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

In order to evaluate vesicourethral dysfunction in diabetic patients, urodynamic studies, IVP and urinalysis were performed on 173 diabetic patients (male 78, female 95) and 17 nondiabetic control cases. In addition to the classical findings as increased volume at the first desire to void and decreased maximum vesical pressure, diabetic patients showed varieties of vesicourethral dysfunctions such as overactive bladder (14.5%), low compliance bladder (11.0%) and loss of detrusor-external sphincter coordination (31.7%). Vesicourethral function of diabetics was classified in following 5 types by analysing the volume at first desire to void, volume at maximum desire to void, maximum vesical pressure, residual urine volume and bladder compliance. 1. Type 1, normal vesical function, 13 cases. 2. Type 2, vesical dysfunction with minimal residual urine, 49 cases. 3. Type 3, vesical dysfunction with residual urine, 66 cases. 4. Type 4, low compliance bladder, 20 cases. 5. Type 5, overactive bladder, 25 cases. Pyuria was observed in 59.8%, hydronephrosis was found in 10.9% and ectasia of lower ureter was found in 17.8% of diabetic patients. The highest incidence of pyuria and abnormality of the upper urinary tract were noted in Type 4 and followed by Type 3 and by Type 2 in decreasing order. Extent of pyuria and ectasis of the upper urinary tract showed statistically significant correlation with residual urine volume and detrusor-external sphincter coordination. When vesicourethral function was compensated by abdominal strain, the volume of residual urine is not elevated, but when the mechanism of compensation is lost or in the absence of detrusor-external sphincter coordination results in gradual accumulation of residual urine. In cases with long standing chronic urinary tract infection may results in fibrosis of the bladder wall with low compliance bladder. Fibrotic obstruction of uretero-vesical junction can cause hydroureteronephrosis and followed by renal function impairment. As vesical damage become irreversible at this end stage, proper management during early stage is crucial for management of diabetic patients. Cholinergic agent were effective to reduce residual urine volume in Type 3. alpha-blocking agent were effective to reduce residual urine volume in Type 3 and some cases of Type 4. In cases in which medication therapy failed to reduce residual urine, the clean intermittent catheterization was successful in control of urinary tract infection and upper urinary tract ectasis. Transurethral resection of the prostate and the bladder neck is indicated in the male patients with a large amount of residual urine in Type 3 and 4.
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PMID:[Vesicourethral dysfunction of diabetic patients]. 189 20

In a 10 year series of 350 consecutive renal transplant operations, the overall urological complication rate was 7.7%. During this period double J stents were introduced and were used either in the treatment of actual urological complications or as a prophylactic measure to protect ureters which had been damaged at retrieval. A total of 34 double J stents were used in 33 patients. The indications were: ureteric obstruction (n = 13), urinary leak (n = 5), short transplant ureter anastomosed using an extravesical ureteroneocystostomy (n = 10) and ureteric injury at the time of organ retrieval (n = 6). Thirty-two double J stents were inserted at open operation and two were inserted by an antegrade method after percutaneous nephrostomy. Improvement in renal function occurred in 16 out of the 18 cases of urological complications. No kidneys were lost and there were no deaths as a direct result of these complications. In a number of cases the insertion of a double J stent was the only treatment, thus eliminating the need for more complex surgery. All 16 patients who had a ureteric stent inserted as a prophylactic measure at the time of transplantation made uncomplicated postoperative recoveries. Urinary tract infection was relatively common (27%) after double J stent insertion, but other complications were rare. In conclusion, double J stents have proved to be a useful adjunct in the management of renal transplant related urological complications.
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PMID:Urological complications of renal transplantation: the impact of double J ureteric stents. 141 89

Certain microorganisms have a propensity for causing urinary tract infection, and the route (either ascending or hematogenous) by which microorganisms contaminate the urinary tract from external sources is frequently characteristic of the microorganism. There are local defense mechanisms both in the urine and at each anatomic site in the urinary tract (urethra, bladder, ureter, and kidney). The defense mechanisms at one site may have opposing effects on microbial growth at other sites in the urinary tract. The outcome following entrance of microorganisms into the urinary tract is a result of competing forces, which consist of these local urinary defense mechanisms, the initial numbers of microorganisms contaminating the urinary tract, and microbial virulence factors.
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PMID:Host defense mechanisms in the pathogenesis of urinary tract infection. 199 33

Vesicovaginal fistulas in three patients and a vesicocutaneous fistula in one patient were treated by percutaneous transrenal occlusion of the ureter with a commercially available silicone occluder (Angiomed, Karlsruhe, Germany) which was secured by means of histoacryl placed on top. Urinary flow was diverted by a permanent nephrostomy tube. We observed no complications (e.g., urinary tract infection, occluder migration, or recurrence of urine discharge) at an average follow-up period of 9.1 months.
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PMID:Therapeutic transrenal occlusion of the ureter: solution of plug migration problem. 204 68

We report a case of right common iliac artery fistula to the left ureter in a patient affected by an invasive bladder tumour treated with radical surgery, radiotherapy and neo-adjuvant chemotherapy. At the time of manifestation, our patient had indwelling catheters and presented an urinary tract infection. Diagnosis was established during autopsy. We feel that the cause of this complication is multifactorial.
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PMID:[Uretero-iliac fistula: presentation of a case and review of the literature]. 205 45

