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Archives of Pathology & Laboratory... Feb 2009Nonneoplastic changes are often identified in nephrectomy specimens removed for renal neoplasms. Although they may be of prognostic or therapeutic importance, they are... (Review)
Review
CONTEXT
Nonneoplastic changes are often identified in nephrectomy specimens removed for renal neoplasms. Although they may be of prognostic or therapeutic importance, they are often overlooked. Nephrectomy is also performed for nonneoplastic lesions, the most frequent of which are urinary obstruction and end-stage renal disease, but the tissue diagnosis of these conditions and the implicated clinicopathologic correlation may not be well appreciated.
OBJECTIVE
To outline these nonneoplastic lesions with special attention to important diagnostic caveats and clinicopathologic correlations.
DATA SOURCES
The presented information was derived from literature, personal experience, and review of case materials at the authors' institutions.
RESULTS
Nonneoplastic lesions are seen in most (90%) nephrectomy specimens removed for renal neoplasms. Although these lesions span the spectrum of "medical" kidney diseases, the most frequent of them are hypertensive nephrosclerosis and diabetic nephropathy. Recognition of these diseases is important because they are often first diagnosed and later confirmed clinically. Furthermore, the severity of these lesions may predicate both short- and long-term renal function and thus help guide treatment. Among conditions that necessitate nephrectomy, advanced urinary obstruction, end-stage renal disease, and end-stage renal disease with acquired cystic changes are probably the most frequent. These conditions have characteristic morphologic features, but they may be associated with superimposing lesions previously not well described. These superimposing lesions may create diagnostic confusion; yet, some of them are the reason for nephrectomy. Thus, acute bacterial infection, urine polyp, granulomatous pyelitis, papillary necrosis, massive bleeding, and renal dysplasia can develop against the background of obstructive nephropathy. Renal neoplasms may develop from the background of end-stage renal disease without cystic changes. A renal neoplasm or massive bleeding with or without neoplasm is usually the reason for nephrectomy in kidney with acquired cystic kidney diseases. Thus, while nonneoplastic changes are frequent in nephrectomy specimens, they are often unrecognized. Awareness of these conditions and a familiarity with their diagnostic features as well as the implicated clinicopathologic correlation should help obviate this diagnostic problem.
Topics: Humans; Kidney; Kidney Diseases; Kidney Failure, Chronic; Nephrectomy; Ureteral Obstruction
PubMed: 19195963
DOI: 10.5858/133.2.189 -
Archivos Espanoles de Urologia Apr 2021We present a unique case with a ureteral fibroepithelial tumor originating from the ureter, which could be confused with a bladder tumor on ultrasound examination due to...
We present a unique case with a ureteral fibroepithelial tumor originating from the ureter, which could be confused with a bladder tumor on ultrasound examination due to its movement in and out of the bladder. METHODS: In cystoscopy, a papillary tumor lesion emerging from the right ureteral orifice was seen. After scanning the other quadrants, however, the tumor was not observed at the right ureteral orifice. It was then protruded back into the bladder. The tumor was seen several times to protrude into the bladder and return to the ureter, possibly due to ureteral peristalsis. Then, a semi-rigid ureteroscope was introduced through the right ureteric orifice, and the tumor was excised in one piece using Holmium laser fiber with 365μm of diameter. The size of the removed tumor was approximately 8 cm long. A double-j stent of 4.8 Fr was placed in the ureter. RESULTS: The patient was discharged on the first day without complications. The fibroepithelial polyps of the ureter, which consist of the stroma of mesoderm origin, covered with histologically normal or hyperplastic urothelial epithelial cells, are extremely rare tumors. It is important to distinguish these polyps from urothelial cancers, since these two entities are different in treatment and prognosis, although similar in symptoms and imaging procedures. CONCLUSIONS: Minimally invasive treatment techniques can be safely applied in the treatment of such exceedingly rare tumors.
