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

In recent years, there has been a complete change in the treatment of reno-ureteral lithiasis due to the availability of new endourological techniques (percutaneous nephrolithotomy, ureteroscopy) and particularly due to the development of extracorporeal shock wave lithotripsy (ESWL). The present study assessed the combination of endourological procedures and ESWL in the treatment of calculi localized in the kidney and lumbar ureter. A prospective study was undertaken to assess 1,500 renal units with calculi in the renal cavity and lumbar ureter that had been submitted to treatment by ESWL and endourological techniques. The results demonstrate that ESWL combined with percutaneous and endoscopic techniques affords effective treatment without major complications in 85.4% of calculi in the renal cavity and lumbar ureter. Treatment with ESWL as monotherapy was successful in 45.6% of the cases and endourological management prior to ESWL was successful in 39.8% of the cases. The most common complication of ESWL was colic and/or kidney referred discomfort (28.6%) and the most important complication was urinary tract obstruction following ESWL (9.67%). These required maneuvers to remove post-ESWL obstruction in 6.1% of the renal units treated. The number of shock waves employed and the kV utilized were associated to intense hematuria and perirenal hematoma. The combination of endourological techniques with extracorporeal shock wave lithotripsy completely eliminated calculi in 80.5% of the renal units at 3 months. 10.5% had remaining stone fragments that could be spontaneously passed, and 7.6% had larger residual fragments that could not be passed.
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PMID:[Treatment of reno-ureteral calculi using ESWL and endourologic technics]. 263 40

Dilatation of the urinary tract may be due to vesicoureteric reflux, urinary tract obstruction, or to primary dilatation. In a proportion of patients these factors may coexist. A retrospective review was carried out to estimate the incidence and features of coexisting reflux and obstruction. Our review indicates that the coexistence of urinary tract obstruction and primary reflux is more common than previously reported, occurring in approximately 1 in 20 patients with reflux. Any patients with reflux who has a dilated and/or tortuous ureter must be suspected of having obstruction. This may be ruled out in the majority of cases by a drainage film after a micturating cystourethrogram and the importance of this simple procedure is emphasised.
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PMID:Obstruction in the refluxing urinary tract--a common phenomenon. 275 84

The Whitaker test has been described as a means of reaching a diagnosis in equivocal upper urinary tract obstruction, but there has been conflicting evidence regarding the validity of this test. The present study assesses the reliability of the test in an experimental model which creates an accurate and predetermined degree of partial obstruction of the ureter. The Whitaker test was performed using the standard perfusion rate of 10 ml./min. in male adult dogs using a long-term indwelling renal intrapelvic cannula before and after application of ureteric obstruction, and after one month. Control animals underwent a sham procedure. Results of in vivo and in vitro perfusion studies were compared. Perfusion studies at multiple flow rates were also performed. The Whitaker test reliably detected the presence of ureteric obstruction and the degree of partial obstruction could be determined. Multiple flow rate studies did not significantly improve test results. Provoked pressures in the highest grade of obstruction were less than expected and this may be due to pyelovenous reflux.
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PMID:The Whitaker test: experimental analysis in a canine model of partial ureteric obstruction. 291 66

The use of percutaneous nephrostomies (PCNs) in 1456 patients (1660 kidneys) treated with extracorporeal shock-wave lithotripsy (ESWL) was evaluated. In this group, 138 PCNs (130 patients) were performed in 133 kidneys. Forty-seven percent of PCNs were placed in patients with staghorn calculi; 24% were for stones in the renal pelvis, and 20% for ureteral stones. The most common indication for PCN was fever and obstruction (57%). In 15%, the indications were failure to decompress an obstructed system from a retrograde direction, clogged double-J ureteral stents, and perforation of the ureter. Prophylactic PCN placement in the treatment of staghorn calculi and large stones in the renal pelvis accounted for 12%. Five percent were placed for miscellaneous other reasons, and for 11% there was no documentation of the indication because they were placed before the patients came to our center. Localization of the collecting system for optimal placement of PCN is unique in ESWL patients because the residual stone fragments provide natural contrast. This eliminates the need for administration of contrast material in 50% of the patients. Twenty-six percent of PCN tracts were subsequently used for other procedures (e.g., percutaneous nephrolithotomy, fragment irrigation, ureteral stone manipulation). Bleeding complications from PCN occurred in 7%. Other minor complications occurred in 12% of cases. PCN is a useful adjuvant to ESWL treatment of kidney stones. Although its major use is to relieve urinary tract obstruction, it is also used as a preliminary step in planning other percutaneous interventional procedures. This is particularly the case in the treatment of large bulky stones in the renal pelvis and staghorn calculi.
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PMID:Percutaneous nephrostomy in conjunction with ESWL in treatment of nephrolithiasis. 325 90

