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

We present herewith our surgical procedure for the management of bilateral hydronephrosis and renal failure due to distal ureter infiltration by cancer of the prostate: transurethral resection of the ureteral meatus and intramural ureter or even extravesical ureter invaded by the carcinoma and placement of a double J catheter. We have performed this technique in 3 patients with good results.
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PMID:Transurethral resection of the ureteral meatus invaded by carcinoma of the prostate: a new approach. 367 6

A semi-automated quantitative fluorescence image analysis (QFIA) technique was developed with the Leitz TAS-Plus to detect bladder cancer using hyperploidy in urinary cells. Absolute nuclear fluorescence intensity (ANFI) (emission at 540 nm with excitation at 436 nm) of individual acridine-orange-stained cells was quantitated using (1) QFIA and (2) simple filter microspectrofluorophotometry (SFM). Both methods employed an internal phosphor particle standard which, when once calibrated against the DNA content of normal cells, obviates the necessity of routinely calibrating against normal cells in each sample. Results of SFM and QFIA were compared with routine Papanicolaou (Pap) cytopathology, using histopathology as the diagnostic standard in 272 samples from 67 symptomatic patients. The sensitivities for detecting low-grade transitional-cell carcinoma were 86% for SFM, 76% for QFIA, and 33% for Pap cytology. QFIA and SFM were significantly more sensitive at detecting bladder cancer than was Pap (0.01 greater than p greater than 0.001). Comparison of sensitivity obtained with bladder washings and urine samples showed that noninvasively obtained urines can be used. ANFI also detected recurrent and precancerous bladder lesions and kidney, ureter, and prostate lesions. This approach may prove generally useful in quantifying biochemical and immunological probes and should be broadly applicable as a research tool for studying the relationship of biochemical markers in the pathogenesis of disease and as a test for cancer control.
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PMID:DNA cytometry and cytology by quantitative fluorescence image analysis in symptomatic bladder cancer patients. 367 95

A case of carcinoma in situ of the renal pelvis in a 70-year-old female is reported. The patient was admitted with the complaints of macrohematuria and left back pain. Urine cytology, which was carried out three times using urine samples collected directly from the urinary bladder proved to be negative. Drip infusion pyelography (DIP) and retrograde pyelography (RP) disclosed stenosis of the left ureter at the level of L3-L4. Selective renal angiography revealed no abnormalities. Based on the DIP and RP findings, the diagnosis of tumor in the left ureter was made, and left total nephroureterectomy with partial cystectomy was performed. The removed kidney showed signs of mild hydronephrosis but no tumor was found macroscopically. The stenosed site of the ureter had scar-like tissue. Microscopic examination revealed that the stenosed ureter consisted of nonspecific granulation tissue but the mucosa of the renal pelvis showed grade III transitional epithelial cell carcinoma, At 24 months after operation, there is no evidence of tumor recurrence, and urine cytology is also negative.
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PMID:[A case of carcinoma in situ of the renal pelvis]. 368 36

Six patients with a history of bladder carcinoma and a radiographic filling defect of the pelvicaliceal system have been investigated or treated percutaneously. In two cases of doubtful diagnosis, percutaneous pyeloscopy showed that no pelvicaliceal tumour was present. In four patients with multifocal or recurrent transitional cell carcinoma and difficult clinical problems, intrarenal tumours were cauterised or resected percutaneously. Radioactive iridium wire (192Ir) was inserted into the surgical track to deliver prophylactic irradiation (4500 cGy) to prevent tumour seeding. Follow-up was from 7 to 36 months. One operated patient developed early wide-spread multifocal disease throughout the urothelium, including the operated kidney, and died of uraemia. The other three patients have shown no recurrence in the operated kidney, though two have developed recurrences in the bladder or ureter. There have been no track recurrences.
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PMID:Percutaneous renal surgery and local radiotherapy in the management of renal pelvic transitional cell carcinoma. 371 42

We present a case of primary ureteral carcinoma in the duplicated renal pelvis and ureter diagnosed by transurethral uretero-renoscopy. The case was of a 78-year-old man with the complaint of sudden asymptomatic macrohematuria. An excretory urogram strongly suggested the presence of duplication of the right collecting system, and cystoscopy revealed a gross hematuria from the right ureteral orifice. A retrograde ureteropyelogram revealed incomplete duplication of the right renal pelvis and ureter fused at about the ureter crossing over the iliac vessels, and a polyp-like filling defect in the lower segment of duplicated ureter at about 4 cm from the fusion of the ureters. Transurethral uretero-renoscopy was employed to investigate the filling defect, and a papillary tumor extended into the lower segment of duplicated ureter was revealed. Tumor was resected by a rigid operating instrument under transurethral uretero-renoscopy. The pathological diagnosis was grade I-transitional cell carcinoma of the ureter, so that right total nephroureterectomy with partial cystectomy was carried out subsequently. Surgical specimen after right total nephroureterectomy with partial cystectomy showed no other tumor in the pelvis or ureter macroscopically, and histopathological studies of surgical specimens were no evidence of malignancy. We believe that transurethral uretero-renoscopy significantly increases the diagnostic accuracy in determining the nature of upper urinary tract lesions, and this procedure is indispensable in the diagnosis of ureteral tumors. The present case was the 7th case of primary ureteral carcinoma in the duplicated renal pelvis and ureter in the Japanese literature.
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PMID:[A case of primary ureteral carcinoma in the duplicated renal pelvis and ureter diagnosed by transurethral uretero-renoscopy]. 372 47

