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

Live donor renal transplantation provides significant advantages when compared with cadaveric donor renal transplantation in terms of improved patient and graft survival, a lower incidence of delayed function, and a shorter waiting time. Yet despite these advantages, live donors continue to be an under utilized source of kidneys for transplantation. Disincentives to live donation include the length of hospitalization, postoperative pain, cosmetic concerns, and the prolonged convalescence associated with the donor operation. In many instances minimally invasive video-assisted techniques have proven more efficacious than standard open procedures in terms of patient discomfort, length of hospital stay, cost, and length of time until the patient can return to full activity. Laparoscopic live donor nephrectomies are being performed at our institution in an attempt to make live donation more attractive to the potential donor. The purpose of this study was to retrospectively review the results of laparoscopic live donor nephrectomy (LapNx) and to compare them with those obtained using the standard open approach (OpenNx). Ten consecutive LapNx were performed from February 1995 through April 1996. The control group consisted of the 20 consecutive OpenNx performed at the same institution from January 1991 through January 1995 immediately before the initiation of the LapNx program. Live donors were considered candidates for LapNx if they possessed at least one kidney with normal renal anatomy with single renal vessels and a single ureter. LapNx was safely performed in all cases. No patients required open conversion or blood transfusions. The allograft warm ischemic time for the laparoscopic cases was 4.2+/-1.3 min. All kidneys harvested laparoscopically produced urine on the table immediately upon revascularization. Presently nine of the ten recipients have functioning allografts. At three months posttransplant the calculated recipient creatinine clearances were 67.0+/-11.5 ml/min and 64.8+/-21.4 ml/min for the LapNx and OpenNx groups, respectively (P=NS). The LapNx donors had a significantly decreased estimated blood loss, shorter time until resumption of oral intake, decreased postoperative pain (in terms of decreased analgesic requirements), shorter hospitalization, and a shorter interval until the resumption of full activities (P<0.05 for all). In addition, the LapNx group donors returned to work sooner than the OpenNx group (3.9+/-1.6 wk vs. 6.4+/-3.1 wk, respectively) (P=0.024). Four individuals agreed to donate a kidney only after learning of the availability of the laparoscopic approach. We conclude that laparoscopic live donor nephrectomy is technically feasible. In addition, it may offer significant advantages over the standard open approach in terms of patient comfort and convenience. These advantages may make live donor renal transplantation more attractive to prospective donors. The potential decrease in hospitalization and convalescence may also prove to be financially advantageous. We believe that further careful study of this procedure is warranted.
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PMID:Laparoscopic assisted live donor nephrectomy--a comparison with the open approach. 935 49

Urological complications constitute significant problem following renal transplantation. Incidence ranges from 4 to 14% in graft recipients. The most important aspects concerning these complications are early diagnosis and prompt treatment, any delay in diagnosis and management may lead to deterioration of renal graft function or graft loss. The following case report discusses management of hydronephrosis in renal graft caused by ureter stenosis due to scarring and fibrosis of its distal end after remote kidney transplantation. The patient was a 33-year-old woman with previous history of end stage renal failure in the course of chronic glomerulonephritis. A triple drug immunosuppressive regimen consisting of Azathioprine (AZT), Cyclosporine A and Encorton (AZT + CsA + Encorton) was administered during a period of three years after kidney transplantation. At this time AZT administration was discontinued due to chronic viral hepatitis type B. Episodes of expansion sensation (discomfort) and graft pain were reported by the patient which after 3 days were followed by a period of oliguria and then anuria. The patient was admitted to the Department of Nephrology CMUJ, where ultrasound imaging revealed graft hydronephrosis. In the presence of such clinical and biochemical indications due to acute graft failure, one hemodialysis session, was performed. The patient was transferred to the Urological Department CMUJ where ureter exploration was attempted, but was unsuccessful. Subsequently percutaneous nephrostomy was performed which lead to immediate diuresis. Next, distal ureter stenosis (located by the urinary bladder) was surgically removed and reimplantation of the ureter was carried out. Due to early diagnosis and surgical reconstruction of the transplanted ureter, renal graft function returned to normal requiring only one hemo-dialysis session.
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PMID:[Urological complications in patient after kidney transplantation. Correction of ureter stenosis with consequent proper renal graft function]. 1176 94

