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

Rupture of the pelvicalycine systems is occasionally observed during infusion pyelograms. Twenty such cases are reported. The usual cause was the presence of stones in the ureter leading to urinary tract obstruction and acute pressure rise in the pelvicalycine system. The anatomical and physiological basis for the rupture is outlined. Subsequently our own cases are described. In 13 patients rupture occurred without previous renal abnormality; in these there was always spontaneous healing once the obstruction had been removed. In five patients rupture occurred in a previously damaged kidney; the changes at the point of rupture and the subsequent possible complications are described. Two cases should be mentioned in detail; in these, rupture persisted and lead to the development of a retroperitoneal pseudocyst. Only one similar case is reported in the literature since 1966.
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PMID:[Contrast extravasation from the pelvicalycine system during infusion pyelography (author's transl)]. 14 26

Carcinoma metastatic to the ureter, representing hematogenous or lymphatic spread from a distant primary neoplasm, was diagnosed in 39 patients. Although the lesions are uncommon and usually represent late manifestations of malignant disease, earlier recognition and relief of urinary tract obstruction may allow for improvement in symptoms and survival.
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PMID:Secondary tumors of ureter. 49 60

There is one renal disease in which unilateral estimation of GFR is desirable for clinical purposes: chronic pyelonephritis. Considering the possibilities for complications to determine unilateral renal function by ureter catheter just in this group of patients, we tried to estimate unilateral GFR with 66mTc-DTPA after a single injection of 5 mCi i.v. on the basis of blood samples at 90, 110 and 130 min after injection and evaluation of gamma-camera data from 25 to 35 min after administration of the dose. 31 patients were studied. In arenal patients clearance values were 7.5 ml/min (+/- 10.47 ml/min), unilaterally nephrectomized patients showed zero values for the removed kidney. Normal patients had a mean GFR of 107 +/- 17.7 ml/min with a partition between right and left kidney of 54.2 +/- 10 to 52.75 +/- 8.5 ml/min. Patients without urinary tract obstruction and unilateral renal disease had values of 27.1 +/- 11 ml/min for the diseased kidney while the normal kidneys gave a mean value of 59.6 ml/min (+/- 13 ml/min). In the presence of urinary tract obstruction, data could not be correlated to the state of renal function. This shows that unilateral estimation of GFR using 99mTc-DTPA is basically possible, but that it is useless in obstructive kidney disease.
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PMID:Unilateral estimation of glomerular filtration rate with 99mTc-DTPA. 69 96

The tightness of the ureterovesical junction depends on all the structures composing the terminal and intra-mural ureter. The muscular, collagenic, and elastic fibers of the ureter constitute a mesh net which is stretched during bladder distention and closes the ureteric orifice as a valve. Congenital vesico-ureteric reflux results from a primary structural insufficiency of the terminal ureter or insufficiency of the bladder wall backing. As embryology shows primary reflux can be caused by a high ectopic implantation of the ureter. It results from the development of an ureteric bud appearing in a lower than normal position on the Wolffian duct. This results in a higher and more lateral opening of the ureteric orifice in the bladder which leads to a shorter intra-mural tunnel predisposing it to reflux. Secondary or acquired refluxes are associated with chronic obstructions (i.e. neurogenic bladder--lower urinary tract obstruction), and inflammatory lesions. Their pathogeneses are described and discussed. The maturation of the ureterovesical junction is considered a mechanism involving a reduced likelihood of secondary reflux. It may also, during the first years of life, palliate some minimal structural deficiencies of the intra-mural ureter, but growth and development are unlikely to normalize an ureter presenting at birth with a severe constitutional anomaly.
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PMID:[The physiopathology of vesicoureteral reflux (author's transl)]. 87 5

Pelvi-ureteric function was studied in pigs with experimental urinary tract obstruction, and again, 5 weeks after relief of the obstruction. Study parameters comprised EMG records taken from pelvis and ureter, measurements of intrapelvic pressure and urine flow, and some supplementary studies of renal function. Total obstruction of 5 and 6 weeks duration induced by cuffing the proximal ureter occasioned severe hydronephrosis and renal failure. Pelvic peristaltic activity was of low frequency, and abnormality was clearly more marked after the longer period of obstruction. There was, for example, some preservation of pelvi-ureteric synergism at 5 weeks, but at 6 weeks ureteric activity was wholly autonomous. Pelvic function was similarly isolated, and non productive. Inspection 5 weeks after reconstruction by pelvis resection and neo-anastomosis of the ureter showed continued absence of renal function and no restitution of normal peristaltic patterns. Partial obstruction, effected by implantation of the ureter in the psoas muscle, induced mild pelvic dilatation and impaired renal function, but there were only minor signs of disruption of normal anterograde pelvi-ureteric activity - irregularities, pauses in activity, and double activity complexes. When the ureter was freed functional patterns returned to normal. Both during obstruction and after relief, pelvic pressure increases during forced diuresis were the equivalent of or lower than the pre-determined norm. Cautery at the pelvi-ureteric junction destroyed the musculature and induced a progressive (fibrous stenosis. There was progressive dissociation of pelvi-ureteric activity, total when obstruction was total in which case ureteric activity was only autonomous, and partial when obstruction was partial in which case varying degrees of synergism and autonomous activity were seen. Successful reconstruction (pelvic resection and neo-anastomosis of the ureter) restored an apparent synergism in pelvi-ureteric function.
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PMID:Experimental hydronephrosis. An electrophysiologic investigation before and after release of obstruction. 107 50

