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

Vesico-ureteric reflux (VUR) is a urinary tract abnormality that affects roughly one-third of patients with renal-coloboma syndrome, an autosomal dominant condition caused by a mutation in PAX2. Here, we report that a mouse model with an identical mutation, the Pax2 1Neu+/- mouse, has a 30% incidence of VUR. In VUR, urine flows retrogradely from the bladder to the ureter and is associated with urinary tract infections, hypertension, and renal failure. The propensity to reflux in the Pax2 1Neu+/- mouse is correlated with a shortened intravesical ureter that has lost its oblique angle of entry into the bladder wall compared with wild-type mice. Normally, the kidney and urinary tract develop from the ureteric bud, which grows from a predetermined position on the mesonephric duct. In Pax2 1Neu+/- mice, this position is shifted caudally while surrounding metanephric mesenchyme markers remain unaffected. Mutant offspring from crosses between Pax2 1Neu+/- and Hoxb7/GFP+/- mice have delayed union of the ureter with the bladder and delayed separation of the ureter from the mesonephric duct. These events are not caused by a change in apoptosis within the developing urinary tract. Our results provide the first evidence that VUR may arise from a delay in urinary tract maturation and an explanation for the clinical observation that VUR resolves over time in some affected children.
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PMID:Vesico-ureteric reflux and urinary tract development in the Pax2 1Neu+/- mouse. 1788 63

The ureter which runs behind the main lower vein is the evolutionary fault of the vascular system. It is the result of the disorder of the foetal vein canals developments. The clinical symptoms resulting from this fault are: the pains in the lumbar region, hematuria, the recurrent pyelonephritis, nephrolithiasis and the arterial hypertension. Ultrasonography, tomography and magnetic resonans imaging are used in the diagnosis. The best treatment is the operation leading to the restoration of the ureter anatomic position. Nowadays the laparoscopic minimal invasive methods are used more and more often. In this study we described 3 patients. Each of them underwent the operation to correct the ureter position. The result was the improvement of the clinical condition.
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PMID:[Retrocaval ureter]. 1796 89

Vesicoureteric reflux (VUR) is a congenital urinary tract defect caused by abnormal insertion of the ureter within the bladder wall. This leads to a defective ureterovesical junction in which urine flows retrogradely from the bladder to the kidneys. Although VUR is associated with recurrent urinary tract infections, renal malformations, hypertension, and reflux nephropathy, its relationship to each of these clinical entities is poorly understood. Mutations in genes expressed by the developing kidney and urinary tract can cause VUR in mice, and some of these same genes have been identified in humans with VUR. By discovering the genes that are associated with VUR, new hypotheses will be generated such that, eventually, the relationship between VUR and its complications will be understood.
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PMID:Gene discovery and vesicoureteric reflux. 1825 65

Vesicoureteral reflux (VUR) refers to the retrograde flow of urine from the bladder into the ureter and renal pelvis. It generally results from congenital maldevelopment of the ureterovesical junction, although VUR may develop in individuals with abnormally high detrusor pressure. VUR increases a child's susceptibility to pyelonephritis and renal scarring. Treatment goals include the prevention of pyelonephritis, reflux nephropathy, and other complications of reflux. Treatment alternatives include antibiotic prophylaxis, urotherapy (correction of voiding dysfunction), and surgical correction (open, injection therapy, or laparoscopic). Recent studies have challenged the presumed benefit of prophylaxis in children with VUR, while long-term retrospective studies have documented a high rate of hypertension in adults with reflux nephropathy. In addition, the risk of persistent VUR in adulthood is unresolved. These reports have stimulated a reevaluation of the role of various treatment options in children with VUR.
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PMID:Therapy for vesicoureteral reflux: antibiotic prophylaxis, urotherapy, open surgery, endoscopic injection, or observation? 1841 99

Fibromuscular dysplasia (FMD) is one of the most common causes of renovascular hypertension in children and women. It is characterized by short multiple stenoses alternated to focal expansions that usually involve the lateral third of the renal artery. Digital subtraction angiography is considered the most accurate method in the diagnosis of renal artery FMD. An indirect sign of FMD-the notches on the ureter secondary to the hypertrophy of the branches of ureteric arteries "climbing" along the ureters-can be visualised during urography. We report the case of a 38-years-old woman with hypertension and no history of familiar predisposition, in which the multidetector computed tomography angiography was able to show both direct and indirect radiological signs of renal artery FMD. 2D and 3D visualisations are useful to suggest the diagnosis of FMD and in the follow-up in patients who underwent to percutaneous transluminal angioplasty.
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PMID:CTA and 2D-3D post-processing: radiological signs of fibromuscular dysplasia of renal artery. 1864 22

