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

Schistosomal obstructive uropathy was studied by clinical, laboratory epidemiologic and pathologic analysis in 155 Egyptian patients treated surgically. Most patients were men; rural farmers or laborers. All had severe urinary schistosomiasis with heavy burdens of Schistosoma haematobium eggs in their urinary tracts. Schistosomal incomplete ureteral stenosis and schistosomal stenosis with ureterolithiasis were the most important obstructive lesions; these lesions were symmetrical and most frequent in the interstitial ureters decreasing proximally. The pathogenesis of these lesions is dependent upon focal destruction of ureteral muscle. The ureteral lesions proximal and consequent to schistosomal obstructive lesions are hydroureters resulting from active dilatation (due to increased hydrostatic pressure consequent to obstruction) and passive dilatation (due to loss of circular muscle action in sites of oviposition in the proximal ureter). Various combinations of these lesions with superimposed effects of bacterial infection and ureterolithiasis produce the spectrum of ureteral lesions attributable to urinary schistosomiasis.
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PMID:Surgical pathology of schistosomal obstructive uropathy: a clinicopathologic correlation. 84 90

Primary amyloidosis is seen in the absence of predisposing disease. It may affect most organs in the body, including the collecting system of the urinary tract. Submucosal calcifications have been described in the renal pelvis and may be pathognomonic for primary amyloidosis of the renal pelvis. We have been able to demonstrate similar submucosal calcifications in the ureter and bladder. The differential diagnosis of submucosal calcification of the distal ureter and bladder must include bilharziasis and tuberculosis. With the recognition of submucosal calcifications, diagnosis of the underlying disease may be readily made. An illustrative case is presented.
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PMID:Primary amyloidosis of urinary bladder and ureter: cause of mural calcification. 87 Oct 49

The relative incidence and intensity of oviposition in schistosomiasis in different layers of both the urinary bladder and the ureter are presented. Histopathological changes in both organs are elucidated. Oviposition was heaviest in the submucosa of the urinary bladder, while the muscle layer was affected in 15% of specimens. Oviposition was mainly periureteral and in outer muscle layer of the ureter, and was present in only 22% in the ureteral submucosa. Epithelial changes, namely, Brunn nests, cystitis glandularis, cystitis cystica, and squamous metaplasia, were more marked in the bladder specimens than in the ureteral specimens. Squamous cell papilloma and squamous metaplasia associated with acanthosis of the bladder specimens were identified. Results indicate unanimously that the heavy deposition of ova in the submucosa of the bladder leads through its mechanical and toxic irritation to marked epithelial and premalignant changes which pave the way for the disturbing frequency of carcinoma of the bladder in the bilharzial patients which is not the case in the ureter.
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PMID:Bilharziasis of urinary bladder and ureter: comparative histopathologic study. 94 67

The authors report 22 cases of uretero-ileo-plasty for uretero-hydronephrosis due to schistosomiasis. The indications for operation depend on the following criteria: the degree of dilatation which varies from simple atonia to very large hydronephrosis which one must not wait for, ureteral stenosis, vesico-ureteral reflux, the degree of renal failure assessed by studies of creatinine and urea clearance and the resistance to treatment. The operative technique which is not specific for bilharziasis includes uretero-ileo-plasty which is often bilateral, for even in asymmetrical cases, the least affected ureter is often of poor quality. There were failures in two cases due to irreversible renal failure, and in two cases, due to peritonitis. The late results of the other cases appear very favourable: increased vesical capacity, diminution of cystalgia, comfort and improved, general health, were the main factors. Stenosis of the anastomosis, vesico-ureteral reflux and urinary infection, acidosis, lithiasis are rare or not very severe.
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PMID:[Uretero-ileoplasty in bilharzian uretero-hydronephrosis]. 95 96

Further analysis of the data obtained from 190 unselected autopsies at the University of Cairo (Faculty of Medicine) hospitals reinforces our conclusion that a high prevalence of urinary schistosomiasis leads to infection intensity causing severe uropathy and mortality, both directly and by way of complications and sequelae. Based on histological study, two stages of urinary schistosomiasis must be considered in epidemiological work: "active disease", characterized by significant egg excretion; and "inactive disease", in which eggs are excreted rarely. The proportion between active and inactive cases is progressively reversed with advancing age, while mean tissue egg burdens rise, plateau, and ultimately decrease, most sharply beyond 50 years of age. A model of the progression of active disease has been derived from the relations of individual organ egg burdens to overall infection intensity, showing that both the onset and the termination of oviposition probably begin in the urinary bladder and spread centrifugally. Therefore, extravesical activity may persist longer than bladder activity. Severe uropathy and mortality occur at all stages of the disease and depend principally, but not exclusively, on egg burden, i.e., on infection intensity. Correlations of infection intensity with degree of uropathy show that severe disease is quantitatively separable from incidental disease by its tissue egg burdens and lesions. However, the factors determining death from urinary schistosomiasis are only partly understood. They include bilateral upper obstructive uropathy and, probably, focal egg concentrations leading to rapid obstruction, such as aberrantly high egg burdens in the left ureter relative to those in the bladder. Analysis of epidemiologically homogeneous population groups reveals close mutual relationships between the total frequency of infection (active plus inactive), the intensity of infection, and the frequency of severe uropathy. A statistical model predicts that any rise in frequency beyond a 30% threshold will result in a linear increase in the frequency of severe disease, whereas below that threshold the bulk of infections will be incidental. These insights, applicable only to pathological material, must be complemented by efforts to establish clinical and laboratory criteria defining the severity and stages of urinary schistosomiasis in living patients, and to examine their population dynamics, so that effects of therapeutic and preventive measures may be evalulated more precisely.
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PMID:A quantitative post mortem analysis of urinary schistosomiasis in Egypt. II. Evolution and epidemiology. 119 Mar 67

