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

Experience with 20 simple ureteroceles in 18 children is reviewed. In most cases hydroureteronephrosis of various grades of severity was present. In 5 cases the related kidney was non-functioning. The ureterocele generally is seen on excretory urography, either as a positive cobra-head dilatation or as a negative filling defect in the cystogram when renal function is impaired. Cystoscopy is diagnostic but confusion may occur when a lax ureterocele is compressed and emptied or even everted by a high intravesical pressure. Expectant management is warranted in the absence of upper tract dilatation but operative intervention is needed in most cases. Nephroureterectomy may be unavoidable if the kidney is afunctional. Simple unroofing or incision of the ureterocele is followed by vesicoureteral reflux and ascending infection. The preferred technique is total excision of the ureterocele and reimplantation of the ureter into the bladder by an antireflux technique.
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PMID:Orthotopic ureteroceles in children. 65 Jul 66

Patients with chronic renal failure and total diversion of the lower urinary tract have been considered poor transplant candidates, and post-transplant urinary diversion, i.e., Bricker loop, has been thought to be necessary. Our experience with nine patients clearly indicates that these patients are actually excellent transplant candidates and that post-transplant urinary diversion rarely is necessary. Ureteroneocystostomy of the allografted ureter was performed in seven patients with pretransplant total urinary diversion and all have completely normal bladder and renal function 10 to 66 months after transplantation; the two patients with Bricker loop procedures performed at transplantation died 7 months after transplantation of rejection and pancreatitis. The excellent results achieved with ureteroneocystostomy are attributed to (1) errors in diagnosis resulting in inappropriate bladder or ureteric surgery early in the course of the patient's disease; (2) confusion of immunologic of functional disorders with anatomic problems; (3) growth and development of the bladder, and (4) complete control of chronic bladder infection by pretransplant nephrectomy, ureterectomy, and antibiotics.
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PMID:Renal transplantation in patients with urinary tract abnormalities. 76 10

Duplications of the genitourinary tract are uncommon and may be a source of confusion in the early diagnosis of ureteral trauma when their presence is not suspected. We present a case of delayed diagnosis of a penetrating injury to a duplicated ureter and its management.
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PMID:Penetrating injury of a duplicated ureter: case report. 198 21

1. Electrophysiological techniques were used to characterize responses of afferent fibers in pelvic nerve of adult, virgin female rats to mechanical or chemical stimulation of internal reproductive organs and to mechanical stimulation of other pelvic organs. 2. In an in vivo barbiturate-anesthetized preparation, pelvic nerve afferent fibers responded to a wide variety of mechanical stimulation applied to restricted regions of the vaginal canal, caudal uterus (body and cervix), bladder, ureter, colon, or anus. 3. Single-fiber mechanoreceptive fields were invariably confined to a single organ. Notably, responses could be evoked not only by gentle stimulation of the unit's receptive field directly on the organ itself, but also by stimulating the field indirectly with intense stimulation through the appropriate part of a contiguous organ. This innervation feature is consistent with the separability of pelvic organ functions under innocuous conditions but their confusion under noxious ones. 4. Receptive fields on the reproductive organs extended from the caudal edge of the vagina to the uterine body (including the cervix) but were most often located in the fornix (vaginocervical junction). Most units had no or low levels of spontaneous activity. Their responses to mechanical stimuli were usually slowly or moderately adapting and time-locked to the stimulus. 5. Fibers with vaginal receptive fields (including the fornix) responded best either to vaginal distension with a balloon or, more often, to a probe moving along the internal vaginal surface in a direction toward the cervix. They were observed most frequently during the proestrus stage of the rat's estrous cycle. These fibers, therefore, seem particularly suited for relaying information about stimuli that occur during mating. 6. Fibers with receptive fields on the uterine cervix and body responded best to static pressure and were observed less frequently than those with vaginal fields, regardless of estrous stage. They were, however, sensitized by hypoxia. In addition, irritation of the uterus increased the probability of observing them. These fibers, therefore, may exert their primary function during reproductive conditions different from those of virgin rats, such as parturition. 7. Response activity of most of the mechanoreceptive afferent fibers supplying reproductive organs increased as the stimulus intensity increased into the noxious range; i.e., into a range in which the stimulus momentarily produced ischemia at the stimulus site. In addition, in an in vitro preparation, pelvic nerve fibers responded in a dose-dependent manner to injections through the uterine artery of bradykinin (BRAD) as well as to other algesic chemicals, 5-hydroxytryptamine (5-HT) and KCl.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Functional properties of afferent fibers supplying reproductive and other pelvic organs in pelvic nerve of female rat. 231 44

