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

The vesicovaginal fistulae encountered in Africa are a real plague. Their origin is obstetrical as a rule, and they occur in young women, often in primiparas. They are seldom simple as they have been operated repeatedly and involve associated lesions and a large loss of substance, so that they raise complex problems of repair. The experience with the treatment of 230 obstetrical fistulae by the same surgeon in Africa leads the author to describe a repair technique fit for complex fistulae, especially those involving an extensive loss of substance and associated lesions (rectovaginal fistula, perineal destruction). With a low approach, the procedure consists in using a filler tissue, namely a skin flap removed from a greater lip, for which the vasculature is maintained by the preservation of a thick musculous and fatty pedicle, cut from the fibers of the bulbocavernosus muscle. Once sutured around the orifice of the fistula, this graft closes it while fostering its healing. Out of the 14 patients treated with this technique, the results achieved were regarded as good for 10 (72%), including 7 after a first operation and 3 after second surgery. In 9 cases, there were associated lesions, including 5 rectovaginal fistulae and 4 cases of complete tearing of the perineum. We have had 4 failures, including 3 definitive ones, and a partial failure with the persistence of urine incontinence in station due to be destruction of the ureter. When the simpler Martius' procedure (on which ours is patterned) is no longer sufficient, the use of a pedicled skin-fat graft taken from the greater lip allows considerably restricting the indications of palliative surgery. Our technique increases the percentage of success for fistulae regarded as irreparable or after the usual repair procedures have failed.
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PMID:[Repair of large urogenital necrosis of obstetrical origin by pedicled myocutaneous plasty of the greater lip. Technique and results]. 205 73

The Mitrofanoff principle has been used to achieve clean intermittent catheterisation (CIC) and urinary continence in 28 children. The mean age at operation was 10.1 years (range, 1 to 19 years). A catheterisable conduit was created using the appendix (19), ureter (8), or vas deferens (1). CIC was commenced 10 to 28 days postoperatively (median, 15 days). After a mean follow-up of 13 months (range, 2 to 45 months), 24 children (86%) have achieved successful CIC and urinary continence. Use of the Mitrofanoff principle is a valuable adjunct to the treatment of urinary incontinence in children and may allow successful CIC in patients who are unable to catheterise urethrally.
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PMID:The use of the Mitrofanoff principle in achieving clean intermittent catheterisation and urinary continence in children. 206 4

The method of diagnosis and therapeutic rules for pathological ureteral duplicity has been highly developed over the last few years. Recent advances in fetal ultrasonography sometimes allow an early diagnosis of renal or intravesical cystic structure to be appraised before complications (urinary tract infection or pyelonephritis, prolapsed ureterocele, recurrent orchitis, primary diurnal and nocturnal urinary incontinence with conserved micturation for a young girl). However, the basis of therapeutic rules remain unchanged, the superior pyelocaliceal system is not preserved in most cases of ureterocele with ureteral duplicity or ectopic ureter, because of major cystic dysplasia; although, in some cases when an earlier diagnosis is made, conservative treatment (primary endoscopy followed by a surgical intervention if necessary) can be proposed. Likewise, the endoscopic injection of Teflon causes the vesico-ureteral reflux to disappear in most cases (70%).
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PMID:[Development of the diagnosis and treatment of pyelo-ureteral duplication in children. Reflections on 179 cases]. 215 57

We report two cases of hydronephroureterosis of the upper moiety in the complete duplex kidney disclosed by urological examination for pyuria and hematuria. The first case was in a 64-year old female and the second case was in a 68-year old female. Urinary incontinence was not seen in either case. Heminephrectomy was performed because the upper moiety was non-functioning and the upper ureter opened at the vesical neck in these cases. The postoperative course was uneventful.
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PMID:[Two case reports of hydronephroureterosis associated with complete double pelvis-ureter accompanied by pyuria and hematuria]. 230 88

Ureteral ectopias, which mostly occur in ureteral duplications, become noticeable in women quite early by characteristic clinical signs (dribble, or urinary incontinence). In males, it is usually only a stenosis-conditioned dilatation of the ureter that results in an uncharacter-istic pattern of complaints. The article presents the clinical pattern of signs and the x-ray findings in a man of 42 year of age, who had not reported any complaints until then, with an excessive dilatation of an extopically discharging single ureter.
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PMID:[Ectopia of the right ureter as the cause of a cystic abdominal space-occupying lesion]. 231 38

