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Query: UMLS:C0403608 (ureter)
 9,655 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Renal function is usually normal or only marginally affected in patients with unilateral ureteral obstruction due to the vicarious function of the contralateral kidney. Few reports exist in which unilateral renal obstruction is associated with anuria (reflex anuria, RA) and acute renal failure. We report the clinical case of a female patient who was referred to the emergency department due to anuria of 72 h duration and acute renal failure (serum creatinine 9 mg/dl) associated with several episodes of violent right flank pain with hematuria following extracorporeal shock wave lithotripsy (ESWL). A few weeks before ESWL, urography showed a 2-cm stone located in the right pelvis whilst the left kidney was functionally normal. On admission, renal ultrasound documented a normal left kidney, whilst the right pelvis was hydronephrotic and there were two indwelling stones at the right pyeloureteral junction. After the patient passed a urinary stone, diuresis restarted and acute renal failure was resolved. Thereafter, urography confirmed that the left kidney, the left ureter and bladder were functionally and morphologically normal. RA with acute renal failure has been so scarcely documented that it is considered to be legend by many clinicians. Major textbooks do not discuss RA with acute renal failure. Vascular or ureteral spasm related in part to a peculiar hyperexcitability of the autonomic nervous system may explain RA. We suggest that nephrologists should always consider RA when evaluating acute renal failure. On the other hand, RA might be relatively common and we cannot rule out that only the most severe and/or better-documented cases have been reported in the medical literature.
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PMID:Reflex anuria from unilateral ureteral obstruction. 1186 59

The authors report a case of a male patient with urate nephrolithiasis aggravated with postrenal anuria due to total obturation of the single kidney's ureter with multiple calculi located as a path. The outcome was satisfactory.
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PMID:[A case of total ureteral obturation of a single kidney with urate calculi]. 1243 45

Because of the extraperitoneal location, generally used for renal grafting, intraperitoneal urine leaks are a rare complication after transplantation. We report a patient on peritoneal dialysis who developed ascites, abdominal pain, anuria and shock suddenly after renal transplantation. The patient was immediately taken back to the operating room. An abnormal implantation of ureter into the peritoneum overlying the bladder when carrying out an unstented parallel incision extravesical ureterone-ocystostomy was identified. After correcting ureter implantation the patient had immediate diuresis, renal function rapidly improved, with no further complications. Contributing causes were poor exposure, thickened peritoneum secondary to recurrent peritonitis, and the presence of residual peritoneal dialysis fluid.
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PMID:[Ureteral implantation in peritoneum. Exceptional complication in renal transplantation]. 1244 76

The prevalence of obstructive uropathy linked to uterine prolapse ranges between 4% and 80%, depending on the series, probably due to the varying degree of severity of the prolapses under consideration. Renal failure or anuria is an unusual complication. Several etiopathogenic theories regarding obstructive uropathy secondary to prolapse have been put forward: ureteral compression by the uterine vessels, severe urethral angulation, ureteral compression against levator ani muscles and the elongation and narrowing of the distal ureter. The major radiological exploration used in studying the urinary tract of these patients is intravenous urography in bipedestation. Emergency treatment for obstructive anuria resulting from a uterine prolapse consists of manually replacement of the prolapse. Surgery is considered to be the definitive ideal treatment, although in the case of surgical or anaesthetic high risk patients, inserting a permanent pessary may constitute a satisfactory solution. We present a case of obstructive anuria resulting from uterine prolapse, which was successfully treated with the insertion of a ring pessary.
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PMID:[Obstructive anuria secondary to uterine prolapse]. 1250 64

We report a case of a 22 years old type 1 diabetic man with a history of weight loss, weakness, anorexia, fever and recurrent urinary tract infection since February 2001. In April 2001, he presented anuria due to obstructive acute renal failure. Hepatosplenomegaly and lymphadenopathy were absent at physical examination. Laboratory tests revealed a high level of gamma globulin (53.4 g/l) and anaemia (haemoglobin 7.7 g/100 ml) without leukopenia and thrombocytopenia. CT scan showed multiple retroperitoneal lymphadenopathies causing compression of the two ureters, hydro-ureter associated with hydronephrosis, hepatosplenomegaly and multiple pulmonary nodes. Lymphadenopathies, anaemia, high level of gamma globulin, high titres of anti-leishmanial antibodies and the excellent outcome after treatment with meglumine antimoniate (Glucantime) confirmed visceral leishmaniasis. This report documented an unusual clinical presentation of Visceral leishmaniasis in a diabetic patient.
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PMID:[Obstructive acute renal failure revealing visceral leishmaniasis in a diabetic patient]. 1272 15