This report deals with the histologic and gross anatomy of the upper urinary tract (calyces, pelvis, and ureter) as well as the nerve supply to this region. It also covers the physiological transport of urine from the kidneys to the bladder, which is reviewed on the basis of experimental and clinical studies. A pacemaker system present in the proximal calyces has been found to have an important physiological role in urine transport. However, clinical experience has shown that urine transport is not affected by surgery such as pyeloplasty and pyelolithotomy which impairs the activity of this pacemaker. Electron microscopic and histochemical studies as well as the maintenance of urine transport after renal grafting suggest that the nerve supply to the upper urinary tract is not dominant in regard to this function. This study also investigated urinary transportation in the presence of urinary tract obstruction due to various diseases, and demonstrated that urine is also conveyed by gravity and not solely by ureteric peristalsis. The use of internal stenting and percutaneous urinary diversion thus appears to be reasonable. Although the detailed etiology congenital hydronephrosis is still unknown, there is no doubt that it involves dysfunction of the ureteropelvic junction, since urine transport is improved by the endoscopic or surgical formation of a physiological tunnel at this junction which can regulate the volume of urine transported according to urine output. It is important for studies of upper urinary tract function to be conducted in close relation to clinical practice and not to simply be confined to esoteric experimental situations.
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PMID:[Anatomy and function of the upper urinary tract]. 147 48

To assess whether ultrasonography (US) with or without plain abdominal radiography (kidney, ureter, bladder [KUB] radiography) can replace intravenous urography (IVU) in detection of acute urinary tract obstruction, 101 consecutive patients with renal colic were evaluated with US followed immediately by IVU. Receiver operating characteristic (ROC) curves for US diagnosis of acute urinary tract obstruction yielded sensitivities of 91% and 92% for two reviewers at a specificity of 90%. There was no statistically significant difference between US and IVU results. When US was combined with KUB radiography, ROC curves yielded sensitivities of 94% and 97% for two reviewers at a specificity of 90%.KUB radiography alone was of limited diagnostic value. For US alone, no false-positive results occurred, and the false-negative results (n = 9 and n = 6 for two reviewers) were encountered in cases of grade 1 hydronephrosis and nondilated obstructive uropathy. The authors conclude that US combined with KUB radiography can replace IVU in initial evaluation and follow-up of the great majority of patients with renal colic.
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PMID:Renal colic: diagnosis and outcome. 143 88

We describe a twin with acardia acephalus or "Twin Reversed Arterial Perfusion Sequence" and prune belly sequence in the co-twin. In a former quite similar case a prune belly appearance of the co-twin of an acardiac fetus was found to be secondary to the ascites caused by cardiac failure. In the present case, we are dealing with the prune belly sequence as a separate condition, given the fact there were no signs of ascites or cardiac failure. We also found associated anomalies: agenesis of the left ureter and kidney, dysplastic right kidney and anal atresia. Urinary tract obstruction has never been described in the co-twin of an acardiac amorphous fetus.
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PMID:Acardiac amorphous twin with prune belly sequence in the co-twin. 187 24

Abdominal ultrasonography was performed on a caprine doe with anorexia, dysuria, and a palpable abdominal mass. Ultrasonography of a large firm mass situated cranial to the pelvic brim revealed a distended urinary bladder, which was confirmed by a dynamic bubble study. The left kidney had a large anechoic renal medulla and dilated renal pelvis and ureter consistent with ureteropyelectasia. Necropsy confirmed the existence of hydronephrosis and hydroureter, as well as cystitis, pyelonephritis, and partial urinary tract obstruction. The cause of the obstructive uropathy was a mass of fibrous tissue that obliterated the uterine cervix and partially obstructed the urethra and left ureter. The cause was presumed to be a cervical trauma from dystocia and forced extraction of a kid, with subsequent chronic fibrosis.
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PMID:Ultrasonographic diagnosis of obstructive uropathy in a caprine doe. 220 3

In recent 5 years, we have experienced 24 cases of advanced gastric cancer associated with obstructive uropathy. Included were 19 cases of undifferentiated, 3 cases of differentiated and 2 cases of unknown histological type. Obstructive uropathy is diagnosed based on the typical radiological findings such as dilatation and delayed demonstration of the upper collecting systems. Pathologically, undifferentiated type of gastric cancer had tendency to spread infiltrating along the vessels, nerves and the lymphatics without alteration of the ordinary anatomical structures. In such cases, mucosal surface of the urinary tract tended to be spared in spite of extensive tumor invasion. It was proven that several radiological findings were characteristic of urinary tract involvement secondary to gastric cancer. Either thread-like ureteral stricture by IVU or ring-like appearance of the ureter by CT is one of those typical findings. Renal sinus involvement may occur continuously to diffuse retroperitoneal invasion and it appears as a thickened wall of renal pelvis or soft tissue mass directly extending into the fatty tissue of renal sinus by CT. In such cases IVU has less diagnostic ability because of the lack of mucosal destruction. If the urinary bladder is involved, it typically shows chestnut-bur appearance by IVU and diffuse wall thickening by CT. In cases of advanced gastric cancer, particularly in cases of histologically undifferentiated type, CT and IVU images should be carefully interpreted in consideration of the infiltrative art of tumor extension.
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PMID:[Gastric cancer and obstructive uropathy]. 238 10


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