TCDD (2,3,7,8-tetrachlorodibenzo-p-dioxin) has been recognized as a kidney and palate teratogen for many years. The etiology of the kidney abnormality has not been revealed, and there is some confusion about the exact nature of the defect. This study examines C57BL/6N fetal mouse kidneys from day 14 of gestation through day 17. Pregnant females received a single dose of 0 or 12 micrograms TCDD/kg by gavage on day 10 pregnancy. Fetal urinary systems were examined on days 14, 15, 16 (a.m.), 16 (p.m.), and 17 (p.m.). The patency of the ureteric lumen was examined by injection of dye into the bladder. TCDD treatment did not delay or prevent breakdown of the ureteric membrane between days 15 and 16. On days 16 through 17, the ureteric lumina of TCDD-exposed fetuses were narrow and tortuous when compared to the control lumens. Sections of ureter were observed by light microscopy. On day 15 the lumina of TCDD-exposed ureters were occluded by epithelial cells. As a result of hyperplasia of the ureteric luminal epithelium, hydroureter and hydronephrosis became pronounced by day 17. We conclude that the kidney abnormality induced by TCDD is true hydronephrosis, which is defined as the accumulation of urine in the kidney due to obstructed outflow.
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PMID:TCDD-induced hyperplasia of the ureteral epithelium produces hydronephrosis in murine fetuses. 362 13

Abdominal cystic masses in childhood are rare and despite improved imaging techniques continue to present diagnostic confusion. Typically such cystic lesions are mesenteric or intestinal in origin. However, rarer causes include cystic dilatation of a blind ending ureter. To date over 100 cases of blind ending ureters have been reported and their management described. We report on a case of non-communicating ureteric cyst associated with a blind ending ureter that recurred following percutaneous drainage and required operative resection. Although percutaneous drainage techniques have been advocated for a variety of abdominal cystic lesions, the experience gained from this case suggests that operative excision is the treatment of choice.
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PMID:Ureteric cyst: an unusual abdominal mass. 821 79

Appendicolithiasis is a condition characterized by a concretion in the vermiform appendix. Appendicoliths are found in 10% of patients with acute appendicitis, but they are seen more frequently in perforated appendicitis and in abscess formation. We herein report a case of acute appendicitis due to appendicolithiasis, which mimics acute disorders of the genitourinary tract and causes diagnostic confusion. A38- year-old man presented to our emergency department with a history of intense, acute, recurrent, crampy right lower quadrant pain radiating to the right groin region, accompanied by nausea. Physical examination revealed muscular defense and rebound tenderness in the right lower quadrant, tenderness in the line of the right ureter and right costovertebral angle tenderness. On X-ray examination, a right kidney stone was identified as was an incidental 3-cm density in the right lower quadrant. The patient underwent appendectomy. The diagnosis was made by operation and also X-ray examination of the appendectomy material showing appendicolithiasis. Acute appendicitis may manifest as a variety of genitourinary disorders. The possibility of an appendicolith with or without acute appendicitis must always be considered in the differential diagnosis of acute lower abdominal and pelvic disorders, and in the consideration of common acute urological disorders.
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PMID:Appendicolithiasis causing diagnostic dilemma: a rare cause of acute appendicitis (report of a case). 1898 58