In this work the impact of schistosomiasis on kidney transplantation was investigated by comparing two groups of patients, group 1 (Schistosoma-infected cases) and group 2 (control cases). In group 1, schistosomiasis was diagnosed in both donor and recipient in 63 cases, in recipient only in 65 cases, and in donor only in eight cases. Schistosomal infection among kidney transplant recipients was S. haematobium in 17 cases, S. mansoni in 58 cases, and mixed in 53 cases. Schistosomiasis was diagnosed by finding Schistosoma eggs in urine, stools, rectal mucosal biopsy, recipient bladder mucosal biopsy, or in the donor ureter obtained during surgery. Patients and donors with active lesions were treated at least 3 weeks before transplantation by the antischistosomal drugs praziquantel and oxamniquine. Follow-up after kidney transplantation showed no significant difference between the two groups regarding the incidence of acute and chronic rejection. Nevertheless, dose of cyclosporin, HBs antigenaemia, incidence of urinary tract infection, renal stones, ureteric stricture, and urinary leakage were significantly greater among schistosomal patients when compared to control cases. Schistosomal reinfection was observed in 23% of cases at high risk. Antischistosomal treatment did not affect the graft function. We have concluded that schistosomiasis may affect the outcome of kidney transplantation.
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PMID:Impact of schistosomiasis on patient and graft outcome after kidney transplantation. 132 22

Urological complications were studied in 310 live donor kidney transplants. All recipients and donors were investigated for urinary schistosomiasis by examining tissue obtained intra-operatively from the donor's ureter or the patient's bladder. Schistosomiasis was histologically documented in 76 cases (patient's bladder (46), donor's ureter (9), both (21)). The incidence of urological complications was 11/76 (15%) in the schistosomal group and 14/234 (6%) in the non-schistosomal group; this was statistically significant. Among the schistosomal patients, the site of infestation had no statistically significant effect on the incidence of urological complications. No deaths or graft losses were directly attributable either to these complications or to their surgical correction.
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PMID:Urological complications following live donor kidney transplantation: effect of urinary schistosomiasis. 847 34

This study was carried out on 68 cases (50 bilharzial stricture lower ureter, eight vesico-ureteral reflux cases and ten control). In cases of reflux associated with bilharziasis heavy ova-deposition was obvious all through the ureteral wall especially per-ureteral sheath. Also heavy deposition in the bladder wall involved the detrusor and trigonal muscle with fibrosis and obliteration of Waldeyer's space and atrophy and fasciculation of detrusor and trigonal muscle. This implies ureteral rigidity, impaired mobility and compression against a firm detrusor buttress.
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PMID:Histopathological study of the bilharzial affection on the bladder and ureter. 157 81

Significant portion of the urologic and nephrologic patients in Yemen are treated because of the early and late complications of schistosomiasis (bilharsiasis). During two years 79 patients with renal insufficiency and complications have been examined and treated by the authors. In combination with moderate restricted renal functions hepatosplenomegaly and signs of portal hypertension were observed in female patients. Granulomatous infiltration, calcification and malignous tumour of the urinary bladder was found in men. Stricture of the ureter, uni- or bilateral consecutive hydronephrosis was detected frequently. In addition to inflammatory components bladder, ureteral and renal stones were verified. In the course of treatment 45 percutaneous nephrostomies were performed and an anterograde pyelography was carried out in 60 patients. Ureteral recanalisation was accomplished by means of an ureter stent in 8 cases. Because of serious uremia maintenance haemodialysis was performed in 52 patients. The aim of this work is to contribute to recognise the disease in early stage and emphasize the importance of establishing diagnosis as early as possible and stress the role of the appropriate causal and symptomatic treatment.
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PMID:[Late urinary tract complications of schistosomiasis]. 181 Dec 3

The commonest urologic complication in 176 cases of chronic urinary bilharziasis was ureteric stricture (87 ureters in 55 patients), with the lower third of the ureter affected in 87% of the cases. Other complications included squamous-cell carcinoma of the bladder, urinary calculi and bladder calcification. Intravenous urography and cystoscopy were the most useful diagnostic methods in 76% of the cases. Post-micturition erect urography and frusemide intravenous urography gave great help in distinguishing between true mechanical and non-mechanical ureteric obstruction in patients with dilated pelvicalyceal system on conventional urograms. Only 17 of 68 dilated ureters were truly obstructed and required excision and ureteroneocystostomy. Postoperative vesicoureteric reflux developed in four of these cases. No deterioration of renal function occurred in the remaining, conservatively treated patients.
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PMID:The continuing challenge of bilharzial ureteric stricture. 250 38


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