Topics: Humans; Polyps; Ureter; Ureteral Neoplasms; Ureteroscopy; Urinary Bladder
PubMed: 33818434
DOI: No ID Found -
Frontiers in Pediatrics 2021To investigate surgical techniques and challenges of laparoscopic in treating pediatric ureteral polyps under laparoscopy. The clinical data of 7 of pediatric ureteral...
To investigate surgical techniques and challenges of laparoscopic in treating pediatric ureteral polyps under laparoscopy. The clinical data of 7 of pediatric ureteral polyps patients who were admitted to the hospital from July 2015 to January 2020 were analyzed retrospectively. There were 6 males and 1 female from 7.7 to 13.9 years old at the mean age of 10.4. Before surgery, all children performed urinary B ultrasound, magnetic resonance urography (MRU), and renal radionuclide scanning. Six cases were observed on the left lateral and 1 on the right. The lesions of 5 cases were located at the ureteropelvic junction, 1 in the upper ureter and 1 in the middle ureter. The polyps were treated intraoperatively by the resecting of the lesion segment and simple polypectomy to retain the attached part of the original diseased segment of the ureter. All surgeries were performed under laparoscopy and B-ultrasound was performed during follow up after surgery. All 7 surgeries were performed successfully under the laparoscope. The surgery time was 80-110 min, and the average surgery time was 97.5 min. The intraoperative bleeding was 10-25 ml and the average postoperative hospital stay was 6 d. Postoperative hematuria occurred in 1 case. Neither urinary leakage nor urinary tract infection was reported post surgery. Preoperative affected pyelectasis of all patients was 2.0-3.7 cm. Three months postoperatively, the affected pyelectasis was measured at 1.2-3.0 cm. No recurrence of polyps was reported after surgery. During the follow-up to April 2020, there was no significant change in the kidney size of all patients, and hydronephrosis was alleviated compared with that before surgery. Laparoscopy is a safe, effective and minimally invasive surgical technique for pediatric multiple ureteral polyps. The surgery plan was designed according to the location and size of polyps, including segmental ureterectomy of polyps + pyeloureterostomy, segmental ureterectomy of polyps + ureter - ureteral anastomosis.
PubMed: 34277523
DOI: 10.3389/fped.2021.689842 -
European Review For Medical and... Feb 2023During the COVID-19 pandemic, people's admissions to the hospital for their current illness were delayed. We aimed to reveal how this situation has affected the...
OBJECTIVE
During the COVID-19 pandemic, people's admissions to the hospital for their current illness were delayed. We aimed to reveal how this situation has affected the endoscopic treatment of ureteral stones.
PATIENTS AND METHODS
Patients who were treated for 59 endoscopic ureteral stones in the pre-pandemic period between September 2019 and December 2019, and patients who were treated for 60 endoscopic ureteral stones between January 2022 and April 2022, when the effectiveness of the COVID-19 pandemic decreased, were evaluated in two groups. Pre-pandemic patients were classified as group 1, and patients treated during the period when the effectiveness of the pandemic decreased as group 2. The patients' ages, preoperative laboratory examinations and radiological findings, localization and size of the stones in the ureter, time until the operation, duration of the operation, length of hospital stay, preoperative ESWL history, complication rates according to the Modified Clavien classification were evaluated. The problems observed in the ureter during the operation were examined separately as edema, polyp formation in the ureter, distal ureteral stenosis, and adhesion of the stone to the mucosa.
RESULTS
In group 1, 9 patients were female and 50 were male, with a mean age of 42.19 ± 14.06 years; in group 2, 17 patients were female and 43 were male, with a mean age of 45.23 ± 12.20 years. The stone size was found to be higher in group 2. Group 1 had more patients who did not develop complications in the Modified Clavien classification, and the proportion of group 2 patients in the grade I-II-IIIA-IIIB classification was higher. Considering the waiting time before hospitalization, it was determined that the rate of group 2 patients was higher in those with a waiting period of 31-60 days (33.9-48.3%) and ≥60 days (10.2-21.7%). Except for the development of ureteral polyps, all other problems rate were found to be higher in group 2 patients compared to group 1.
