:25170788

Seklehner, Stephan; Heißler, Ortwin; Engelhardt, Paul F; Riedl, Claus

2014-08-23

402

The Effect of Tamsulosin, an Alpha-1 Receptor Antagonist as a Medical Expelling Agent in Success Rate of Ureteroscopic Lithotripsy  

PubMed Central

Background: Tamsulosin is an ?-1A-specific blocker which induces selective relaxation of ureteral smooth muscle with subsequent inhibition of ureteral spasms and dilatation of the ureteral lumen and facilitates stone expelling. Objectives: In this study we aimed to assess the efficacy of tamsulosin for improving the success rate of ureteroscopic lithotripsy (URS) for lower ureteral stones. Patients and Methods: In a prospective study by a randomized controlled clinical trial, which was performed from June 2008 to December 2010, we enrolled one hundred and forty-two subjects and eventually 102 patients completed the clinical trial. All the patients underwent ureteroscopic lithotripsy with the pneumatic wolf lithotripsy. The patients were randomly divided into 2 groups: the study group including 52 patients, received tamsulosin with our traditional treatment (hydration and analgesic when required), and the control group with 50 patients who received placebo with traditional treatment. The number of colic episodes, lower urinary tract symptoms, analgesic dosage, and days of spontaneous passage of the stones through the ureter were recorded in a diary after lithotripsy. Results: The results showed that tamsulosin treatment group had low expulsion time (P = 0.011), low urinary tract symptoms, least analgesic needs and low adverse effects, all with statistically significant differences comparable with the control group (P < 0.05). Conclusions: Administration of ?-1A-specific blocker reduced analgesic dosage and colic episodes and rate of adverse effects after ureteroscopic lithotripsy of lower ureteral stones and decreased gravel expulsion time after URSL. PMID:24719805

Ketabchi, Ali Asghar; Mehrabi, Soha

2013-01-01

403

Is high diuresis an important prerequisite for successful SWL-disintegration of ureteral stones?  

PubMed

A randomised comparison was made between high and normal diuresis during the primary session of extracorporeal shock wave lithotripsy (SWL) for removal of ureteral stones. High diuresis was accomplished by pressure infusion of approximately 1 L of Ringer acetate solution together with 20 mg of furosemide during the 30-40 min treatment session (Group D). These patients also had a bladder catheter. Patients in Group 0 had a normal diuresis and no bladder catheter. The mean (SD) number of treatment sessions for the 65 patients in Group D were 1.26 (0.51) and for the 60 patients from Group 0 1.35 (0.84) [p > 0.10]. 51 (78%) and 46 (77%) patients in Group D and Group 0, respectively, required only one SWL session. Stones were located in the proximal, mid and distal ureter in 22, 9, and 29 of the patients in Group D and in 22, 5, and 38 in Group 0. No difference in treatment outcome was observed with regard to stone localisation. The stone treatment index (STI(GR)) calculated for Group D and Group 0 were 4.77 and 4.70, respectively. In conclusion there was no obvious advantage of using a forced diuresis during the primary SWL-session for treating patients with ureteral stones. Although a high diuresis and bladder catheter might be beneficial in certain complicated cases, in most situations it seems appropriate to omit this step. PMID:19997723

Tiselius, Hans-Göran; Aronsen, Trine; Bohgard, Stina; Fredriksson, Marita; Jonason, Elsie-Marie; Olsson, Monica; Sjöström, Kristina

2010-04-01

404

Radiation-induced endometriosis in Macaca mulatta  

SciTech Connect

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.

Fanton, J.W.; Golden, J.G. (USAF School of Aerospace Medicine, Brooks AFB, TX (USA))

1991-05-01

405

The renal scan in pregnant renal transplant patients  

SciTech Connect

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.

Goldstein, H.A.; Ziessman, H.A.; Fahey, F.H.; Collea, J.V.; Alijani, M.R.; Helfrich, G.B.

1985-05-01

406

Small bowel obstruction secondary to strangulation through a defect in the falciform ligament after blunt abdominal trauma in a pediatric patient.  

PubMed

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

Sykes, Joseph A; Norton, Karen I; Bhattacharya, Nishith; Stombaugh, Lauretta

2010-06-01

407

Pathology and first occurrence of the kidney trematode Paratanaisia bragai (Santos, 1934) Freitas, 1959 (Digenea: Eucotylidae) in Phasianus colchicus L., 1758, from Brazil.  

PubMed

The kidney trematode Paratanaisia bragai is reported for the first time parasitizing the ring-necked pheasant (Phasianus colchicus L., 1758) and the pathological alterations associated to the parasitism are referred on the basis of 50 specimens of this bird from backyard flocks in 11 counties of the state of Rio de Janeiro, Brazil after clinical examination, necropsies, and histopathological analysis. The counting of the kidney flukes was based on worms recovered from one of the kidneys, since the other was fixed in 10% formalin and then routinely processed for histopathological procedures. The prevalence of P. bragai was of 22%, with a mean intensity of 44.3, mean abundance of 9.7, and range of infection of 3-153. Parasitized birds did not present with clinical signs and kidney gross lesions. Microscopic lesions were mild and characterized by dilatation of the renal medullary collecting ducts, occasional flattening of the lining epithelium of the ducts and inflammatory reaction of variable intensity with granulocytes around the ureter branches and medullary collecting ducts. The severity and pattern of the microscopic lesions seem not to be associated to the size of the worm burden and could be related to the mechanic action of the parasites, without traumatism, in despite of the presence of the tegumentar spines in specimens of P. bragai. PMID:16113870

Gomes, Delir Corrêa; Menezes, Rodrigo Caldas; Tortelly, Rogério; Pinto, Roberto Magalhães

2005-05-01

408

Percutaneous Nephroscopic Surgery  

PubMed Central

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

2010-01-01

409

ARA290, a non-erythropoietic EPO derivative, attenuates renal ischemia/reperfusion injury  

PubMed Central

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

2013-01-01

410

Posterior nutcracker syndrome with left renal vein duplication: a rare cause of haematuria in a 12-year-old boy.  

