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

The advantages of percutaneous nephrostomy include (1) achieving rapid, safe drainage of an obstructed collecting system with use of local anesthesia and sedation rather than general anesthesia, and (2) facilitating use of antegrade pyelography under fluoroscopic guidance to determine the cause of the obstruction. In addition, during temporary diversion the functional status of the obstructed kidney can be evaluated. If function is adequate, a pyeloplasty or reimplantation of a ureter may supplant nephrectomy. Use of percutaneous nephrostomy is a relatively new technique for treatment of obstructive uropathy in children. In the case reported here of an 8-year-old girl with a duplicated right collecting system and distal obstruction of the upper pole ureter, the procedure offered a rapid and safe alternative to surgical insertion of a nephrostomy tube.
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PMID:Percutaneous nephrostomy in a child with obstructive uropathy. 705 76

In 1628 patients with ureteral calculi there were 1511 (92,81%) successful immediate stone extractions (1950--1960) or "delayed" calculi removals by means of the ureteric catheter loop left temporarily in the ureter (1964--1980). 95--98% calculi have been successfully treated since the introduction of the catheter loop designed by Zeiss. Anesthesia, antibiotics and X-ray control were required. Multiple loops were used in 74 patients out of 1408. The procedure is not dangerous if X-ray equipment and instruments are adequate. The immediate stone extraction was successful only in 65% (1965--1960) where as the "delayed" extraction by means of the Zeiss-catheter loop was successful in 95--98%. Less than 5% loop extractions are unsuccessful. The mortality rate was less than 0,15%. The procedure can be repeated without limitation.
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PMID:[Removal of ureteral calculi transurethrally with special reference to the so-called "indwelling Zeiss loop" (author's transl)]. 719 22

The conduction velocity of peristaltic movements of the canine ureter was measured under anaesthesia with a new type of diameter gauge using an image sensor. The peristaltic velocity was 34.1 +/- 6.2 mm/sec in 10 experiments. Noradrenaline at a low dosage of 1 microgram/kg i.v. reduced the resting diameter, increased the conduction velocity to 47--56 mm/sec, and approximately doubled the frequency of contraction. The application of acetylcholine also caused an increase in both frequency and conduction velocity (42--46 mm/sec). A plot of the conduction velocity against the mean period of peristaltic contraction was hyperbolic in shape.
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PMID:Conduction velocity of peristaltic waves in the in vivo ureter: application of a new diameter gauge. 723 14

The hydrostatics and dynamics of the upper urinary tract were studied in 12 children with congenital hydronephrosis by means of intrapelvic pressure and bipolar electromyography leads from the pelvis and ureter. Studies were performed intraoperatively with the child under general anesthesia. Measurements were obtained during a baseline period of normal diuresis and during diuresis induced by furosemide. The baseline pressure in the hydronephrotic pelvis was within normal limits in most cases but a tendency toward an increased mean baseline pressure was observed in severe hydronephrosis when the cases were grouped according to the excretory urogram. During diuresis the average pressure increase in severe hydronephrosis was parallel to that in moderate hydronephrosis. The peristaltic pattern showed discoordination in pelvis conus transmission but usually preserved anterograde transmission from the conus down the ureter. The results seem to indicate a slight functional obstruction at the pelvioureteral junction. This obstruction leads to the observed alterations in peristalsis and to a slight elevation of the intrapelvic pressure in more severe cases.
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PMID:Electrophysiological investigation of hydronephrosis in children. 732 Nov 17

Percutaneous nephrostomy under ultrasonic guidance is a reliable method for suprapublic urinary diversion with a low complication rate. Indications are acute or chronic obstruction of the upper urinary tract from the intravesical ureter to the neck of renal calyx. Etiology of the obstruction may be a renal or ureteral calculus, an intrinsic or extrinsic (radiogenic, inflammatory, tumorous) stenosis of the ureter or a functional ureteral obstruction (megaureter, reflux). In the reported case of an ultrasonically guided percutaneous nephrostomy, the indication for urinary diversion was blocking renal calculus with urosepsis. Any operative procedure was contraindicated because of several internal disease. With sufficient urinary drainage, fever subsided and gradual dilatation of the nephrostomy channel with instrumental extraction of the calculus could be performed under local anesthesia. Percutaneous nephrostomy is recommended for urinary diversion in cases of blocking renal calculi with infection if an operation cannot be performed. This approach bears the option of a later cure by intrumental extraction, litholypaxy or chemical dissolution of the stone.
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PMID:[Case report: percutaneous nephrostomy and instrumental extraction of a blocking renal claculus under local anesthesia (author's transl)]. 742 82

In 200 cases the antireflux plasty by the Cohen advancement technique proved to be a simple and reliable method of reflux treatment. The resulting impossibility of normal endoscopic retrograde catheterization of the ureter after the Cohen procedure. With the patient under general anesthesia the bladder is punctured with a thin trocar by a stab incision at the appropriate pole of the suprapubic skin incision scar. The surgeon directs the trocar under endoscopic control to the ureteral orifice, while an assistant carefully inserts the ureteral catheter into the ureter. This method proved to be easy and without major risk in 5 children.
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PMID:Retrograde catheterization of the ureter after antireflux plasty by the Cohen technique of transverse advancement. 746 89

