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

This is a report on the follow-up data of 18 patients with posterior urethral valves diagnosed during the first year of life. One infant died of progressive renal failure; a slight elevation of serum creatinine levels in three children aged 4-6 years indicated a doubtful prognosis. On initial examination, ten patients showed severe unilateral or bilateral reflux. Seven of 14 refluxing units remained non-functioning and had to be removed. Following transurethral fulguration of the valves, five infants developed unilateral or bilateral reflux which was not evident on initial preoperative voiding cystograms. In contrast to those in other series, none of these refluxes ceased spontaneously. Ureteral reimplantations were done on 11 ureters of eight patients, but regression of ureteral dilatation postoperatively remained unsatisfactory in six instances, none of whom had a true mechanical obstruction. We conclude that many of these megaloureters encountered in infants with posterior urethral valves are concomitant with profound and often irreversible damage of the ureter wall. Surgery of such ureters, therefore, should be avoided whenever feasible.
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PMID:Infants with posterior urethral valves: a retrospective study and consequences for therapy. 249 91

Partial ureteric obstruction was produced by insertion of an obstructing stent into the left ureter of 21 mongrel dogs and the duration of obstruction was varied as follows: Group A (n = 7) for 60 days; Group B (n = 7) for 28 days; Group C (n = 7) for 14 days. Intrapelvic pressure monitoring confirmed that obstruction had been produced by stent insertion and relieved by reimplantation of the left ureter following the designated obstruction period. The extent of recovery of renal function was assessed by creatinine clearance, with group C maintaining normal function, group B recovering 31% and group A recovering 8% of control function. Methyl-methacrylate extrusion casts of the renal microvasculature were made in group B and C kidneys and studied by scanning electron microscopy. During obstruction there was evidence of arteriolar constriction. These changes provide a morphological basis for the renal functional alterations and support the concept that post-obstructive renal failure is a vascular injury.
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PMID:Renal injury and recovery in partial ureteric obstruction. 273 3

Ectopic ureter is quite a rare malformation, and it can be more or less serious depending on its anatomy (monolateral or bilateral ectopy, duplicated ureter, single ureter) and the associated malformations. It's more common in female patients. Ectopic ureteral orifice can be either intravesical (bladder neck) or, more often, extravesical. Ectopia in women is more frequently found in the urethra and the vaginal vestibule; much less frequently in vagina and in uterus. In men it is mostly found in the posterior urethra; in the male genital tract is very rare. In most cases ectopic ureter is associated with pyelo-ureteral complete duplication: the upper kidney usually works badly or doesn't work at all, due to renal dysplasia or pyelonephritis. More rarely ureteral ectopia affects a single urinary system and can be monolateral or, in the most serious forms, bilateral. The main clinical signs are urinary incontinence accompanied by regular micturition (more exactly pseudoincontinence) in the female patients, and urinary infection. In the male there is no urinary incontinence. Authors report their experience about 54 ectopic ureters in 51 children. Treatment is always by surgery: the choice has to be made between conservative or radical attitude. 38 total exeresis of the ectopic excretory pathway (upper heminephroureterectomy or nephroureterectomy), 9 ureteral reimplantations, 1 uretero-pyeloanastomosis have been done. Outcome is always satisfactory in monolateral forms, more uncertain in bilateral forms with single ectopic ureter, due to incontinence and reduced bladder capacity problems and the possible associated renal failure.
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PMID:[Ectopic ureter]. 276 91

A total of 433 extracorporeal lithotripsy procedures was performed for renal, ureteral and bladder stones by means of a system of ultrasonographic detection and piezoelectric destruction in 386 patients. The stones were detected easily in 87 per cent of the patients, difficult to detect in 10 per cent and impossible to detect in 3 per cent. Mean duration of treatment was 35 minutes. Mean number of piezoelectric waves was 2,700 at 1.25 per second. With a frequency of 1.25 to 5 per second, extracorporeal lithotripsy was performed without any local, regional or general anesthesia, and without premedication in 210 patients. Of the 217 patients with a renal stone reviewed at 3 months 161 (74 per cent) had successful results and 56 (26 per cent) failed therapy. Thirty patients (14 per cent) underwent 2 or 3 sessions. The morbidity was low: 2 per cent of the patients suffered ureteral obstruction, 1.5 per cent had subcapsular hematoma and 4 per cent had fever. No significant modifications of laboratory tests were necessary and no patient suffered renal failure. Of the stones 31 in the lumbar ureter, 15 in the pelvic ureter and 8 in the bladder were treated, with success rates of 87, 46 and 50 per cent, respectively. A total of 103 patients was treated on an outpatient basis. This outpatient treatment, together with the low cost and minimal maintenance of the apparatus, and the absence of anesthesia constitute a new progress in the treatment of renal stones.
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PMID:Piezoelectric extracorporeal lithotripsy by ultrashort waves with the EDAP LT 01 device. 328 Aug 30

