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

Experimental infiltration of the intravesical ureter of the normal bladder in the living, anesthetized animal with magnesium sulfate or physiological salt solution caused a reflux of urine into the ureter in 6 out of 18 guinea pigs (33 per cent); in 22 out of 27 rabbits (81 per cent), and in 14 out of 17 dogs (82 per cent). The vesical pressure necessary to produce this experimental reflux is low and ranges between 2 and 12 mm. of Hg; hydrostatic pressure of the bladder contents often sufficed to drive urine into the kidney pelvis. After an experimental reflux had occurred, increased vesical pressure often failed to raise the level of the regurgitant column in the ureters of rabbit and dog: these higher pressures had rendered an incompetent valve competent. Control pressures ranging between 8 and 40 mm. of Hg without a preceding infiltration, caused no reflux in the great majority of dogs. The amount of infiltrated fluid necessary to produce reflux varied from 0.2 cc. in the guinea pig to 0.5 to 2 cc. in dog. Spontaneous regurgitation, that is regurgitation without a preceding infiltration, was seen in 4 guinea pigs, 4 rabbits and 2 dogs. Antiperistalsis of the ureters, that is a wave of contraction passing from the bladder to the kidney, was never seen in our animals with experimental reflux. Biopsy of the bladder in rabbit and dog showed edema of the ureterovesical valves after infiltration in most of our animals. Hemorrhages into the submucosa in the neighborhood of the ureteral valves were observed in some. The bladders of 3 rabbits, exhibiting spontaneous reflux without infiltration showed pouting, edematous lips of the ureterovesical orifices. The cause of experimental regurgitation is a non-obstructive edema of the vesical valve; this edema renders the valve flap more rigid and therefore incompetent at relatively low intravesical pressures. Higher intravesical pressures may again render the incompetent valve competent. The experimental results are applied to the human subject because the urinary bladder of dog and of man are quite similar in structure and function. Reasons are presented suggesting that the described type of reflux may cause pyelitis and pyelonephritis.
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PMID:EXPERIMENTAL LOCAL BLADDER EDEMA CAUSING URINE REFLUX INTO URETER AND KIDNEY. 1987 Jun 95

The incidence of Corynebacterium urealyticum infection in kidney recipients is low. Its common clinical manifestation is encrusted cystitis or encrusted pyelitis. Herein, we report an unusual case of a 19-year-old kidney recipient with necrotizing pyelitis due to C urealyticum in the absence of mucosal encrustation or calculi. The patient was readmitted 30 days posttransplantation to remove a stent. Cystoscopy demonstrated a normal vesical wall without encrustation. The stent was removed without problems. Culture yielded negative findings. That night, the patient had fever and hematuria. Therapy included forced diuresis with high fluid intake, and diuretic and antibiotic administration. The patient was then discharged. However, 15 days later he was readmitted because of hematuria with a significant decrease in hemoglobin concentration. Echography demonstrated the presence of hyperechogenic material in the pelvis and ureter. Pyelography demonstrated the presence of numerous coagula obstructing the urinary tract. In addition, severe hematuria required transplant nephrectomy.
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PMID:Corynebacterium urealyticum infection in a pediatric kidney transplant recipient: case report. 2053 4

Genitourinary schistosomiasis is produced by Schistosoma haematobium, a species of fluke that is endemic to Africa and the Middle East, and causes substantial morbidity and mortality in those regions. It also may be seen elsewhere, as a result of travel or immigration. S haematobium, one of the five fluke species that account for most human cases of schistosomiasis, is the only species that infects the genitourinary system, where it may lead to a wide spectrum of clinical symptoms and signs. In the early stages, it primarily involves the bladder and ureters; later, the kidneys and genital organs are involved. It rarely infects the colon or lungs. A definitive diagnosis of genitourinary schistosomiasis is based on findings of parasite ova at microscopic urinalysis. Clinical manifestations and radiologic imaging features also may be suggestive of the disease, even at an early stage: Hematuria, dysuria, and hemospermia, early clinical signs of an established S haematobium infection, appear within 3 months after infection. At imaging, fine ureteral calcifications that appear as a line or parallel lines on abdominopelvic radiographs and as a circular pattern on axial images from computed tomography (CT) are considered pathognomonic of early-stage schistosomiasis. Ureteritis, pyelitis, and cystitis cystica, conditions that are characterized by air bubble-like filling defects representing ova deposited in the ureter, kidney, and bladder, respectively, may be seen at intravenous urography, intravenous ureteropyelography, and CT urography. Coarse calcification, fibrosis, and strictures are signs of chronic or late-stage schistosomiasis. Such changes may be especially severe in the bladder, creating a predisposition to squamous cell carcinoma. Genital involvement, which occurs more often in men than in women, predominantly affects the prostate and seminal vesicles.
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PMID:Genitourinary schistosomiasis: life cycle and radiologic-pathologic findings. 2278 92

