• Title/Summary/Keyword: Ureter obstruction

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Extracorporeal Shock Wave Lithotripsy for Proximal Ureter Stone with Complete Obstruction : Analysis of the Appropriate Session for Changing Treatment Modality According to Stone Size (완전 폐색을 동반한 상부 요관 결석에 대한 체외충격파쇄석술 : 결석의 크기에 따른 적절한 치료 전환 시기 분석)

  • Son, Soon-Yong;Lee, Won-Hong
    • Journal of radiological science and technology
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    • v.28 no.4
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    • pp.287-291
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    • 2005
  • To determine the appropriate session for changing treatment modality according to the size of proximal ureter stone with complete obstruction, We analyzed 201 patients with proximal ureter stone primarily treated by Dornier MPL 9000 lithotripter from January, 2002 to August, 2004. Of total 201 patients, the patients without complete obstruction were 142, and with complete obstruction were 59. In the patients without complete obstruction, the accumulative stone free rate of the first, second, and third session were 68.3%, 86.6%, and 94.4%, respectively. The accumulative stone free rate according to the stone size at third session were 100%, 90.5%, 00.0% in stones less than 10 mm, 10 to less than 20 mm, and larger than or 20 mm, respectively. In the patients with complete obstruction, the accumulative stone free rate of the first, second, and third session were 44.1%, 66.1%, and 76.3%, respectively. The accumulative stone free rate according to the stone size at third session were 100%, 65.5%, 33.3% in stones less than 10 mm, 10 to less than 20 mm, and larger than or 20 mm, respectively. In our study, the size of proximal ureter stone with complete obstruction influenced noticeably on the success rate of extracorporeal shock wave lithotripsy (ESWL). We propose that the proximal ureter stones larger than or 10 mm with complete obstruction are treated by ureteroscopic manipulation than ESWL as the first line treatment modality.

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Unilateral Hydroureteronephrosis caused by Adhesion of the Ureter following Ovariohysterectomy in a Bitch

  • Park, Chul-Ho;Kim, Yong-Min;Lee, Sang-Ho;Oh, Ki-Seok;Son, Chang-Ho
    • Journal of Embryo Transfer
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    • v.30 no.3
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    • pp.261-263
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    • 2015
  • A 10-year-old spayed female Yorkshire Terrier visited for a physical checkup. The bitch had a history of ovariohysterectomy for treatment of pyometra a year ago. On physical examination, the dog was bright and alert. Complete blood counts, serum biochemistry and blood gas analysis results did not show any deviations within normal ranges. Radiographic and ultrasonographic examinations revealed unilateral hydronephrosis and hydroureter of the right kidney and ureter, and obstruction of the distal ureter was observed. On the basis of these results, nephroureterectomy was performed. During the operation, the adhesion of the distal ureter and surrounding tissue cells were observed without the evidence of the ureteral ligation. The distal ureteral obstruction was presumed to be adhesion caused by fibrous tissue formation between ureter and retained broad ligament, or incompletely removed blood clots following ovariohysterectomy. This case report describes the occurrence of hydroureteronephrosis caused by adhesion of the distal ureter following ovariohysterectomy in a bitch.

A Case of Hypospadias in Korean Native Calf (한우 송아지에서의 요도하열(hypospadias) 발생 증례)

  • Cho, Yong-Il;Lee, Sung-Soo;Han, Sang-Hyun;Ko, Moon-Suck;Suh, Guk-Hyun;Hur, Tai-Young;Kang, Seog-Jin;Kang, Seong-Soo
    • Journal of Veterinary Clinics
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    • v.24 no.2
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    • pp.288-291
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    • 2007
  • Hypospadias is a malformation in which the urethra open on the ventral side of the penis and its frequency is about from 0.3% to 0.5% male birth in human. It is considered a disorder both genetic and environmental factors involves in pathogenesis. A KNC(Korean native calf) showing symptoms of fusion defect of the male ventral urethra, penile defect, bifid scrotum and low body weigh was born. To prevent an ascending urinary tract infection, dermatitis and loss of hair, surgical operation was performed to make a genitals like a female. After the operation, the KNC got a regenerative hair and normal urination. However the KNC became anorexia, loss in weight and weak. Seventy days after birth, the KNC died. The view of autopsy was a yellowish hepatomegaly, hydronephrosis, closed ureter and complex disorder in interanl organ. The symptoms of hepatomegaly and hydronephrosis could be due to a fluid therapy as a consequence of ureter obstruction. The normal urination of the KNC before it got sick, suggested that ureter obstruction in the case of this KNC was formed at its postnatal growth stage.