PubMed

The nutcracker syndrome (NCS) is a rare cause of haematuria. It embraces an extended nonpathognomonic spectrum of symptoms that imply a difficult diagnosis. Ultimately it may be associated with substantial morbidity and even life-threatening events. We report a rare cause if a 12-year-old boy who presented with a history of frequent intermittent episodes of painless constant haematuria. The cystoscopy showed a bloody urine ejaculate from the left ureter meatus. The Doppler ultrasonography showed turbulent pattern of venous blood flow of the posterior renal vein branch behind the aorta. The abdominopelvic computer tomography (apCT) revealed left renal vein (LRV) duplication with a dilated retroaortic branch, entrapped between the aorta and the vertebral column, promoting the renal nutcracker syndrome. The patient was initially hospitalized and managed with oral iron supplements and continuous saline bladder irrigation, not requiring additional treatment. The child is currently asymptomatic, with haemoglobin value returning to normal and therefore proposed to conservative management with close followup. The authors present a case report of episodic haematuria caused by a rare entity-posterior nutcracker syndrome with renal vein duplication. PMID:22919536

Preza Fernandes, J; Amorim, Rui; Gomes, M J; Oliveira, V; Reis, A; Ribeiro-Castro, J

2012-01-01

411

Diagnosis of ovarian vein syndrome (OVS) by computed tomography (CT) imaging: a retrospective study of 11 cases.  

PubMed

This article aims to explore the characteristics of computed tomography (CT) images of ovarian vein syndrome (OVS). The approval of the research ethics committee and the written informed consent of the patients were obtained. The CT images of 11 patients who had been diagnosed with OVS were retrospectively analyzed. All patients were examined with CT urogram, both plain CT scans and enhanced CT scans (including arterial phase, venous phase, and secretory phase). The datum was pulled into a computer workstation for post-processing. Ureteral obstruction at the position and ureteral dilation above it, where the ovarian vein crosses over the ureter, were found in all 11 patients. In addition, 4 patients presented with right upper ureteric calculi, 10 with right renal calculi (including 8 patients with multiple renal calculi that also had obvious uronephrosis), and 2 with a urinary calculus or cystolith. The diameter of the ovarian vein in them ranged from 5 mm to 13 mm. Varicose veins around the uterus were found in 2 patients, and the diameter of the left ovarian vein was larger than 7 mm in 1 patient.In conclusion, analysis of CT images is a vital method in diagnosing OVS. PMID:25101988

Wang, Ruizhi; Yan, Yan; Zhan, Songhua; Song, Litao; Sheng, Weihua; Song, Xu; Wang, Xiaolin

2014-08-01

412

Preoperative intestinal stent decompression with primary laparoscopic surgery to treat left-sided colorectal cancer with obstruction: a report of 21 cases  

PubMed Central

Objective This work aimed to study the safety and efficacy of preoperative intestinal stent decompression combined with laparoscopic surgery to treat left-sided colorectal cancer with obstruction (LCCO). Methods Retrospective analysis was conducted on data obtained from 21 LCCO patients admitted to The First Affiliated Hospital of Zhejiang Chinese Medicine University during March 2008 and December 2011. To remove the intestinal obstruction, preoperative intestinal stent placement under colonoscopic guidance was performed. Approximately 7 to 10 days after the operation, laparoscopic radical surgery of colorectal cancer was conducted. Results Among the 21 cases studied, laparoscopic surgery was successful in 20 patients. Emergent laparotomy was conducted in one patient because of tumor invasion in the ureter. The duration of the operation ranged from 180 to 320 min, and the average time was 220 min. The recovery time for bowel function ranged from 2 to 5 days with an average time of 3 days. Postoperative infection of the incision occurred in one case. No anastomotic leakage was observed in any of the cases. Conclusion Preoperative intestinal stent decompression, combined with primary stage laparoscopic surgery, is a safe and effective method for the treatment of LCCO. PMID:23882425

Zheng, Chao; Wu, Yu-Lian; Li, Qing

2013-01-01

413

Optimal Shock Wave Rate for Shock Wave Lithotripsy in Urolithiasis Treatment: A Prospective Randomized Study  

PubMed Central

Purpose We aimed to compare the effects of a fast shock wave rate (120 shocks per minute) and a slow shock wave rate (60 shocks per minute) on the shock wave lithotripsy (SWL) success rate, patient's pain tolerance, and complications. Materials and Methods A total of 165 patients with radiopaque renal pelvis or upper ureter stones were included in the study. Patients were classified by use of a random numbers table. Group I (81 patients) received 60 shock waves per minute and group II (84 patients) received 120 shock waves per minute. For each session, the success rate, pain measurement, and complication rate were recorded. Results No statistically significant differences were observed in the patients according to age, sex, body mass index, stone size, side, location, total energy level, or number of shocks. The success rate of the first session was greater in group I than in group II (p=0.002). The visual analogue pain scale was lower in group I than in group II (p=0.001). The total number of sessions to success and the complication rate were significantly lower in group I than in group II (p=0.001). Conclusions The success rate of SWL is dependent on the interval between the shock waves. If the time between the shock waves is short, the rate of lithotripsy success decreases, and the pain measurement score and complications increase. We conclude slow SWL is the optimal shock wave rate. PMID:23185672

Moon, Keun Bai; Lim, Go San; Hwang, Jae Seung; Lim, Chae Hong; Lee, Jae Won; Son, Jeong Hwan

2012-01-01

414

The life cycle and molecular phylogeny of a gorgoderid trematode recorded from the mussel Nodularia douglasiae in the Yodo River, Japan.  