Infection stones are more likely to form after urinary diversion as the result of urinary stasis. To prevent urinary stasis due to encrusted pyelitis in a transplanted kidney, we describe an alternative a surgical treatment: ileo-pelvic anastomosis. In our patient with a transplanted kidney, the ileal conduit had previously been anastomosed end-to-side owing to renal tuberculosis with an atrophied bladder; the transplanted ureter was anastomosed to the ileum in the left lower abdomen with an ileal conduit on the opposite side. Routine check-up revealed hydronephrosis with infected pyelitis and ureteritis in the transplanted kidney. We performed ileo-pelvic end-to-end anastomosis to prevent urinary stasis by lengthening the ileal conduit and performed augmentation cystoplasty to support the atrophied bladder following tuberculosis. We suggest that this approach may be useful in similar cases.
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PMID:Ileo-pelvic anastomosis and augmentation cystoplasty for treatment of encrusted pyelitis in a transplanted kidney. 2355 Feb 63

Encrusted uretero-pyelitis is a rare and serious disease, related to the presence of calcifications in the pelvicalyceal system and ureter, associated with chronic urinary tract infection. In most cases, the causal agent of this infection lithiasis is corynebacterium urealyticum. The specific aspect of calcifications on CT scan can help to suggest diagnosis. To avoid a delay in diagnosis (which is frequent), an accurate exploration by the bacteriologist is crucial. The combination of a glycopeptides antibiotherapy and urine acidification has proved its effectiveness, as described in the medical literature. We report the case of a 77-year-old male patient, successfully treated for a bilateral encrusted uretero-pyelitis by local acidification (Thomas's solution) followed by oral acidification (ammonium chloride).
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PMID:Encrusted Uretero-pyelitis: Case Report. 2733 96

Encrusted pyelitis is a chronic urinary tract infection associated with mucosal encrustation induced by urea splitting bacteria. More than 40 bacteria have been implicated but the most frequent is Corynebacterium group D2. Predisposing factors are debilitating chronic diseases and preexisting urological procedures. Immunosoppression is an important cofactor. For these reasons the disease is almost always nosocomially acquired and renal transplant recipients are at particular risk. The symptoms are not specific and long lasting: dysuria, flank pain and gross haematuria are the most frequent; fever is present in two-thirds. The demonstration of urine splitting bacteria in constantly alkaline urines and radiological evidence of extensive calcification of pelvicalyceal system, ureter and bladder at US or CT scan in a clinical context of predisposing factors are the mainstay of diagnosis. Treatment is based on adapted antibiotic therapy, acidification of urine and excision of plaques of calcified encrustation. The prognosis relies on timing of diagnosis; delay can be detrimental and result in patient's death and graft loss. We describe a unique case of 69-year-old man with two contemporary diseases: autoimmune thrombotic thrombocytopenic purpura and encrusted pyelitis with a fatal evolution.
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PMID:[Encrusted Pyelitis during a case of Thrombotic Thrombocytopenic Purpura]. 3023 34

Diabetes mellitus (DM) is a common disease in Oman as in rest of Gulf Cooperation Council where metabolic syndrome is of high prevalence. DM is a foremost risk factor for urinary tract infections (UTIs). It is also linked to more complicated infections such as emphysematous pyelonephritis (EPN), emphysematous pyelitis (EP), renal/perirenal abscess, emphysematous cystitis, xanthogranulomatous pyelonephritis, and renal papillary necrosis. The diagnosis of these cases is frequently delayed because the clinical manifestations are generic and not different from the typical triad of upper UTI, which include fever, flank pain, and pyuria. A middle-aged female with DM and chronic kidney disease stage IV was admitted with recurrent UTI with extended-spectrum beta-lactamase-producing Escherichia coli. At presentation, she was afebrile, clinically stable, had no flank pain and there was no leukocytosis. Laboratory test for C- reactive protein done twice and was only mildly elevated at 7 and 11 mg/dL. A computed tomography scan of kidney-ureter-bladder (CT-KUB) was recommended and reported as "no KUB stone but small atrophic left kidney with dilatation of the pelvicalycial system and ureter and the presence of air in the collecting system suggestive of EP." Thus, commonly associated with DM, especially in females, debilitated immune-deficient individuals, and patients harboring obstructed urinary system with infective nidus. Air in the kidney is not always due to EPN. UTI with a gas-producing organism can ascend to the kidney in the presence of vesicoureteral reflux.
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PMID:Gas in the kidney in asymptomatic Escherichia coli urinary tract infections in a patient with severe vesicoureteral reflex. 3124 37


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