Two Cases of Duplicated Collecting System with Lower Pole Ureteropelvic Juncton Obstruction (하극 신우요관이행부 폐색을 동반한 중복요관 치험 2례)

  • Ko Woo Jin;Hong Chang Hee;Chang Soo Yeon;Han Sang Won
    • Childhood Kidney Diseases
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    • v.4 no.2
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    • pp.170-174
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    • 2000
  • Ureteropelvic junction obstruction and duplicated collecting system are common urologic anomalies in upper urinary system, but they seldom occur in combination. These obstruction can occur in both partial or complete duplicated collecting system. Complete duplication of the ureter may be asymptomatic or recognized when complications develop as a result of reflux into the lower pole ureter or obstruction of the upper pole with an ectopic ureterocele. It is difficult to choose an optimal therapy due to the high variability in function, degree of obsturction, damage and potential fir regeneration in growing kidney. We report our experience of successful surgical interventions in the ureteropelvic junction obstruction of the lower pole with complete duplicated collecting system.

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Bilateral Ureteral Obstruction Related to Pelvic Rhabdomyosarcoma Presenting with Acute Kidney Injury: A Case Report

  • Han, Sanghoon;Han, Kyoung Hee
    • Childhood Kidney Diseases
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    • v.23 no.2
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    • pp.116-120
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    • 2019
  • Bilateral renal obstruction is a rare critical condition, requiring a prompt diagnostic approach and treatment to restore the renal function. The most commonly observed obstructive uropathy in children is congenital malformation, such as posterior urethral valves and bilateral ureteropelvic junction obstruction. Malignant pelvic masses obstructing the ureter are widely reported in adults but are rarely observed in children. The treatment of ureteral obstruction related to pelvic malignancy is a therapeutic challenge with a median survival duration of 3-7 months in adults; however, pediatric patients with pelvic malignancy leading to ureteral obstruction had better outcomes, with a reported 5-year mortality rate of 20%, than the adult patients. Here, we report a rare case of bilateral ureteral obstruction associated with pelvic rhabdomyosarcoma presenting with acute kidney injury treated by ureteral diversion with double J stent, and concommittent emergency hemodialysis, leading to restoration of good renal function. We suggest that bilateral ureteral obstruction should be released as soon as possible using surgical or interventional approach to minimize the obstruction period, and subsequential chemotherapy may contribute to improvement of survival and recovery of renal function.

Effect of Acute Unilateral Ureteral Obstruction on Handling of $Li^+$ by Contralateral Kidney in Rabbits (급성 일측 수뇨관 폐쇄후 상대신의 $Li^+$처리에 관한 연구)

  • Sung, Ho-Kyung;Earm, Yung-E
    • The Korean Journal of Physiology
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    • v.16 no.2
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    • pp.165-175
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    • 1982
  • Changes in handling of $Li^+$ by contralateral kidney during acute $Li^+$ loading were investigated immediately after unilateral ureteral obstruction. Carotid artery, jugular vein, renal vein and ureter of experimental animal were catheterized and renal venous flow was shunted to .external jugular vein. In experimental group right ureter was ligated. One to two hours after operation a single shot of LiCl solution (2 mEq/kg) was intravenously injected and then .arterial, renal venous blood and urine samples were taken sequentially for 1 to $1{\frac{1}{2}}$ hours. Urine volume, plasma and urinary concentrations of $Li^+$, $Na^+$ and $K^+$ were measured and urinary excretion of them were calculated. Results obtained were as follows: 1) In experimental group urine volume, urinary excretion of $Na^+$, and $K^+$ by contralateral kidney after unilateral ureteral obstruction were slightly larger than mean value of both kidney in control group. 2) During acute $Li^+$ loading contralateral kidney in experimental group showed limited $K^+$ excretion, but urinary flow and $Na^+$ excretion were comparable to mean value of both kidney in control group. 3) Urinary osmolar concentration in experimental group was much lower than that in control group, and it was maintained at low level even after Li loading. 4) In experimental group plasma$Li^+$ concentration decreased more slowly than in control group after a single shot of LiCl solution. 5) Urinary excretion of $Li^+$ in experimental group was markedly decreased, even lesseer than mean of both kidney in control group. 6) From the above results it was concluded that immediately after unilateral ureteral obstruction contralateral kidney showed normal water and $Na^+$ diuretic response to Li load but urinay $Li^+$ excretion was decreased and reclaimed $Li^+$ to systemic circulation.