We dissolved the cystine calculi incarcerated in the ureter by irrigation with tromethamine-E via percutaneous nephrostomy. Case 1: A 25-year-old man with a past history of cystinuria and staghorn calculi in the right kidney, suffered from obstructive renal failure caused by the incarceration of a stone (18 x 15 mm) in the left middle ureter. After recovering promptly from renal failure by left percutaneous nephrostomy, he received continuous irrigation with tromethamine-E through an angiographic catheter percutaneously placed in the ureter. The ureteral calculus was reduced by 70% in size after the irrigation for 35 days, and then extracted percutaneously. Case 2: A 3-year-old child had multiple cystine calculi in the right renal pelvis and ureter. Although a calculus in the renal pelvis was extracted by the percutaneous ultrasound lithotripsy, two calculi incarcerated in the middle ureter were impossible to remove by a percutaneous approach. The irrigation with tromethamine-E was initiated through the catheter placed percutaneously in the right ureter. Both calculi completely dissolved 47 days later. The chemolysis by irrigation with tromethamine-E was greatly valuable in the treatment of cystine calculi. This dissolution could be an alternative to surgery especially in the treatment of ureteral cystine calculi, which might be difficult to be extracted by the percutaneous or transurethral approach.
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PMID:[Chemolysis of cystine calculi incarcerated in the ureter by the alkaline organic amine, tromethamine-E]. 344 60

Ureteral obstruction can lead to renal failure without involving detectable dilatation of the calyces, renal pelvis, or ureter proximal to the obstruction. This phenomenon was noted in seven patients who had clinical obstruction that we were not able to diagnose using computed tomography (CT) or ultrasonography (US). These patients underwent percutaneous nephrostomy (PCN), which resulted in brisk diuresis and improved renal function. We obtained an accompanying antegrade urogram in these cases, which demonstrated the level of obstruction and indicated that dilatation of the collecting system was minimal or not present. When obstructive uropathy is suspected, we believe it is essential to consider performing PCN to evaluate and potentially reverse renal failure, even when CT and US scanning do not demonstrate obstruction.
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PMID:Nondilated obstructive uropathy: percutaneous nephrostomy performed to reverse renal failure. 352 4

We present herewith our surgical procedure for the management of bilateral hydronephrosis and renal failure due to distal ureter infiltration by cancer of the prostate: transurethral resection of the ureteral meatus and intramural ureter or even extravesical ureter invaded by the carcinoma and placement of a double J catheter. We have performed this technique in 3 patients with good results.
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PMID:Transurethral resection of the ureteral meatus invaded by carcinoma of the prostate: a new approach. 367 6

Nephrogenic diabetes insipidus usually presents with polyuria, polydipsia, fever, vomiting, dehydration and failure to thrive. However, in infancy polyuria may be absent because of dehydration and reduced glomerular filtration rate. In 2 cases the main presenting feature was hypotonia, with marked head lag. Family studies confirmed the X-linked mode of inheritance of the disease; in case 1 the disease appeared to have arisen as a new mutation in the mother, and in case 2 the carrier status was traced back to the great-grandmother. Pitfalls in the diagnosis and detection of the carriers are discussed. Treatment with thiazide diuretics and prostaglandin synthesis inhibitors is effective in reducing urine volumes and polydipsia. The early detection of the disease and adequate management may prevent such complications as megacystis, mega-ureter and hydronephrosis, with resulting renal failure. Mental and physical retardation may also be avoided.
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PMID:Nephrogenic diabetes insipidus presenting with infantile hypotonia. A report of 2 cases. 373 62

Theophylline, the bronchodilating agent, can cause life-threatening, generalized seizures when plasma concentrations exceed the usual therapeutic concentration range. However, the plasma concentrations of theophylline associated with this neurotoxic effect vary widely between patients. To determine the reasons for the wide variation, and thereby to facilitate prevention or early treatment of theophylline-induced neurotoxicity, an animal model of theophylline-induced seizures was developed and has now been used to determine the effect of experimental renal failure on the concentrations of theophylline that cause convulsions. Adult female rats were subjected to bilateral ureteral ligation or injected with uranyl nitrate to produce renal failure or dysfunction. Sham-operated and saline-injected rats, respectively, served as controls. Theophylline was infused i.v. at either 1.03 or 2.06 mg/min until the onset of maximal seizures. Renal failure due to ureter ligation was associated with a substantial reduction of the dose of drug required to produce seizures, the concentrations of total and free (unbound) theophylline in serum and the concentrations of theophylline in the brain and cerebrospinal fluid at onset of seizures. The concentrations of theophylline metabolites were very low and did not account for the enhanced neurotoxicity. No apparent change in the neurotoxicity of theophylline was observed in rats with uranyl nitrate-induced renal dysfunction. The results of the investigation on ureter-ligated rats are consistent with recent clinical findings of a higher incidence of theophylline-induced neurotoxicity in azotemic patients. The experimental methodology may therefore be suitable for the prospective identification of other potential clinical risk factors for theophylline neurotoxicity.
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PMID:Kinetics of drug action in disease states. XVIII. Effect of experimental renal failure on the pharmacodynamics of theophylline-induced seizures in rats. 380 13

Ultrasound scans were performed on 6 adult males with simple ureteroceles, 2 of which were detected on primary scanning of patients in renal failure and 4 after excretory urography. Two complications were also detected--obstruction with hydro-ureter formation and tumour formation in a ureterocele. A scheme is proposed for differentiating ureteroceles from other causes of bladder filling defects using ultrasound examination.
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PMID:Simple ureteroceles--ultrasonographic recognition and diagnosis of complications. 388 Sep 29


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