CONCLUSIONS
During the COVID-19 pandemic, there was a delay in the treatment of ureteral stones in patients. In the next period, as a result of this delay, negative effects on the ureteral mucosa were detected and, accordingly, an increase in the complication rates of the operation was observed.
Topics: Humans; Female; Male; Adult; Middle Aged; Pandemics; COVID-19; Endoscopy; Ureter; Hospitalization
PubMed: 36876675
DOI: 10.26355/eurrev_202302_31371 -
International Journal of Clinical and... 2015We presented a rare case with giant ureteral polyp that mimics bladder tumor in adult women, originating from the middle segment of the left ureter. The patient was a... (Review)
Review
We presented a rare case with giant ureteral polyp that mimics bladder tumor in adult women, originating from the middle segment of the left ureter. The patient was a 42-year-old woman, with a 2.1×1.3 cm bladder mass detected incidentally on a health screening ultrasound. Computerized tomography (CT) of the pelvis revealed a solid tumor situated near to trigon. Cystoscopy demonstrated a tumor that periodically prolapsed into the bladder. After the tumor was identified as a ureteral polyp by ureteroscopy, an ureteroscopic resection by diode laser was performed. The tumor measured 9.0×0.5 cm, and the final pathological diagnosis was ureteral fibroepithelial polyp. No recurrence was observed at the 5-month follow-up.
Topics: Adult; Diagnosis, Differential; Female; Humans; Lasers, Semiconductor; Polyps; Ureteral Neoplasms; Ureteroscopy; Urinary Bladder Neoplasms
PubMed: 26823781
DOI: No ID Found -
International Braz J Urol : Official... 2017A 41-year-old male presented at Emergency Department (ED) with right flank pain associated with hematuria for 3 days. Patient had a previous history of nephrolithiasis....
A 41-year-old male presented at Emergency Department (ED) with right flank pain associated with hematuria for 3 days. Patient had a previous history of nephrolithiasis. The physical examination and blood tests were normal. Urine analyses showed haematuria > 1.000.000/μL. After clinical evaluation, a computer tomography (CT) showed right ureteral dilata¬tion caused by a 5 mm proximal stone and a distal intraluminal mass of 8 cm in length. In this setting, an ureteroscopic biopsy was performed and revealed a large polypoid lesion histologically suggestive of fibroepithelial polyp. Due to technical difficulties (intraluminal mass length and technical issue for the passage of guidewire) and after discussing all available minimally invasive options, we opted for a laparoscopic approach. Instead of ureterectomy of the affected segment of the ureter, as classically performed, we proceeded with an ureterotomy, blunt dissection of the tumor and ureterolithotomy, with complete removal of the mass. This approach did not require ureteral anastomosis and the ureteral dilatation facilitated its primary closure. No complications occurred, even after 3 years of follow-up.
Topics: Adult; Humans; Male; Neoplasms, Fibroepithelial; Polyps; Tomography, X-Ray Computed; Ureteral Neoplasms; Ureteroscopy
PubMed: 28379670
DOI: 10.1590/S1677-5538.IBJU.2016.0471 -
Journal of the Belgian Society of... Sep 2020A fibroepithelial polyp is an intraluminal, long, slender neoplasm that frequently occurs in the ureteropelvic junction and upper ureter.
A fibroepithelial polyp is an intraluminal, long, slender neoplasm that frequently occurs in the ureteropelvic junction and upper ureter.
PubMed: 33024927
DOI: 10.5334/jbsr.2232 -
World Journal of Pediatric Surgery 2021To summarize the diagnosis and treatment experience of children with intermittent hydronephrosis caused by ureteral fibroepithelial polyp (UFP).
OBJECTIVE
To summarize the diagnosis and treatment experience of children with intermittent hydronephrosis caused by ureteral fibroepithelial polyp (UFP).
METHODS
From 2017 to 2020, cases of hydronephrosis caused by ureteral polyp in Anhui Provincial Children's Hospital were retrospectively enrolled for investigation. Demographic data, clinical manifestations, operation details, pathology and outcomes were collected from patients' medical data for analysis.
