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

Is the renal dysplasia (RD) commonly seen in babies with urinary tract obstruction a developmental consequence of the obstruction or is it an associated embryologic malformation? We produced complete unilateral ureteral obstruction in six 58- to 66-day old lamb fetuses by clipping a silastic ring on the ureter. Three fetuses survived to term. All obstructed kidneys were not only grossly hydronephrotic but dysplastic by histologic criteria; ie, parenchymal disorganization, primitive epithelial structures, and marked fibrosis. The contralateral unobstructed control kidneys were normal. The changes were similar to those seen in the human neonate with obstruction and RD, suggesting that in this model RD was caused by obstruction to the flow of urine early in fetal development.
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PMID:Correction of congenital hydronephrosis in utero III. Early mid-trimester ureteral obstruction produces renal dysplasia. 666 93

Fifty-eight children with ureteroceles are the subject of this study. The lesions occurred more commonly in females and affected the left urinary transport system predominantly. Ectopic ureterocele was the most common type and virtually always developed on the ureter originating from the upper renal unit of a duplex kidney. There was a high incidence of associated urinary tract obstruction or vesico-ureteral reflux. The most common presenting symptoms were those of urinary infection followed by discovery of an abdominal mass. A characteristic filling defect in the bladder was seen on excretory urogram, and voiding cystourethrography revealed vesicoureteric reflux in 50% of the patients. Management of an infant or child with a ureterocele should begin with appropriate antibiotic treatment if infection is present, followed by excision or drainage of the involved renal segment(s). A pus filled upper pole and ureter may need to be removed or drained urgently in some ill patients. Ureteroceles are often complicated anatomic problems, which should be treated by surgeons who are familiar with the various facets of this congenital malformation.
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PMID:Ureteroceles in children: clinical study and report of 58 cases. 673 94

We treated successfully 3 patients with upper urinary tract obstruction after an aortoiliac reconstructive vascular operation: 2 with ureterolysis and 1 with transureteroureterostomy. A review of the literature reveals that the incidence of this complication of reconstructive vascular surgery is unknown. Obstruction occurred whether the ureter was anterior or posterior to the graft, and usually presented within 1 year postoperatively in 62 per cent of the patients and was silent in 13 per cent. The obstruction was caused by retroperitoneal fibrosis in 90 per cent of the patients, direct surgical injury in 5 per cent and pseudoaneurysm formation in 5 per cent. Prior pelvic irradiation, and extensive and/or repeat vascular surgical procedures may have been contributory. Ureterolysis, the most common form of treatment, resulted in improvement in 85 per cent of the upper tracts, while renal loss occurred in 10 per cent. The ureter should be placed anterior to the graft during aortoiliac graft procedures. A prospective study is needed to ascertain the true incidence of this complication after reconstructive vascular surgery.
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PMID:Obstructive uropathy--a potentially serious complication of reconstructive vascular surgery. 682 77

Congenital ureteric valves causing upper urinary tract obstruction was discovered after operation in 4 adults who had presented with different urological problems. The fifth patient, an infant, presented with failure to thrive and was suspected of having a congenital ureteric valve prior to operation. The infant had gross hydronephrosis and was treated by excision of the segment containing the valve and end-to-end anastomosis of the ureter and pyeloplasty because of a narrow pelviureteric junction. Three adults had severe kidney damage and underwent nephrectomy. The fourth adult, who had a horseshoe kidney with 4 small stones in the lowermost calix, underwent pyelolithotomy; in addition, the segment bearing the valve was excised and a ureteropyelostomy was carried out.
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PMID:Congenital ureteric valves--a cause of urinary obstruction. 708 50

Percutaneous nephrostomy is increasingly used for temporary relief of upper urinary tract obstruction. The technique described involves the use of angiographic catheters and guides, and will provide drainage for several weeks or months. The patient is placed in the prone oblique position after intravenous contrast to opacify the kidneys. The oblique position ensures that a needle advanced vertically toward the kidney will pass along a posterior oblique line, entering the outer aspect of the kidney away from the hilum and directing guide wires and catheters toward the ureter. A fine needle is passed vertically into the kidney to determine its depth and to provide a pyelogram. A needle-cannula is then directed at the collecting system along a similar line until urine comes back. An angiographic J-guide is introduced and the needle exchanged for a series of vessel dilators, to dilate the track through the tissues. Finally, a catheter is passed over the guide wire into the collecting system, secured to the patient and attached to the drainage bag. Other maneuvers such as ureteral stenting can be added to this technique. The complications and technical difficulties are discussed.
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PMID:Percutaneous nephrostomy--technique. 725 15

Primary renal candidiasis is an uncommon disorder. It typically presents as urinary tract obstruction secondary to bezoar in the ureter, progressive oliguria (at times alternating with episodes of diuresis), ureteral colic, passage of tissue- or stone-like material, pyuria, and/or progressive renal failure. The patient described here presented with gross and microscopic hematuria. In our literature review, we found neither of these reported as clinical signs of primary renal candidiasis. With the widespread use of drugs (eg, antibiotics, antineoplastic chemotherapeutic agents, systemic corticosteroids) which facilitate the growth of Candida, primary renal candidiasis should be considered in the patient who presents with hematuria.
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PMID:Gross hematuria: a rare manifestation of primary renal candidiasis. 735 38

