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

Ureterosciatic herniation, the protrusion of the hernia sac through the sciatic foramen, is an extremely rare cause of ureteral obstruction. We describe a case revealed by severe left back pain in a 72-year-old female. She was referred to our hospital for urological assessment of left hydronephrosis observed by ultrasonography. Intravenous ureterography (IVU) showed findings compatible with a left sciatic ureter, a dilated ureter with a fixed kinking, which is known as the 'curlicue' sign. We decided to attempt recovery of the herniated ureter using a retrograde approach. Ureteral stent placement was performed to decompress the dilated upper urinary tract. The ureterosciatic hernia was relieved with the passage of a flexible guide wire and a double-pigtail stent. Three months after ureteral stenting, she refused continuing to have an indwelling stent and the stent was removed. Thereafter, IVU revealed recurrent ureterosciatic hernia; however, there was no hydroureter or hydronephrosis. The patient is currently being under observation for 6 years after stenting and continues to be without hydronephrosis or symptoms. Placement of an internal stent possibly provides the rigidity to the ureter, thereby reducing the hernia and urinary obstruction. In the previous reports, most symptomatic patients have been treated surgically, with conservative therapy reserved for asymptomatic patients. For the patient who is elderly or a poor surgical candidate, retrograde stenting may provide safe reduction and efficacious treatment. This endourological approach provides a minimally invasive means for the management of urinary obstruction caused by ureterosciatic herniation.
Case Rep Nephrol Dial
PMID:Minimally Invasive Endourological Techniques may Provide a Novel Method for Relieving Urinary Obstruction due to Ureterosciatic Herniation. 2584 69

A 92-year-old woman was referred to our hospital from a family practice with the chief of complaint of vomiting. Subsequent computed tomography imaging revealed left hydroureteronephrosis without clear evidence of ureteral stones or ureteral tumors and that the lower part of the ureter was shifted to the outside of the cavum pelvis minor from the greater sciatic foramen. Retrograde pyelography was performed, and the shadow of a mass, which constricted and obstructed the distal left ureter, was observed. The patient was diagnosed with ureterosciatic hernia, and a left retrograde ureteral stent was indwelled and the hernia was repaired. Cases of ureterosciatic hernia are very rare. We describe one case of ureterosciatic hernia and review the relevant literature.
Case Rep Nephrol Dial
PMID:Treatment of ureterosciatic hernia with a ureteral stent. 2596 Sep 96

Encapsulating peritoneal sclerosis (EPS), treated with surgical enterolysis as a final option, may become refractory to surgical intervention due to intraperitoneal complications. We report the case of a 59-year-old man presenting with EPS who underwent enterolysis at the age of 50, following 15 years of peritoneal dialysis (PD) and peritonitis. During the patient's first surgery, complete surgical enterolysis could not be performed due to severe intestinal adhesions with a deteriorated/calcified small bowel. Six months after the surgery, the obstructive bowel symptoms occurred several times a year. Nine years later, the patient suffered cystitis-like symptoms and fecal discharge from the urinary meatus. The patient was subsequently diagnosed with EPS recurrence with ureteroileal fistula between the right ureter and ileum. During the second surgical intervention, we conducted a divided jejunostomy, as surgical enterolysis and fistulectomy were unachievable due to severe ileal adhesion with calcified capsule and inflammation. Thereafter, symptoms reduced dramatically and oral intake became possible. Three years following surgery, the patient's condition is improved, with no evidence of EPS recurrence or cystitis-like symptoms. Although EPS with ureteroileal fistula is extremely rare, we propose that jejunostomy may be an effective treatment option for patients with EPS refractory to surgical enterolysis or intestinal bypass due to intraperitoneal complications.
Perit Dial Int
PMID:Effective Remedy for Encapsulating Peritoneal Sclerosis with Ureteroileal Fistula. 2912 1


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