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

Uretero-cystostomy was used as reconstructive procedure in 298 cadaver kidney transplantations. Necrosis of the graft ureter occured in 10 cases (3.4%). 2 of these graft ureters had malformations and 1 was denuded at donor nephrectomy. The occurrence of ureteral necrosis was not related to histocompatibility or number of rejection crises nor to the duration of the warm ischemia. A higher incidence of ureteral necrosis after long cold ischemia is demonstrated, but the material is too small to permit conclusive evidence on this point.
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PMID:Ureteric necrosis after kidney transplantation. 80 Oct 99

Endopyelotomy has been established as a valuable procedure to relieve the obstruction of ureteropelvic junction or upper ureteral stenosis. However, in a case with a long stenotic segment and in a case with high insertion type of ureteropelvic junction obstruction, we had often poor results by the conventional technique. To resolve these problems, we developed a new technique of endopyeloureterotomy via transpelvic extraureteral approach. We made an auxiliary incision in renal pelvis or dilated ureter involved with stricture to pass a 22 Fr. urethrotome equipped with a cold knife into the retroperitoneal space. Then we incised a stenotic segment by the knife through the urethrotome until the normal caliber of ureteric lumen was found. A 10-16 Fr. stent was left in place in the incised segment for 3 weeks. We treated 38 patients with ureteropelvic junction stenosis or upper ureteral stenosis by this procedure between August 1988 and June 1990. A total of 39 procedures were performed on 39 ureteropelvic junctions or upper ureters. Original disease were congenital anomalies in 23 patients, strictures secondary to urinary calculi in 12 and postoperative strictures in 4. The length of incision was 2 to 6 cm with the average being 3.2 cm. Postoperative follow-up period ranged 4 to 32 months with the average being 19 months. Obstructive changes disappeared or improved in 37 procedures (95%). In two procedures we failed. Thus this new technique of endopyeloureterotomy might be an useful procedure to relieve ureteropelvic junction stenosis or upper ureteral stenosis with a long stenotic segment or high insertion type of ureteropelvic junction stenosis.
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PMID:[Endopyeloureterotomy via transpelvic extraureteral approach]. 143 71

Between 1985 und March 1991 we have managed 8 upper urinary tract obstructions in kidney transplants using an endourological approach. After a graft rejection was excluded an obstruction was initially diagnosed by nephrosonography and further confirmed by IVP or antegrade pyelography. To investigate the urodynamic relevance of the stenosis, all patients underwent preoperative diuretic isotope renography. In all cases a percutaneous pyelostomy was done to preserve renal function. 7 of these 8 patients demonstrated a stenosis of the ureter, while in one case, the obstruction was caused by a coagulum in the renal pelvis. Incision of the stricture then was performed with a flexible knife antegrade or retrograde and stented for 4-6 weeks. In 6 out of 7 cases with a proven stenosis of the ureter, the cold knife incision lead to a successful outcome, while in one patient, the kidney had to be removed due to uncontrolled bleeding 12 days after successful percutaneous incision. Our results indicate, that the cold-knife-technique for the management of upper urinary tract obstructions in kidney transplants is a promising, fast and in most of the cases effective method. Due to its minimalinvasive character and excellent results, this approach is able to replace open reintervention in most cases.
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PMID:[Obstructive uropathy after kidney transplantation. Experiences with endourologic incision of ureteral stenoses]. 146 88

A case of ureteral complication observed after endopyelotomy is reported. A 19-year-old female patient suffering from right hydronephrosis due to uretero pelvic junction stenosis was treated with endopyelotomy. The stenotic ureter was incised by cold knife for a distance of 5 cm through full thickness. The cut ureteral segment was intubated with a ureteral stent catheter of 10 Fr calibre. The top of the catheter was advanced 1 cm from the edge of the incised ureter. To prevent protrusion of the catheter tip, a flexible guide wire 0.038 inches in diameter was inserted into the catheter and the tip of the guide wire was advanced to the bladder. Antegrade pyelography performed 3 weeks after the operation revealed a lesion resembling a pseudo-ureter. It was made by the catheter that had slipped out of the incised ureter. The lumen of the true ureter was also preserved without stenosis. After removal of the stent catheter and safety guide wire, the true ureter was intubated with a double J catheter of 10 Fr calibre. One week later the pseudo-ureter was not demonstrated by excretory urography performed. Finally, hydronephrosis due to uretero pelvic junction stenosis was treated successfully.
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PMID:[A case of ureteral complication following endopyelotomy]. 156 56

Between 1985 and October 1989 we managed 13 patients with primary and 43 with secondary obstruction of the upper urinary tract with the endourological cold-knife technique. We treated 26 patients with stenosis of the ureteropelvic junction, 9 with infundibular stenosis, 12 with ureteral obstruction after inflammation or radiation therapy, 7 with stricture of the ureter in kidney transplants and 2 with stenosis of the ureter after ureterosigmoidostomy. Endourological management was successful in 42 of 56 cases with a decrease or total elimination of obstruction. Stenosis recurred in 9 patients. Our results indicate that the cold-knife technique should be attempted as the initial approach in all cases of primary or secondary obstruction of the upper urinary tract.
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PMID:The cold-knife technique for endourological management of stenoses in the upper urinary tract. 189 51

The paper deals with an endoscopic correction technique for ureteropelvic stricture, namely percutaneous endopyelotomy. The authors employed the technique in 16 patients both with primary and postoperative strictures of a ureteropelvic segment. Endopyelotomy was concomitant with nephrolith extraction in some cases. The diagnosis and outcomes of the therapy were assessed from X-ray, radioisotopic, and urodynamic findings. The specific features of percutaneous endopyelotomic techniques: paracentetic nephrostomy through the upper and middle calices, introduction of a guidewire along the ureter and an auxiliary wire into the pelvis, bougienage of the nephrostomic fistula and introduction of a nephroscope into the pelvis, dissection of the stricture using a cold knife, and splintage of the ureteropelvic stricture are also described. The authors note good results of the therapy and consider the technique to be highly effective. The technique is found to be superior to open pyeloplasty.
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PMID:[Percutaneous endopyelotomy]. 208 61

