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

The results of urethrocystography in 193 patients with urodynamically and clinically confirmed recurrent incontinence were analyzed. Severe displacement of the vesical cervix and the proximal section of the urethra predisposes the patient to recurrent stress incontinence. The roentgenological findings (difference of over 30 mm in the distance between the vesical cervix and the ischium, outflow of contrast medium next to the catheter under stress with differential values between 20 and 40 mm, angle of inclination of the proximal urethra of over 45 degrees) are significantly more frequent in cases of recurrent stress incontinence than in cases of first occurrence (132 patients). Of the 193 patients 164 (84%) had previously undergone a vaginal operation. In 60% of these 164 patients the difference in the distance between the vesical cervix and the ischium was 30 mm or more under "resting" stress, and in a further 19% it was between 26 and 30 mm, often with outflow of contrast medium during "pressing". Stress incontinence has a damaging effect on the supporting apparatus of the urethra and the bladder, and also on the ureter and the kidneys. Ureteral drainage disorders and chronic pyelonephritis are the changes most commonly diagnosed in roentgenograms. No statistically significant differences between recurrent and first-time stress incontinence were found. Urethrocystographic findings facilitate selection of the surgical procedure. It appears possible to reduce the frequency of recurrence if preoperative roentgenological findings are taken into account.
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PMID:[Recurrent stress incontinence]. 405 46

Ten patients (4 boys and 1 girl, 4 adult women and 1 man) were operated upon for incontinence due to epispadias (5 children and 2 women), or the result of multiple operations for stress incontinence (2 women), or of a transurethral bladder neck resection (the adult man), using Leadbetter's technique, which is described. In 4 patients with a sufficiently long trigonum, it was not considered necessary to perform ureterovesical reimplantation. Interesting results were obtained as they were assessed as very good in 4 and good in 2 of the 7 cases of epispadias, good in 1 of the 2 cases of sphincter lesions following surgery, and poor after endoscopic resection of the bladder neck in the man. All patients retained a normal upper urinary tract. In those patients who became continent, the new urethra measured 3.3 to 5 cm in length, whereas it was too short and dilated in cases remaining incontinent. Initial pollakiuria improved in the children after several months. These findings suggest that the ureter should be reimplanted in all cases, to allow the formation of a muscular, newly formed urethra of sufficient length. This operation appears to be effective for treating incontinence due to epispadias and traumatic sphincter lesions in women. It gives poor results in incontinence after prostate surgery and from neurological bladder. Reeducation of the child is as important as selection of patients for operation and a strict operative technique.
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PMID:[Surgical treatment of total urinary incontinence based on Leadbetter's technic]. 649 47

The authors present 3 cases where the diagnosis of ectopic insertion of the ureter, responsible for incontinence, had been missed: -- 2 cases of refluxing urethral insertions, including 1 case of single ureter, -- 1 case of vaginal ectopic ureter with duplicity. The authors stress that an ectopic insertion of the ureter can be asymptomatic until adulthood when it may present as simply as urinary stress incontinence. The diagnosis is suggested by a history of incontinence developing since childhood, accompanied by radiological signs of pyeloureteric duplicity or a small atrophic kidney. When the diagnosis is missed, successive surgical treatments are bound to fail, while excision of the renal segment drained by the ectopic ureter results in cure.
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PMID:[Refractory urinary incontinence]. 686 71

Burch colposuspension is a simple retropubic approach for the management of stress incontinence. Major complications are rare but kinking of the ureter can occur in such a procedure, especially in patients who previously have undergone hysterectomy. Careful dissection of the vagina and identification of the ureters are necessary before colposuspension is attempted.
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PMID:Kinked ureter with unilateral obstructive uropathy complicating Burch colposuspension. 686 96

Teloscopy, a method of suprapubic cystoscopy, involves placing a telescope into the dome of a full bladder to examine the bladder interior. A 5-mm Dexide cannula was pierced through the dome of the bladder and a telescope was inserted through it. This specialized cannula sleeve maintained bladder distention and allowed an excellent wide-angle view of the interior of the bladder and ureteral orifices. In a retrospective analysis, 103 consecutive women with stress urinary incontinence who underwent retropubic urethropexy were placed into one of three categories: Burch laparotomy (13), Burch laparoscopy (44), or laparoscopy with mesh and staples (46). Teloscopy was performed and indigo carmine was given intravenously at the end of the procedure in 90 patients. Of these, seven (8%) were positive. In all seven a suture was seen through the bladder mucosa, and in five an additional obstructed ureter was observed. In all seven women the suture was removed and replaced, and all obstructed ureters were patent before the end of the procedure. Average time required was 4 minutes. No complications, short- or long-term, occurred in the 90 women. Our results support the view that cystoscopy should be performed at the end of bladder neck suspension.
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PMID:Teloscopy after bladder neck suspension. 993 16

