Cases reported "Ureteral Obstruction"

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1/161. Upper urinary tract obstruction: pressure/flow studies in children.

    34 upper urinary tract pressure/flow studies were carried out in 24 children. Obstruction was reliably diagnosed in 8 studies, and excluded in 21. This technique may provide information of clinical value in the patient with upper urinary tract dilatation.
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keywords = upper
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2/161. Ureteric obstruction due to kinking of the reservoir inlet in a continent urinary reservoir.

    We report a case of symptomatic intermittent upper tract obstruction in a continent urinary reservoir. The ureters were of great intraperitoneal length and were positioned in front of the mesenterium, resulting in a mobile reservoir. Only the retroperitoneal part of the ureters was dilated due to kinking in the peritoneal passage. After the ureters were shortened and reanastomosed retroperitoneally, the repeated episodes of abdominal pain and discomfort disappeared..
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ranking = 1.625747508285
keywords = abdominal pain, upper
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3/161. The appendix as right ureteral substitute in children.

    PURPOSE: The appendix has occasionally been used to replace sections of the right ureter. We reviewed the literature of the last 25 years on the use of the appendix as right ureteral replacement and report our experience with right ureteral substitution using the appendix. MATERIALS AND methods: We retrospectively reviewed the charts of 3 children who underwent appendiceal replacement of the right ureter. The appendix replaced the upper third of the ureter and the lower ureter in 1 and 2 cases, respectively. RESULTS: Followups of 4, 7 and 15 years, respectively, demonstrated that the appendix transports urine satisfactorily and permits renal function to be maintained with no evidence of obstruction. CONCLUSIONS: We believe that our small series supports the use of the appendix as a right ureteral substitute in select cases.
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keywords = upper
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4/161. trichomonas vaginalis in a perinephric abscess. A case report.

    A patient with chronic vulvo-vaginitis due to trichomonas vaginalis, and obstructive uropathy associated with renal calculi, developed a perinephric abscess following trauma incurred in a motorcycle accident. T. vaginalis was seen on smear and cultured from the purulent drainage from the perinephric abscess. Although T. vaginalis is commonly pathogenic only to the lower genito-urinary system, the upper urinary tract may very rarely be involved by ascending infection. If this protozoan spreads to extraluminal sites the inflammatory potential is marked, as has been found in animals with experimental infection. Examination of a fresh smear of pus may be critically important in the diagnosis of closed-space infections of unknown etiology.
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keywords = upper
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5/161. Functional urinary tract obstruction developing in fetuses with isolated gastroschisis.

    OBJECTIVE: To evaluate the frequency and natural history of urinary tract abnormalities developing in fetuses presenting with initially isolated gastroschisis. methods: Serial ultrasounds were performed prospectively on fetuses identified by our prenatal diagnosis program as having a gastroschisis. When abnormalities in the urinary tract were identified prenatally, newborns were evaluated by a pediatric urologist. RESULTS: Over a 1-year period four out of 12 fetuses with gastroschisis developed deformations of the urinary tract. In three fetuses the bladder herniated through the abdominal wall defect. Two also had upper tract dilatation. A fourth fetus developed bilateral hydronephrosis with a normally situated bladder. Once the gastroschisis was repaired none of the newborns had evidence of structural obstruction of the urinary tract, however, hydronephrosis with or without reflux persisted for several months. CONCLUSIONS: Deformations of the fetal urinary tract can develop secondary to gastroschisis. They do not appear to represent separate malformations and evaluation with fetal karyotyping may not be indicated. When hydronephrosis is present ongoing urologic evaluation of the neonate is indicated.
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keywords = upper
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6/161. Bladder outflow obstruction masquerading as pelviureteric junction (PUJ) obstruction.

    We report a case of bladder outflow obstruction presenting with upper tract dilatation mistaken initially as pelviureteric junction (PUJ) obstruction. The lower tract obstruction ought to be dealt with first before upper tract obstruction is assessed because the renal pelvic pressure is significantly affected by vesical filling and high bladder pressure.
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ranking = 1
keywords = upper
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7/161. An endourologic approach to complete ureteropelvic junction and ureteral strictures.

    BACKGROUND AND PURPOSE: Complete stricture of the ureteropelvic junction (UPJ), ureter, or both represents a secondary upper tract obstruction and is a challenge for surgical management. The endourologic repair of these complete strictures remains controversial because of the many unsatisfactory results in the literature. The aim of this study was to achieve recanalization of the ureter or the UPJ using endourologic techniques to prove durable success of this technique. patients AND methods: We present data on the 21 patients with complete UPJ or ureteral strictures treated over 5-year period. The length of the obliterated portion of the ureter or UPJ ranged from 0.3 to 1.7 cm. The stricture was at the UPJ level in 12 patients (57%), in the upper ureter in 3, and in the lower ureter in 4. The technique was a combined approach, with antegrade introduction of the guidewire and retrograde cold-knife incision in the majority of the cases. In five cases, the incision was carried out in the reverse direction with a guidewire introduced retrograde up to the stricture level. An originally designed 6F to 7F polyethylene double-J stent with a movable 12F to 16F silicon sheath or percutaneous tube was placed at the completion of the procedure. RESULTS: The follow-up period ranged from 6 to 48 months. Recanalization was achieved in 17 patients (81%), of whom 14 became symptom free. Other surgical outcomes necessitated open surgical intervention (pyeloplasty, nephrectomy) in two patients. One patient developed a clinically significant recurrent urinary tract infection and deterioration of kidney function. Thus, the overall success rate of the endourologic management of the complete UPJ and ureteral strictures was 67% in our series. CONCLUSION: Endourologic management with retrograde or antegrade pyeloureterotomy can be successful in patients with short (up to 1.0-cm) obliterative strictures who are without extensive hydronephrosis and with preserved renal function.
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ranking = 1
keywords = upper
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8/161. Reversible acute renal failure in association with bilateral ureteral obstruction and hydronephrosis in pregnancy.

    This is a case report of a 16-year-old girl with renal failure in pregnancy in association with bilateral ureteral obstruction and hydronephrosis. The presenting symptom was a common nonspecific type of abdominal pain. The diagnosis was made on incidental laboratory work to rule out preeclampsia. Renal function reverted back to normal after induced vaginal delivery.
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ranking = 1.125747508285
keywords = abdominal pain
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9/161. Trans-pyeloureteric anastomosis in the management of pelviureteric junction obstruction.

    BACKGROUND: The application of pyeloureteric anastomoses in the management of pelviureteric junction obstruction is described. methods: Two patients, one requiring a ureterocystoplasty for bladder augmentation but with a coexistent contralateral pelviureteric junction (PUJ) obstruction and the other with gross hydronephrosis but an atretic ipsilateral ureter, underwent trans-pyeloureteric anastomosis to relieve the obstruction. RESULTS: Both patients demonstrated satisfactory drainage of the upper tracts on postoperative imaging. CONCLUSIONS: Transureteropyeloplasty represents a novel and valid technique of urinary tract reconstruction in complex cases of PUJ obstruction.
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ranking = 0.5
keywords = upper
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10/161. Simultaneous upper and lower urinary tract obstruction associated with severe genital prolapse: diagnosis and evaluation with magnetic resonance imaging.

    Genital prolapse causing both urethral and ureteral obstruction is an infrequent occurrence, especially in the absence of uterine prolapse. We report on a patient with massive genital prolapse causing both urethral and ureteral obstruction in whom magnetic resonance imaging demonstrated the level of obstructive uropathy and, after surgical repair of the prolapse, confirmed restoration of the normal pelvic and upper urinary tract anatomy.
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ranking = 2.5
keywords = upper
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