Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0403608 (ureter)
 9,655 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

An 86-year-old Caucasian female presented with two weeks history of discomfort discharging urine, occasional hematuria, and suprapubic pain. The patient had a history of left salpingo-oophorectomy for an ovarian tumor, performed four years earlier. Ultrasound showed a solid mass surrounding the orifice of the left ureter. Bladder washing cytology yielded single, loosely cohesive syncytial aggregates of rather uniform cells. A few discretely grooved nuclei ("coffee bean nuclei") were seen. Histologic examination revealed muscular tissue infiltrated by oval to round cells, arranged in solid and follicular structures. The tumor cells were immunoreactive for estrogen receptor, inhibin, vimentin, and calretinin. The use of antibodies to pancytokeratin, inhibin, estrogen receptor, S-100, calretinin, and chromagranin could help confirm granulosa cell tumor. To my knowledge, there was no previous report on bladder washing cytology of metastatic granulosa cell tumor.
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PMID:Bladder-washing cytology of metastatic ovarian granulosa cell tumor. 1211 30

Genitourinary endometriosis is a rare manifestation of a common disease. Ectopic endometrial tissue may extrinsically involve or intrinsically invade the bladder or ureter, and, less commonly, the urethra or kidney. Bladder involvement usually presents with irritative symptoms, whereas ureteral disease may present with asymptomatic renal failure. Therefore, a high index of suspicion is necessary, and genitourinary endometriosis should be considered in all symptomatic women with a history of cesarean delivery of other gynecologic surgery. In women beyond reproductive age, definitive surgical treatment is preferred, with removal of the ectopic tissue, relief of obstruction, and castration with or without hysterectomy. In those who desire future fertility, conservative surgery and/or hormonal therapy is often recommended.
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PMID:Endometriosis of the urinary tract. 1247 26

Bladder, bowel, and sexual dysfunction caused by iatrogenic lesions of the inferior hypogastric plexus (IHP) are well known and commonly tolerated in pelvic surgery. Because the pelvic autonomic nerves are difficult to define and dissect in surgery, and their importance often ignored, we conducted a gross anatomic study of 90 adult and four fetal hemipelves. Using various non-surgical approaches, the anatomic relations and pathways of the IHP were dissected. The IHP extended from the sacrum to the genital organs at the level of the lower sacral vertebrae. It originated from three different sources: the hypogastric nerve, the sacral splanchnic nerves from the sacral sympathetic trunk (mostly the S2 ganglion), and the pelvic splanchnic nerves, which branched primarily from the third and fourth sacral ventral rami. These fibers converge to form a uniform nerve plate medial to the vascular layer and deep to the peritoneum. The posterior portion of the IHP supplied the rectum and the anterior portion of the urogenital organs; nerve fibers traveled directly from the IHP to the anterolateral wall of the rectum and to the inferolateral and posterolateral aspects of the urogenital organs. The autonomic supply from the IHP was supplemented by nerves accompanying the ureter and the arteries. An understanding of the location of the autonomic pelvic network, including important landmarks, should help prevent iatrogenic injury through the adoption of surgical techniques that reduce or prevent postoperative autonomic dysfunction.
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PMID:Topography of the pelvic autonomic nervous system and its potential impact on surgical intervention in the pelvis. 1258 66

Bladder agenesis is an extremely rare congenital anomaly. We report a case of bladder agenesis in a newborn girl with a prolapsing ectopic ureter and solitary dysplastic kidney. The classification of this disorder and the management of this patient are reviewed.
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PMID:Agenesis of the bladder with solitary renal dysplasia: management of a challenging condition. 1518 14

The first case is a 50-year-old female. She was consulted to our hospital for further examination of right hydronephrosis that was shown by ultrasonography. Cystoscopy revealed tumorous lesion around the right orifice. Bladder tumor was suspected and transurethral biopsy of the bladder was performed. The second case is a 54-year-old man. He was consulted to our hospital because right hydronephrosis was shown by counterized tomography. A tumorous or stenotic lesion in the lower end of ureter was suspected. Cystoscopy revealed yellowish and thickened tissue in the trigonal area. Bladder amyloidosis was suspected and transurethral biopsy of the bladder was performed. The histopathological diagnosis indicated amyloidosis and systemic amyloidosis was excluded. Both cases were treated by occlusive dressing technique therapy using Dimethyl sulfoxide (DMSO) successfully.
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PMID:[Localized amyloidosis of the bladder treated effectively by occlusive dressing technique therapy using Dimethyl sulfoxide (DMSO): two case reports]. 1636 58

