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

Report about the employment of a sterile 35% barium sulphate (Falibaryt)-suspension for cystography in course of preoperative examination for correction of urinary stress incontinence. The Falibaryt-suspension was found to be an eminently suitable, harmless and cheap medium in 928 examinations. In one case the authors observed a unilateral vesico-renal reflux. By osmodiuresis with intravenous infusion of 200 ml mannitol 15% the contrast medium was removed out of the ureter and kidney's pelvic in a short time. The authors give references to make provision for retrograde instillation of barium sulphate suspensions. By consideration of these provisions the use of barium sulphate (Falibaryt)-suspension is harmless and recommended.
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PMID:[Falibaryt as a contrast medium]. 122 Apr 44

A thirty-two-year-old Samoan woman was referred for evaluation of "unstable bladder" and a history of continuous life-long urinary incontinence. A comprehensive radiographic and urodynamic evaluation demonstrated the unusual combination of a vaginal ectopic ureter draining a dysplastic kidney and genuine stress urinary incontinence. Appropriate treatment based on the recognition of both abnormalities resulted in restoration of continence.
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PMID:Ectopically draining dysplastic kidney associated with genuine stress urinary incontinence: unusual combined cause of incontinence. 152 58

In order to understand the pathology of incontinence, it is important to investigate urinary symptoms, urological and neurological examinations and urodynamics. There are two kinds of incontinence. One is true incontinence in which urine passes through urethra, and the other is false incontinence due to the ectopic opening of the ureter, for example to the vagina. The former includes stress incontinence, urge incontinence, reflex incontinence, overflow incontinence and total incontinence. Stress incontinence occurs with the sudden increase of abdominal pressure such as cough, running and exertion. The cause of stress incontinence is thought to be weakening of pelvic floor muscles after delivery or aging. In these patients, the bladder base and urethra move downwards and backwards, which make the posterior vesico-urethral angle more than 120 degrees. Treatment of stress incontinence includes pelvic floor exercise, administration of alpha-stimulants which increase the tonus of the internal sphincter and surgery to elevate the urethra. Urge incontinence is observed when detrusor instability occurs. It is also seen in patients with neurological diseases such as multiple cerebral infarction or with benign prostatic hypertrophy (BPH). Treatment of urge incontinence includes administration of anticholinergics to decrease bladder hyperreflexia. Reflex incontinence is seen in patients with spinal cord disorders. It occurs due to reflex contraction of detrusor and the treatment involves administration of anti-cholinergics. Overflow incontinence is seen in patients with voiding difficulties due to BPH. It occurs when residual urine increases and when the intravesical pressure exceeds urethral pressure on body movement. Treatment for this is intended to improve voiding difficulties. Total incontinence occurs when total sphincter function is damaged.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[The pathology and treatment of incontinence]. 159 84

Computed tomography (CT) and magnetic resonance (MR) imaging have become invaluable imaging modalities in the diagnosis of diseases involving the lower urinary tract. Both CT and MR imaging are able to accurately stage bladder carcinoma, with MR imaging able to distinguish between superficial and deep muscle invasion of tumor. CT and MR are also the studies of choice for evaluating retroperitoneal fibrosis, which often affects the urinary tract; MR imaging is often able to detect the presence of active inflammation and occasionally rule out a malignant cause. MR imaging holds promise for the evaluation of stress urinary incontinence and urethral disease. Although diseases of the distal ureter continue to be most accurately diagnosed by intravenous urography and retrograde studies, CT and MR imaging may serve a helpful secondary role.
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PMID:Computed tomography and magnetic resonance imaging of the female lower urinary tract. 163 Dec 89

Surgery for incontinence, other than genuine stress incontinence, is a small part of the general gynecologist's practice. He or she must maintain a high index of suspicion for diverticula and fistulae. Included here are several good review articles that outline the state of the art and include classic references in the bibliography. Patients with cancer with a genitourinary fistula and incontinence may be managed in a variety of ways. Percutaneous nephrostomy and occlusion of the distal ureter may be an option in patients with incurable disease. Continent diversion, such as the Indiana pouch, offers a long-term remedy to the appropriate patient, even one who has been irradiated, as reported by Mannel. Iatrogenic incontinence is distressing to the patient and her doctor. Webster and Kreder offer keen insight into the evaluation of patients who have postoperative, obstructive, voiding dysfunction. They describe an operative correction, the obturation shelf repair, quite similar to the paravaginal defect repair, which restores "normal anatomy" and results in excellent relief of voiding dysfunction in approximately 90% of their patients. Postoperative bladder care is of concern to the doctor, patient, and nursing staff. Noble's article on the timing of catheter removal is innovative and practical.
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PMID:Urologic surgical techniques. 190 17

A case of ectopic ureter in a 45 year old woman arising after the onset of stress incontinence is reported. The patient presented complete pyeloureteral duplication with an ectopic ureter whose orifice drained into the proximal urethra. The embryology, diagnostic and therapeutic problems of the case are discussed with emphasis on the tardive appearance of the symptoms.
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PMID:[Ectopic ureter. Description of a clinical case with appearance of stress urinary incontinence]. 276 63

