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

A retrospective review was performed of the records of 148 Croatian children with urolithiasis treated between 1989 and 2003. The study evaluated age, gender, family history, clinical symptoms, location of stone, laboratory findings, stone composition, mode of treatment and compared our results with data from higher and lower socio-economic countries. The mean age of our patients was 9.38 years (10 months to 18 years). Thirty-seven children (25%) were less than 5 years (group 1), 44 (29.7%) were between 5 and 10 years (group 2) and 67 (45.3%) were older than 10 years of age (group 3). There were 60 girls and 88 boys with overall male to female ratio of 1.47. Abdominal pain (83%) and haematuria (59.5%) were the main symptoms in the groups 2 and 3. Urinary tract infection was predominant symptom in the group 1 (62.1%). Calculi were located in the kidney in 90 children (60.8%), in the ureter in 39 (26.4%), in the bladder in 8 (5.4%). Urinary tract anomalies with or without infection were associate with a greater frequency of urolithiasis in the youngest age group and hypercalciuria was predominant cause in children over 5. Stone analysis was performed in 80 children. Predominant constituent of stones was calcium oxalate (48.7%), followed by struvite (25%), calcium phosphate (13.7%), cystine (10%) and uric acid (1.2%). Calcium oxalate stones were most common in all age groups. Struvite stones were most prevalent in the children younger than 5 years of age. Most patients (33.1%) underwent surgery for removal of their calculi. In 31.8% of children stones were passed spontaneously and the highest spontaneous passage rate was in the group 3 (37.3%). Stone composition, location and etiology in Croatian children are similar to those in developed Western countries.
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PMID:Pediatric urolithiasis in Croatia. 1474 67

We studied 51 patients with true ureterocele (primarily, orthotopic and unilateral--84.3 and 82.3%, respectively) combined with urolithiasis. Mean age of the patients was 41.9 +/- 2.0 years, size of ureterocele--20.7 +/- 1.3 mm and mean concrement area--1.4 +/- 0.2 cm2. In adult patients with orthotopic or heterotopic disease surgery consisted of perforation (n = 5) or dissection of ureterocele wall (n = 38). Endoscopic operations were indicated in small and middle sized ureterocele (less than 30 mm in size), unaffected contractility of terminal ureter, moderate urodynamic disorders of the upper urinary tracts, normal function of the kidney and no pyelonephritis exacerbation. Endoscopic section of ureterocele wall combined with ureterolithoextraction (n = 26), contact ureterolithotripsy using Ho:YAG laser or ultrasound (n = 19). Open surgery (ureterocystoneostomy by Politano-Leadbetter was made in orthotopic ureterocele over 30 mm in size and in marked urodynamic disturbances of the upper urinary tracts (n = 6). At discharge, a complete elimination of the stones in ureterocele patients was 81.6%. Effective use of extracorporeal shock-wave lithotripsy of nephroliths within 2 months after removal of ureterocele raised this percent to 87.7. Thus, choice of surgical policy in ureterocele complicated by urolithiasis depends on its size, variant of combination of this defect with the concrement, anatomofunctional state of the upper and lower urinary tracts, age of the patient and presence of pyelonephritis.
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PMID:[Ureterocele and urolithiasis]. 1502 44

Urolithiasis is a common diagnosis in patients presenting at our hospital with flank pain. One of the most important steps in the diagnostic algorithm of renal colic is the presence of hematuria, but this fact has been challenged by authors reporting a negative urinalysis for microscopic hematuria in about 9-18% of such patients. Our aim was to investigate whether the same results are obtained when a sample of urine is tested with a urine dipstick test (UDT) at the time of the initial examination. Data from patients with the clinical diagnosis of renal colic examined at the emergency department of our hospital were reviewed, and the sensitivity of hematuria in urine samples tested by UDT was recorded in a group consisting of patients for whom imaging showed evidence of a stone >3 mm in size. In cases in which UDT was negative, or showed only traces of red blood cells (RBCs), a formal urinalysis was performed. A total of 609 patients were finally included in the study, with a mean age of 49.2 years. Average stone size was 5.8 mm, located mainly in the lower part of the ureter. Dipstick analysis was positive for hematuria in 92.9%. A urinalysis, with a cut-off point of less than three red blood cells per high power field, was used as a means to verify the results of the UDT in 17.8% of cases: in 7.1% of UDT negative patients and 10.7% of patients with traces of blood. The urinalysis was negative in 5.1% of patients, adding only 2% to the diagnostic accuracy of UDT. Therefore, our findings suggest that the sensitivity of a UDT for hematuria in cases of suspected renal colic has a high degree of accuracy when performed at the emergency department, and can be used as a first-line, low cost examination. A microscopic analysis may be useful when the UDT is negative or not clear enough, to verify the results.
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PMID:The presence of microscopic hematuria detected by urine dipstick test in the evaluation of patients with renal colic. 1504 79

Clinical studies have revealed that location of the occlusion in the kidney and upper third of the ureter raises the risk of severe infectious-toxic complications of urolithiasis. It is shown experimentally that mechanisms of compensation of impaired urinary transport along the upper urinary tracts differ in obstruction of the upper and lower third of the ureter.
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PMID:[Role of the level of obstruction and urodynamics of the upper urinary tract in infectious-toxic complications in urolithiasis. (Clinical and experimental study). ]. 1519 4

