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

When ureteral length is extensively compromised, preservation of the kidney without recurring to external urinary diversion may be attempted by various techniques. The choice depends on the extension and localization of the defect. We report a technique solution performed in a patient with multiple ureteral tumors and solitary kidney. A 70-years old underwent TURB for superficial bladder cancer and right nephroureterectomy for upper urinary tract tumor. He was admitted for hematuria and renal failure which need a percutaneous nephrostomy. Urography and pielo-RMN showed multiple and irregular defects of proximal left ureter. We performed a left ureterectomy with ureteral substitution by tailored and retroperitonealized ileal segment with simultaneous ileal bladder augmentation. The six months follow-up including serum creatinine, sonography, urodynamic evaluation, urinary cytology, excretory urogram and pielo-RMN shows good results. Ureteral replacement with ileum is indicated only for extensive ureteral diseases in which ureteroneocystostomy or vesical Psoas hitch and/or Boari bladder flap are not feasible. With particular attention to surgical aspects as tailoring ileum (to improve propulsion of urinary bolus, limit the absorbing surface area and decrease mucus formation) and the use of an ileal segment longer than 15 cm (to prevent reflux) and with an accurate patient selection, we think that this procedure can assure satisfactory results also in difficult cases.
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PMID:[Technical solution for single kidney patients with multiple ureteral neoplasms]. 1182 68

Renal function is usually normal or only marginally affected in patients with unilateral ureteral obstruction due to the vicarious function of the contralateral kidney. Few reports exist in which unilateral renal obstruction is associated with anuria (reflex anuria, RA) and acute renal failure. We report the clinical case of a female patient who was referred to the emergency department due to anuria of 72 h duration and acute renal failure (serum creatinine 9 mg/dl) associated with several episodes of violent right flank pain with hematuria following extracorporeal shock wave lithotripsy (ESWL). A few weeks before ESWL, urography showed a 2-cm stone located in the right pelvis whilst the left kidney was functionally normal. On admission, renal ultrasound documented a normal left kidney, whilst the right pelvis was hydronephrotic and there were two indwelling stones at the right pyeloureteral junction. After the patient passed a urinary stone, diuresis restarted and acute renal failure was resolved. Thereafter, urography confirmed that the left kidney, the left ureter and bladder were functionally and morphologically normal. RA with acute renal failure has been so scarcely documented that it is considered to be legend by many clinicians. Major textbooks do not discuss RA with acute renal failure. Vascular or ureteral spasm related in part to a peculiar hyperexcitability of the autonomic nervous system may explain RA. We suggest that nephrologists should always consider RA when evaluating acute renal failure. On the other hand, RA might be relatively common and we cannot rule out that only the most severe and/or better-documented cases have been reported in the medical literature.
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PMID:Reflex anuria from unilateral ureteral obstruction. 1186 59

The purpose of this study is to show whether selective (celecoxib) and non-selective (piroxicam) inhibitors of COX-2 can alter the morphological and functional changes after the release of a 24 h complete ureteric obstruction in tissue from solitary rat kidney. Forty male Sprague-Dawley rats weighing 225-250 g were used. The animals were divided into four groups. In group 1 rats (control, n=10), only right nephrectomy was performed. Group 2 rats (untreated, n=10) underwent right nephrectomy and the left ureter was completely obstructed. In group 3 rats (celecoxib), the same operation was performed as described for group 2 and than celecoxib was administered by gavage for a period of 24 h. Group 4 rats (piroxicam) underwent the same operation as described for group 2, then piroxicam was administered intramuscularly at least 1 h before the release of the for 24 h complete ureteric obstruction. All animals were then prepared for functional and histopathological studies. The administration of celecoxib produced a significant decrease in blood urea nitrogen levels when compared to the animals receiving piroxicam and the animals with no treatment. Moreover, celecoxib caused a significant decreased in creatinine levels when compared to the untreated group. Urine volume and the urinary sodium values were increased in the celecoxib group when compared with the other groups. The administration of celecoxib and piroxicam caused a significant decrease in the number of interstitial macrophages when compared to the untreated group. The Bowman space was significantly increased in the untreated group when compared with the celecoxib and the piroxicam groups. These studies indicate that celecoxib may be an important factor affecting renal morphological and functional changes after the release of a 24 h complete ureteric obstruction.
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PMID:Renal effects on a solitary kidney of specific inhibition of cyclooxygenease-2 after 24 h of complete ureteric obstruction in rats. 1220 39