PubMed

In 2009, a novel larval trematode of the family Gorgoderidae was found in the gonads of Nodularia douglasiae (Unionidae) from the lower reaches of the Yodo River, Osaka Prefecture, Japan. This is the first collection of trematodes in a unionid mussel in Japan. We investigated the morphology and life cycle of the trematode, and conducted a molecular phylogenetic analysis with other gorgoderid species, both those collected in the Yodo River water system and those reported in the literature. Immature adult worms were obtained from the ureters of the common carp Cyprinus carpio, the first known instance of a gorgoderid from these fish in Japan. Morphological characteristics and molecular data show that it belongs to the subfamily Gorgoderinae (genus Phyllodistomum sensu lato). Regarding the morphology, first intermediate host, and the infection site of adult worms, it resembles Phyllodistomum elongatum Nybelin, 1926 from Europe, but no comparable molecular data exist for Ph. elongatum. Three cytochrome c oxidase subunit I haplotypes were detected in the specimens analyzed, suggesting that the present species is indigenous to the Yodo River water system. The 28S ribosomal DNA data showed that this species is a member of the clade consisting of Ph. cf. symmetorchis, Ph. folium, Pseudophyllodistomum and Xystretrum. However, its phylogenetic position within the clade differs between the maximum likelihood and maximum parsimony trees, and the sister species of the present species remain unclear. PMID:25220581

Urabe, Misako; Ishibashi, Ryo; Uehara, Kazuhiko

2015-02-01

415

Remote control of renal physiology by the intestinal neuropeptide pigment-dispersing factor in Drosophila  

PubMed Central

The role of the central neuropeptide pigment-dispersing factor (PDF) in circadian timekeeping in Drosophila is remarkably similar to that of vasoactive intestinal peptide (VIP) in mammals. Like VIP, PDF is expressed outside the circadian network by neurons innervating the gut, but the function and mode of action of this PDF have not been characterized. Here we investigate the visceral roles of PDF by adapting cellular and physiological methods to the study of visceral responses to PDF signaling in wild-type and mutant genetic backgrounds. We find that intestinal PDF acts at a distance on the renal system, where it regulates ureter contractions. We show that PdfR, PDF's established receptor, is expressed by the muscles of the excretory system, and present evidence that PdfR-induced cAMP increases underlie the myotropic effects of PDF. These findings extend the similarities between PDF and VIP beyond their shared central role as circadian regulators, and uncover an unexpected endocrine mode of myotropic action for an intestinal neuropeptide on the renal system. PMID:22778427

Talsma, Aaron D.; Christov, Christo P.; Terriente-Felix, Ana; Linneweber, Gerit A.; Perea, Daniel; Wayland, Matthew; Shafer, Orie T.; Miguel-Aliaga, Irene

2012-01-01

416

Remote control of renal physiology by the intestinal neuropeptide pigment-dispersing factor in Drosophila.  

PubMed

The role of the central neuropeptide pigment-dispersing factor (PDF) in circadian timekeeping in Drosophila is remarkably similar to that of vasoactive intestinal peptide (VIP) in mammals. Like VIP, PDF is expressed outside the circadian network by neurons innervating the gut, but the function and mode of action of this PDF have not been characterized. Here we investigate the visceral roles of PDF by adapting cellular and physiological methods to the study of visceral responses to PDF signaling in wild-type and mutant genetic backgrounds. We find that intestinal PDF acts at a distance on the renal system, where it regulates ureter contractions. We show that PdfR, PDF's established receptor, is expressed by the muscles of the excretory system, and present evidence that PdfR-induced cAMP increases underlie the myotropic effects of PDF. These findings extend the similarities between PDF and VIP beyond their shared central role as circadian regulators, and uncover an unexpected endocrine mode of myotropic action for an intestinal neuropeptide on the renal system. PMID:22778427

Talsma, Aaron D; Christov, Christo P; Terriente-Felix, Ana; Linneweber, Gerit A; Perea, Daniel; Wayland, Matthew; Shafer, Orie T; Miguel-Aliaga, Irene

2012-07-24

417

Urinary Tract Effects After Multifocal Nonthermal Irreversible Electroporation of the Kidney: Acute and Chronic Monitoring by Magnetic Resonance Imaging, Intravenous Urography and Urinary Cytology  

SciTech Connect

Purpose: The nonthermal irreversible electroporation (NTIRE) is a novel potential ablation modality for renal masses. The aim of this study was the first evaluation of NTIRE's effects on the renal urine-collecting system using intravenous urography (IVU) and urinary cytology in addition to histology and magnetic resonance imaging (MRI). Methods: Eight percutaneous NTIRE ablations of the renal parenchyma, including the calyxes or pelvis, were performed in three male swine. MRI, IVU, histology, and urinary cytology follow-ups were performed within the first 28 days after treatment. Results: MRI and histological analysis demonstrated a localized necrosis 7 days and a localized scarification of the renal parenchyma with complete destruction 28 days after NTIRE. The urine-collecting system was preserved and showed urothelial regeneration. IVU and MRI showed an unaltered normal morphology of the renal calyxes, pelvis, and ureter. A new urinary cytology phenomenon featured a temporary degeneration by individual vacuolization of detached transitional epithelium cells within the first 3 days after NTIRE. Conclusions: This first urographical, urine-cytological, and MRI evaluation after porcine kidney NTIRE shows multifocal parenchyma destruction while protecting the involved urine-collecting system with regenerated urothelial tissue. NTIRE could be used as a targeted ablation method of centrally located renal masses.

Wendler, Johann Jakob, E-mail: johann.wendler@med.ovgu.de [University of Magdeburg, Department of Urology (Germany); Pech, Maciej [University of Magdeburg, Department of Radiology and Nuclear Medicine (Germany); Porsch, Markus; Janitzky, Andreas [University of Magdeburg, Department of Urology (Germany); Fischbach, Frank [University of Magdeburg, Department of Radiology and Nuclear Medicine (Germany); Buhtz, Peter; Vogler, Klaus [University of Magdeburg, Institute of Pathology (Germany); Huehne, Sarah [University of Magdeburg, Department of Urology (Germany); Borucki, Katrin [University of Magdeburg, Institute of Clinical Chemistry (Germany); Strang, Christof [University of Magdeburg, Department of Anaesthesiology (Germany); Mahnkopf, Dirk [Institute of Medical Technology and Research (Germany); Ricke, Jens [University of Magdeburg, Department of Radiology and Nuclear Medicine (Germany); Liehr, Uwe-Bernd [University of Magdeburg, Department of Urology (Germany)

2012-08-15

418

The Accuracy of Transrectal Ultrasound-Guided Biopsy for Decision Making in Prostate Cancer  

PubMed Central

Background: The most important surgical complications of renal transplantation are stenosis and obstruction of anastomosis of the ureter to the bladder. Hence, routine use of ureteral stents to prevent such complications seems logical; however, the optimal time to remove the ureteral stent is still controversial. Objectives: The purpose of this study was to compare the benefits and complications of the early or delayed ureteral stent removal post-transplantation. Patients and Methods: All patients who underwent kidney transplantation in Modarres Hospital from May 2011 through March 2012 were recruited. The patients were allocated to three groups. Ureteral stent removed 10, 20, and 30 days after transplantation in groups one, two, and three, respectively. Results: A total of 91 patients had undergone renal transplantation in our center. Ureteral stent was removed at 10, 20, and 30 days after surgery. Urologic complications among the three groups included hydronephrosis, urinoma, and collection around the graft; there was no statistically significant difference among study groups with regard to frequency of complications. Conclusions: We can remove the ureteral stent at shorter interval after renal transplantation with no increased risk of urologic complications.