Ureteral obstruction secondary to endometriosis is relatively uncommon. We present a 43-year-old multiparous woman who suffered from periodic left loin pain in the terminal period of her menstruation. Excretory urogram demonstrated left hydronephrosis and hydroureter and obstruction of the lower left ureter just inferior to the left sacroiliac joint without urolithiasis. An enhanced computed tomography scan showed soft tissue density mass around the left ureter at the level of the stenosis. She underwent transperitoneal laparoscopic ureterolysis and adhesiotomy of the left ureter under the diagnosis of ureteral endometriosis. Because blueberry spots were clearly observed on the pelvic brim, the fibrous tissue surrounded the ureter was removed with peritoneal bleeding spots. Histological examination of the surrounding tissue confirmed the ectopic endometriosis. Even though retroperitoneoscopy is frequently used for ureteral lesion, transperitoneal laparoscopy has an advantage for resection of ectopic endometriosis surrounding the ureter.
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PMID:Hydronephrosis due to ureteral endometriosis treated by transperitoneal laparoscopic ureterolysis. 1524 70

The objective of the study was to determine the value of spiral computerized tomography (CT) in detecting urolithiasis in pediatric patients and compare its efficacy with ultrasound (US). Twenty-nine infants aged between 2 to 94 months with clinical presentation suggestive of urolithiasis and a negative or indeterminate plain film were included in the study. Abdominal US and spiral CT were performed in all patients. Presence, size and localization of stones were noted for each patient on both CT and US. The diagnosis of urolithiasis was confirmed by passage of stones spontaneously, extracorporeal shockwave lithotripsy (ESWL), surgery, or clinical follow-up. Presence of stones was confirmed in 23 of 29 patients (79%). Eight patients had single stone and the remaining 15 had multiple stones either in a single localization (single kidney or single ureter) or multiple localizations. Spiral CT detected 57 stones (45 renal and 12 ureteral). US detected 34 stones (59.6%) in 18 (78.2%) patients. US was able to localize 31 stones (68.8%) in 21 kidneys (75%), and 3 stones (25%) in 11 ureters (27.2%). Spiral CT is very effective in the diagnosis of pediatric urolithiasis. Spiral CT is more efficient than US in imaging pediatric patients with symptoms and signs of urolithiasis, when KUB is inconclusive.
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PMID:Comparison of spiral CT and US in the evaluation of pediatric urolithiasis. 1558 58

Idiopathic urolithiasis in children has become more frequent in the past few decades as a result of increasing affluence and rapid change in our society's dietary habits. In Western societies, calcium stones in the kidney and ureter predominate. Pediatric urolithiases, unlike the adult form, require a comprehensive metabolic evaluation, because metabolic and enzymatic derangements play an important role in their pathogenesis. The recent advancements in endoscopic procedures, interventional radiology, and lithotripsy have allowed children to be managed effectively without open surgery. Pediatric urolithiasis requires a close working relationship between the urologist for acute surgical management of urolithiasis and the nephrologists for prevention of stone formation. In many children and adolescents with urolithiasis, a nonpharmacologic approach involving the adoption of healthy nutrition habits may suffice.
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PMID:Urolithiasis in adolescent children. 1584 85

In 1988-2003 we operated 156 patients with various ureteral lesions. Of them 7 patients (6 males and 1 female, mean age 34-43 years) received kidney transplant (autotransplantation). Ureteral lesions were caused by previous surgery (n=3), gunshot wound (n=2), urolithiasis (n=2. The follow-up results (for 15 period maximum) show that operative outcomes were satisfactory in 6 patients. One transplant was removed 7 days after the transplantation because of purulent pyelonephritis and necrosis of the ureter. The rest patients retain good function of the transplanted kidney and passability of the upper urinary tract. Thus, surgical autotransplantation of the kidney performed in affected middle and low thirds of the ureter is an alternative to life-long nephrostomy and nephrectomy and has a good long-term prognosis in relation to function of a transplanted kidney.
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PMID:[Autotransplantation of the kidney in ureteral injuries]. 1598 23

The authors discuss the consequences of lithotripsy treatment in children with urolithiasis. The study included 316 children (168 girls and 148 boys) aged 2-18 years treated in our Department since 1991 until 2004 y. In 316 children 597 lithotripsy procedures (526 kidney and 71 ureter units) were performed. In the study group of patients after lithotripsy treatment most often were observed: hematuria 408/597 (68,3%) and in ultrasonography examinations changes in kidney parenchyma 128/526 (24,3%) and urinary retention in urinary tract 72/526 (13,7%). The most often complications after lithotripsy treatment were short-term changes. The authors think that lithotripsy procedure is a safe method in the treatment of the children with urolithiasis.
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PMID:[Consequences of lithotripsy treatment in children with urolithiasis]. 1606 77

Ten clinical cases of neuromuscular dysplasia of the ureter (NMDU) are reported. Eight patients were young (24-38 years), two--of the middle age (41-58 years). NMDU was bilateral in two patients. Ureteral achalasia of the congenital solitary kidney occured in one case. One 28-year-old female with megaureter of the solitary kidney had interstitial cystitis. Clinical picture of the disease was characterized primarily with acute pyelonephritis, pain and secondary urolithiasis. Surgical treatment consisted in resection of the affected part of the ureter with modeling of the lumen of the latter on the drainage and Boari plastic repair. Bilateral Boari operation was made in 2 patients. In one case of ureteral achalasia and ureterocele direct ureterocystoanastomosis was created with good result. Sigmocystoplasty with transplantation of the solitary kidney ureter into the intestinal transplant was made in the patient with scar contracture of the detrusor and megaureter. Functional result of the operation was good. Complications were registered in 4 patients, 2 of which were reoperated. In nine patients of ten good and satisfactory functional results were obtained.
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PMID:[Surgical treatment of neuromuscular dysplasia of the ureter]. 1609 12


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