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Archivos Espanoles de Urologia Dec 2022The objective of our study was to share the experience of the ectopic ureter and to characterize associated clinical features, medical images, and management.
BACKGROUND
The objective of our study was to share the experience of the ectopic ureter and to characterize associated clinical features, medical images, and management.
METHODS
A retrospective analysis was performed on 13 cases of ectopic ureter confirmed by surgery. The gender, age, abnormal urinary leakage, the site of the ectopic ureter, renal dysplasia, and surgical methods of the patients were compared and analyzed.
RESULTS
Eleven females and 2 males with ectopic ureters were analyzed. Eight cases had the clinical symptom of persistent or intermittent urine leakage since birth. One case was with complete persistent urine leakage, and 4 cases with no urine leakage. The site of the ectopic ureters was mostly unilateral. Ectopic ureters were located in the vagina in 6 cases, urethra in 4 cases, prostate in 1, and uncertain in 2 cases. There were 3 cases with ectopic kidney and renal atrophy, 3 cases had "Y" ureter, and 8 cases had repeated ureters with duplex kidneys. Twelve cases were treated with surgery, and 1 case underwent bilateral ureteral stent implantation. Three cases were complicated with ureteral stump syndrome after surgery.
CONCLUSIONS
The classic symptom of the ectopic ureter is continuous wetting with intermittent normal micturition in most young girl patients. Ectopic ureter is often associated with duplex kidneys, ectopic kidneys and atrophic kidneys. The surgical approach should be personalized. The aim of the surgery is to make the patient without urine leakage and preserve kidney function.
Topics: Male; Female; Humans; Ureter; Retrospective Studies; Kidney Pelvis; Ureteral Obstruction; Kidney Diseases; Kidney
PubMed: 36651090
DOI: 10.56434/j.arch.esp.urol.20227510.118 -
Ugeskrift For Laeger Apr 2023This review summarises the current reconstructive urological procedures seeking to optimise urinary tract function. This includes nephrectomy to avoid complications in... (Review)
Review
This review summarises the current reconstructive urological procedures seeking to optimise urinary tract function. This includes nephrectomy to avoid complications in non-functioning kidneys and reconstruction of uretero-pelvic junction stenosis. Re-implantation of the ureters is indicated in case of reflux or stenosis. The technique depends on the defect and ranges from re-implantation to transplantation of the kidney into the pelvis. Intestine is used for bladder augmentation or to create a new reservoir. Urethral reconstruction is used for complicated strictures, while penile reconstruction includes insertion of implants and straightening procedures.
Topics: Humans; Urology; Constriction, Pathologic; Ureter; Kidney; Plastic Surgery Procedures
PubMed: 37057698
DOI: No ID Found -
Postgraduate Medical Journal Mar 1958
Topics: Disease; Humans; Ureter; Ureteral Diseases
PubMed: 13517987
DOI: 10.1136/pgmj.34.389.159 -
Archivos Espanoles de Urologia May 2017Although the laparoscopic ureteral reimplantation (LUR) has a history of over 20 years, its presence in the literature is relatively sparse, almost always in the form of... (Review)
Review
Although the laparoscopic ureteral reimplantation (LUR) has a history of over 20 years, its presence in the literature is relatively sparse, almost always in the form of small case series with low statistical power, which has prevented consistent results. It has proven to be a safe and effective technique, improving the safety profile and perioperative complications compared to open ureteral reimplantation (OUR). The few long-term results suggest a similar success rate between the open and laparoscopic approaches. Although we do not found in the literature a strong evidence of the benefits of anti-reflux reimplantation techniques in adults, most of the published series include these procedures. Ureteral reimplantation is considered the treatment of choice in ureteral injuries below the iliac vessels. This is its main indication now. Intraoperative recognition of the injury and immediate LUR avoid other complications, but most of ureteral injuries are diagnosed in the early postoperative period. Although the classical recommendations advise urinary diversion and delayed treatment, the immediate approach is feasible, and indeed seems to improve results in complications, stay and long-term renal function. In situations of postoperative peritonitis secondary to a ureteral fistula, immediate LUR offers specific advantages, at least theoretically, for the protective effect of pneumoperitoneum in abdominal sepsis.
Topics: Humans; Iatrogenic Disease; Intraoperative Complications; Laparoscopy; Time Factors; Treatment Outcome; Ureter; Ureteral Diseases; Urologic Surgical Procedures
PubMed: 28530620
DOI: No ID Found -
Ugeskrift For Laeger Sep 2018
Topics: Adult; Choristoma; Cystoscopy; Female; Humans; Ureter; Urinary Incontinence, Stress; Urography
PubMed: 30259838
DOI: No ID Found -
The Journal of International Medical... Nov 2022Ganglioneuroma is a rare tumor originating from neural crest tissue of the sympathetic nervous system. We report on an approximately 55-year-old woman who was admitted... (Review)
Review
Ganglioneuroma is a rare tumor originating from neural crest tissue of the sympathetic nervous system. We report on an approximately 55-year-old woman who was admitted to hospital with abdominal pain. Surgery revealed a tumor in her right ureter, which was pathologically confirmed as a ganglioneuroma. The patient underwent transabdominal total hysterectomy, bilateral adnexal resection, release of pelvic and intestinal adhesions, right ureteroscopy, right ureter retrograde intubation, right ureteral lesion excision, and ureteral anastomosis. A literature review indicated that most ganglioneuromas are benign tumors. Clinicians may consider total or subtotal tumor resection, depending on the tumor location and patient's condition. The patient's clinical condition may improve after surgery combined with periodic long-term follow-up.