Ghadian, Ali Reza; Heidari, Fatemeh; Afkhami, Ali Reza

2014-01-01

419

The C5a receptor is expressed by human renal proximal tubular epithelial cells  

PubMed Central

The C5a receptor is expressed by a variety of cell types. These studies demonstrate by immunohistochemistry that the receptor is present on the surface of proximal and distal tubular epithelial cells from normal kidney. In addition, the receptor was detected on transitional epithelial cells of the ureter and bladder. Primary proximal tubular cultures and a proximal tubular cell line both also expressed the C5a receptor, as demonstrated by immunofluorescence and by FACS analysis. The presence of mRNA encoding the receptor was confirmed by reverse transcriptase-polymerase chain reaction analysis. As opposed to its effect on glomerular mesangial cells, the receptor did not mediate a proliferative response by the proximal tubular cells. C5a also did not enhance the synthesis/secretion of transforming growth factor-beta 1, monocyte chemoattractant protein-1, platelet-derived growth factor-AB or tumour necrosis factor-alpha by cultured proximal tubular cells. Therefore, although the C5a receptor clearly is expressed by proximal tubular cells, clarification of its functional relevance on this cell type awaits further studies. PMID:10931135

Zahedi, R; Braun, M; Wetsel, R A; Ault, B H; Khan, A; Welch, T R; Frenzke, M; Davis, A E

2000-01-01

420

[Septic shock following intracavitary Bacillus Calmette-Guerin therapy for postcystectomy ureteral cancer].  

PubMed

A 72-year-old female patient was diagnosed as having a tumor in her bladder at the department of obstetrics and gynecology. Transurethral resection of bladder tumor was performed in November, 2002. Pathology showed transitional cell carcinoma (TCC), G2>G3, pT1. Chemotherapy consisting of methotrexate, adriamycin and cisplatin and bladder instillation of Bacillus Calmette-Guerin (BCG) was performed. Re-biopsy revealed transitional cell carcinoma, G2, carcinoma in situ of the bladder and she received radical cystectomy with ureterocutaneostomy in June, 2003. After the cystectomy, the left ureter showed signs of cancer so BCG was administered through the left ureterocutaneostomy. During the second instillation, she had a high temperature and also exhibited signs of chills with frequent shivering followed by dyspnea, severe hypotension and tachycardia. We started the patient on dopamine and norepinephrine drips to maintain blood pressure and then started isoniazide and meropenem for presumed septic shock. The next day, the patient continued to be febrile and her condition deteriorated. After she was given endotoxin absorption therapy, she regained normal blood pressure and her heart rate, but was still febrile. After 13 days, rifampicin, ethambutol, and pyrazinamide were administered and after 18 days predonisolone was begun. From that point the patient's general condition gradually improved. PMID:15518130

Ishida, Kenichiro; Yuhara, Kazuya; Kanimoto, Yuusuke

2004-09-01

421

Local therapeutic efficacy with reduced systemic side effects by rapamycin-loaded subcapsular microspheres.  

PubMed

Kidney injury triggers fibrosis, the final common pathway of chronic kidney disease (CKD). The increase of CKD prevalence worldwide urgently calls for new therapies. Available systemic treatment such as rapamycin are associated with serious side effects. To study the potential of local antifibrotic therapy, we administered rapamycin-loaded microspheres under the kidney capsule of ureter-obstructed rats and assessed the local antifibrotic effects and systemic side effects of rapamycin. After 7 days, microsphere depots were easily identifiable under the kidney capsule. Both systemic and local rapamycin treatment reduced intrarenal mTOR activity, myofibroblast accumulation, expression of fibrotic genes, and T-lymphocyte infiltration. Upon local treatment, inhibition of mTOR activity and reduction of myofibroblast accumulation were limited to the immediate vicinity of the subcapsular pocket, while reduction of T-cell infiltration was widespread. In contrast to systemically administered rapamycin, local treatment did not induce off target effects such as weight loss. Thus subcapsular delivery of rapamycin-loaded microspheres successfully inhibited local fibrotic response in UUO with less systemic effects. Therapeutic effect of released rapamycin was most prominent in close vicinity to the implanted microspheres. PMID:25542803

Falke, Lucas L; van Vuuren, Stefan H; Kazazi-Hyseni, Filis; Ramazani, Farshad; Nguyen, Tri Q; Veldhuis, Gert J; Maarseveen, Erik M; Zandstra, Jurjen; Zuidema, Johan; Duque, Luisa F; Steendam, Rob; Popa, Eliane R; Kok, Robbert Jan; Goldschmeding, Roel

2015-02-01

422

Minimal deviation mucinous adenocarcinoma of the uterine cervix that proved difficult to differentiate from endometrial cancer: A case report.  

PubMed

Minimal deviation adenocarcinoma (MDA), also known as adenoma malignum of the uterine cervix, accounts for only ~1% of uterine cervical adenocarcinomas. Adenoma malignum of the uterine cervix was initially described by Gusserow in 1870. Using magnetic resonance imaging (MRI), MDA appears as multilocular lesions with solid components that extend from the endocervical glands to the deep cervical stroma. Cytological evaluation and biopsies have low detection rates, therefore, it is difficult to diagnose MDA accurately prior to treatment. The current study describes a rare case of MDA that was difficult to differentiate from endometrial adenocarcinoma of the corpus uteri preoperatively, as the endometrial biopsy results suggested a well-differentiated endometrioid adenocarcinoma and MRI did not show typical images for MDA. A total abdominal hysterectomy with bilateral salpingo-oophorectomy was performed under the diagnosis of endometrial cancer, and the mass was subsequently diagnosed as MDA of the uterine cervix by pathological examination of the hysterectomy specimen. Postoperatively, although two types of adjuvant chemotherapy were performed, the remaining tumor continued to grow, causing obstruction of the bilateral ureters and leading to bilateral hydronephrosis. The patient is currently alive with the disease 10 months following the surgery. PMID:25364411

Nishii, Yuko; Fukuda, Takeshi; Imai, Kenji; Yamauchi, Makoto; Hashiguchi, Yasunori; Ichimura, Tomoyuki; Yasui, Tomoyo; Sumi, Toshiyuki

2014-12-01

423

[Primary diffuse large B-cell lymphoma of the uterus complicated with hydronephrosis].  