Thrombus within the renal collecting system and ureter after percutaneous intervention is usually self-limited, but when it is obstructive enough to produce anuria, it can cause deterioration of renal function. Herein a case of a patient with a transplant kidney in whom clot anuria developed after conversion of a nephroureteral stent to a nephrostomy catheter is presented. Internal urine drainage was restored with the use of a rheolytic mechanical thrombectomy device, with subsequent return of normal renal function.
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PMID:Treatment of obstructive nephroureteral clot with a rheolytic mechanical thrombectomy device. 1284 3

This study presents ureteral injuries in gynecologic oncology surgical procedures performed at the Department of Obstetrics and Gynecology in Novi Sad, in the period from 1991 to 2001. Intraoperative ureteral injuries were recorded in 4 (1%) patients, including: partial ureteral dissection, bilateral ureteral ligation and complete ureteral dissection bellow the lower pole. In 3 (75%) cases, injuries were recognized immediately, and surgical reparation was performed. The patient with bilateral ureteral ligation presented with increased creatinine levels, anuria and development of hydronephrosis detected by ultrasonography 24 h later. Leading reasons for operative ureteral injuries include inadequate experience of surgeons, carelessness during surgery, wrong indication and wrong approach to ureter. Preparation of ureter with minimal trauma, precise localization and visualization of the complete ureteral length, as well as preservation of its vascular network, are of utmost importance in prevention of injuries.
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PMID:Ureteral injuries in gynaecologic oncology surgery procedures. 1456 50

Although ultrasonography is regarded as the gold standard in the diagnosis of obstructive nephropathy, dilatation is sometimes not observed by ultrasonography. We report upon a case of minimally dilated obstructive nephropathy due to an ureter stone in a kidney donor with volume depletion. A 54-year-old man was admitted due to anuria and abdominal pain of 2 days duration. Ten years previously, his right kidney was donated for transplantation, and one month before admission, he abstained from all food except water and salt, for 30 days for religious reasons. He had lost 8 kg of body weight. On admission, he had clinical signs of volume depletion, i.e., a dehydrated tongue and decreased skin turgor. Laboratory data confirmed severe renal failure, his blood urea nitrogen level was 107.3 mg/dL, and his serum creatinine 16.5 mg/dL. The plain X-ray was unremarkable and ultrasonography showed only minimal dilatation of the renal collecting system. On follow-up ultrasonography, performed on the 5th hospital day, the dilatation of the collecting system had slightly progressed and a small stone was found at ureter orifice by cystoscopy. Removal of stone initiated dramatic diuresis with a rapid return of renal function to normal by the third day.
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PMID:Minimally dilated obstructive nephropathy initially suspected as pre-renal azotemia in a kidney donor with volume depletion. 1471 34

Acute ureteral obstruction is always associated with high intrapelvic hydrostatic pressure. Objective diagnosis of renal colic can be made by direct measurement of intrapelvic pressure (IPP). We propose a very simple device for estimation of IPP consisting of ureteral catheter and polyethylene tube 150 cm long. The device gives intrapelvic pressure in centimeters of urinary column. The figures obtained corresponded to those in measurement of IPP in cm of water column. In normal 187 examinees IPP ranged from 0.5 to 14.2 cm urinary column. Mean normal IPP in females was higher than in males. In 187 patients with renal colic IPP varied from 55 to 150 cm of urinary column. Mean IPP at the height of renal colic was in females and males 97.4 +/- 3.0 and 89.8 +/- 2.5 cm of urinary column, respectively. Thus, IPP in health and renal colic is higher in females than in males. In bilateral renal colic and colic in solitary kidney catheterization of the ureter is mandatory because of anuria. Ureteral catheterization is also indicated in cases of renal colic combination with attack of acute pyelonephritis. If ureteral catheterization is indicated, IPP pressure should be measured. This is important for diagnosis of both acute ureteral obstruction and pathogenesis of anuria.
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PMID:[Acute ureteral obstruction (renal colic)]. 1685 97

We report a rare case of generalized peritonitis caused by nontraumatic, intraperitoneal rupture of the ureter. An 80-year-old woman with a history of bilateral vesicoureteral reflux and long-term urethral indwelling catheter drainage presented with a very distended abdomen. Computed tomography showed massive ascites and intraperitoneal free gas. We performed an emergency laparotomy, assuming a gastrointestinal perforation; but could not find a cause of generalized peritonitis. Postoperatively, she presented with anuria and massive peritoneal drainage. The findings of a cystogram confirmed intraperitoneal ureteral rupture. She was managed successfully with ureteral stenting. The diagnosis of this condition requires a high degree of clinical suspicion, along with radiographic evidence and peritoneal fluid analysis. Image-guided interventions play a crucial role in the management of ureteral urine leaks after a correct diagnosis has been made.
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PMID:Intraperitoneal rupture of the ureter as a cause of generalized peritonitis: report of a case. 1693 92


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