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

During a 4-year-period, 5 cases of ureteral obstruction by aorto-iliac aneurysm were detected. Over the same period 50 aorto-iliac aneurysms were resected. One of the 5 patients was not operated on. In the remaining 4, the aneurysm was resected and replaced by a Dacron bifurcation graft. Nephrectomy was performed in the first 2 patients. Autotransplantation of the remaining kidney was carried out in one case following enucleation of a hypernephroma ex vivo. In the other 2 patients, ureterolysis and intraperitoneal transposition of the ureter was performed in conjunction with resection of the aneurysm. One of the latter patients suffered from uraemia due to a non-functioning kidney on the other side. Ureteral obstruction appears to be a relatively common complication of aorto-iliac aneurysm. Elective evaluation of patients with aortic aneurysms should include late aortograms visualizing the ureters.
Scand J Thorac Cardiovasc Surg 1979
PMID:Ureteral obstruction by aorto-iliac aneurysms--a common complication? 38 45

The arterial vasodilator activity of endothelium-derived relaxing factor (EDRF) is mediated by activation of the soluble form of guanylate cyclase, causing increased levels of guanosine-3',5'-cyclic monophosphate (cGMP). Because of its extreme lability, the actions of EDRF are local. The ability to monitor changes in renal interstitial fluid cGMP would be of great advantage in clarification of local mechanisms controlling renal function. Utilizing a renal interstitial microdialysis technique, we investigated changes in renal interstitial and urinary cGMP in response to right intrarenal arterial administration of the EDRF inhibitor, NG-monomethyl-L-arginine (L-NMMA), in anesthetized dogs (n = 5) in metabolic balance at a sodium intake of 40 mEq/day. Urine was collected directly from the right and left ureter. L-NMMA at 20-60 micrograms/kg/min significantly decreased right renal interstitial and right urinary cGMP levels (p < 0.01) without changing left renal interstitial and urinary cGMP levels (p < 0.01). L-NMMA at 100 micrograms/kg/min decreased both right and left renal interstitial and urinary cGMP levels (p < 0.01). These data demonstrate the ability to monitor renal interstitial cGMP in vivo. There was a dose-dependent decrease in renal interstitial and urinary cGMP in response to intrarenal EDRF inhibition. Additionally, they suggest that EDRF acts as a renal paracrine substance through the modulation of renal interstitial cGMP.
J Cardiovasc Pharmacol 1992
PMID:Endothelium-derived relaxing factor modulates renal interstitial cyclic GMP. 128 58

Focal necrosis of the ureter was observed in our patient 7 days after CT-guided chemical sympathectomy. The injection of phenol was apparently rendered remote from the ureter and still caused ureteric necrosis. Ureteric injury may thus result following chemical sympathectomy, not from direct puncture of the ureter, but from unpredictable individual diffusion pathways.
Cardiovasc Intervent Radiol
PMID:Focal necrosis of the ureter following CT-guided chemical sympathectomy. 162 85

The horseshoe kidney is a rare anomaly that can significantly complicate aortic surgery. A bulky isthmus, abnormalities of renal anatomy, and a variable blood supply associated with a horseshoe kidney can pose technical difficulties in terms of aortic reconstruction. The left retroperitoneal approach affords an excellent exposure of the abdominal aorta in patients with a horseshoe kidney without dividing the renal isthmus and avoids the risk of injury to a ureter in an anomalous location. This is a case report of a patient with a horseshoe kidney who underwent a successful repair of an abdominal aortic aneurysm by a left retroperitoneal approach.
J Cardiovasc Surg (Torino)
PMID:The retroperitoneal approach to aortic surgery associated with horseshoe kidney. 175 95

The introduction and acceptance of percutaneous nephrostomy as a safe and effective alternative to surgical nephrostomy served as the impetus for the development and expansion of an ever-increasing number of techniques that are encompassed by the term "interventional uroradiology." This article reviews many of the nonvascular interventional techniques that have proliferated during the past decade and that are currently used in the kidney, ureter, and perinephric space. The authors emphasize those procedures that are most frequently employed, as well as their own preferences and perspectives on these procedures.
Cardiovasc Intervent Radiol
PMID:Interventional procedures in the upper urinary tract. 193 74

Three patients with isolated iliac artery aneurysm with ureteral obstruction and/or renal failure are presented. One patient had a stenotic lesion of the right ureter caused by direct compression of common and internal iliac artery aneurysms. Resection of the aneurysms and graft replacement were successfully performed. The other patients, who had hydroureteronephrosis and renal failure caused by entrapment of the ureters in perianeurysmal fibrosis, were treated surgically by ureterolysis, resection with graft replacement of the common iliac artery aneurysms, and endoaneurysmorraphy of the internal iliac artery aneurysms. One has had a good postoperative course, whereas the other died from a rare complication of rectosigmoid colon perforation caused by direct compression by the graft.
J Cardiovasc Surg (Torino)
PMID:Surgical treatment of isolated iliac artery aneurysm with ureteral obstruction and/or renal failure. 234 77