PubMed

Malignant lymphoma sometimes originates from extranodal sites; however, the uterus has rarely been reported as the site of the primary lesion. We present a patient with malignant lymphoma of the uterus complicating bilateral hydronephrosis. A 67-year-old previously healthy woman was seen at a clinic because of massive genital bleeding. She was referred to our hospital for further examination of a uterine tumor. Computed tomography scans revealed a pelvic tumor invading to the retroperitoneal region, which caused bilateral obstruction of the ureters and hydronephrosis. No lymph node swelling was detected. Magnetic resonance imaging showed a bulky uterine tumor that was homogenously low on T1-weighted imaging and isointense on T2-weighted imaging, while the endometrium was intact. A pathological examination of the biopsy specimen from the uterine cervix revealed diffuse infiltration of CD20-positive atypical large lymphoid cells, which was compatible with diffuse large B-cell lymphoma (DLBCL). Since the tumor expanded from the uterus and no other abnormal lesion was observed in imaging studies including gallium scintigraphy, a diagnosis of DLBCL of the uterus, clinical stage IE was made. The patient received six cycles of rituximab plus CHOP chemotherapy followed by involved field irradiation. She achieved complete remission and has been alive for more than two years without relapse. PMID:23666223

Isosaka, Mai; Hayashi, Toshiaki; Mitsuhashi, Kei; Tanaka, Michihiro; Adachi, Takeya; Kondo, Yoshihiro; Suzuki, Takashi; Shinomura, Yasuhisa

2013-04-01

424

Minimal deviation mucinous adenocarcinoma of the uterine cervix that proved difficult to differentiate from endometrial cancer: A case report  

PubMed Central

Minimal deviation adenocarcinoma (MDA), also known as adenoma malignum of the uterine cervix, accounts for only ~1% of uterine cervical adenocarcinomas. Adenoma malignum of the uterine cervix was initially described by Gusserow in 1870. Using magnetic resonance imaging (MRI), MDA appears as multilocular lesions with solid components that extend from the endocervical glands to the deep cervical stroma. Cytological evaluation and biopsies have low detection rates, therefore, it is difficult to diagnose MDA accurately prior to treatment. The current study describes a rare case of MDA that was difficult to differentiate from endometrial adenocarcinoma of the corpus uteri preoperatively, as the endometrial biopsy results suggested a well-differentiated endometrioid adenocarcinoma and MRI did not show typical images for MDA. A total abdominal hysterectomy with bilateral salpingo-oophorectomy was performed under the diagnosis of endometrial cancer, and the mass was subsequently diagnosed as MDA of the uterine cervix by pathological examination of the hysterectomy specimen. Postoperatively, although two types of adjuvant chemotherapy were performed, the remaining tumor continued to grow, causing obstruction of the bilateral ureters and leading to bilateral hydronephrosis. The patient is currently alive with the disease 10 months following the surgery. PMID:25364411

NISHII, YUKO; FUKUDA, TAKESHI; IMAI, KENJI; YAMAUCHI, MAKOTO; HASHIGUCHI, YASUNORI; ICHIMURA, TOMOYUKI; YASUI, TOMOYO; SUMI, TOSHIYUKI

2014-01-01

425

Endoscopic surgery and telemedicine in microgravity: developing contingency procedures for exploratory class spaceflight  

NASA Technical Reports Server (NTRS)

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.

Jones, J. A.; Johnston, S.; Campbell, M.; Miles, B.; Billica, R.

1999-01-01

426

Iron chelation by deferoxamine prevents renal interstitial fibrosis in mice with unilateral ureteral obstruction.  

PubMed

Renal fibrosis plays an important role in the onset and progression of chronic kidney diseases (CKD). Although several mechanisms underlying renal fibrosis and candidate drugs for its treatment have been identified, the effect of iron chelator on renal fibrosis remains unclear. In the present study, we examined the effect of an iron chelator, deferoxamine (DFO), on renal fibrosis in mice with surgically induced unilateral ureter obstruction (UUO). Mice were divided into 4 groups: UUO with vehicle, UUO with DFO, sham with vehicle, and sham with DFO. One week after surgery, augmented renal tubulointerstitial fibrosis and the expression of collagen I, III, and IV increased in mice with UUO; these changes were suppressed by DFO treatment. Similarly, UUO-induced macrophage infiltration of renal interstitial tubules was reduced in UUO mice treated with DFO. UUO-induced expression of inflammatory cytokines and extracellular matrix proteins was abrogated by DFO treatment. DFO inhibited the activation of the transforming growth factor-?1 (TGF-?1)-Smad3 pathway in UUO mice. UUO-induced NADPH oxidase activity and p22(phox) expression were attenuated by DFO. In the kidneys of UUO mice, divalent metal transporter 1, ferroportin, and ferritin expression was higher and transferrin receptor expression was lower than in sham-operated mice. Increased renal iron content was observed in UUO mice, which was reduced by DFO treatment. These results suggest that iron reduction by DFO prevents renal tubulointerstitial fibrosis by regulating TGF-?-Smad signaling, oxidative stress, and inflammatory responses. PMID:24586712

Ikeda, Yasumasa; Ozono, Iori; Tajima, Soichiro; Imao, Mizuki; Horinouchi, Yuya; Izawa-Ishizawa, Yuki; Kihira, Yoshitaka; Miyamoto, Licht; Ishizawa, Keisuke; Tsuchiya, Koichiro; Tamaki, Toshiaki