Topics: Humans; Female; Middle Aged; Ganglioneuroma; Ureter
PubMed: 36412222
DOI: 10.1177/03000605221123671 -
Research in Veterinary Science Dec 2022Cats exhibit high susceptibility to urinary organ-related diseases. We investigated the healthy ureter morphologies and compared these with ureters that were surgically...
Cats exhibit high susceptibility to urinary organ-related diseases. We investigated the healthy ureter morphologies and compared these with ureters that were surgically resected distal to a urolithiasis obstruction in cats. Healthy ureters (total length 9.88 ± 0.38 cm) developed adventitia composed of collagen fibers (ADCF), containing a longitudinal muscular layer, toward the distal segment. The healthy ureter was the smallest in the middle segment (4.71-6.90 cm from the urinary bladder) with significantly decreased luminal and submucosal areas compared to those in the proximal segment. Diseased cats exhibited a high incidence of calcium oxalate urolithiasis with renal dysfunction, regardless of age, sex, and body size. Diseased ureters showed increased perimeters, inflammation, and decreased nerves in ADCF. Collagen fibers were increased in the submucosal area, intermuscular spaces, and ADCF, particularly near the obstructed lesion. The mean resected ureter length was 5.66 ± 0.49 cm, suggesting a high obstruction risk in the middle segment. The middle segment also increased the cross-sectional area of the ureter and ADCF, regardless of the distance from the obstructed lesion. The ureters in several cases either lacked the transitional epithelium, or exhibited transitional epithelial hyperplasia, and some of these formed the mucosal folds. In conclusion, we demonstrated the following characteristics and histopathological features of cat ureters: decreases in the ureter size, lumen area, and submucosa area from proximal to middle segment in healthy; ADCF changes in urolithiasis, including increased connective tissues with inflammation and decreased nerves. These data are important to understand the pathogenesis of feline ureteral obstruction.
Topics: Animals; Cat Diseases; Cats; Collagen; Inflammation; Ureter; Ureteral Obstruction; Urolithiasis
PubMed: 35850013
DOI: 10.1016/j.rvsc.2022.06.029 -
Japanese Journal of Radiology May 2021The widely held dogma of three physiological narrowings in the upper urinary tract has proven incorrect by recent several studies using computed tomography images. There... (Review)
Review
The widely held dogma of three physiological narrowings in the upper urinary tract has proven incorrect by recent several studies using computed tomography images. There are only two common obstruction sites: the upper ureter and the ureterovesical junction. The second narrowing, where the ureter crosses the iliac vessels, cannot be regarded anymore as a common obstruction site. The mechanism by which stones lodge in the upper ureter is explained anatomically by the change in ureteral mobility and compliance at the level where the ureter exits the perirenal space. This level can be identified radiologically as the point where the ureter crosses under the ipsilateral gonadal veins, termed the "crossing point". Kinking of the upper ureter is another manifestation of this anatomical phenomenon, visible in radiological images. It is caused by loosening of the ureter at or above the crossing point (within the perirenal space), corresponding with renal descent such as during the inspiratory phase. This new anatomical discovery in the retroperitoneum will not only bring about a paradigm shift in terms of the physiological narrowings in the upper urinary tract, but may also lead to the development of new surgical concepts and approaches in the area.
Topics: Humans; Male; Retroperitoneal Space; Tomography, X-Ray Computed; Ureter
PubMed: 33420862
DOI: 10.1007/s11604-020-01080-7 -
Tomography (Ann Arbor, Mich.) Feb 2023While upper tract access through the insensate conduit following urinary diversion takes less time and incurs fewer costs than percutaneous kidney access does for the... (Randomized Controlled Trial)
Randomized Controlled Trial
While upper tract access through the insensate conduit following urinary diversion takes less time and incurs fewer costs than percutaneous kidney access does for the treatment of ureter and kidney pathology, endoscopic ureteroenteric anastomoses (UEA) identification can be difficult. We injected India Ink into the bowel mucosa near the UEA during ileal conduit diversion (IC) to determine the safety and feasibility of ink tattooing. Patients undergoing IC were prospectively randomized to receive ink or normal saline (NS) injections. The injections were placed 1 cm from UEA in a triangular configuration, and loopogram exams and looposcopy were performed to identify reflux (UR), UEA, the tattooing site and strictures in 10 and 11 patients randomized with respect to ink and NS injections, respectively. Ink patients were older (72 vs. 61 years old, = 0.04) and had a higher Charlson Comorbidity Index (5 vs. 2, = 0.01). Looposcopy was performed in three ink and four NS patients. Visualization of UEA was achieved in 100% of the ink and 75% of the NS patients ( = 0.26). The ink ureteroenteric anastomotic stricture (UEAS) rate was higher ( = 3 vs. = 1) and six patients vs. one patients underwent surgery, respectively, for UEAS ( = 0.31). The study was halted early due to safety concerns. Our pilot study demonstrates that ink can be well visualized following injection near UEA during IC. However, the ink cohort had more UEAS than previously cited in the literature and our prior institutional UEAS rate of 6%. While this study sample is small, the higher incidence of UEAS after ink injection led us to question the utility and safety of ink injection following IC.
Topics: Humans; Middle Aged; Ureter; Cystectomy; Pilot Projects; Tattooing; Urinary Bladder Neoplasms; Anastomosis, Surgical; Retrospective Studies
PubMed: 36960996
DOI: 10.3390/tomography9020037 -
The Pan African Medical Journal 2016
Topics: Gastrointestinal Diseases; Humans; Kidney Pelvis; Ureter
PubMed: 28292161
DOI: 10.11604/pamj.2016.25.204.9529