We aimed to show whether the administration of exogenous L-Arg would alter the morphological, functional changes and interaction of nitric oxide and cell adhesion molecules such as tenascin and lectin after release of twenty-four hours complete ureteric obstruction in the solitary rat kidney tissue. Forty prepubertal Wistar-Albino rats were separated into 4 groups, each containing 10 rats. In the group 1 (Sham-control, n = 10), right nefrectomy was performed; the left ureter was visualized but not ligated. In the remaining 30 rats, the abdomen was opened and undergone right nephrectomy and the left ureter was completely obstructed. After 24 hours, thirty rats were divided as group 2, 3, and 4, each containing 10 rats. In-group 2, no drug treatments were given. In-group 3 L-Arg (L-arginine methyl ester) was infused immediately after abolishing ureteric obstruction. In-group 4 L-NAME was give separately during L-Arg administration during 30 minutes immediately after abolishing ureteric obstruction. Than, the animals were prepared for functional and histopathological studies. BUN value was decreased significantly in L-Arg group when compared with untreatment and L-NAME groups (p < 0.05, p < 0.001 respectively). Creatinine values were decreased in L-Arg group when compared with untreatment group (p < 0.002). Urine flow and urinary Na value was increased significantly in L-Arg group when compared to other obstruction groups (p < 0.001, p < 0.001). The increase in the number of macrophages in Untreated and L-NAME group were significant (p < 0.001, p < 0.001) when compared to L-Arg group. Immunohistochemical study showed that tenascin and lectin expression was severe in tubulus basal membrane of untreated and L-NAME treated rats. In L-Arg group, tenascin and lectin expression was moderate in tubulus membrane. Our results suggest that the administration of exogenous L-Arg protect the functional and degenerative effects of acute complete obstruction in the solitary kidney tissue of the rats. Nitric oxide cause these positive effects by decreasing preglomerular vascular resistance, regulation of neutrophil function and preventing the expression of cell adhesion molecules such as tenascin and lectin.
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PMID:Interaction of nitric oxide and cell adhesion molecules after 24 hours of complete ureteric obstruction in the rats on a solitary kidney. 1223 Feb 67

We report our experience with kidney autotransplantation and evaluate the benefit of this operative method in selected patients. Between 1991 and 2001, 8 patients underwent kidney autotransplantation in our department, 2 involving iatrogenic ureter lesion, 3 - gross hematuria due to kidney vascular abnormalities, 2 - renal arteries stenoses, 1 with long ureteric stenose. In short-term follow-up period 7 patients had normal kidney function (serum creatinine level was 99.5 micromol/l), 1 patient had impaired kidney function (serum creatinine content was 170 micromol/l), serum creatinine level improved in 4 patients and were stable in another 4 patients, 3 patients experienced relief gross hematuria. In long-term follow-up period 5 patients had normal kidney function and no experienced hematuria episodes. We concluded that kidney autotransplantation is feasible and effective method for the surgical treatment with good results for selected patients with ureteric lesions, renovascular disorders, it also appears to be effective treatment for patients with gross hematuria. Kidney autotransplantation allows to recover or stabilise impaired kidney function due to renovascular or ureteric disorders and to avoid nephrectomy due to gross hematuria, due to vascular abnormalities.
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PMID:[Results of the kidney autotransplantation]. 1255 45