RESULTS
All seven cases of UFP were boys, including six cases on the left side of the ureter and one case on the right side, at the median age of 7.1 years (3-14 years), with abdominal intermittent pain as the first symptom. All cases underwent laparoscopic pyeloureteroplasty. All the operations were completed successfully; postoperative pathology indicated the presence of primary UFP. Postoperative follow-ups of 1-30 months showed satisfactory recovery and relief from hydronephrosis.
CONCLUSIONS
Laparoscopic pyeloureteroplasty or ureteroureterostomy is one of the optimal treatments for ureteral polyp at present. The surgical method should be determined according to the number of polyps, the length and the diameter of the affected ureter, and also the status of renal function of the patients.
PubMed: 36474643
DOI: 10.1136/wjps-2020-000243 -
Translational Andrology and Urology Mar 2021Three-dimensional (3D) image reconstruction technology is widely used in surgical operations for its intuitive visualization. Pyeloplasty requiresprecise cutting and...
BACKGROUND
Three-dimensional (3D) image reconstruction technology is widely used in surgical operations for its intuitive visualization. Pyeloplasty requiresprecise cutting and suturing. The reconstruction technology can accurately determine the location and scope of the stenosis at the junction of the renal pelvis and ureter and the relationship with the surrounding vasculature. The purpose of this article is to retrospective evaluate the application value of image reconstruction technology in pyeloplasty based on high-resolution 3D CT images.
METHODS
A total of 20 patients with renal pelvic ureteral junction obstruction admitted to our hospital from August 2019 to August 2020 were selected. In this group, left pyeloplasty was performed in 8 patients and right pyeloplasty in 12 patients. In terms of conditions, there was 1 case with secondary pyeloplasty, 6 cases of patients with kidney stones, 2 cases with renal ectopic blood vessels, 1 case with renal prolapse, 1 case with horseshoe kidney, and 1 case with ureteral polyps. There were 12 males and 8 females, with an average age of 34.65±10.67 years and an average body mass index (BMI) of 22.48±3.03 kg/m. In all patients, 3D CT reconstruction technology was used to guide the formulation of robot-assisted laparoscopic pyeloplasty plans; verify the consistency between the actual operation and the preoperative planning; and observe the operation time, blood loss, postoperative exhaust time, indwelling drainage tube time, and follow-up for comorbidities.
RESULTS
The operation was successful in all 20 patients. The actual operation was 100% consistent with the preoperative planning, the operative time was 160.80±63.26 min, the intraoperative blood loss was 47±30.45 mL, the postoperative exhaust time was 1.15±0.37 days, the drainage tube indwelling time was 4.35±1.50 days, and the average follow-up time was 7.95±3.41 months. There were no complications.
CONCLUSIONS
Three-dimensional image reconstruction technology based on high-resolution CT has high clinical application value in the treatment of ureteropelvic junction obstruction (UPJO), which simplifies the operation process and shortens the operation time, and is a valuable tool for auxiliary surgeons in devising the operation plan.
PubMed: 33850765
DOI: 10.21037/tau-21-202 -
Canadian Urological Association Journal... 2016Endometriosis is a common gynecological condition, but involvement of the urinary tract is rare. Ureteral endometriosis can present in a nonspecific fashion, and may...
Endometriosis is a common gynecological condition, but involvement of the urinary tract is rare. Ureteral endometriosis can present in a nonspecific fashion, and may mimic ureteral malignancy. This case report describes a 44-year-old woman who initially presented with chronic flank pain and was found to have left-sided renal dysfunction and a distal left ureteric mass. She was eventually diagnosed with ureteral endometriosis after undergoing nephroureterectomy for what was thought to be either a ureteral fibroepithelial polyp or transitional cell carcinoma. Ureteral endometriosis should be considered in the differential diagnosis for a woman presenting with obstructive uropathy in the presence of a ureteric mass.
PubMed: 27330580
DOI: 10.5489/cuaj.3191