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

Genitourinary tuberculosis should be managed on an outpatient basis, patients being seen once a week. The treatment of choice is a short-course regimen comprising 2 months of either three or fours drugs - streptomycin, rifampicin, isoniazid, and pyrazinamide - followed by isoniazid and rifampicin three times a week for either 2 or 4 months, depending on the severity of the lesion. Patients should be followed-up, normally for one year, and be told to report to their doctors if they have any recurrence of urinary symptoms. However, if they have renal calcification they should be followed-up as for any other case of calcification and seen annually for at least 10 years. Surgery still has an important part to play in the present management. Radical surgery, nearly always nephrectomy or epididymectomy, should be carried out when there are destructive lesions. Reconstructive surgery, mainly the the repair of strictures at the lower end of the ureter and bladder augmentation for a small fibrotic bladder, is frequently required. Both radical and reconstructive surgery should be carried out in the first 2 months of intensive chemotherapy. There is no reason now why all patients should not be able to return to a normal efficient life - free from all association with the disease - not later than 4 months after the start of treatment.
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PMID:Tuberculosis: genitourinary tuberculosis. 11 90

Long-term complications of ureteral replacement by the small intestine are discussed. A new concept of tailoring the intestinal graft has proved successful in experimental animals. The first clinical application of this technique involves a 22-year-old women whose left kidney and right ureter were destroyed by tuberculosis. Excellent results were noted at the 3-year followup.
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PMID:Ureteral replacement using a new variation of the tailored ileal segment. 43 53

The authors review 123 cases of cutaneous urine shunts in adults. - 93 cutaneous ureterostomies in 63 patients (58 malignant and 5 tuberculous lesions). There were 5 postoperative deaths (8%) and in the 36 operated cases followed-up for varying periods there was 1 death only from progressive renal insufficiency (2.7%), 10 minor incidents (27.8%) and 2 cases with kidney stones (5.5%). Not one of these patients had to be operated on again - 3 cutaneous uretero-ureterostomies with 2 excellent results and necrosis of the foot of the Y in the other case. - 45 transintestinal cutaneous ureterostomies (38 ileal loops and 7 colon grafts) for fistula of the lower urinary tract (2 cases), malignant tumors (35 cases), tuberculosis (1 case), bladder extrophia (1 case), neurological bladder (6 cases). There were 4 early postoperative deaths (8.9%) and 5 severe complications (2 eviscerations, 2 occlusions, 1 digestive tract hemorrhage). Of the 37 operated cases followed-up for varying periods, 5 (13.5%) had diminished renal function, 23 (62%) had late complications requiring further operations in 17 cases (45.9%). These complications were 7 cases of stenosis of the ureter, 1 case of fistual of the ureter, 1 ileal fistula, 4 cases of stenosis of the graft opening, 3 prolapses of the graft, 1 skin lesion, 5 kidney stones and 1 case in which reflux was poorly tolerated. - 12 transprosthetic cutaneous ureterostomies with only 2 good results. No cutaneous shunt operation is exempt from complication. Transprosthetic cutaneous ureterostomies are probably the least affected. Direct cutaneous ureterostomies are statistically better tolerated than transintestinal cutaneous ureterostomies, which appear to have the major inconvenience of deteriorating at a later stage, requiring repeated further operations.
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PMID:[Cutaneous urine shunts in adults (author's transl)]. 49 Jul 67

This paper starts with an introduction on the urodynamic, biochemical and histological aspects of the ileon in its function as urine conductor, reviewing the factors which justify its use in Urology to replace the tubercular ureter. There follows the clinical and technical description of a patient with pyelic retraction and multiple ureteral stenosis of phymic etiology, who underwent a complete replacement of the ureter and pelvis by a segment of the ileon. The authors then analyse the results obtained according to general controls in the urinary apparatus 16 years after the operation. They come to the conclusion that a well-fitted ileal segment is always preferable to a bad ureter, contributing to the exceptional nature of the mutilation of organs in urinary tuberculosis.
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PMID:[Surgical treatment of tuberculous pyelic retraction with an ileum segment. Review 16 years after the operation]. 57 Mar 78

