Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0403608 (ureter)
 9,655 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

There are a number of factors that affect ureteral dilatation in patients with posterior urethral valves. These include large urinary outputs, a noncompliant bladder, and distal ureteric fibrosis. Dilatation alone does not imply obstruction, and careful studies should be obtained to document obstruction prior to considering any surgery. Our prejudice leads us to avoid ureteric reconstruction in the period immediately after valve ablation. Our findings suggest that these patients have hypertonic bladders immediately after valve ablation period, so it could be hazardous to reimplant the ureter in such a bladder and thereby expose these kidneys to unnecessary high pressures. Each patient with persistent dilatation should be treated on an individual basis. Some will require no treatment, some reimplantation with or without tailoring, and some an augmentation cystoplasty. More conservative approaches include double and triple voiding regimens, intermittent catheterization, anticholinergics, alpha sympathomimetic blockers, and regimens to decrease urinary output. These same regimens also seem to have a role in improving the level of continence, as does the onset of adolescence. Fortunately, the majority of patients with posterior urethral valves can be treated with valve ablation alone. Unfortunately, a number of patients who have creatinines of less than 1.0 mg per dl following treatment in the first year of life will go onto renal failure years later. Rapid progression to renal failure usually does not ensue until the teenage period, when proteinuria and hypertension seem to be the hallmarks. The progressive renal failure that develops in these patients may be related to the hyperfiltration syndrome that Brenner and Levine reported in patients with a decreased number of nephrons. A role for decreased intake of protein may have some influence in preserving the function of patients with a reduced number of nephrons and hopefully will affect the ultimate prognosis. The author anxiously awaits the formation and results of studies that will employ such a dietary regimen for patients with a history of severe valves in the hope of preserving renal function. However, such reports are not likely to be forthcoming during this decade.
 ...
PMID:Current issues regarding posterior urethral valves. 388 21

A case of neonatal adrenal hemorrhage associated with transient obstruction of the kidney and hypertension is reported. Sonography demonstrated a mass in the right suprarenal area, consistent with hemorrhage into the adrenal gland. DTPA renal scan showed prolonged retention of the injected material in the right kidney, consistent with obstructed outflow from the renal collecting system. Gradual decrease in the size of the suprarenal mass was associated with relief of the renal obstruction as evidenced by a normal repeat renal scan, and a return to normal of the blood pressure. It appears that the cause for the hypertension was the acute renal obstruction, which was due to either direct pressure on the proximal ureter by a large adrenal mass or secondary to displacement of the kidney by the mass resulting in kinking of the proximal ureter.
 ...
PMID:Transient obstruction of the kidney and hypertension due to neonatal adrenal hemorrhage. Case report. 391 65

We report a case of renal hypertension 6 months after a panhysterectomy for cervical cancer. Clinical investigation revealed that recurrent cancer obstructed the left ureter, resulting in the formation of a gigantic perirenal pseudocyst and, subsequently, hypertension. Constriction of the renal parenchyma was responsible for the overactivity of the renin-angiotensin system (the Page phenomenon). Ultrasound-guided percutaneous drainage relieved the symptomatology completely.
 ...
PMID:Renal hypertension secondary to perirenal pseudocyst: resolution by percutaneous drainage. 405 80

Renal autotransplantation has been a treatment of choice for renovascular hypertension, renal artery aneurysm, complicated staghorn calculi, ureteral disorders and others. The paper reports 5 cases of extensively damaged ureter and discusses the indication and the results of operation. There were three cases of postoperative extensive ureteral stricture. One patient had postoperative ureteral injury with retroperitoneal abscess. The last one showed renal foreign body calculi with recurrent pyelonephritis after ureterocutaneostomy. The postoperative course of four patients had been uneventful revealing well functioning autotransplanted kidneys without hydronephrosis and infection during the follow-up period of 22 to 42 months. However, the patient with the ureteral injury and retroperitoneal abscess died of bleeding from renal vein anastomosis on the 15th postoperative day, since the renal pedicle showed marked inflammatory change including renal vein wall. Subsequently, autotransplantation is contraindicated in the cases with marked inflammation in the renal pedicle. In cases of various other ureteral lesions including long distance ureteral stricture, this procedure is recommended when neither the end to side ureteral anastomosis, Boari's bladder flap operation nor bladder hitch operation is feasible.
 ...
PMID:[Renal autotransplantation for ureteral lesions--the indication and the results of operation]. 639 56

A case of renovascular hypertension in a patient with a congenitally solitary kidney associated with retrocaval ureter is reported. Aortorenal bypass with autogenous saphenous vein graft and concomitant mobilization of the ureter by division and reanastomosis of the inferior vena cava were performed. Pathogenesis of the stenotic lesion of the renal artery was fibromuscular dysplasia. Postoperative improvement of hypertension was not so good as expected. Soon after administration of nifedipine (20mg/day) was started, blood pressure decreased down to 130/80mmHg and had been well controlled. Problems regarding renovascular hypertension with a solitary kidney and surgical treatment of retrocaval ureter are discussed.
 ...
PMID:[Renovascular hypertension with a solitary kidney associated with retrocaval ureter: a case report]. 649 2

