Bilateral ureteral obstruction following aortobifemoral bypass graft

In this report we present a case of bilateral ureteral obstruction, a potentially serious late complication of aortic bifurcation surgery. The incidence, aetiology, clinical presentation and treatment are discussed.     

Treatment of pain owing to acute ureteral obstruction with prostaglandin-synthetase inhibitor: a prospective randomized study

Pain owing to acute ureteral obstruction seems to be related closely to tension in the walls of the renal pelvis. Renal prostaglandins are involved intimately in the events leading to the pain. A prostaglandin-synthetase inhibitor, diclofenac sodium, was used in the treatment of acute ureteral pain, and was compared to the traditional treatment of a combination of spasmolytic and narcotic drugs. Also, the need for overhydration as part of the management was tested. The 91 patients entered into the prospective randomized trial were divided into groups. Diclofenac sodium had a 90 per cent success rate in relieving pain at 30 minutes, and the combination of pethidine and hyoscine butyl bromide had a statistically higher success rate at 97.5 per cent (p equals 0.05). However, the latter therapy had a higher rate of side effects (p equals 0.01). There was no difference in the response between the groups in relation to whether they received intravenous fluids.     

Ureteral intussusception owing to a malignant ureteral polyp

We report a case of ureteral intussusception owing to well differentiated transitional cell carcinoma. The occurrence and radiological features of ureteral intussusception are discussed.     

Ureteropelvic junction obstruction of the upper pole moiety in complete ureteral duplication

Ureteropelvic junction obstruction of the upper pole moiety is reported in 2 patients with complete ureteral duplication. A normal upper pole ureter of a duplicated system in conjunction with upper pole dilatation should alert the urologist to the presence of an upper pole ureteropelvic junction obstruction. Traditional pyeloplasty techniques can be applied to this anomaly with successful salvage of renal parenchyma. The embryological implications of this combination of anomalies occurring in a single patient are discussed briefly.     

Urethral obstruction owing to retroperitoneal cystic lymphangioma

We report a case of cystic lymphangioma arising from retroperitoneal tissues of the pelvis, which caused urethral obstruction and eventual urinary retention. Sonography and computerized tomography demonstrated a retroperitoneal cystic mass in the pelvis. A preoperative diagnosis of retroperitoneal cystic lymphangioma was suggested by typical computerized and sonographic features.     

Bilateral ureteral obstruction as a complication of vascular graft surgery

Three cases of bilateral ureteral obstruction subsequent to aortic femoral bypass surgery are presented, with a discussion of the cause and prevention of this complication.     

经皮顺行输尿管支架植入在移植肾输尿管梗阻中的应用11例

目的 探讨经皮顺行输尿管支架植入治疗移植肾输尿管梗阻的有效性和安全性.方法 2009年3月至2011年3月间11例肾移植输尿管梗阻患者,其中急性梗阻2例,慢性梗阻9例.11例梗阻的原因为移植肾输尿管膀胱吻合口狭窄5例,结石梗阻2例,原因不详4例.术前以超声评估移植肾及集合系统,选择合适穿刺部位,在X线透视下完成顺行肾盂和输尿管造影;明确梗阻位置后,通过穿刺针植入斑马导丝直至膀胱,再经膀胱镜从尿道引出斑马导丝,沿斑马导丝顺行植入输尿管支架管,X线下观察输尿管支架上端进入肾盂后,拔除斑马导丝,再次透视,确认支架管位置.移植肾肾盂造瘘管引流1～2周后拔除,输尿管支架在术后半年至1年内取出.在术后1周、1个月、3个月、6个月行B型超声及肾功能检查,之后每隔半年检查.结果 11例中10例手术成功,1例因输尿管狭窄段过长置管失败.输尿管支架植入手术耗时为(54±27) min,患者血清肌酐由术前(326±147) μmol/L下降至术后(89±49) μmol/L.随访6～27个月,患者均未发生并发症.结论 经皮顺行输尿管支架植入治疗移植肾输尿管梗阻是一种安全、有效的方法.     

Unilateral ureteral obstruction secondary to sarcoidosis

An episode of unilateral ureteral obstruction secondary to sarcoidosis is described. Corticosteroid treatment resulted in prompt and complete resolution of the obstruction and associated lymphadenopathy. We believe this represents the first reported case of ureteral obstruction secondary to sarcoidosis.     

Bilateral ureteral obstruction secondary to endometriosis

Endometriotic ureteral obstruction is an uncommon but serious event often unrecognized until hydronephrotic renal atrophy has occurred. A case of bilateral endometriotic ureteral obstruction treated with danazol (Danocrine) is reported, and the literature is reviewed.     

Unilateral ureteral obstruction: beyond obstruction

Unilateral ureteral obstruction is a popular experimental model of renal injury. However, the study of the kidney response to urinary tract obstruction is only one of several advantages of this model. Unilateral ureteral obstruction causes subacute renal injury characterized by tubular cell injury, interstitial inflammation and fibrosis. For this reason, it serves as a model both of irreversible acute kidney injury and of events taking place during human chronic kidney disease. Being a unilateral disease, it is not useful to study changes in global kidney function, but has the advantage of a low mortality and the availability of an internal control (the non-obstructed kidney). Experimental unilateral ureteral obstruction has illustrated the molecular mechanisms of apoptosis, inflammation and fibrosis, all three key processes in kidney injury of any cause, thus providing information beyond obstruction. Recently this model has supported key concepts on the role in kidney fibrosis of epithelial–mesenchymal transition, tubular epithelial cell G2/M arrest, the anti-aging hormone Klotho and renal innervation. We now review the experimental model and its contribution to identifying novel therapeutic targets in kidney injury and fibrosis, independently of the noxa.     

Newborn and toddler intestinal obstruction owing to congenital mesenteric defects

Transmesenteric hernia is a rare cause of intestinal obstruction most commonly affecting the small bowel. The mesenteric defect is usually 2 to 3 cm in diameter. The authors describe 2 cases of young pediatric patients presenting with bowel obstruction resulting from a congenital mesenteric defect. The initial patient had a 30-cm-wide congenital defect in the ileal mesentery through which the sigmoid colon and some loops of small bowel had herniated. The second patient is a newborn infant who presented with symptoms and radiographic evidence of proximal bowel obstruction initially thought to be resulting from malrotation with midgut volvulus but was found at surgical exploration to have a small defect in the ileal mesentery.     

Bilateral ureteral obstruction due to malignant lymphoma

Two cases are presented of bilateral ureteral obstruction and uremia due to pressure from nodes involved in disseminated lyinphonna. Their successful management is reported.     

Methylmethacrylate upper ureteral obstruction

A case of upper ureteral obstruction caused by methylmethacrylate cement after fixation of an L2-L3 vertebral fracture is reported. The probable mechanism, radiographic findings, and management of this complication are reviewed.     

Failure of ureteral stents subject to extrinsic ureteral obstruction and stent occlusions

International Urology and Nephrology - To quantify the occurrence of stent failure and the dynamic behavior of urine flow in ureter-stent systems, including the relative flow in the ureter and...