A variety of methods for urinary diversion are employed in patients with gynecologic malignancies depending on whether there is an obstruction or fistula formation due to either tumor growth or radiotherapeutic injury. Percutaneous nephrostomy (PCN) has a low complication rate and is a good method for palliative urinary diversion or may precede some form of permanent diversion to restore the kidney function first. Indication for palliative diversion in tumor obstruction depends on many individual factors. A relative contraindication is tumor progression during therapy. 6-month survival was about 70% in patients with previously untreated tumors or recurrences. This rate is far better than reported in earlier studies, so that a palliative diversion has to be considered for these patients. Also a high rate of recanalization after therapy could be observed in the untreated group, allowing the PCN to be removed. However, this has not been shown to be a prognostic factor. In the individual patient some other aspects, such as quality of life and social status, have to be taken into account before a final decision can be made. Ureteral obstruction after radiotherapy is a rare finding and often mistaken for a more likely recurrence. Different methods to restore the urinary tract, such as reimplantation of the ureter, should be used as a first choice. When the stenosis is due to radiocystitis, enterocytoplasty will often be indicated. Diversion has then to be omitted. The poor quality of life because of permanent incontinence due to fistula formation makes diversion mandatory even if life expectancy is very short. Surgical closure of a large radiogenic fistula is rarely successful. In this situation, ileal conduit has proven its efficacy for long-term urinary diversion.
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PMID:Urinary diversion in gynecologic malignancies. 245 37

The incidence of ectopic ureter in companion animals is low. The most common clinical sign is urinary incontinence. Many animals with ectopic ureters have other urinary tract abnormalities that may contribute to urinary incontinence. A properly performed excretory urographic study in combination with pneumocystography is most likely to confirm the diagnosis and can demonstrate ureteral morphology. Surgical treatment options for ectopic ureter are varied and should be aimed at preserving the effected ureter and kidney. Common complications of surgery are hydroureter and hydronephrosis. These complications may be minimized with proper surgical technique. Medical therapy has been used successfully to control continued urinary incontinence following surgery.
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PMID:Ectopic ureter surgery and its problems. 252 Jan 3

A case of long-standing, undetected urinary tract malformation is presented. Over a period of 15 years the patient had gone for regular examinations by a gynecologist because of paravaginal tumor and urinary incontinence. Operation revealed urinary calculi in an ectopic ureter. Despite of life-long continuous urinary incontinence, an i.v. pyelography was never offered. Embryology, symptoms and an investigation program concerning ectopic ureter are presented.
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PMID:Paravaginal tumor: ureterolithiasis in an ectopic ureter. 252 Aug 17

This report describes the author's personal experience in the surgical treatment of 54 patients. The approach is called posterior sagittal ano recto vagino urethroplasty (PSARVUP). Forty patients underwent a primary procedure, and 14 a secondary operation. The anatomic variations found were multiple, integrating a wide spectrum of defects. The posterior sagittal approach proved to be a good initial approach, and permitted complete repair of the defect in 47 patients. Seven patients required a laparotomy in addition. The length of the common channel varied from 0.5 to 7 cm. Common channels longer than 3 cm usually required some technical alternative to replace the vagina. In at least 34 cases, the vagina was reconstructed primarily without any additional technical manoeuvres. Different degrees of vaginal and uterine septation were found in 25 of 50 cases. Hydrocolpos was an associated defect in 14 of 49 patients. Sixty-eight percent of the patients had an important associated urological defect. Twenty-six patients were clinically evaluated without medical management, twenty-one of whom had voluntary bowel movements by the age of 3 years, but most of them had minor episodes of soiling. Nineteen patients had a normal sacrum, and five had urinary incontinence that was successfully managed by intermittent catheterization. Seven patients had a very abnormal sacrum, and five of them had urinary incontinence. Twenty patients underwent a late postoperative vaginoscopy, 14 of whom showed an adequate introitus and vagina, whereas five had different degrees of narrowing of the introitus. Six patients had a urethrovaginal fistula. One ureter was accidentally divided and one vagina had complete ischaemic necrosis.
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PMID:The surgical management of persistent cloaca: results in 54 patients treated with a posterior sagittal approach. 266 2

A case of obstructive uropathy secondary to a periurethral teflon injection, performed to correct urinary incontinence, is presented. The obstruction of one ureter was caused by an inflammatory reaction followed by fibrosis, which could be explained by the presence of a local infection or of intolerance to the teflon paste. The use of prophylactic antibiotics and routine renal echography are mandatory after periureteral or periurethral injections of large quantity of teflon.
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PMID:[Obstructive uropathy secondary to the periurethral injection of teflon paste]. 268 54


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