Superficially, the causes of voiding difficulties in children may seem quite simple, but a thorough understanding of the anatomy physiology and neurology of normal and abnormal lower urinary tract function is necessary in uncovering the etiology of often seemingly siple complaints. An ectopic ureter, neurogenic bladder, urinary tract obstruction, or simple urinary tract immaturity, for example, can all cause a child to present with the complaint of "wetting." A familiarity with all the possible causes of voiding dysfunction is required to distinguish significant from insignificant symptoms. While a "wait and see" attitude often results in the spontaneous resolution of a problem such as simple nocturnal enuresis, the misdiagnosis of a severe disorder, such as urinary outflow obstruction, may permit the insidious development of irreversible renal failure. Our purpose in writing this monograph was not to provide a comprehensive guide to the diagnosis of voiding dysfunction in children, but rather to enhance the clinician's appreciation of the complexity of these problems. Our hope is that the perspective that we have provided will obviate the diagnostic and therapeutic exaggeration of insignificant voiding complaints, while assuring that the presence of significant lesions is not overlooked.
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PMID:Voiding dysfunction in children. 741 33

Cold-knife incision of stenoses in the transplant ureter was performed in 11 patients with upper urinary tract obstruction in renal transplants. The operations were complicated by bleeding in 2 patients and the graft had to be removed in 1 of them. The stenoses could be treated successfully in 10 of the 11 patients (91%) and the mean serum creatinine concentration decreased significantly from 3.4 to 1.8 mg./dl. After a mean of 26 months only 1 obstruction recurred, so the long-term success rate was 82%. Because of the favorable long-term results and the low incidence of complications, we recommend endo-urological cold-knife incision of ureteral stenosis as the first-line treatment for upper urinary tract obstruction in renal transplants.
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PMID:Endo-urological cold-knife incision for ureteral stenosis after renal transplantation. 805 50

One hundred and fifty two cases of genito-urinary tract endometriosis reported in Japan including our 2 cases were reviewed. The incidence and mean patients' age were respectively 0.7% and 22 years old for kidneys, 37.5% and 38.8 years old for ureter and 61.8% and 36.2 years old for bladder. Clinical symptoms in ureteral endometriosis were similar to those in upper urinary tract obstruction and in vesical endometriosis, lower urinary tract symptoms such as pain on urination, irritative bladder symptoms and macrohematuria were frequently observed. Vesical lesions tend to be located on the posterior wall in the retrotrigone or trigone, and ureteral lesions tend to be located in the bilateral lower segments. The incidence of extrinsic type of ureteral endometriosis was 6 times higher than that reported as intrinsic type, and mixed type was reported in only 3.5%. Recent first choice for mild endometriosis is hormonal therapy with Danazole or LH-RH analogue. Surgical treatment is recommended in severe cases or patients in whom hormonal therapy is not effective.
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PMID:[Genitourinary endometriosis: report of 2 cases and clinical aspects of patients in Japan]. 819 77

Collagen studies in newborn rats with incomplete ureteric obstruction were performed to describe and quantify changes in collagen deposition resulting from urinary tract obstruction at an early developmental age. Incomplete ureteric obstruction was created in three-day-old rats by placing the left ureter in a tunnel formed by the psoas muscle, and sham-operated controls underwent a laparotomy. The rats were sacrificed at 10, 17, 24 or 31 days. Collagen types I, III, IV, and V were localized by indirect immunofluorescence microscopy, the total collagen content of the kidney was quantitated using hydroxyproline analysis, and collagen types I and III were quantitated using cyanogen bromide (CNBr) peptide analysis. Increased immunofluorescent staining for all of the collagens was found in the diffusely widened medullary interstitium of the obstructed kidney, and more focally in the cortical interstitium. Collagen types I, III and V, but not collagen type IV, were also found in bands in the interstitium at the junction of the cortex with the medulla. Increased staining for collagen type IV was found in thickened and tortuous tubular basement membranes (TBM) of the obstructed kidneys. The total collagen content of the obstructed kidney was significantly increased compared to the amounts in both the contralateral kidneys and in the kidneys from sham-operated controls at 24 and 31 days of age (P < 0.01 in each case, Wilcoxon matched pairs rank sum test and Mann Whitney U-test, respectively). The amount of collagen in the kidneys correlated with the degree of hydronephrosis (Spearman correlation test, r = 0.78, P < 0.02). CNBr peptide analysis demonstrated that over 50% of the collagen in the normal neonatal rat kidney was collagen type I and approximately 25% was collagen type III. In the obstructed kidneys most of the collagen was also collagen type I and collagen type III, although the proportion of total collagen comprised by these collagen types was decreased compared with the controls. The amount of collagen type III in the contralateral kidneys was reduced compared to that in the controls. Thus, the neonatal renal response to obstruction resulted in increased amounts of a range of collagens in the interstitium and TBM, and the extent of this response was partially related to the degree of hydronephrosis.
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PMID:Collagen studies in newborn rat kidneys with incomplete ureteric obstruction. 823 Oct 33


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