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

Urethral bladder substitution is traditionally suggested to good prognosis cystectomized patients. In our series this diversion was chosen for all but the salvage cystectomized men. Between the 1st of February 1991 and the 30th of April 1996, one hundred consecutive men underwent lower urinary tract reconstruction after radical cystoprostatectomy for bladder cancer. An orthotopic ileal neobladder was constructed (in 84 cases according to Kock's technique and in 16 to Studer's technique). Total early complication rate was 29% (29/100), including one perioperative death due to sepsis (mortality rate 1%). 13 patients required surgery (6 retroperitoneal hematomas, 2 wound dehiscences, 1 urinary fistula, 1 lymphocele, 1 rectal-neobladder fistula, 1 rectal-cutaneous fistula, 1 necrosis of the terminal ureter). The late complication rate was 19% (19/100); in 8 cases reparative surgery was required (1 mechanical ileus, 2 bladder neck stenoses, 3 stenoses of the ureteral anastomosis, 2 laparoceles). Four patients were lost at the follow-up; out of the 96 remaining patients only 85 were evaluable for continence: continence during the day was achieved in a period between there to six months in 78 patients (91.7%); night continence was achieved with planned awakenings in 60 patients (70.5%). Eight patients recovered potency, another 7 had successful intercourses after PGE1 intracavernous injection. Renal function based on creatinine value was mildly impaired in 5/78 evaluable patients (6.4%) (peak creatinine 2.8 mg%). In 29 patients tumour progression was observed (29%): 9 pelvic and 20 metastatic. Among the latter 2 urethral recurrences were observed (2%). Twenty-four patients died for metastatic cancer, one for primitive lung cancer, one patient for postoperative septic shock. Adjuvant chemotherapy was administered in 11 patients without complication with an indwelling catheter in the neobladder to avoid drug reabsorption. Four patients showed complete response (2 are alive after a mean of 12 months), 6 were non responders and 1 had a partial response. In our series the ileal neobladder is a feasible method of urinary diversion when urethral cancer involvement is ruled out. Early and late complications are proportionally decreasing with experience and overall continence is satisfactory. The fate of the neobladder depends on both the technique and patient's compliance. Only educated patients can cope successfully with neobladder diversion without major complications. All the patients operated for non salvage cystectomy deserve to be diverted with a continent urethral bladder substitution.
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PMID:[100 orthotopic neobladders in men after cystectomy: a 5-year experience]. 902 35

The authors describe their case of the extremely rare multiple metastases of cutan melanoma malignum in the upper urinary tracts as it was treated with operations. In the case of their 17-year old patient first percutan resection of the right side of the renal pelvis-wall was done then one and half months later ureteronephrectomia was carried out on the right side because of metastases in the renal pelvis and the ureter. The primary tumour had been removed from the hairy area of the head 9 months earlier in a dermatological department. The authors have met only 14 similar cases in the international literature. In Hungary no review of any similar case has been found.
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PMID:[Multiple metastases of malignant cutaneous melanoma into the upper urinary tract]. 906 33

Eleven patients with stage IA2-IIA carcinoma of the cervix have been treated by combined laparoscopic-vaginal radical hysterectomy and bilateral pelvic lymphadenectomy (3-Stage IA2, 5-stage IB, 3-Stage IIA). The patients were unselected. Three patients had bulky (&gte; 5 cms) tumors, one of whom weighed 239 lbs; one had prior anterior-posterior repair, was apareunic and had significant vaginal narrowing; two patients had extensive pelvic adhesions, one of whom also had a 480 gram uterus. Pelvic lymph node metastases were present in one patient and paracervical lymph node metastases in one. The technique used has undergone significant modification. The laparoscopic phase of the procedure contributes much more to the operation than the lymphadenectomy for it allows a symbiotic partitioning of the operation into the laparoscopic and vaginal components. Only those steps of the operation are carried out vaginally that are easier to perform from below (division of the uterosacral and cardinal ligaments, unroofing of the ureter), and they are made much easier by the preceding laparoscopic phase of the operation. Laparoscopic development of the para-vesical and para-rectal spaces makes vaginal entry into these spaces very straightforward, and laparoscopic division of the uterine artery facilitates vaginal unroofing of the ureter. By allowing the proximal ureter to be freed from the medial leaf of the broad ligament, and the proximal attachments and blood supply of the uterus to be divided, the laparoscopic phase of the operation also permits the cervical ligaments to be divided before the ureters are freed from the vesico-cervical ligament, which helps to avoid a Schuchardt incision in most patients.
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PMID:Laparoscopic-Vaginal Radical Hysterectomy 907 93

We investigated the clinicopathological features of 62 patients with transitional cell carcinoma of the renal pelvis and ureter. Four patients had been treated for bladder cancer. Among 58 patients without precedent bladder cancer, 6 had coexistent bladder cancer and bladder cancer subsequently developed in 13. The 5-year cause-specific survival rate was 33% in cases with coexistent bladder cancer, 75% in those with subsequent bladder cancer and 62% in patients without association of bladder cancer. Distant metastases were found in 23 of 62 (37%) cases, the most frequent site being lymph nodes. The site of the primary tumor (renal pelvis and/or ureter) and the pathological findings such as grade, stage, type of infiltration, venous and lymphatic invasion, were significantly correlated to cause-specific survival. Multivariate analysis showed the most influential factors to be the type of infiltration and the site of the primary tumor. Therefore, patients with INF beta or gamma tumors both in the renal pelvis and ureter had a poor prognosis. However, association of bladder cancer was not related to survival.
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PMID:[A clinicopathological study on carcinoma of the renal pelvis and ureter]. 939 5

