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

Primary vesico-ureteric reflux must be graded according to severity. Significant reflux up a dilated ureter appears to be an important factor in causing renal damage. There is evidence in favour of the theory that the renal deterioration seen in some cases of reflux can be explained on a congenital basis of site or origin of the ureteral bud and resultant dysplasia of the developing kidney. Surgery should be reserved for selected patients with significant reflux.
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PMID:Current concepts in congenital vesico-ureteral reflux. 35 43

The authors report two new observations of ureteral metastases from prostatic cancers and review the 17 already published cases. The relative rarity might well be only apparent, in relation with the delay in the exploration of the first observations. The diagnostic criteria are less clinical and radiological than anatomo-pathological, the metastases contrasting themselves with ureteral invasion by direct propagation. The anatomical status shows no predominance between tumoral or infiltrating forms, nor of any particular site on the ureter, while noting a relative frequence of bilateral involvement. The therapeutic approach is dependant upon these factors. The prognostic is reserved, at the cost of a segmental ureteral resection or a nephro-ureterectomy.
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PMID:[Ureteral metastases from prostatic cancers. 2 cases. Review of the literature]. 74 53

Crohn's disease was the topic of a meeting of gastroenterologists in Bergen last year with the purpose of working out consensus guidelines for diagnosis and treatment of this chronic disease. The most important diagnostic procedures are radiology, gastrointestinal endoscopy and histopathology. Transmural, segmental involvement is characteristic, whereas granulomas are found in only 25% of biopsy specimens. Corticosteroids are effective in active Crohn's disease located to all parts of the intestine, whereas sulfasalazine and metronidazole are most effective in Crohn's colitis. Azathioprine and 6-mercaptopurine should be reserved for patients with chronic active disease that is unresponsive to steroids or requires higher doses. Azathioprine also has a prophylactic effect. Surgery is indicated in patients whose quality of life is diminished in spite of adequate medical treatment, in patients with bowel or ureter stenosis, fistula or abscess, and in patients with acute perforation or toxic dilatation. Limited resection is recommended, and stricture plasty can be alternative to extensive resection.
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PMID:[Crohn disease. Diagnosis and treatment]. 200 75

Unsuspected malignant disease was discovered by frozen-section examination of the ureteral margins in 8 of 403 patients (2%) undergoing cystectomy for treatment of bladder cancer. Once malignant disease was demonstrated, a short segment of the proximal ureter was resected in 6 patients; in 5 instances dysplastic changes remained at the second margin, which was anastomosed to the bowel. No clinically recognized tumor developed at this site in any of the 8 patients. In an additional 26 instances (19 patients), dysplastic changes were known to be present in the ureteral margin at the time of ureteroenteric anastomoses. Again, no recognizable tumor has developed at the anastomotic site after a median follow-up of six years. We conclude that frozen-section examinations of the ureteral margins prior to constructing the ureteroenteric anastomosis are not indicated for the patient undergoing routine cystectomy for bladder cancer, but should be reserved for patients who are at increased risk for carcinoma in situ (those with multifocal bladder carcinoma in situ or transitional cell carcinoma of the prostatic ducts).
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PMID:Are frozen-section examinations of ureteral margins required for all patients undergoing radical cystectomy for bladder cancer? 272 45

The ectopic ureterocele is a relatively frequent congenital abnormality of the urinary tract. Its clinical signs are often uncharacteristic. Therefore the sometimes discrete changes in the diagnostic evaluations have to be looked for. The various procedures of which the excretory urography still plays a central role are discussed with their possibilities and limitations. The removal of the mostly dysplastic upper segment with its ureter is usually the most sensible treatment. Only in rare cases, where scintigraphically and clinically the segment seems preservable, a ureteropyelostomy is indicated. The different indications for primary and secondary excision of the ureterocele itself are outlined. A minimal therapy, that does not correct the underlying anatomical abnormality like the endoscopic incision should be reserved for uroseptic emergencies.
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PMID:[Ectopic ureterocele--diagnosis and therapy]. 329 82