2014-01-01

427

Evaluation of the Outcome of Laparoscopic Radical Prostatectomy by a Single Surgeon: Experience with an Initial 30 Cases  

PubMed Central

Objective: We carried out this study to clarify whether operative methods of laparoscopic prostatectomy (LRP) could become a standard therapy. The purpose was to evaluate the technical feasibility, oncologic effectiveness and perioperative and postoperative morbidity of LRP performed by a general urologist. Patients and Methods: Between June 2004 and May 2006, 30 patients with clinically localized prostate cancer consecutively underwent LRP by a single surgeon. Oncologic data were assessed by histopathological examination and by postoperative prostate-specific antigen (PSA) levels. Results: Complete laparoscopic removal of the prostate and seminal vesicles was achieved in all 30 patients. The average operation time was 250.9 min (range, 168 to 394 min). The total positive surgical margin rate was 20.7% (6 of 29 cases), with a total PSA recurrence rate was 23.3% (7 of 30 cases), but the frequencies tended to be decreased in the later phase cases. Perioperative complications were encountered in 5 patients; four of these patients were in the initial 10 cases. Two of the 30 cases (6.7%) required a blood transfusion (first case and 11th case). There were three surgical complications, one ureter injury, one rectal injury and one sigmoid serosal injury. The catheter duration intervals were reduced in the later cases. Conclusions:From our experience with one surgeon, with whom perioperative complications were concentrated in the initial 10 cases, we conclude that LRP should be performed by experienced surgeons after intensive training.

Akita, Hidetoshi; Okamura, Takehiko; Naiki, Taku; Nagata, Daisuke; Tozawa, Keiichi; Kohri, Kenjiro

2010-01-01

428

Renal morphology and function immediately after extracorporeal shock-wave lithotripsy.  

PubMed

The acute effects of extracorporeal shock-wave lithotripsy (ESWL) on morphology and function of the kidney were evaluated by excretory urography, quantitative radionuclide renography (QRR), and magnetic resonance imaging (MRI) in 33 consecutive patients. Excretory urograms demonstrated an enlarged kidney in seven (18%) of 41 treatments and partial or complete obstruction of the ureter by stone fragments after 15 (37%) of 41 treatments. Total effective renal plasma flow (ERPF) was not changed after ESWL, but the percentage ERPF of the treated kidney was decreased by more than 5% in 10 (30%) of 33 cases. QRR images showed partial parenchymal obstruction in 10 (25%) of 41 treated kidneys and total parenchymal obstruction in 9 (22%). MRI disclosed one or more of the following abnormalities in 24 (63%) of 38 treated kidneys: (1) loss of corticomedullary differentiation, (2) perirenal fluid, (3) subcapsular hematoma, (4) hemorrhage into a renal cyst, and (5) unexplained abnormalities. Treated kidneys were normal by all three imaging methods in 26% and abnormal by one or more tests in 74% of cases. The morphologic and functional changes are attributed to renal contusion resulting in edema and extravasation of urine and blood into the interstitial, subcapsular, and perirenal spaces. PMID:3875231

Kaude, J V; Williams, C M; Millner, M R; Scott, K N; Finlayson, B

1985-08-01

429

Extracorporeal shock wave lithotripsy induces the release of prostaglandins which increase ureteric peristalsis.  

PubMed

The aim of this study was to identify the changes in secretion of prostaglandins into the urinary tract as a result of treatment by extracorporeal shock wave lithotripsy (ESWL) and to determine their effects on ureteric motility. Sixteen patients with renal or upper ureteric calculi were studied. A peripheral blood and urine sample was collected immediately before and after ESWL, with further samples taken 24 h later. The following variables were assessed by radioimmunoassay:prostaglandin E2 (PGE2), prostaglandin F1 alpha (PGF1 alpha), and thromboxane B2 (TXB2). An in vitro canine study was then designed to study the activity of TXB2, PGF1 alpha and PGE2 on an isolated intact canine ureter model. Significant elevations of TXB2 were found immediately after ESWL in both serum and urine, which fell almost to pre-treatment levels by 24 h. PGF1 alpha levels showed significant elevations at 24 h but no immediate increase as seen with TXB2. In contrast, PGE2 levels were unchanged in the urine but significantly decreased in the serum. In vitro studies showed that both TXB2 and PGF1 alpha repeatedly produced an increased frequency of ureteric contraction. ESWL results in the release of prostaglandins from the urinary tract which are shown to cause increased ureteric peristalsis. PMID:8343888

Horgan, P G; Hanley, D; Burke, J; Couse, N F; Fitzpatrick, J M

1993-06-01

430

TERT promoter mutations are associated with distant metastases in upper tract urothelial carcinomas and serve as urinary biomarkers detected by a sensitive castPCR  

PubMed Central

TERT promoter C228T and C250T mutations occur in various malignancies including bladder cancer (BC) and may serve as urinary tumor markers. However, the mutation association with clinical variables in upper tract urothelial carcinomas (UTUCs) is unclear. There is also a lack of sensitive tools to detect the minor mutant TERT promoter in bulk urinary DNA. Here we analyzed 220 UTUC patients [98 with renal pelvic carcinoma (RPC) and 122 with ureter carcinoma (UC)] and developed a Competitive Allele-Specific TaqMan PCR (castPCR) for urinary assay. We identified C228T or C250T mutations in 42 of 98 (43%) RPC and 23 of 122 (19%) UC tumors. Distant metastases were significantly correlated with UTUC patients harboring TERT promoter mutations (P = 0.001). C228T were detected in 6/10 and 9/10 of urine samples from patients with mutation-carrying tumors using Sanger sequencing and castPCR, respectively. When urine samples from 70 BC patients were analyzed together, the sensitivity of urinary C228T assay was 89% and 50% for castPCR and Sanger sequencing, respectively (P < 0.001). Collectively, TERT promoter mutations occur in UTUCs with a high frequency in RPCs and predict distant metastasis. castPCR assays of the mutation are a useful tool for urine-based diagnostics of urological malignancies. PMID:25474136

Liu, Li; Yuan, Xiaotian; Liu, Jikai; Kong, Feng; Wang, Chang; Ren, Hongbo; Yan, Keqiang; Hu, Sanyuan; Xu, Zhonghua; Björkholm, Magnus; Fan, Yidong; Zhao, Shengtian; Liu, Cheng; Xu, Dawei