We evaluated the clinical experience of 115 women with early stage cervical cancer who had been operated in our Gynecologic Oncology Clinic. Of these, 85 were in stage I, and 30 in stage II. Intraoperative complications occurred in 16 patients including 3 cases concerning bladder, 1 ureter, 1 aorta, 5 v.cava inferior, 1 internal iliac a., 3 internal iliac v., 1 obturator nerve and 1 rectovaginal septum hematoma formation. Postoperative complications were observed in 38 patients. These were 14 bladder dysfunctions, 10 lymphocyst formations, 6 urinary infections, 12 wound infections, 3 pelvic infections, 2 eviscerations and 1 incisional hernia. However, no death occurred due to intraoperative or postoperative complications. Pelvic lymph node metastases were observed in 32 patients of whom 17 had only unilateral involvement, most often in the obturator region. Para-aortic lymph node metastases were diagnosed in 4 patients, all of whom were in stage II.
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PMID:Complications of radical hysterectomy: clinical experience of 115 early stage cervical cancers. 951 8

This case illustrates in a 55 year old man a testicular metastasis from a prostatic TCC occurring fourteen years after a bladder localisation of the same type. To our knowledge no other similar observation has been reported in the literature so far. Metastatic disease should be considered in the differential diagnosis of testis tumours arising in patients with a history of urothelial TCC from bladder, ureter or even prostate as described here.
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PMID:[Testicular metastasis of transitional cell carcinoma of the prostate]. 986 75

We report a case of transitional cell carcinoma in a patient with chronic renal failure receiving hemodialysis for 22 years. A 55-year-old man was admitted to our hospital. Under diagnosis of invasive bladder cancer and left renal pelvic tumor, removal of the whole urinary tract, e.g., bilateral nephroureterectomy and total cystourethrectomy was performed. Transitional cell carcinoma was found in bilateral renal pelvis, left ureter, bladder and prostate in the resected specimen. Thirteen months after the operation, multiple lung metastases and pathologic bone fracture of the 4th lumber vertebra were found. Chemotherapy (3 courses of modified CISCA, consisting of cisplatin, adriamycin and cyclophosphamide) was performed, but the died of systemic metastases of cancer and bleeding due to perforation of multiple gastric ulcers.
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PMID:[Synchronous multifocal development of invasive transitional cell carcinoma of the urinary tract in a patient with renal failure receiving long-term hemodialysis: a case report]. 989 30

The authors report a case of isolated mesenteric fibromatosis un associated with familial adenomatous polyposis or Gardner's syndrome or prior abdominal surgery. These neoplasms are usually asymptomatic until when the compression of the small or large bowel or the ureter causes symptoms; although they are benign lesions without metastases, local recurrences are very frequent. Surgical removal is the primary treatment; until now no satisfactory results have been obtained with other therapeutic modalities.
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PMID:[Isolated mesenteric fibromatosis. A clinical case]. 1038 Mar 62

To assess the prognostic factors in patients with transitional-cell carcinoma of the renal pelvis and/or ureter, a series of 138 patients with transitional-cell carcinoma of the renal pelvis and/or ureter was collected in a retrospective multicentre study. 12 patients with distant metastases were excluded from the statistical evaluation. All but 3 patients underwent radical surgery: nephroureterectomy (n = 71), nephroureterectomy and lymphadenectomy (n = 20), nephroureterectomy and partial bladder resection or transurethral resection (n = 20), nephrectomy (n = 10), and ureterectomy (n = 5). Sixty-one per cent (n = 77) of the tumours were located in the renal pelvis, and 21% (n = 27) in the ureter (both in 22 [17%]). Following surgery, residual tumour was still present in 33 patients (16 microscopic and 17 macroscopic). Postoperative radiotherapy was given to 45 (36%) patients. The median follow-up period was 39 months. In a median period of 9 months, 66% of the patients relapsed (34 local, 7 locoregional, 16 regional, and 24 distant). The 5- and 10-year survival were 29% and 19%, respectively, in all patients. In univariate analyses, statistically significant factors influencing the outcome were Karnofsky index, pT-classification, pN-classification, tumour localisation, grade, and residual tumour after surgery. Multivariate analysis revealed that independent prognostic factors influencing outcome were pT-classification, the existence of residual tumour, and tumour localisation. In patients with urothelial renal pelvis and/or ureter tumours, a radical surgical attitude is mandatory; and the presence of tumour in the ureter is associated with a poorer prognosis.
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PMID:Prognostic factors in urothelial renal pelvis and ureter tumours: a multicentre Rare Cancer Network study. 1050 34

Desmoid tumours are rare lesions with a local invasive potential and a risk of recurrence, considered to be benign due to the absence of metastases. They are classified as fibromatoses and may be associated with Gardner's syndrome. The authors report an unusual case, in a 33-year-old woman, of a desmoid tumour invading the right ureter with upper tract dilatation. Etiologic factors (traumatic, hormonal, auto-immune...) are discussed, together with the treatment of choice to lower the risk of recurrence.
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PMID:[Desmoid tumor of the mesentery secondary to colectomy. An exceptional cause of ureteric obstruction]. 1063 21


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