Either transurethral ureteroscopy (URS) or extracorporeal shock wave lithotripsy (ESWL) was the primary method of intervention in two series of patients presenting consecutively with stones located in the ureter distal to the radiological marking of the sacroiliac joint. Of 65 patients treated by URS, successful evacuation of the major part of the stone was achieved in 97% in one or two sessions. Of those subsequently attending for review, 93% proved stone-free but 3% required surgery for serious complications. In the ESWL series of 53 patients, successful stone fragmentation was recorded in 94%, with 2 patients requiring a supplementary endourological or surgical procedure. No significant complications were related to ESWL and 90% of those followed up after successful ESWL proved stone-free at 6 weeks. In uncomplicated cases, the mean procedure time for ESWL was one-third of that required for URS and the hospital stay one-half. It is suggested that ESWL should be the primary method of intervention in patients with distal ureteric stone, with URS reserved for the small number that prove refractory to such treatment.
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PMID:Primary choice of intervention for distal ureteric stone: ureteroscopy or ESWL? 340 63

The historical background to extracorporeal lithotripsy using shock waves is described and indications for use of this treatment discussed in relation to other types of therapy for reno-ureteral lithiasis: percutaneous or trans-ureteral endoscopy. The reduction in invasive surgical procedures is emphasized. The first human use of extracorporeal lithotripsy by shock waves dates back to 1980. Since then, more than 30,000 calculi have been treated in this way, either exclusively or in combination with other therapy. For simple small calculi (less than 1 cm in diameter and situated in the pelvis or a calyx) the incidence of complications is minimal: renal colic (15%), fever (13%), need for complementary therapy (7%). With extension of use of extracorporeal lithotripsy to complex calculi (multiple calculi, staghorn calculi) these figures increased to 30, 5 and 12% respectively. Patients with obstructive and infected lithiasis were treated by percutaneous drainage nephrostomy with intensive antibiotic therapy prior to extracorporeal treatment. Extending indications also provided data on contraindications: coagulation disorders, major vascular problems, abnormal size or weight of patient, pregnancy and finally difficulty in localizing calculi. Of interest is the almost total lack of efficacy of shock waves for treating staghorn calculi. Treatment in these cases should be by an initial percutaneous approach to reduce size of calculus followed by extracorporeal lithotripsy under nephrostomy cover. Surgery for lithiasis should therefore be reserved for complex lithiasis cases with large caliceal calculi proximal to a long narrow infundibulum and to calculi proximal to a stenosis of pyelo-ureteral junction. Whenever possible, lumbar ureter calculi should be raised towards the pelvis by endoscopic manipulation before extracorporeal lithotripsy.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Extracorporeal lithotripsy in the treatment of renal lithiasis. 5 years' experience]. 379 77

Serious morbidity from renal transplant biopsy is reported to be infrequent. However, 4 of 43 patients who had renal transplant biopsy between July, 1981, and March, 1984, experienced anuria from upper urinary tract obstruction by blood clots. Although these clots usually dissolve, 3 patients (7%) experienced persistent clot anuria and deterioration of renal function. Awareness of this complication is important. Retrograde pyelography and ureteral catheterization are preferred primarily for diagnosis and treatment. Percutaneous techniques are reserved for those cases in which the ureter cannot be catheterized cystoscopically.
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PMID:Persistent clot anuria complicating renal transplant biopsy. 389 47

Ureteric obstruction is a recognised complication of aortic bifurcation grafting where the graft material is in close proximity to the ureter as it crosses the common iliac vessels. We have assessed the value of routine postoperative urography in (1) a retrospective 6-year study of ruptured aortic aneurysm repair (11 patients reviewed) and (2) a prospective 18-month study of all patients receiving intra-abdominal dacron grafts (24 assessable patients) in a district general hospital. Renal function was normal in all cases and only 1 ureter was shown at urography to be minimally dilated but not significantly obstructed out of 32 'at risk' ureters in 18 patients in the 2 studies. This complication is uncommon, and no particular advantage can be demonstrated in positioning the ureters either behind or in front of the graft limbs. There is no place for routine urography which should be reserved for the patient with symptoms of ureteric obstruction.
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PMID:Ureteric obstruction after dacron vascular replacement. 622 69

Of 149 renal transplants performed between May 1965 and December 1980 a stapled ureteroureterostomy was done in 112 (75 per cent) using a commercially available stapling device. Calculus developed in 7 patients (6.3 per cent) in whom this technique was used, with the interval between transplantation and calculus formation being 13 months to 6 years. We conclude that the stapled ureteroureterostomy should be reserved for special instances, such as a short donor ureter or when the correction of urological complications demands a rapid ureteroureterostomy.
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PMID:Calculus formation in renal transplant patients. 638 57


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