To determine the impact of prenatal detection on neonates with hydronephrosis of the upper pole of a duplex collecting system, we reviewed 40 such cases seen between June 1982 and April 1989. This six-per-year rate contrasts with fewer than one case per year that was seen at our hospital from 1947 to 1977. Nineteen patients had an ectopic ureterocele, and 21 had an ectopic ureter without a ureterocele. Thirty-three (83%) were girls. Thirty-three cases were discovered because of abnormal findings on a prenatal sonogram, and 20 of those infants were asymptomatic. In the 33 patients whose prenatal sonographic findings were abnormal, the sonogram was diagnostically precise for hydronephrosis of the upper pole of a duplex collecting system in only 39%. This imprecision did not adversely affect management or outcome. Postnatal sonography modified the prenatal diagnosis in 75% of these 33 patients. Voiding cystourethrography was the most sensitive and precise imaging technique for detecting both ureterocele and reflux. Lower pole reflux was almost twice as common when an ectopic ureterocele was present (63%) than when one was not (33%). Prenatal sonographic detection of hydronephrosis of the upper pole of a duplex collecting system decreased the proportion of neonates presenting with urinary tract infection and urosepsis because of prophylactic antibiotics initiated at birth and continued until surgical correction. Precise prenatal diagnosis was not needed for effective surgical treatment.
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PMID:Importance of prenatal detection of hydronephrosis of the upper pole. 211 33

Five children (three girls and two boys) who had a duplex collecting system with an ectopic ureter or a ureterocele that was not detected with either imaging or cystoscopy were seen during a 10-year period. Four had urinary tract infection. The fifth was noted to have hydronephrosis when CT scanning of the abdomen was done for trauma. In each case, voiding cystourethrography showed reflux into what was thought to be a single (nonduplex) collecting system, but was found during surgery to be the lower pole of a duplex system. Excretory urography in four patients, sonography in two, and CT scanning in one did not show signs of duplication on the affected side. In each case cystoscopy failed to show a duplex system on the affected side. The diagnosis of duplication of the collecting system with ectopic ureter or ureterocele was made in each case only when the bladder was opened to reimplant the ureter. Direct opacification of the previously unsuspected upper pole ureter in each case showed it to be bind-ending and terminating at the level of the kidney. Radiologists and surgeons should be aware that duplex systems may not always be visible on urography and sonography.
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PMID:The unsuspected double collecting system on imaging studies and at cystoscopy. 211 58

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

Ultrasonography and intravenous pyelography (IVP) were compared for their diagnostic value in 65 patients (29 women, 36 men; mean age 57 [19-85] years) thought to have disease of the kidneys or urinary tract (microhaematuria in 16, macrohaematuria in 5, urinary tract infection in 11, suspicion of renovascular hypertension in 6, suspected tumour in 5, suspected nephrolithiasis in 15, and flank pain of uncertain cause in 7). Ultrasound established an abnormal condition in 29, in five of which IVP gave false positive results, false-negative results in three. The false-negative results were an indirect sign of renal artery stenosis in one patient and in one patient each of duplex ureter and cystic ureteritis. Mild hydronephrosis (n = 3), stone in a kidney or the renal calyx system (n = 2) and tumour of the right kidney (n = 1), diagnosed by ultrasound, were not seen by IVP. Concordant results were thus obtained in 70% of cases. Ultrasound examination of the urinary tract gives such reliable results that in many cases an additional IVP is unnecessary.
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PMID:[A comparison of sonography and intravenous pyelography in diseases of the kidneys and urinary organs]. 240 30

Exocrine secretions of 16 of 22 pancreas allografts were drained into the urinary tract. Seven of these 16 patients have functioning allografts, six with pancreaticocystostomies and one with duct-to-ureter anastomosis. A notable problem has been a chronic metabolic acidosis, along with weight loss and hypotension, secondary to chronic bicarbonate loss and volume depletion through the urinary pancreatic fistula. This occurred as early as one week posttransplant, and intermittently thereafter up to four years. The syndrome was aggravated by episodes of renal dysfunction (acute tubular necrosis or rejection), and febrile syndromes. An inverse relationship between serum and urine bicarbonate concentrations existed, with a correlation coefficient, r = -0.746, (P less than 0.05). A negative correlation was also noted between serum bicarbonate and serum creatinine, r = 0.726, (P less than 0.05). Hyperchloremic metabolic acidosis with normal anion gap occurred despite periods of marginal pancreas allograft function resulting from ongoing rejection. Treatment consisted of intravenous and/or oral bicarbonate supplementation, and bicarbonate dialysis for uremic patients. In addition, one patient was first seen with severe balanitis and urethritis due to documented activation of trypsinogen and chymotrypsinogen, presumably caused by recurrent episodes of urinary tract infection. Urinary assay revealed a 10(2-3) increase in activated trypsin and chymotrypsin in comparison with other asymptomatic allograft recipients. Conversion to ductal enteric drainage led to resolution of both the balanitis and bicarbonate wasting. Measurement of urinary amylase levels were gross indicators of graft viability since no correlation could be found between these levels, onset of hyperglycemia, and eventual graft rejection confirmed by pathological examination.
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PMID:Pancreatic allograft exocrine urinary tract diversion. Pathophysiology. 243 6


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