The urinary tract reconstruction in renal transplantation is usually performed by a ureterocystoneostomy according to Gregoire-Lich technique. In selected patients, native ureteral ligation with nephrectomy was done when end-to-end anastomosis for ureteroureterostomy was performed. Recently, some Authors have proposed the ligation of the native ureter without nephrectomy. We report our experience in the ligation of the native ureter with no associated nephrectomy. MATERIALS AND METHODS. In 978 renal transplantations performed from April 1986 through December 2006, we evaluated 68 recipients (69.5%) who underwent ureteral ligation without nephrectomy. Mean diuresis was 314 cc/day (range 0-1200 cc/day). Follow-up was 1 to 187 months. RESULTS. Only one patient (1.5%) required native nephrectomy for fever and abdominal pain. None of the other patients showed infections involving native kidney or flank pain during the follow-up. DISCUSSION AND CONCLUSION. Our experience confirms the safety and feasibility of native ureter ligation without omolateral nephrectomy. Nephrectomy is indicated in the case of coexistent intrinsic renal disease, such as non-treatable nephrovascular hypertension, symptomatic polycystic kidney disease, chronic renal infection.
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PMID:[Ligation of the native ureter in kidney transplant]. 2108 93

Primary tumors of the renal pelvis and ureter account for about 8% of all urinary tract tumors. More than 90% of them are urothelial carcinomas. On the other hand, unilateral multicystic renal disease is an uncommon pathologic condition that may be mistaken for unilateral autosomal dominant polycystic kidney disease, multilocular cystic nephroma or cystic neoplasm. We present the case of a 54-year-old male known with arterial hypertension, admitted in the Second Surgery Department of Emergency County Hospital, Constanta, with intense right flank and right lumbar pain. This symptom started one month before hospital admission. Based on clinical features and imaging evaluations we established a presumptive diagnosis of unilateral autosomal dominant polycystic kidney disease. For these reasons, total right nephrectomy was performed. Pathologic examination of the nephrectomy specimen revealed high-grade urothelial carcinoma of the renal pelvis associated with unilateral multicystic renal disease. The particularity of this case lies in the uncommon association between two rare renal pathological conditions diagnosed by pathological examination.
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PMID:Urothelial carcinoma of the renal pelvis associated with cystic disease of the kidney. 2142 1

Vesicoureteral reflux (VUR) may be congenital or acquired. The most frequent form of congenital VUR is primary VUR. Its prevalence in adults is not exactly known, but it is higher in women, whose greater propensity for urinary tract infections increases the likelihood of an instrumental examination leading to the diagnosis of less severe cases. In men, even severe VUR may go undiagnosed for a long time. Primary VUR is due to a defect in the valve mechanism of the ureterovesical junction. In physiological conditions, the terminal ureter enters the bladder wall obliquely and bladder contraction leads to compression of this intravesical portion. Abnormal length of the intravesical portion of the ureter due to a genetic mutation (whose location is yet to be established) leads to VUR. In its less severe forms VUR may be asymptomatic, but in 50-70% of cases it manifests with recurrent cystitis or pyelonephritis. The manifestations leading to a diagnosis of VUR in adults, besides urinary tract infections, are proteinuria, renal failure and hypertension. The gold-standard diagnostic examination is a micturating cystourethrogram. Reflux nephropathy develops as a result of a pathogenetic mechanism unrelated to high cavity pressure or urinary tract infections but due to reduced formation of the normal renal parenchyma (hypoplasia or dysplasia). Abnormal renal parenchyma development is attributable to the same genes that control the development of the ureters and ureterovesical junction. VUR is considered only a marker of this abnormal development, playing no role in scar formation. There is no conclusive evidence regarding the indications for VUR correction. However, the risk that VUR leads to recurrent pyelonephritis and reflux nephropathy must be kept in mind. VUR certainly has to be corrected in women who contemplate pregnancy.
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PMID:[Vesicoureteral reflux in adults]. 2216 11

A 55-year-old gentleman with a medical history of hypertension presented to emergency department with sudden onset of central abdominal pain and left flank pain. A CT KUB (kidney, ureter and bladder) was performed to assess the patient for a possible renal calculus and other potential gastrointestinal causes. However, an extensive aortic dissection from the arch of the aorta to the iliac arteries was detected. Hypotensive blood pressure control was started in an attempt to reduce the shear stress on the aortic wall. Unfortunately, the drop in blood pressure reduced splanchnic perfusion, resulting both duodenal perforation (secondary to duodenal ischaemia of the watershed area) and the development of acute renal failure. The patient underwent an emergency laparotomy for the perforated duodenum and biliary peritonitis. He was transferred to the intensive care unit for 18 days postsurgery for renal, respiratory, nutritional and cardiovascular support and was finally discharged home.
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PMID:Aortic dissection: a case of atypical clinical manifestation and valuable lessons in management. 2269 30

Extra-adrenal pheochromocytomas, or paragangliomas, are rare tumours that may develop from extra-adrenal chromaffin cells, and most occur in the organ of Zuckerkandl. Extra-adrenal paraganglioma of the prostate is extremely rare. We report a 53-year-old man with hypertension and lower urinary tract symptoms, who was initially diagnosed with benign prostate hyperplasia. Computed tomography (CT) showed a large heterogenously enhancing mass in the prostate, imprinting the right distal ureter and urinary bladder. Before surgical intervention, CT-guided biopsy of the prostatic mass was performed and the result of histologic examination confirmed extra-adrenal paraganglioma. He underwent radical prostatectomy, partial cystectomy and right ureteroneocystostomy. The patient recovered and his blood pressure returned within normal range after surgical removal of the prostate tumour. In this article, we stress that the rarity of prostatic paraganglioma, preoperative localization and imaging-guided biopsy were useful in determining the surgical strategy.
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PMID:Extra-adrenal paraganglioma of the prostate. 2376 43


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