Ninety patients with a variety of advanced-stage malignancies were treated with surgical resection, when feasible, and with intraoperative radiotherapy. Certain patients received additional external beam radiotherapy. During clinical follow-up, 45 patients died. Twenty-two patients (49% of deaths) underwent detailed autopsies between 1 and 18 months after treatment, with special attention directed towards assessing radiation damage to various tissues. Histological changes related to radiation were generally manifested as fibrosis. Mild fibrotic changes in retroperitoneal soft tissues and mild hypocellularity in vertebral bone marrow were consistently present in patients treated for pancreatic carcinoma, gastric carcinoma, and retroperitoneal or pelvic sarcomas. Fibrosis of the soft tissues of the porta hepatis without narrowing of the bile duct was present in patients treated for pancreatic or gastric cancer. perineural fibrosis was present in retroperitoneal and pelvic nerve trunks in patients treated for abdominal or pelvic sarcomas and in patients treated for unresectable carcinoma of the pancreas. Significant radiation-related changes were generally not observed in major blood vessels, intestine, or ureter. Intact irradiated primary tumors consistently displayed necrosis.
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PMID:Pathological tissue changes following intraoperative radiotherapy. 378 52

Flow cytometric (FCM) examination of DNA distribution based on heterogeneity index score (HIS) and ploidy pattern and of bladder irrigation specimens were compared with conventional urine cytologic examinations to evaluate the diagnostic efficacy of each method. Of 56 patients with histologically proved bladder tumors, 24 (43%) had positive urine cytology, 41 (73%) had positive FCM, and 45 (80%) had positive urine cytology and/or positive FCM. When bladder tumors were graded histologically, 8 of 11 patients (73%) with grade I bladder carcinoma, 22 of 28 patients (79%) with grade II, and 15 of 17 patients (88%) with grade III had positive urine cytology and/or positive FCM. Of the 28 patients with grade II, 12 with positive urine cytologic results had higher mean HIS (117.5) when compared with 16 (61.1) in whom urine cytology was negative. Of those who continued to have positive FCM in the face of negative findings on cystoscopic and urine cytologic examinations during follow-up, 3 patients eventually were found to have tumors (2 distal ureter, 1 bladder). These results indicate that FCM examinations for DNA distribution of bladder irrigation specimens are as useful as conventional urine cytology in the management of bladder tumors, can be more sensitive for detection and monitoring of the disease, and can contribute further to accurate diagnosis of the disease when combined with conventional urine cytology.
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PMID:Flow cytometry based on heterogeneity index score compared with urine cytology to evaluate their diagnostic efficacy in bladder tumor. 381 Nov 3

Five years after prostate resection and hormonal treatment for carcinoma of prostate a 76 year old patient presented with bone and lung metastases and dilatation of left upper collecting system. After castration a double J stent was inserted in the ureter. Two years later he was admitted for alteration in general condition related to cholecystitis. A standard radiograph showed the catheter fractured into four pieces, although no urinary signs had been reported during this 2-year period. Cholecystectomy was performed and the patient reviewed 6 weeks later: urography showed good functioning of the kidney and the absence of obstruction of the collecting system. The process of fragmentation continued and a bladder calculus developed on fragments falling into bladder: it was extracted by lithotripsy. The patient was asymptomatic and refused further investigation or treatment. This case is one of several reported in the literature and silicone or C-flex should be substituted for polyethylene.
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PMID:Spontaneous breakage of a double pigtail stent and bladder stone formation. 381 64

Since carcinoma of the prostate usually metastasizes to pelvic lymph nodes or to bone or by direct extension, a discrete metastatic papillary lesion involving the ureter is unusual. We report such a case in a fifty-three-year-old man. Review of the literature has identified 11 other cases of carcinoma of the prostate metastatic to the ureter. None of the previously reported cases, however, described a discrete papillary intraluminal tumor in which there was no direct extension outside the ureteral wall. In addition, small foci of tumor were within intraluminal lymphatics as well as within the ureterovesical resection margin. These findings together with immunoperoxidase results confirm the unusual behavior and presentation of metastatic prostate carcinoma involving the ureter. Later a bladder tumor developed and histology again revealed metastatic prostate carcinoma.
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PMID:Prostate carcinoma metastatic to ureter. 382 36

Patients with carcinoma of the urinary bladder have a poor prognosis. When distant metastasis develops, such patients seldom survive for more than several months. For them, surgery and/or radiotherapy are of little value, and systemic chemotherapy has been thought to be the most useful treatment. Forty-six patients with advanced transitional cell carcinoma, including bladder cancer, (33 bladder, 9 ureter, 4 renal pelvis cases) were treated by a three drug combination chemotherapy, using two protocols (protocol I: adriamycin + cyclophosphamide + 5-fluorouracil, protocol II: adriamycin + cyclophosphamide + cis-platinum). Protocol I induced responses in 5 of the 24 patients (21%, 1 complete response, 4 partial responses), and protocol II in 7 of the 22 patients (32%, 1 complete response, 6 partial responses). The overall response rate was 26%. The durations of response (median duration 5.1 months) and of survival (median duration 11.3 months) in all responders were relatively short. The three-combination chemotherapy, especially protocol II, was effective against transitional cell carcinoma of the urinary tract, but the results were not satisfactory.
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PMID:[Combination chemotherapy of advanced bladder cancer]. 382 29


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