Vesicorenal reflux raises specific problems in adults, as regards both the surgical indications and the operative technique. The operative results are discussed in relation to fifty seven ureters reimplanted in thirty six patients, and the indications for surgical management are outlined. Refluxes clinically associated with lumbalgia, fever and pyuria, always require surgery. The most difficult problems arise from "asymptomatic" refluxes revealed by checkups for renal insufficiency, proteinuria or arterial hypertension. In these cases, the characteristics of the ureter (e.g. wide or narrow) and the existence or absence of renal scars must be taken into consideration. Refluxes in narrow ureters should be followed closely, and the advisability of surgery should be carefully weighed in patients with a wide ureter with no visible damage to the parenchyma.
 ...
PMID:[Vesico-renal reflux in adults. Study of 57 ureters reimplanted by the submucosal advancement method]. 652 94

Partial obstruction of the ureter was created in newborn rats, and its effects were studied after 1, 2, 3, 6 and 9 weeks--that is, until adult age. Within 1 week, a considerable hydronephrosis had appeared. Within 2 weeks, parenchymal weight was found slightly reduced (8 per cent) on the obstructed side, and, within 3 weeks, equivalently increased on the contralateral, intact side. After these points in time, there was no further deterioration. Histological examination revealed marked deformation of the papilla and minor foci of degeneration and inflammation within 1 to 2 weeks which tended to become chronic in type after 3 to 9 weeks. Arterial hypertension was not noted. Thus, the effects of partial ureteric obstruction on the renal parenchyma are 1) discrete, 2) not in proportion to the degree of hydronephrosis, 3) fully compensated by contralateral hypertrophy and 4), after reaching an early maximum, not increasing with time.
 ...
PMID:Experimental partial ureteric obstruction in newborn rats. IV. Do the morphological effects progress continuously? 664 11

Primary vesicoureteral reflux was seen in 2 siblings in a family of 5 (1 daughter and 2 sons). Voiding cystogram of elder sister, who complained of fever and backache, showed bilateral reflux at the age of 6. Left reflux disappeared soon but right reflux persisted. Right antireflux operation was performed at the age of 9, but right renal function deteriorated gradually. Right nephrectomy was done at the age of 12 because of persistent pyuria and renal stones. The second case was her younger brother who was sent to us because of proteinuria and hypertension. Excretory urogram showed left small kidney and voiding cystogram showed bilateral reflux with moderately dilated ureter and calyceal blunting. Urinalysis revealed normal findings except for proteinuria and he had no urological symptoms. Renal angiogram and renal vein renin study were unremarkable, so bilateral antireflux operation was done. Findings of urinalysis of his parents and younger brother were normal and cystogram of his brother was normal.
 ...
PMID:[Familial vesicoureteral reflux]. 667 4

The study was undertaken to focus attention on idiopathic retroperitoneal fibrosis, which may confront any surgeon operating in the abdomen or retroperitoneal area. Eleven patients, six men and five women varying in age from 35 to 76 years, were treated from 1969 to 1983. Two patients gave a history of methysergide and one gave a history of ergotamine ingestion. Two patients had associated aortic aneurysms and two had renal artery stenosis. Symptoms were related to entrapment of retroperitoneal structures, primarily the ureter, vena cava, gonadal veins, the aorta and its branches. Abdominal and costovertebral angle pain, testicular pain and swelling, and renovascular hypertension were the most common symptoms. The most common differential diagnostic problem was retroperitoneal tumor. Intravenous or retrograde pyelography were suggestive of the diagnosis in five patients, ultrasonography in two, and computerized axial tomography in another. Treatment consisted of ureterolysis and intraperitoneal transplantation or omental wrapping of the ureter in five, nephrostomy in two, renal-iliac arterial bypass graft in two, and renal autotransplantation in one. One patient was treated conservatively. Good results were achieved in eight, fair results in two, and one patient died postoperatively. Idiopathic retroperitoneal fibrosis should be kept in mind diagnostically in patients with unexplained abdominal pain and/or retroperitoneal lesions, and the surgeon prepared to employ appropriate operative measures for relief when it is encountered.
 ...
PMID:Idiopathic retroperitoneal fibrosis. A sometime surgical problem. 670 19

Unilateral uareteral obstruction (UUO) in 6-week old male spontaneously hypertensive rats (6-w-SHR) accelerated the elevation of blood pressure and developed stroke with high frequency from 3 weeks after operation, whereas UUO had no effect in either 20-week old SHR or 6-week old normotensive Wistar Kyoto rats. Urinary protein excretion and plasma urea and renin concentrations in 6-w-SHR began to increase 2 weeks after UUO. Removal of the obstructed kidney in 6-w-SHR one week after UUO prevented the acceleration of hypertension, while the same treatment 2 weeks after operation did not. In the ureter-obstructed kidneys of 6-w-SHR, hydronephrotic atrophy was markedly observed already one week after operation, while in the opposite kidneys, hypertensive vascular lesions were manifested from the second week. These results indicate that with regard to reversibility of the hypertensive process, the obstructed kidney is more important in the early postoperative stages and the contralateral kidney more important later.
 ...
PMID:Acceleration of hypotension and development of stroke in the spontaneously hypertensive rat by unilateral ureteral obstruction. 699 78


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>