The authors report on 58 patients with ureteral stump disease. Therapeutic errors, certain specific conditions, but also nephrectomies done for diseases other than pyelo-calyceal tumors and tuberculosis may increase the severity of ureteral stump pathology. The clinical symptoms are often vague, and are demonstrated too late. The incidence may be reduced and the outcome improved by removal of the ureter whenever favourable conditions for development exist, and by looking for them by efficient exploration and complete excision, if nephrectomy is followed by even less marked changes.
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PMID:Incidence and complications of ureteral stump pathology. 57 29

Renal duplication is the most common malformation within the urinary tract system and as such a particular challenge to the pediatrician with regard to diagnosis and therapy. It is discovered either by chance or in relation to chronically recurring urinary tract infections. Urinary tract infection is the main clinical symptom in 2/3 of all the patients with renal duplication. Incidence, age-and sex-distribution, predilection of side or bilateral occurrence, configuration of the ureter and the statistically significant combination with vesico-uretral reflux show systematic regularities and are discussed in connection with the literature. Ureterocele, concrements, obstructions or hydronephrosis often are consequences of renal duplication or, as with hydronephrosis, correlated malformations like aplasia, hypoplasia, malrotation, horseshoe kidney or duplication of the urethra. There is a causative relation between renal duplication and tumors or tuberculosis. Other correlated malformations are particularly heart malformations or myelomeningocele. It depends on the severity of the disease whether therapy will be symptomatic or operative. Between 1968 and 1974 we saw 114 children with renal duplication.
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PMID:[Renal duplication in childhood. Incidence and clinical significance (author's transl)]. 66 29

Some experimental data concerning the pathogenesis of tuberculous injury to the kidneys have been obtained from a complex study of the microcirculatory blood bed on a model of tuberculosis of the kidneys in 112 rabbits. Clinical investigations and clinico-experimental correlations have provided pathogenetic grounds for a surgical method of the treatment of tuberculosis of the kidneys complicated with strictures or the ureter. The pathogenetic association of the main tuberculous focus in the renal parenchyma with the tuberculous injury to the ureter and perivascular expansion of specific infection has been pointed to. The effectiveness of pathogenetically grounded surgical intervention has been proved in 52 patients followed-up from 1.5 to 7 years.
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PMID:[Pathogenetic justification of organ-preserving operations and their role in improving the effectiveness of the comprehensive treatment of renal tuberculosis]. 71 19

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 authors' experience involves 11 cases. In four instances, insertion of the ureteral catheter via endoscopy was impossible. Two of these patients were not subjected to surgery because of their great age. In the other two, anti-reflux uretero-vesical reimplantation and insertion of a modelling ureteral catheter was carried out by an open surgical approach. A good result was obtained in both. In the other six patients, it was possible to insert the catheter via endoscopy. This gave five successess and one failure. The single failure was a case of long standing tuberculous stenosis of the ureter. The modelling ureteral catheter, when inserted by endoscopy, gives, in combination with corticosteroids and anti-tuberculous therapy, almost constantly successful results in recent cases of stenotic tuberculosis of the ureter in young patients.
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PMID:[Treatment of tuberculous stenosis of the ureter by use of a modelling ureteral catheter. Apropos of 11 cases]. 91 98

Introduction of specific chemotherapy and vaccination leads to a remarkable recession of renal tuberculosis in the younger age group. Renal tuberculosis is the result of a haematogenous spread of tubercle bacillus. Haematogenous spreading occurs immediately after primary infection, or, in elderly patients, in combination with recurrency of tuberculous foci in lungs and hilar-lymphnodes. Simultaneous metastasis in the skeleton, especially in the vertebrae, are observed in 30%. The incubation period between tuberculous spread and clinical manifestation of renal tuberculosis lasts several years, in the average 5-8 years, for calcareous kidneys it may last as long as 20 years and more, for tuberculous pyelitis only a few months. Today it is possible to treat renal tuberculosis with drugs (Streptomycin, PAS and INH). In 13% the cicatrisation is combined with obstruction of calices and partial hydronephrosis, in 7% with obstruction of the ureter and total hydronephrosis. Early chemotherapy may prevent the development of tuberculous hydronephrosis.
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PMID:[Pathology of renal tuberculosis (author's transl)]. 95 6


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