1/11. 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.- - - - - - - - - - ranking = 1keywords = upper (Clic here for more details about this article) |
2/11. Ureteral pressure flow studies in difficult diagnostic problems.Before a ureteral operation is undertaken for dilated, non-refluxing ureters it is essential to determine whether obstruction is present, since an operation is unnecessary and can be hazardous if there is no obstruction or infection. Obstruction is most accurately diagnosed by perfusing the upper tract at a known flow rate and measuring the resulting pressure. This test was performed on 5 patients in whom there was doubt as to the presence of obstruction from the radiographic evidence. In 4 of the 5 patients low pressure was found, the obstruction was excluded and an operation was avoided. In the fifth patient the obstruction was confirmed and relieved. The pressure flow test is useful in the diagnosis or exclusion of obstruction in the upper urinary tract.- - - - - - - - - - ranking = 1keywords = upper (Clic here for more details about this article) |
3/11. Bladder outlet obstruction after operation for ureterocele.Two patients with ureterocele-induced bladder outlet obstruction are presented. In each instance, a broad-based diverticulum had developed in the floor of the bladder as a result of the muscular defect created by a simple ureterocele in one patient and an ectopic ureterocele in the other. This bladder diverticulum produced secondary obstruction of the bladder outlet during the act of voiding. urinary diversion in one patient had been carried out because of bladder outlet obstruction and was being seriously considered in the other patient because of upper tract deterioration. After the correct diagnosis was established, reconstruction of the muscular defect eliminated the obstruction and reestablished satisfactory bladder function. urinary diversion was thus prevented in one patient and undiversion accomplished in another, when the true obstructing nature of the bladder diverticulum was established and correct therapy instituted.- - - - - - - - - - ranking = 0.5keywords = upper (Clic here for more details about this article) |
4/11. Wegener's granulomatosis of the prostate gland.Wegener's granulomatosis (WG) is a systemic granulomatous vasculitis affecting medium and small arteries, venules, and arterioles. The upper and lower respiratory tract and kidney are primarily involved. patients with classic WG essentially present with upper airway and pulmonary involvement. Renal disease is common. Involvement of other organ systems is also relatively frequent, most often heart, joints, muscles, eyes, skin, and central and/or peripheral nervous system. We present a patient in whom WG was diagnosed primarily because of prostate involvement. This seems to be a rare manifestation.- - - - - - - - - - ranking = 1keywords = upper (Clic here for more details about this article) |
5/11. Adenomectomy in a patient on regular dialysis treatment.A 55-year-old patient presented with terminal renal insufficiency caused by lower urinary tract obstruction due to prostatic adenoma. The case history of the patient on regular dialysis treatment was complicated by recurrent, therapy-resistant urinary tract infections accompanied by septic fever outbreaks and anemic relapses. Following suprapubic transvesical adenomectomy, no fever episodes, negative urine cultures and improvement in the anemic condition were all noted. Due to the fact that the upper age limit for acceptance into a hemodialysis program and possible kidney transplantation has been raised, it is important to note that an increasing number of men with prostatic adenomas may be encountered in these collectives. dialysis patients require successful treatment of urinary tract obstructions prior to transplantation. Immunosuppressive therapy which follows transplantation increases the risk of infection which can endanger the graft and the patient's life.- - - - - - - - - - ranking = 0.5keywords = upper (Clic here for more details about this article) |
6/11. Ovarian cancer causing upper and lower urinary tract obstruction.BACKGROUND. Cervical cancer is the gynecologic malignancy most commonly associated with urinary tract obstruction. Ovarian cancer rarely causes this problem, but when it does, the obstruction is due to impedance of flow in the pelvic ureters. CASE REPORT. A 34 year old female treated by total abdominal hysterectomy with ovarian preservation 9 months earlier for presumed stage IV endometriosis and menorrhagia presented with a recurrent pelvic mass along with symptoms of bladder outlet obstruction. Intravenous urography and computed tomography showed bilateral hydronephrosis and confirmed the bladder outlet obstruction. laparotomy revealed a large pelvic mass, grossly resembling endometriosis, obstructing the right ureter and impinging upon the urethrovesical junction. Final pathological analysis revealed a mucinous cystadenocarcinoma of the ovary. CONCLUSION. Urinary tract obstruction, including both urethrovesical junction and ureteral obstruction, may be caused by ovarian cancer.- - - - - - - - - - ranking = 2keywords = upper (Clic here for more details about this article) |
7/11. Abdominoscrotal hydrocele causing upper urinary tract displacement and obstruction.We report on a case of abdominal hydrocele in which the abdominal component caused displacement and obstruction of the upper urinary tracts. We review the surgical management of this rare condition.- - - - - - - - - - ranking = 2.5keywords = upper (Clic here for more details about this article) |
8/11. The adynamic terminal ureteral segment.Recently, we observed hydroureteronephrosis owing to an adynamic transmural distal ureteral segment associated with a thickened bladder, consequent to bladder outlet obstruction. Histological examination disclosed a loss of intrinsic musculature of the terminal ureteral segment with fibrosis. The importance of this entity is in the fact that upper tract dilatation and deterioration may progress, despite apparently successful correction of the bladder outlet uropathy.- - - - - - - - - - ranking = 0.5keywords = upper (Clic here for more details about this article) |
9/11. Posterior urethral valves in adults: a report of 2 cases.Herein we review 2 cases of posterior urethral valves in adults. Significant secondary bladder neck obstruction occurred in both cases and required transurethral incision before the bladder outlet obstruction was relieved. The management is described of the secondary upper tract changes that occurred.- - - - - - - - - - ranking = 0.5keywords = upper (Clic here for more details about this article) |
10/11. Complications of vesicoureteral operations from incoordination of micturition.Recently, a study was made of 8 boys with complications after corrective surgical procedures for dysfunction of the voiding mechanism. One of these patients already had been subjected to irreversible diversion before the basic disorder was recognized but the majority was treated with suggestion (often with hypnosis) as well as with drugs affecting the smooth muscle (1 adolescent was too hostile to accept treatment). Because the bladder was dysfunctional, the operations either failed or sequelae persisted until measures such as suggestion, hypnotherapy and retraining reversed the incoordination of micturition. Operation or reoperation in 5 children might not have been necessary if bladder coordination had been established earlier. The case of boys with poor urinary control but free of neurologic stigmas are suspect. If they require an operation for repair of congenital urinary defects such as reflux, equal attention must be paid to psychologic and habit patterns causing bladder dysfunction. Otherwise, the operation is done essentially into a neurogenic bladder. It is concluded that psychologically conditioned incoordination of voiding may alone produce mid and upper tract damage. The cases of boys with problems of urinary control not explained by neurologic or anatomic defects should be suspected and corrective surgical procedures may fail if bladder dysfunction is not corrected by retraining, suggestion and even hypnotherapy.- - - - - - - - - - ranking = 0.5keywords = upper (Clic here for more details about this article) |
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