Open surgical repair of upper urinary collecting system strictures or obstructions is difficult and is less likely to be accepted by the patient than an endoscopic or ureteroscopic approach. In the hands of an experienced urologic endoscopist the use of our cold blade has the advantage of less trauma to the ureter, already compromised by poor blood supply, than blind dilation; there is visual control of the procedure and acceptance by the patient that the urologic surgeon is doing the procedure; and it is adaptable to rigid or flexible endoscopes and ureterorenoscopes. Furthermore, there is information that the results are better, at least in the short term, than the more traumatic endoscopic procedures associated with dilation. However, only long-term future series will give us an evolving view of this resistant problem. Finally, the ureteral knife we have developed has the potential to be converted to an electrosurgical device for incision or coagulation, when appropriate. An application is pending with the US Food and Drug Administration concerning electrosurgical applications of the ureteral knife (in conjunction with J.R. La Course, PhD, and G.C. Gerhard, PhD, Department of Electrical Engineering and Computer Sciences, University of New Hampshire, Durham). The high dielectric constant of the sheath, combined with hemostatic or incisional properties in this latter mode, would likely prove advantageous.
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PMID:New coaxial ureteral stricture knife. 230 27

Organ transplantation is predominantly vascular surgical procedure. Vascular aspects of renal transplantation are important in all surgical phases of this procedure: --donor-nephrectomy (living-related or cadaver nephrectomy)--include nephrectomy undamaged kidneys, each with good length of renal artery (with or without aortic patch), renal vein (with or without caval patch) and ureter --organ-ex situ-surgery (bench surgery) sometimes is necessary after cold perfusion with Collins solution --implant surgical procedure, which include--dissection of recipient vessels (localisation.) --venous anastomosis (type and technique) --arterial anastomosis (type and technique) --use of vascular grafts (autografts or alografts) for kidney revascularisation during implantation (???) In the period 1987-1988, in our Experimental Surgery Unit a total of 20 dogs were operated (experimental kidney autotransplantation) under the same surgical team. The aims of those experimental autotransplantations were: training of the surgical team for routine human renal transplantations and usefulness of vascular grafts (autografts or allografts) for kidney revascularisation. We divided animals into the three groups: The first group (5 dogs)--revascularisation using AUTOVENOUS grafts The second group (5 dogs)--revascularisation using ALLOGRAFTS (Dacron or e-PTFE-Goretex grafts) The third group (10 dogs)--direct revascularisation without vascular grafts (control group) The best results were in the third group (no early vascular thrombosis) especially with end-to-end arterial anastomosis (we prefer it) and end-to-side venous anastomosis. Unfortunately in the second group, results were bad (vascular anastomotic thrombosis in the all cases during the first 48 hours).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Vascular aspects of experimental transplantation of the kidney in dogs]. 232 10

The effects of capsaicin, substance P (SP) and neurokinin A (NKA) on motor activity and vascular permeability was investigated in the rat lower urinary tract (bladder dome and neck, proximal urethra and ureters). Capsaicin produced contractions of the rat bladder dome and neck and of the proximal urethra in vitro, which were unaffected by tetrodotoxin and abolished by ganglionectomy. SP and NKA were almost equipotent in producing a contraction of the rat isolated bladder dome or neck and urethra. However, the maximal response to NKA was about twice that of SP on the urethra and bladder neck. Capsaicin did not affect motility of the unstimulated rat isolated ureter, while NKA or SP activated rhythmic contractions, NKA being about 850 times more potent than SP. Either capsaicin or field stimulation produced a transient inhibition of the NKA-activated rhythmic contractions of the rat isolated ureter which was prevented by capsaicin-desensitization. The capsaicin-(1 microM) or field stimulation-induced inhibition of NKA-activated rhythmic contractions of the rat isolated ureter were unaffected by removal of pelvic ganglia but abolished by cold storage (72 h at 4 degrees C). Intravenous capsaicin induced an inflammatory response (Evans blue leakage) in the bladder, proximal urethra and ureters in vivo. Plasma extravasation was greater in the ureters, urethra and bladder neck than in the dome. SP, NKA and histamine produced a dose-dependent dye leakage in all segments of the rat urinary tract, the response being slightly greater in the bladder neck than in the dome. The capsaicin-induced inflammatory response was abolished by systemic capsaicin-desensitization and reduced, to a variable extent, by pelvic ganglionectomy, in the various tissues examined. Topical application of tetrodotoxin on the bladder dome failed to affect the capsaicin-induced plasma extravasation in the urinary bladder. These findings indicate that chemoceptive, capsaicin-sensitive nerves are present throughout the whole rat lower urinary tract and their activation determines a variety of visceromotor responses and an increase of vascular permeability. In various instances the response to capsaicin may be explained by the action of tachykinins but some effects may involve other sensory neuropeptides.
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PMID:Regional differences in the effects of capsaicin and tachykinins on motor activity and vascular permeability of the rat lower urinary tract. 244 29

During a 16-month interval 235 kidneys were recovered from 120 consecutive donors, 15 of which were not transplanted for a variety of reasons. The factors believed to be important in producing a low wastage rate of procured kidneys included careful management of the donor during the brain death period, en bloc resection to avoid damage to vascular structures and the ureter, and avoidance of cold ischemia.
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PMID:Results from a single kidney procurement center. 634 38


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