The diagnosis of neurogenic bladder can be easy in myelomeningocele and much more difficult in occult dysraphia or medical etiologies. Careful clinical examinations and urodynamic investigations are mandatory for the diagnosis and the follow up of affected patients. Clinico-anatomical correlations are poor. If urinary leak is the first apparent symptom, preservation of the upper urinary tract is the main goal of the surgeon. If natural history of the neurogenic bladder is destruction of the detrusor and paralysis of the trigona, obstructive uropathy is the main physiological concern. Urinary leak must be integrated in the global context of the bladder function in order to determine urinary incontinence type. Ideal micturition is voluntary, must be complete, and needs the synergistic action of a reservoir with a good capacity, a normal compliance, and adequate sphincter outlet resistances. Continence is obtained by balancing these functions, and associating medical treatment and surgery is necessary. Bladder intermittent catheterization is the clue to obtain in most of the cases complete evacuation of the bladder and protection of the upper urinary tract. Increasing bladder capacity is achieved more often by augmentation cystoplasty (colon, ileus, stomach and ureter can be used). Autoplasty at the beginning, artificial tissue engineering will be the future. Augmentation of the bladder outlet resistances need surgical reconstruction (young dees, Pipi-salles procedures...) or uretral and bladder neck suspensions, artificial urinary sphincters, endoscopic injections of bulking agents. All these techniques can be proposed and combined according to the patient's gender, age and social environment. Continent cystostomy allows obtaining continence in difficult cases and after unsuccessful surgery of the bladder neck. Other techniques are under evaluation and sacral neuromodulation give at the moment some promising results. Managing neurogenic bladder must not be considered only in urological terms: orthopedic troubles, digestive and sexual disorders must not be forgotten in order to obtain at least an "acceptable social life".
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PMID:[Neurogenic bladder in children: basic principles in diagnosis and treatment]. 1655 Oct 3

Idiopathic hypercalciuria (IH) has been speculated to have a predisposing role in the development of urinary tract infection (UTI), due to the uroepithelial cell damage it leads to. In this study, we aimed to investigate the effects of hypercalciuria on the bladder, ureters, and kidneys in rats with experimentally induced hypercalciuria.Normocalcemic hypercalciuria was induced by furosemide (60 mg/100 mL of drinking water) administration to 16-week-old male Wistar Albino rats for 14 days. Calciuria (calcium/creatinine ratio, mg/mg, Ca/Cr) increased from 0.07+/-0.01 at the beginning of administration to 0.41+/-0.1 on day 14 (p=0.000). The Ca/Cr ratio was 0.14+/-0.06 at the beginning of the study and 0.25+/-0.06 on day 14 in the control group rats (p=0.002 vs. the hypercalciuric group rats on day 14). Bladder, ureter, and kidney specimens of the rats, dissected on the 14th day, were fixed in 10% formalin and 2.5% gluteraldehyde solutions for light and electron microscopic examination, respectively. Histopathological and ultrastructural examination of the hypercalciuric rats revealed proliferation and apical cytoplasmic vacuole formation in transitional epithelial cells, mitotic activity in the intermediate cell line, vasodilatation, edema, and separation of collagen fibers in the bladder and ureter specimens. Light microscopic examination of the kidney specimens revealed a lot of erythrocyte in the glomerular capillary lumen, while electron microscopy revealed vacuolization of proximal and distal tubules, tubular degeneration, interstitial edema, and vasodilatation.In this study, hypercalciuria was observed to have adverse effects on the cell architecture of the uroepithelium and disruption of the epithelial barrier of the bladder and ureters and all kidney structures, especially on the proximal epithelial cells.
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PMID:Evaluation of histologic changes in the urinary tract of hypercalciuric rats. 1692 50