Renal autotransplantation was performed in five patients and extracorporeal vascular reconstruction was required in two of these cases. One had a carcinoma of the mid-ureter with a solitary kidney. Two patients had ureteral injury. One was iatrogenic from a prior operation, and the other had intrinsic ureteral disease secondary to schistosomiasis. The fourth patient had renovascular hypertension with disease extension into the interlobar renal arteries and a single kidney. The final patient had a large, renal arteriovenous malformation and polycystic kidneys. All have functioning grafts at follow-up ranging from 10 to 36 months. There is no evidence of tumor recurrence after 30 months in the patient with ureteral malignancy. The patient with renovascular hypertension has adequate blood pressure control with medication 12 months after surgery. His creatinine which had risen in the post-operative period to 4.2 mg/dl, has returned to its pre-operative valve of 1.8 mg/dl. None of the other four patients had any post-operative decline in renal function. These cases illustrate that the technique of nephrectomy, extracorporeal surgery, and renal autotransplantation can be applied to a variety of benign and malignant diseases of the kidney and ureter not amenable to conventional in-situ correction, thus allowing maximal preservation of renal parenchyma. We also have demonstrated that the procedure can be successfully performed in the presence of significant infectious risk (Case 2: indwelling nephrostomy), and retroperitoneal infection (Case 3: schistosomiasis). We feel that this procedure is currently underutilized.(ABSTRACT TRUNCATED AT 250 WORDS)
J Cardiovasc Surg (Torino)
PMID:Renal autotransplantation and extracorporeal reconstruction for complicated benign and malignant diseases of the urinary tract. 329 82

A case of double inferior vena cava (IVC) impeding surgery of the abdominal aorta is presented. The patient also had duplication of the kidney and ureter on both sides. The anatomical anomalies of the IVC, kidney and ureter interfering with abdominal aortic surgery are reviewed.
J Cardiovasc Surg (Torino)
PMID:Anomalous inferior vena cava impeding implantation of aortobifemoral vascular prosthesis. 341 53

Hydronephrosis is reported to be an infrequent late complication of aortofemoral bypass operations. To more clearly define the true incidence of the problem, excretory urograms were performed on 53 asymptomatic patients following successful aortic reconstruction. Unilateral hydronephrosis was found in seven of 50 patients (14%) in whom aortofemoral bifurcation grafts were placed. In each instance, the ureteral obstruction occurred at the point where the ureter crossed the graft limb. Dilatation was mild or moderate in all cases, with no significant deterioration of renal function. All seven patients underwent extensive urologic evaluation and have been followed nonoperatively to date. Hydronephrosis produced in a canine aortic-graft model suggests that a dense fibrotic reaction occurs surrounding the prosthesis, and invades the muscular wall of the ureter. Ureteral obstruction after aortofemoral bypass appears to occur more often than previously thought. Routine pre- and post-operative IVP studies are indicated. If renal function remains good, careful follow-up without re-operation seems warranted.
J Cardiovasc Surg (Torino)
PMID:Hydronephrosis following aorto-femoral bypass grafts. 713 Feb 57

The records of 16 patients with 44 aneurysms of the iliac artery during a 12-year period (1981 to 1992) were retrospectively reviewed. The mean age was 71.2 (range 53-81) years; the male/female ratio was 7:1. An extremely high incidence of isolated iliac artery aneurysm was noted relative to abdominal aortic aneurysm (11.7%) during the same period. Aneurysms ranged in size from 2 to 12 cm. Rupture occurred in four patients (25%). Six patients presented urologic complications of ureteral stenosis, with hydronephrosis caused by perianeurysmal fibrosis in five. Thirteen patients underwent surgical treatment with emergency operation performed in four with rupture and one with impending rupture. The mortality rate for ruptured aneurysm was high (50%). The operative procedures for common iliac aneurysms were open resection in 18, aneurysmectomy in two, and thromboexclusion in three. For internal iliac aneurysms, the procedures were aneurysmorrhaphy (partial resection) in five, obliterative endoaneurysmorrhaphy in seven, aneurysmectomy in two, and thromboexclusion in two, with appropriate graft replacement. Endarterectomy and reimplantation of the inferior mesenteric artery, and internal iliac artery graft interposition were performed to prevent colon ischaemia in three and two patients, respectively. Ureterolysis was performed in three patients with ureteral stenosis caused by perianeurysmal fibrosis, which improved hydronephrosis and renal function in two. Early diagnosis and elective surgery before rupture is the treatment of choice for saving the patient's life. The importance of preventing colon ischaemia for bilateral internal iliac aneurysms and ureterolysis for ureter entrapped within perianeurysmal fibrosis is emphasized.
Cardiovasc Surg 1994 Aug
PMID:Isolated iliac artery aneurysm and its management. 795 55


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