2014-01-01

431

Abdominal Wall Closure of Renal Transplant Recipients: An Undermined Challenge  

PubMed Central

Tension-free muscle closure is essential in kidney transplantation, both in adult and pediatric patients. Tight muscle closure may lead to renal transplant compartment syndrome either due to compression of the renal parenchyma or due to kinking of the renal vessels. It may also cause kinking of the transplant kidney ureter, wound dehiscence and incisional hernia. Many techniques have been proposed in an attempt to achieve tension-free closure. There is a wrong belief among some surgeons that using prosthetic mesh may increase the incidence of infection complications in these immunosuppressed patients. Also, there is fear that one is not able to monitor the renal graft by ultrasound and perform biopsy in the presence of a mesh. Other alternative techniques to mesh closure include subcutaneous placement and intraperitonealization of the kidney transplant. These techniques however, are valuable when mesh closure is unfavorable or contraindicated as in case of the presence of a potential source of infection like a stoma. Abdominal wall fasciotomy can be adjunctive to various techniques of muscle closure. PMID:25013568

Halawa, A.

2010-01-01

432

Robotic-assisted laparoscopic surgery: recent advances in urology.  

PubMed

The aim of the present review is to summarize recent developments in the field of urologic robotic surgery. A nonsystematic literature review was performed to retrieve publications related to robotic surgery in urology and evidence-based critical analysis was conducted by focusing on the literature of the past 5 years. The use of the da Vinci Surgical System, a robotic surgical system, has been implemented for the entire spectrum of extirpative and reconstructive laparoscopic kidney procedures. The robotic approach can be applied for a range of adrenal indications as well as for ureteral diseases, including benign and malignant conditions affecting the proximal, mid, and distal ureter. Current evidence suggests that robotic prostatectomy is associated with less blood loss compared with the open surgery. Besides prostate cancer, robotics has been used for simple prostatectomy in patients with symptomatic benign prostatic hyperplasia. Recent studies suggest that minimally invasive radical cystectomy provides encouraging oncologic outcomes mirroring those reported for open surgery. In recent years, the evolution of robotic surgery has enabled urologic surgeons to perform urinary diversions intracorporeally. Robotic vasectomy reversal and several other robotic andrological applications are being explored. In summary, robotic-assisted surgery is an emerging and safe technology for most urologic operations. The acceptance of robotic prostatectomy during the past decade has paved the way for urologists to explore the entire spectrum of extirpative and reconstructive urologic procedures. Cost remains a significant issue that could be solved by wider dissemination of the technology. PMID:24993800

Autorino, Riccardo; Zargar, Homayoun; Kaouk, Jihad H

2014-10-01

433

Comparison of conventional radiography combined with ultrasonography versus nonenhanced helical computed tomography in evaluation of patients with renal colic.  

PubMed

The aim of this study is to determine whether kidneys ureters bladder X-ray (KUB) film combined with ultrasound (US) can be effectively used in evaluation of renal colic and miss stones with clinically significant size identified on nonenhanced computed tomography (NECT) in patients with urolithiasis. This retrospective study evaluated the clinical and radiological records of 300 patients at our institution undergoing KUB and/or US and/or NECT for the evaluation of renal colic from June 2007 to December 2010. Of patients with negative findings on KUB and/or US, 22 had renal stones on NECT (mean size 4.4 mm, range 3-8), 3 had lower ureteral stone (mean size 3.3 mm, range 2-5). In patients with isolated suspicious renal ectasia without stone image, two had renal stone on NECT (mean size 4 mm, range 2-6), 5 had upper ureteral stone (mean size 4.4 mm, range 4-6), 7 had middle ureteral stone (mean size 3.7 mm, range 3-4) and 14 had lower ureteral stone (mean size 4 mm, range 2-6). The cost-effective and almost radiation-free combination of KUB and US should be preferred for diagnosis of urolithiasis, as it detects most of the ureteral and renal calculi which are clinically significant. PMID:22415439

Ekici, Sinan; Sinanoglu, Orhun

2012-10-01

434

The management of concomitant renal oncocytoma and giant coronary and bilateral common iliac artery aneurysms.  

PubMed

We present the rare case of a 66-year-old Caucasian male patient presenting with intermittent left-side abdominal pain. He underwent a kidneys, ureters, and bladder computed tomography scan on which an incidental 45-mm giant aneurysm of the left anterior descending coronary artery was discovered along with 55-mm right-sided and 62-mm left-sided common iliac artery aneurysms and a 100-mm benign renal oncocytoma. He underwent on-pump coronary artery bypass grafting of the left anterior descending, left circumflex and right coronary arteries using internal mammary artery and saphenous vein grafts. He subsequently underwent simultaneous open left nephrectomy and bilateral common iliac aneurysm repair using a bifurcated tube graft. He made a full recovery postoperatively. Giant coronary artery aneurysms are rare. In the pediatric population, they are predominantly secondary to Kawasaki disease. In adults, atheromatous disease is the leading cause. The coexistence of giant coronary artery aneurysms with extracoronary artery aneurysms is extremely unusual. We propose that the identification of giant coronary artery aneurysms necessitates further imaging investigations to identify the presence of extracoronary aneurysms. To our knowledge, this is the first description of such a case in the literature. PMID:24200531

Clarke, Jonathan; Choong, Andrew; Raja, Shahzad; Amrani, Mohamed; Hellawell, Giles; Hussain, Tahir

2014-05-01

435

A trial placement of a prophylactic ureteral catheter during the excision of a huge pelvic mass with incidental cystotomy  

PubMed Central

Ureteral injuries are one of the major complications following gynecologic surgeries. They are serious, troublesome, often associated with significant morbidity, and are one of the most common causes for legal action against gynecologic surgeons. The reported rates of injury depend on the vigilance of diagnosis, type of surgery and other risk factors. We present a case of a 48 year old obese Caucasian female with no significant past medical history who came in with back pain and progressive abdominal swelling for the past three months and was found to have a very large pelvic mass. After preoperative evaluation, including: medical history, physical exam, and imaging studies showing a heterogenous mass 24.6 x 33.0 x 43.1, we predicted that the risk of urinary tract injuries was very high. We used preoperative prophylactic bilateral ureteral catheters to prevent injury. A surgical oncologist was consulted and an exploratory laparotomy was performed with removal of the large multi–lobulated pelvic mass + total abdominal hysterectomy, bilateral salpingo–oophorectomy, and appendectomy all performed at the same time. Patient had an incidental cystotomy during the procedure, which was repaired intra–operatively. The ureters remained intact with no injuries. The importance of thorough preoperative identification, evaluation and anticipation of ureteral injuries will be discussed in detail. PMID:24707391

2013-01-01

436

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

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

Terek, M C; Tamsel, S; Aygul, S; Akman, L; Irer, S V; Itil, I M; Alper, G

2006-01-01

437

Bitter triggers acetylcholine release from polymodal urethral chemosensory cells and bladder reflexes.  