An 86-year-old Caucasian female presented with two weeks history of discomfort discharging urine, occasional hematuria, and suprapubic pain. The patient had a history of left salpingo-oophorectomy for an ovarian tumor, performed four years earlier. Ultrasound showed a solid mass surrounding the orifice of the left ureter. Bladder washing cytology yielded single, loosely cohesive syncytial aggregates of rather uniform cells. A few discretely grooved nuclei ("coffee bean nuclei") were seen. Histologic examination revealed muscular tissue infiltrated by oval to round cells, arranged in solid and follicular structures. The tumor cells were immunoreactive for estrogen receptor, inhibin, vimentin, and calretinin. The use of antibodies to pancytokeratin, inhibin, estrogen receptor, S-100, calretinin, and chromagranin could help confirm granulosa cell tumor. To my knowledge, there was no previous report on bladder washing cytology of metastatic granulosa cell tumor.
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PMID:Bladder-washing cytology of metastatic ovarian granulosa cell tumor. 1211 30

A 53-year-old man was admitted with epigastric discomfort. Excretory pyelography demonstrated left non visualizing kidney. Computed tomography showed the dilatation of left renal pelvis and a mass along with a left lower ureter. Retrograde pyelography showed the stenosis of left lower ureter. Urine cytologies from both voided and upper urinary tract showed class I. Ureteroscopy revealed the normal ureteral mucosa, suggesting extrinsic obstruction of the ureter. The operation was performed under the diagnosis of retropelvic tumor. The tumor could be easily resected from the left ureter. The pathological diagnosis was follicular lymphoma. There was no prolificative accumulation on Gallium scintigraphy after the operation. The tumor was considered to have originated from paraureteral tissue.
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PMID:[A case of malignant lymphoma originating from paraureteral tissue]. 1224 80

Because of the minimal invasiveness of the laparoscopic approach, we introduced the laparoscopic dismembered pyeloplasty in our treatment modalities for patients with primary UPJ obstruction. We report on our technique and the results after a median follow-up of more than 2 years. Between August 1997 and September 2002, 52 patients underwent a laparoscopic dismembered pyeloplasty at our institution. All patients had a symptomatic primary PJ obstruction. We prefer the transperitoneal route with laterocolic exposure of the kidney. After preparation and exposure of the ureter and the renal pelvis, we performed in each case the dismembered Anderson-Hynes pyeloplasty with resection of the pelvis and reanastomosis between the ureter and renal pelvis. Intracorporeal suturing and knotting techniques were used exclusively. All procedures could be performed successfully. In no case was conversion to open surgery necessary. The mean operative time was 180 min. Crossing vessels were present in 57% of patients. The mean postoperative hospital stay was 4 days. The first patient had an anastomosis insufficiency, which required laparoscopic repair. The same patient failed in the follow-up. He developed a late recurrence of the stenosis and needed an open repair. In all other patients the obstruction was resolved or significantly improved. The long-term success rate is 98% with a follow-up of 25 months. Our results with laparoscopic dismembered pyeloplasties compare favorably with those achieved by open pyeloplasties with less perioperative morbidity and discomfort. We do believe that laparoscopic dismembered pyeloplasty will be the method of choice in the treatment of UPJ obstruction.
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PMID:[Laparoscopic dismembered pyeloplasty with Anderson-Hynes technique]. 1267 68