Symptomatic clinical changes and urodynamic changes are apparent in the female urinary tract system during pregnancy, the menstrual cycle and following the menopause. The sex hormones exert physiological effects on the female urinary tract, from the ureters to the urethra, with oestrogens having an additional influence on the structures of the pelvic floor. High affinity oestrogen receptors have been identified in bladder, trigone, urethra and pubococcygeus muscle of women. Oestrogen pretreatment enhances the contractile response of animal detrusor muscle to alpha-adrenoceptor agonists, cholinomimetics and prostaglandins, as well as enhancing the contractile response to alpha-agonists in ureter and urethra. Progesterone on the other hand decreases tone in the ureter, bladder and urethra by enhancing beta-adrenergic responses. The dependence on oestrogens of the tissues of the lower urinary tract contributes to increased urinary problems in postmenopausal women. Urinary symptoms due to atrophic mucosal changes respond well to oestrogen replacement therapy. However, because they recur when treatment is stopped, continuous therapy with low dose natural oestrogens is recommended. Oestrogens may be of benefit in postmenopausal women with stress incontinence, but the doses necessary for clinical effect are higher than for the treatment of atrophic urethritis. The practice of adding a progestagen to long term oestrogen therapy to reduce the risk of endometrial carcinoma may, however, exacerbate stress incontinence by decreasing urethral pressure. Cyclical therapy with oestrogens may therefore be more appropriate particularly in women who are not suitable for surgery or have a mild degree of stress incontinence, along with other conservative measures such as pelvic floor exercises and alpha-adrenoceptor agonists. The place of oestrogen therapy in motor urge incontinence has not been determined. The risk of developing endometrial carcinoma as a result of long term high dose oestrogen replacement therapy must be borne in mind but remains to be clarified. However, oestriol has less of a uterotrophic effect compared to other oestrogens in standard therapeutic doses and is to be preferred. Side effects are usually dose related and tend not to be a problem with low dose therapy.
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PMID:Sex hormones and the female urinary tract. 306 38

Thirty-nine cases of functional reconstruction of exstrophied bladder are reviewed. There were 20 females and 19 males. In a first group of 31 staging was planned and carried out in 26 while 3 are awaiting a second stage. In a second group of 8 a single operation was performed. Out of the 31 early cases there were 2 deaths and 10 failures, 16 show good or very good functional result. All 16 show moderate renal scarring from reflux pyelonephritis which occurred between I and II stage. Single operation consisted of innominate osteotomy, bladder and bladder neck and urethral reconstruction and anti-reflux procedure (osteotomy was omitted in a 3 days old baby). Three, operated upon when aged 8 mths., 1 year and 4 years, were breakdowns of previous closure. They are incontinent and will need further surgery at the bladder outlet. Four are dry in the morning and suffer from occasional stress incontinence and enuresis. One, now aged 4 years, still wears pads. These last 5 are awaiting final assessment of and eventually further surgery to improve continence. In all 8 cases pyelo-calyceal cavities are normal except for a moderate right dilatation in one because of kinking of the reimplanted ureter. Delay in bladder closure (mean age 5 mths.) and severe changes to the bladder wall and possibly staging seems to be responsible for most of the failures and for renal damage occurring, after closure, in bladders showing moderate compliance. Single operation allows full protection of upper tract and kidney and should be preferred in patients aged over 2 months. Better functional results may be obtained if operation is performed soon after birth.
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PMID:Functional reconstruction of exstrophied bladder. Timing and technique. Follow-up of 39 cases. 307 Oct 25

About 5% of our population suffers from urinary incontinence. Basically urinary incontinence is caused by two mechanisms: (1) loss of voluntary control of the urinary bladder due to detrusor hyperactivity or detrusorhyperreflexia, resulting in urge or reflex incontinence and (2) sphincter weakness or sphincter paralysis resulting in urinary stress incontinence. Less frequent are overflow incontinence and loss of urine due to ectopic ureter or a fistula. Therapy of urge incontinence is basically conservative: Causes for secondary detrusor hyperactivity must be eliminated. With idiopathic hyperactivity "bladder drill" with or without support of parasympathicolytic agents is the method of choice. Also in patients with less severe degrees of genuine urinary stress incontinence conservative therapy is helpful: pelvic floor exercises, performed in an accurate ("feel and move"), regular and persistent way, reduction of body weight in obese persons, regular bladder emptying and the elimination of "stress situations", e.g. chronic bronchitis due to nicotine abuses may improve the situation considerably. The treatment of neurogenic incontinence is rather complex and must be based on the underlying pathophysiology of detrusor and sphincter dysfunction, but also in these patients therapy is mainly conservative. Elderly people have double the incidence of urinary incontinence found in younger age groups. About 20% of those in old persons homes have been found to be incontinent. 80% of these elderly people suffer from urge incontinence as a result of bladder hyperactivity, in about 30% bladder hyperactivity is combined with residual urine and consequent urinary tract infection which makes bladder instability worse. Moreover physical immobility increases the problem of urgency.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Urinary incontinence--conservative therapy]. 368 33

Major complications of the Burch procedure for stress urinary incontinence are rare. Inadvertent kinking of the ureter during this procedure has been described only once previously in the literature. We present a second such case, hoping to draw attention to this rare but significant complication.
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PMID:Ureteral obstruction as a complication of the Burch colposuspension procedure: case report. 382 83


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