PubMed

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

Deckmann, Klaus; Filipski, Katharina; Krasteva-Christ, Gabriela; Fronius, Martin; Althaus, Mike; Rafiq, Amir; Papadakis, Tamara; Renno, Liane; Jurastow, Innokentij; Wessels, Lars; Wolff, Miriam; Schütz, Burkhard; Weihe, Eberhard; Chubanov, Vladimir; Gudermann, Thomas; Klein, Jochen; Bschleipfer, Thomas; Kummer, Wolfgang

2014-06-01

438

Laparoscopic trocar port site endometriosis: a case report and brief literature review.  

PubMed

Endometriosis is defined as the presence of ectopic endometrial tissue outside the lining of the uterine cavity. It occurs most commonly in pelvic sites such as ovaries, cul-de-sac, and fallopian tubes but also can be found associated with the lungs, bowel, ureter, brain, and abdominal wall. Abdominal wall endometriosis, also known as scar endometriosis, is extremely rare and mainly occurs at surgical scar sites. Although many cases of scar endometriosis have been reported after a cesarean section, some cases of scar endometriosis have been reported after an episiotomy, hysterectomy, appendectomy, and laparoscopic trocar port tracts. To our knowledge, 14 case reports related to trocar site endometriosis have been published in the English language literature to date. Herein, we present the case of a 20-year-old woman (who had been previously operated on for left ovarian endometrioma 1.5 years ago by laparoscopy) with the complaint of a painful mass at the periumbilical trocar site with cyclic pattern. Consequently, although rare, if a painful mass in the surgical scar, such as the trocar site, is found in women of reproductive age with a history of pelvic or obstetric surgery, the physician should consider endometriosis. PMID:23102079

Emre, Arif; Akbulut, Sami; Yilmaz, Mehmet; Bozdag, Zehra

2012-01-01

439

Iron Chelation by Deferoxamine Prevents Renal Interstitial Fibrosis in Mice with Unilateral Ureteral Obstruction  

PubMed Central

Renal fibrosis plays an important role in the onset and progression of chronic kidney diseases (CKD). Although several mechanisms underlying renal fibrosis and candidate drugs for its treatment have been identified, the effect of iron chelator on renal fibrosis remains unclear. In the present study, we examined the effect of an iron chelator, deferoxamine (DFO), on renal fibrosis in mice with surgically induced unilateral ureter obstruction (UUO). Mice were divided into 4 groups: UUO with vehicle, UUO with DFO, sham with vehicle, and sham with DFO. One week after surgery, augmented renal tubulointerstitial fibrosis and the expression of collagen I, III, and IV increased in mice with UUO; these changes were suppressed by DFO treatment. Similarly, UUO-induced macrophage infiltration of renal interstitial tubules was reduced in UUO mice treated with DFO. UUO-induced expression of inflammatory cytokines and extracellular matrix proteins was abrogated by DFO treatment. DFO inhibited the activation of the transforming growth factor-?1 (TGF-?1)-Smad3 pathway in UUO mice. UUO-induced NADPH oxidase activity and p22phox expression were attenuated by DFO. In the kidneys of UUO mice, divalent metal transporter 1, ferroportin, and ferritin expression was higher and transferrin receptor expression was lower than in sham-operated mice. Increased renal iron content was observed in UUO mice, which was reduced by DFO treatment. These results suggest that iron reduction by DFO prevents renal tubulointerstitial fibrosis by regulating TGF-?-Smad signaling, oxidative stress, and inflammatory responses. PMID:24586712

Tajima, Soichiro; Imao, Mizuki; Horinouchi, Yuya; Izawa-Ishizawa, Yuki; Kihira, Yoshitaka; Miyamoto, Licht; Ishizawa, Keisuke; Tsuchiya, Koichiro; Tamaki, Toshiaki

2014-01-01

440

Clarithromycin co-administered with amikacin attenuates systemic inflammation in experimental sepsis with Escherichia coli.  

PubMed

To assess the efficacy of clarithromycin as an immunomodulator in experimental sepsis with Escherichia coli, acute pyelonephritis was induced after ligation of the right ureter and injection of the test isolate into the renal pelvis in 40 rabbits. Four groups of treatment were applied with administration of therapy on advent of sepsis-associated pulmonary oedema, as follows: A: controls; B: clarithromycin; C: amikacin, D: both agents. Survival was recorded along with estimation of serum levels of endotoxins (LPS), of tumour necrosis factor-alpha (TNFalpha), malondialdehyde (MDA) and of bacterial counts. Mean survival of groups A, B, C and D was 2.51, 7.60, 10.25 and 11.40 days, respectively. Serum levels of TNFalpha and of MDA of group A increased over-time. Pulmonary oedema at 6 h after bacterial challenge was accompanied by increase of TNFalpha and MDA; administration of clarithromycin decreased their values. It is concluded that intravenous clarithromycin might constitute a promising immunomodulatory agent for the management of sepsis since its efficacy was proved after administration on presentation of sepsis-associated pulmonary oedema. The presented findings emphasise the need for further clinical research of the use of clarithromycin for the therapy of Gram-negative sepsis. PMID:15664488

Giamarellos-Bourboulis, Evangelos J; Baziaka, Fotini; Antonopoulou, Anastasia; Koutoukas, Pantelis; Kousoulas, Vassilios; Sabracos, Lambros; Panagou, Charalambos; Perrea, Despina; Giamarellou, Helen

2005-02-01