An 86-year-old woman with a previous excision of a large retroperitoneal low-grade liposarcoma presented with a 4-month history of persistent left flank discomfort. Workup revealed left hydronephrosis secondary to obstruction, which was caused by a recurrent liposarcoma in the intraluminal ureter. She underwent a left nephroureterectomy for symptomatic palliation. Pathologic study revealed high-grade liposarcoma. Despite negative surgical margins, the tumor rapidly recurred, leading to death only 4 months after surgery. This case highlights the aggressive nature of liposarcoma.
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PMID:Liposarcoma presenting as an intraluminal ureteral mass. 1273 39

We report a case of schwannoma in psoas muscle, difficult to make a preoperative differential diagnosis from multilocular renal cyst in a 44-year-old woman. She complained of epigastric discomfort, and abdominal computerized tomography revealed a left multi-cystic renal tumor. Drip infusion pyelography showed the tumor displacing the left kidney superiorly, and pushing the left ureter medially. Magnetic resonance imaging demonstrated that the tumor structure was multilocular. At the operation, the tumor was observed in psoas muscle and was revealed as schwannoma in microscopic findings.
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PMID:[A case of schwannoma in psoas muscle]. 1510 Nov 70

Inherited defects of the DNA mismatch repair system are the underlying cause of the hereditary non-polyposis colorectal cancer (HNPCC) syndrome and are responsible for 3-4% of all cases of colorectal cancer. The HNPCC syndrome also carries the risk of development of additional malignancies such as endometrial, stomach, small bowel, ovarian, pancreas, ureter, renal pelvis, biliary tract and brain tumours. Amsterdam I and II criteria have been developed to clinically identify affected families. The revised Bethesda criteria function to select patients whose tumours should be investigated for microsatellite instability, the molecular hallmark of defects of the DNA mismatch repair proteins such as hMLH1 and hMSH2. Microsatellite instability-positive cases should be investigated for germline defects in the respective genes. This facilitates identification of affected family members that have to be included in special surveillance programmes, while unaffected family members are spared the physical discomfort and psychological burden of cancer surveillance. In this article, strategies for effective clinical as well as genetic detection of affected individuals, surveillance and appropriate preventive measures are discussed. Open questions include the role of chemoprevention, preventive surgical procedures, new endoscopic procedures as well as non-invasive 'virtual colonoscopy' and the exact implications of some mutations of the DNA mismatch repair genes. Perhaps most importantly, efforts should be made to more efficiently transfer information about the HNPCC syndrome and the cancer risk associated with it from the specialists to primary health care providers and the general public.
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PMID:Critical issues in the identification and management of patients with hereditary non-polyposis colorectal cancer. 1635 31

Seminal vesicle cysts associated with ectopic ureter and renal agenesis is a rare condition. We report on a 23-year-old man with a history of pelvic discomfort and post-coital testicular pain. The investigation disclosed a left seminal vesicle cyst, and an absent left kidney. The patient was successful submitted to resection of the left seminal vesicle, ureter, and dysplastic renal tissue altogether, through laparoscopic approach. Laparoscopy has shown to be an excellent treatment option for this rare condition.
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PMID:Laparoscopic removal of seminal vesicle cyst with ectopic ureteral insertion and renal remnant. 1574 40

The association of a seminal vesicle cyst with ipsilateral renal agenesis was initially reported in 1914 by Zinner, and it is a very rare congenital anomaly. The association of this anomaly with an ectopic ureter entering the seminal vesicle cyst is even less common. In these cases, clinical symptoms appear in patients 15 years or older due to the distention of the seminal vesicle caused by the secretions of the reproductive tract. Perineal discomfort and recurrent epididymitis are the most often presentations. Urogenital upper tract image studies are mandatory in the management of a cystic pelvic mass and magnetic resonance imaging (MRI) is the best of this radiographic studies, that also reveals the ectopic ureter draining into the seminal vesicle. We report an additional case of this rare congenital anomaly where only MRI provided a correct preoperative diagnosis and a right surgical approach.
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PMID:[Right renal agenesis and ureter ectopic abouchement in cystic dilation of seminal vesicle]. 1605 Feb 6


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