A 64-year-old woman underwent right nephroureterectomy of the ureter by the intussusception method under the diagnosis of right renal pelvic tumor in December 2001. Stress incontinence appeared postoperatively, and though conservative treatment was performed, it did not improve. The result of the pad-weighting test was 56 g indicating serious incontinence. In chain cystography, contrast media from the posterior wall of the urinary bladder to the vagina leaked out by the lateral view, and in cystoscopy, a fistula of about 2 mm in diameter was recognized in the right ureteral orifice trace. Under the diagnosis of vesicovaginal fistula, we performed transvaginal repair of the vesicovaginal fistula in November 2003. The urethral catheter was removed on the 14th postoperative day. After removal of the urethral catheter, urge incontinence was recognized, but it improved gradually. The recurrence of fistula and tumor has not been recognized at present.
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PMID:[Vesicovaginal fistula which arose postoperatively after removal of the ureter by the intussusception method for renal pelvic tumor: a case report]. 1557 22

We describe an unusual complication caused by urethral catheterization which, to our knowledge, has not yet been reported. A 16 Fr urethral balloon catheter was unintentionally placed into the left ureter through the ureteral orifice in a 51-year-old woman following retropubic suspension surgery for stress urinary incontinence. After retrograde urography from the urethral catheter and removal of the catheter, reoperation was performed and a double pig-tail ureteral stent was placed in the left ureter with subsequent proper replacement of a urethral catheter. The patient had uneventful postoperative recovery. Although the presented accident was an unexpected complication which might be associated with anatomical changes resulting from colposuspension, we should have confirmed the catheter position intraoperatively.
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PMID:Placement of a urethral catheter into the ureter: An unexpected complication after retropubic suspension. 1573 21

Management of urethral erosion typically entails two options: sling incision (in the early postoperative period) or excision of the suburethral part of the sling (urethrolysis). This paper describes a different endoscopic technique. A forty-year-old woman with a synthetic sling implanted 10 years prior presented with persistent lower urinary tract symptoms. A kidney ureter bladder X-ray showed a stone at the level of the bladder neck. Disintegration of the stone revealed eroding mesh embedded in the urethral wall. Complete resection of the mesh using an electrocautery knife was performed. Two months since the procedure, the patient has had an uneventful course. Both vaginal and urethral walls are intact, and she is capable of normal voiding with some stress incontinence. Although it is unusual, a sling eroding the urethra is a diagnosis that needs to be considered even 10 years after surgery. Endoscopic management is feasible and can be successful.
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PMID:Endoscopic excision of an eroding calcified mesh sling, 10 years after primary surgery. 1875 81

A 45-year-old woman was admitted to our hospital with a chief complaint of stress urinary incontinence. She had undergone simple hysterectomy due to myoma uteri at another hospital. X-ray examination and ultrasonography revealed a hydronephrosis on the right side after the surgery, which was improved immediately without intervention. She was diagnosed as having stress incontinence according to the history, findings of frequency/volume chart, 1-hour pad test, cystoscopy, drip infusion pyelography, magnetic resonance imaging and so on. Periurethral injection with non-animal stabilized hyaluronic acid/ dextranomer was performed. Incontinence was improved, but was not cured completely. After indigo carmine intravenous injection, cystoscopy was performed but no urine flow was noted from the right ureteral orfice. At the transvesical investigation, blue fluid was found at the vagina, and she then was diagnosed as having right ureterovaginal fistula. She underwent ureterovaginal fistula repair and reimplantation of the right ureter, and her incontinence was cured. To our knowledge, this is the first case of ureterovaginal fistula associated with stress incontinence.
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PMID:[A case of iatrogenic ureterovaginal fistula associated with stress urinary incontinence]. 1994 93

To overcome problems of damaged urinary tract tissues and complications of current procedures, tissue engineering (TE) techniques and stem cell (SC) research have achieved great progress. Although diversity of techniques is used, urologists should know the basics. We carried out a literature review regarding the basic principles and applications of TE and SC technologies in the genitourinary tract. We carried out MEDLINE/PubMed searches for English articles until March 2010 using a combination of the following keywords: bladder, erectile dysfunction, kidney, prostate, Peyronie's disease, stem cells, stress urinary incontinence, testis, tissue engineering, ureter, urethra and urinary tract. Retrieved abstracts were checked, and full versions of relevant articles were obtained. Scientists have achieved great advances in basic science research. This is obvious by the tremendous increase in the number of publications. We divided this review in two topics; the first discusses basic science principles of TE and SC, whereas the second part delineates current clinical applications and advances in urological literature. TE and SC applications represent an alternative resource for treating complicated urological diseases. Despite the paucity of clinical trials, the promising results of animal models and continuous work represents the hope of treating various urological disorders with this technology.
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PMID:Tissue engineering and stem cells: basic principles and applications in urology. 2096 44


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