Although the vast majority of bladder tumors are epithelial neoplasms, a variety of nonneoplastic disorders can cause either focal bladder masses or diffuse mural thickening and mimic malignancy. Some of these entities are rare and poorly understood such as inflammatory pseudotumor, which produces ulcerated, bleeding polypoid bladder masses. These masses may be large and have an extravesical component. Bladder endometriosis manifests as submucosal masses with characteristic magnetic resonance imaging features consisting of hemorrhagic foci and reactive fibrosis. Nephrogenic adenoma has no typical features, and pathologic evaluation is required for diagnosis. Although imaging features of malacoplakia are also nonspecific, characteristic Michaelis-Gutmann bodies are found at pathologic evaluation. The various types of cystitis (cystitis cystica, cystitis glandularis, and eosinophilic cystitis) require pathologic diagnosis. Bladder infection with tuberculosis and schistosomiasis produces nonspecific bladder wall thickening and ulceration in the acute phase and should be suspected in patients who are immunocompromised or from countries where these infections are common. The diagnosis of chemotherapy cystitis and radiation cystitis should be clinically evident, but imaging may be used to determine severity and to assess complications. Extrinsic inflammatory diseases such as Crohn disease and diverticulitis may be associated with fistulas to the bladder and focal bladder wall abnormality. The extravesical findings allow the diagnosis to be made easily. Finally, extrinsic masses arising from the prostate or distal ureter may cause filling defects, which can be confused with intrinsic bladder masses.
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PMID:From the archives of the AFIP: Inflammatory and nonneoplastic bladder masses: radiologic-pathologic correlation. 1710 55

Cases are presented to illustrate pitfalls in radiologic and histopathologic diagnosis in urology. In a 73-year-old woman, ultrasound revealed calcification in an irregular mass arising from the left wall of the bladder. Bladder biopsy reported the mass as papillary transitional cell carcinoma. Histologically, the specimen showed marked hyperplasia of the urothelium with formation of Brunn's nests and no evidence of dysplasia or malignancy. A review of medical images showed that the mass was a calcified uterine fibroid. In a 36-year-old man, a calcified opacity in the pelvis was reported as a ureteric calculus, and the patient underwent ureteroscopy. No stone was found. A review of an intravenous urogram showed that the radio-opaque shadow appeared outside the left ureter. A 41-year-old man with tetraplegia developed hydronephrosis as the result of a calculus in the renal pelvis. Ureteric stenting was performed, followed by shock wave lithotripsy. A follow-up x-ray of the abdomen showed a small radioopacity that projected over the line of the left ureter at the L-3 level-probably a ureteric calculus. A review of a computed tomography scan revealed that the calculus, noted on plain film at the level of L-3, had become extruded and was lying posterior to the ureter. A 59-year-old man underwent nephrectomy for a 5-cm solid lesion in the mid pole of the left kidney. Histology showed multiple synchronous renal cell carcinomas and angiomyolipomas. The patient underwent further investigation for von Hippel-Lindau disease and tuberous sclerosis. A review of tissue blocks from the nephrectomy specimen, however, showed no evidence of angiomyolipoma. What was interpreted as renal angiomyolipoma was actually simple distorted blood vessels in areas of renal scarring. To prevent mistakes in diagnosis and to detect medical errors without delay, the authors recommend that physicians set aside time to reflect upon their clinical practice, regularly participate in honest and informal case discussions, and seek a second opinion when in doubt.
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PMID:Pitfalls in radiologic and histopathologic diagnosis of urologic disease--report of 4 cases. 1727 70

We present a 69-year-old man with repeated urinary tract infection and lower abdominal pain. Kidney-ureter-bladder (KUB) scout film showed a huge, 320-g triangular pelvic calculus that was surgically removed with excellent results. Bladder stone is a common disease, but it is rare for such a calculus to be so large as to cause bilateral hydronephrosis. Surgical intervention by cystolithotomy or endoscopic cystolithotripsy can achieve satisfactory results. Bladder outlet obstruction should be treated simultaneously. Close follow-up, however, is mandatory because the recurrence of urolithiasis is high in those patients with voiding problems and recurrent urinary infection. To the best of our knowledge, this is the largest bladder stone in a human male. This case report also illustrates the importance of radiologic evaluation of patients with repeated urinary infections.
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PMID:A huge pelvic calculus causing acute renal failure. 1827 20


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