Pelvic surgery is the most common cause of iatrogenic ureteral injury. The majority of patients with ureteral injuries have no identifiable predisposing risk factors. A simple maneuver that has been taught successfully at our institution that facilitates the identification of the ureter is described. When injury is discovered during surgery, correction of the injury can be repaired with minimal risk of long-term sequelae. Postoperatively, patients with ureteral injury typically present with costovertebral angle tenderness, ileus, fever, and flank pain with a minimal rise in serum creatinine. To prevent ureteral injuries, the surgeon must have a thorough knowledge of the location of the ureter during various pelvic procedures and the specific regions where it is most susceptible to injury.
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PMID:Prevention of ureteral injuries in gynecologic surgery. 1274 97

A 3-yr-old boy with posterior urethral valves underwent cadaveric renal transplant. On the ninth day after transplantation the patient developed a urinary leak, with complete ureteral necrosis. There was insufficient length of undamaged ureter to permit ureteroneocystostomy, unavailability of a native ureter to permit ureteroureterostomy, and an inability to mobilize the transplant kidney or bladder sufficiently to permit direct pyelovesicostomy. As the kidney was otherwise functioning perfectly, we decided to create an appendiceal conduit in the hope of salvaging the patient's renal allograft. At present, 7 months post-transplant, the child is clinically well with a serum creatinine of 0.7 mg/dL. Complete ureteral necrosis is an infrequent but devastating complication following renal transplantation. We report a novel method that allowed an otherwise normally functioning cadaveric graft to be salvaged.
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PMID:Use of appendix for complete transplant ureteral necrosis. 1275 52

A 54-year-old woman was admitted to our hospital for oliguria and left lower abdominal pain. She had renal dysfunction with a serum creatinine of 9.1 mg/dl and blood urea nitrogen of 96.5 mg/dl. Plain computed tomography and magnetic resonance imaging revealed right dwarf kidney and left giant hydronephrosis with extravasation of urine. MR-urography revealed left dilated ureter caused by ureterovesical junction (UVJ) stenosis. Therefore, percutaneous nephrostomy was immediately performed to treat postrenal failure, with resulting collection of approximately 1,650 ml of urine. Subsequently, left ureterocystoneostomy was performed for the treatment of UVJ stenosis because improvement of left UVJ stenosis had not been confirmed by nephrostography during follow-up. Judging from the past history of myoma operated and reactive fibrosis of stump of left ureter histopathologically, it was considered that acquired UVJ stenosis had led to giant hydronephrosis.
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PMID:[A case of unilateral giant hydronephrosis with contralateral dwarf kidney]. 1289 39

An effective and ultrarapid technique for kidney transplantation in the rabbit is introduced. Vascular anastomosis was completed using a novel cuff technique in which mating cuffs were used to join the delicate renal vein. The ureter was reconstructed by spatulated end-to-end anastomosis, with special attention to the rabbit's unique ureteral vascular anatomy. The total vascular anastomosis time was 3.4 +/- 1.3 min, and there were no episodes of bleeding or thrombosis. The ureter complication rate was 7.3%. Kidneys transplanted after 5 h of cold storage using the new technique yielded better postoperative creatinine results than similar preserved kidneys transplanted using previously described methods. We suggest this technique for studies of long- and short-term kidney preservation and transplantation in the rabbit, as well as for veterinary transplantation in which donor kidneys must be stored for only a short time before use.
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PMID:Ultrarapid nonsuture mated cuff technique for renal transplantation in rabbits. 1294 29

The stop flow technique was used to investigate the permeability characteristics of the dog nephron to various C(14)-labeled non-electrolytes. 12 minutes after clamping the ureter, creatinine, PAH, and C(14) compound were injected intravenously. 2 minutes later, urine samples were collected. Urea and glycerol were able to enter the tubular urine along the entire nephron at rates which were commensurate with their molecular weights. No significant movement of larger molecules (D-arabinose, D-glucose, and mannitol) could be detected. However, after administration of twenty units of pitressin, D-arabinose was able to diffuse across the distal and proximal tubular epithelium.
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PMID:Transcellular diffusion of non-electrolytes across the renal tubular epithelium. 1448 56


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