Over 14 years of clinical use of extracorporeal shockwave lithotripsy (SWL), great technical modifications resulted in the development of many second-generation lipthotripters. The Siemens Lithostar machine, with its standard shockwave tube, was introduced in 1986. The objective of this study was to assess the safety and effectiveness of the newly proposed Lithostar shock tube C in the treatment of urinary calculi. Between July 1992 and August 1993, 319 patients (214 males and 105 females, average 49.7 years) with 433 renal or ureteral stones or both were treated at five centers in Canada and the United States. Most of the stones (72%) were located in the kidneys, while 28% were located in the ureters. Most (81%) of the treated sides (side = kidney and ureter) presented with single stones, 11% presented with two stones, and 8% presented with three or more stones. The average stone burden was 13.6 mm. The average duration of treatment for the whole population of patients was 39.3 minutes using an average number of shockwaves of 3633 in a minimum and maximum energy setting of 0.11 and 3.82, respectively. The majority of treatments (92%) were performed without anesthesia. Fragmentation was achieved in 93.5% of treatments, with a 3-month stone-free rate of 62.5% and a success rate (stone free or fragment < 5 mm) of 72%. Auxiliary procedures were necessary in conjunction with 108 treatments, and most of them were in form of catheter/stent placement. Treatment applied on a separate occasion to different stones but in the same collecting system (either a kidney or a ureter) were considered retreatments.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Safety and effectiveness of Lithostar shock tube C in the treatment of urinary calculi. 755 Feb 63

We report our experience on performing ureteroscopic procedures using local anaesthesia with or without intravenous analgesia. During a two year period 334 ureteroscopic procedures were performed in our hospital. 159 of them were begun but only 138 completed without the use of general or regional anaesthesia. In 9 patients ureteroscopy was performed with lindocaine jelly in the urethra only, and in 129 with additional intravenous analgesia Fentanyl, a synthetic morphine derivative, was used for intravenous analgesia. Ureteroscopy was performed for stone fragmentation or extraction in 119 patients for taking away a double J catheter which showed migration into ureter in 8 and for diagnostic purposes in 11. Ureteric lesions were observed in 7 patients (5%). The findings suggest that ureteroscopy when performed without general or regional anaesthesia does not increase the risk of complications or compromise the results of treatment.
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PMID:[Ureteroscopy under local anesthesia with or without intravenous analgesia]. 758 6

Single-stomal ureterostomy such as double barreled ureterocutaneostomy and cutaneous transureteroureterostomy have usually been performed by transperitoneal approach. However, extraperitoneal method is preferable since the patients for whom ureterocutaneostomy is indicated usually have a deteriorating general condition. We have reported single-stomal ureterocutaneostomy which can be done extraperitoneally. A total of thirteen patients, one man and twelve women, for whom permanent urinary diversion was indicated, have undergone this extraperitoneal ureterocutaneostomy for February 1988 to June 1994. Those with retroperitoneal lesions or with a history of paraaortic radiotherapy were excluded. The mean age was 61.7 (range: 42-76). The reasons for urinary diversion were vesicovaginal fistula in seven, obstructive nephropathy in four, rectovesical fistula in one and postoperative urine leak from the bladder in one. All patients had been treated for malignant diseases and had undergone transperitoneal surgery. Six patients had colostomy and ten had clinically evident recurrent diseases. In the operation, left ureter was dissected and severed extraperitoneally through left paramedian incision or left lumbotomy. The ureteral end was pushed to the right in a retroperitoneal tunnel created by blunt dissection. Then the ureter was picked up through the contralateral retroperitoneal approach. After both ureters were exposed, ureterocutaneostomy was made in right hypogastrium. Transureteroureterstomy with end-cutaneous ureterostomy, double barreled ureterocutaneostomy and ureteroureterostomy with loop ureterostomy were done in six, four and three patients, respectively. The mean operative time was 119 (range: 75-175) minutes and the mean intraoperative blood loss was 210 (range: 48-682) grams. Arrhythmia developed during retroperitoneal manipulation in one patient for whom the operation was done under spinal anesthesia.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Single-stomal ureterostomy by extraperitoneal approach]. 759 79

Internal double-J stents are used to maintain ureteral patency and require replacement within 4-6 months. We present our experience with 15 consecutive patients who had 35 internal ureteral stents retrieved and in whom 27 were successfully replaced, retrogradely under fluoroscopic control. The double-J stents were retrieved using an Amplatz gooseneck snare. Replacement was more successful in female patients, and was technically more difficult via an ileal conduit or transplant ureter. We found this new technique to be straightforward and well tolerated by the patients. The procedure was performed on an outpatient basis, and no serious complications were reported. This technique is considerably cheaper than cystoscopic replacement under epidural or general anaesthesia, and is recommended for the retrieval and replacement of internal ureteral plastic stents in most patients.
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PMID:Retrograde radiological retrieval and replacement of double-J ureteric stents. 861 52


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