A 53-year-old man presented with right flank pain for 6 days. Computerized tomography revealed a 3 cm long segment of ureteral narrowing with wall thickening and hydronephrosis, suspicious for ureteral cancer. Under the clinical diagnosis of ureteral carcinoma a right nephroureterectomy was performed. The wall of the distal ureter, 2.5 cm from the bladder cuff, had a luminal-narrowing, firm mass-forming lesion with abrupt transition from the adjacent ureter. Histologically, the resected ureteral mass showed transmural fibrosing, chronic inflammation with numerous plasma cells, epithelioid granulomas, and obliterative phlebitis. Histological findings were consistent with idiopathic segmental ureteritis (ISU) with differential diagnoses of IgG4-related sclerosing disease, including lymphoplasmacytic inflammatory pseudotumor (IPT) and idiopathic retroperitoneal fibrosis. IgG4 immunostaining in this case was barely positive, excluding the possibility of IgG4-related IPT. Although the majority of luminal obliterated segmental lesions of the ureter are neoplastic in nature, non-neoplastic inflammatory processes as seen in this case may occur in the ureter, causing diagnostic confusion with true neoplasms. Herein we report a rare case of ISU that was clinically misdiagnosed as malignancy preoperatively. ISU of the current case may be an IgG4-unrelated subtype of IPT.
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PMID:Idiopathic segmental ureteritis, misdiagnosed as ureteral cancer preoperatively: a case report with literature review. 2109 36

Symptomatic Mullerian duct cysts are uncommon. A young adult male presented to us with a palpable supra-pubic mass, pain and lower urinary tract symptoms. Initial imaging modalities showed a large cystic lesion in the pelvis with a non-visualized right kidney. A short, blind ending right ureter on retrograde pyelography added to the confusion. On exploration, the lesion was noted to be separate from the seminal vesicles, bladder and posterior urethra. The right kidney was absent. The cystic lesion was excised completely preserving the vas and seminal vesicles. A high index of suspicion is needed for identification of this rare condition. Use of MRI (magnetic resonance imaging) can help improve the diagnostic accuracy. Many a times though, the diagnosis is evident only on exploration.
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PMID:A large mullerian duct cyst presenting as an abdominal mass with ipsilateral renal agenesis: an unusual presentation. 2357 7

IgG4-related disease (IgG4-RD) is a recently recognized multi-organ fibro-inflammatory lesion characterized by elevated IgG4 serum levels and mass-forming lesions. This condition shows similar histological features independently of the site of origin including storiform fibrosis, obliterative phlebitis, and dense lymphoplasmacytic infiltrate with a conspicuous IgG4-positive plasma cell component. Since this disease has only recently been categorized as a single specific nosologic entity, lesions with these typical morphological features have previously been named in different ways, creating some confusion and making it difficult to identify cases published in the literature. Lesions with features suggesting IgG4-RDs have very rarely been reported in the ureter, and they have been named using the terms "inflammatory pseudotumor" and "idiopathic segmental ureteritis." Herein, we describe the clinicopathological features of ureteral IgG4-RD found in two different patients. An 82-year-old female and a 77-year-old male underwent ureteral resection due to severe ureteral wall thickness and lumen stenosis suggestive of urothelial carcinoma. However, histological examinations showed transmural fibro-inflammatory lesions, with abundant IgG4 plasma cells intermixed with histiocytes, lymphocytes, fibroblasts, and scattered eosinophils. We have also accurately reviewed the literature in order to identify, among lesions diagnosed with different names, examples of ureteral IgG4-related lesions to give the reader a comprehensive overview of this relatively rare inflammatory disease. We suggest using the name "ureteral IgG4-RD" for those lesions showing the same morphological features as IgG4-RDs located elsewhere.
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PMID:IgG4-related disease of the ureter: report of two cases and review of the literature. 2366 67


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