We report a case in which a normal right common iliac artery in a normal anatomical relationship to the right ureter at the crossing point caused partial urinary tract obstruction apparently by an over pressure effect. The ureter was attached to the promontorium periosteum following ureterolysis to relieve the obstruction. To our knowledge, such a condition has not been reported previously. We believe that over pressure of the common iliac artery should be considered in the differential diagnosis of extrinsic ureteral obstruction, particularly in muscular subjects.
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PMID:Ureteral obstruction owing to over pressure of a normal right common iliac artery: a case report. 339 40

Little information is available on the relationship between urinary infection in children and infants, with or without vesicoureteral reflux, and dilatation of the urinary tract. The purpose of this study was to determine the effects of infection and reflux on the diameter of the ureter at excretory urography in children with acute, febrile urinary tract infections and in infants with bacteriuria found at screening. Standardized measurements of ureteral diameter were obtained for 79 children (2 months to 6 years old) with urinary tract infections and for 45 infants with bacteriuria. Patients with urinary tract obstruction or malformations were excluded. Seventy-one children with febrile urinary tract infection had ureteral visualization that allowed measurements. Ureteral diameter in this group was significantly wider than in a reference group, and 42 children (59%) had ureteral diameters that were more than 2 standard deviations above the normal mean. Ureteral diameter at excretory urography increased with increasing grades of reflux, but dilatation occurred also in the absence of reflux. Twenty-two of the 45 infants in the group with bacteriuria had sufficient ureteral visualization for measurements. The ureters in this group were wider than in the reference group, and eight infants had ureteral diameters that were more than 2 standard deviations above the normal mean. We conclude that ureteral dilatation is a common effect of acute urinary tract infection and bacteriuria in children.
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PMID:Ureteral dilatation in children with febrile urinary tract infection or bacteriuria. 349 73

The prenatal diagnosis of urinary tract obstruction was made in 10 neonates. These findings were confirmed postnatally by sonography, urography, voiding cystourethrography, and scintigraphy. There were 8 neonates with unilateral obstruction of the ureter, and 2 with urethral valves and reflux. Nephrectomy because of hydronephrosis was necessary in 2 instances. The prenatal diagnosis of a urinary tract obstruction is of great importance, because the neonate may be operated upon without delay. Thus the diseased kidney can be saved. Diuretic radionuclide urography is helpful in differentiating between dilated obstructed and dilated nonobstructed kidneys.
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PMID:[Pre- and postnatal diagnostic imaging of congenital urinary tract disorders]. 352 Jun 41

CT findings in three cases of ureteral metastases are reported. Metastases to the ureter is an uncommon cause of the upper urinary tract obstruction. The most common primary sites include breast, stomach and neoplasms from pelvic organs. Radiographic studies revealed an ureteral stenosis in all the presenting cases. CT scans demonstrated a thickened regular ureteral wall at the level of the narrowing and no other abnormalities of the retroperitoneum. Such CT features suggest the possibility of ureteral metastases in a patient with the appropriate clinical setting. Histological studies, whenever possible, must confirm these radiographic findings. Early recognition of ureteral metastases and appropriate treatment for relief of urinary tract obstruction may prolong survival time.
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PMID:Ureteral metastases--computed tomographic findings. 359 18

Serious morbidity from renal transplant biopsy is reported to be infrequent. However, 4 of 43 patients who had renal transplant biopsy between July, 1981, and March, 1984, experienced anuria from upper urinary tract obstruction by blood clots. Although these clots usually dissolve, 3 patients (7%) experienced persistent clot anuria and deterioration of renal function. Awareness of this complication is important. Retrograde pyelography and ureteral catheterization are preferred primarily for diagnosis and treatment. Percutaneous techniques are reserved for those cases in which the ureter cannot be catheterized cystoscopically.
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PMID:Persistent clot anuria complicating renal transplant biopsy. 389 47

The evolution of the 99mTc-dimercaptosuccinic acid (DMSA) renal uptake is followed after ligation of the right ureter in rats. The DMSA uptake falls rapidly from 35% before ligation to 13% after 24 h, and decreases further to 1.5% after 31 days. The ligated ureter was desobstructed after 10, 17, 24 and 31 days, respectively, DMSA uptake was controlled 4, 11 and 18 days after desobstruction. In the first group, deobstruction after 10 days, the DMSA uptake rose from 7 to 15%, while in the fourth group it rose from 1.5 to 2%. It is concluded that DMSA uptake provides a reliable index for renal function after acute urinary tract obstruction in rats. If the DMSA uptake has fallen below 4% very little renal function can be expected to be regained, whereas above 4% the function can improve considerably.
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PMID:Evaluation of 99mTc-dimercaptosuccinic acid renal uptake as an index of individual kidney function after acute ureteral obstruction and desobstruction. An experimental study in rats. 630 3


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