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Disseminated Histiocytic Sarcoma with Ureteric Involvement in a Jindo Dog

  • Cho, Hee-Soo;Cheong, Jong-Tae;Park, Hyun-Jung;Kim, Jae-Hoon;Jung, Ji-Youl;Yun, Youngmin;Song, Woo-Jin
    • Journal of Veterinary Clinics
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    • v.38 no.5
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    • pp.249-253
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    • 2021
  • We describe the case of a Jindo dog that presented with a 2-month history of an abscess-like mass on the skin of the left hip. The patient was initially diagnosed with a suspected insect bite and was treated with a topical dressing. After observing no improvements, surgical debridement was done to remove the abscess. Nine days after surgery, the patient started showing severe anorexia, vomiting, lethargy, and oliguria. Azotemia was detected, and the patient was diagnosed with acute kidney injury. Ultrasonography depicted an abdominal mass (4.6 × 7.5 cm) in the right ureter, and severe hydronephrosis in the right kidney. The patient was euthanatized. Results of the necropsy, histopathologic examination, and immunohistochemistry for tumor cells, confirmed that the patient had developed hydronephrosis and disseminated histiocytic sarcoma which had metastasized to the lungs. To the best of our knowledge, this is the first report of acute renal failure produced by ureter invasion and urinary tract obstruction resulting from the abdominal mass of disseminated histiocytic sarcoma in dogs.

Retroperitoneal Abscess Caused by Staphylococcus intermedius in a Dog (개에서 Staphylococcus intermedius에 의한 복막후농양 발생례)

  • Lee, Sang-Gwan;Hoh, Woo-Phil;Eom, Ki-Dong;Lee, Keun-Woo;Oh, Tae-Ho
    • Journal of Veterinary Clinics
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    • v.26 no.2
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    • pp.176-180
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    • 2009
  • Two year-old female miniature schnauzer was presented with depression, abdominal pain and inappetence. Physical examination revealed tachypnea, fever, and abdominal pain. Leukocytosis with neutrophilia was shown in complete blood count. Radiograph revealed the increase of opacity in parallel to vertebra and dislocation of descending colon. Calculi and sludge in bladder, hydronephrosis and dilation of proximal ureter in right kidney were observed in ultrasonographic examination; also, irregular shape of structure in retroperitoneal cavity was observed. Urinalysis showed protein urine and hemtauria. Many epithelial cells, spindle cells, calcium oxalate dihydrate crystals, struvite crystals, amorphous crystals and granular casts, WBC, cocci were examined in urine sediment test. ERD-kit test result was highly positive. Based on those test and excretory urogram pyelonephritis and complete unilateral obstruction of ureter were confirmed. A balloon type structure in retroperitoneal cavity was found through the exploratory laparotomy. In cytologic examination of aspirated fluid from dilated area many degenerated neutrophils and phagocytized cocci were observed. Staphylococcus intermedius was cultured from aspirated fluid. Based on these clinical results retroperitoneal abscesses caused by Staphylococcus intermedius was diagnosed with ureter obstruction and concurrent cystic calculi. Nephrectomy of right kidney with ureter was performed.

Evaluation and Management of Antenatal Hydronephrosis

  • Hong, Young Kwon;Lee, Jun Ho
    • Childhood Kidney Diseases
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    • v.19 no.1
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    • pp.8-13
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    • 2015
  • Antenatal hydronephrosis (ANH) is one of the most common abnormal findings detected on prenatal ultrasound (US), and it has been reported in 1-5% of all pregnancies. The likelihood of significant postnatal pathologic abnormality in the urinary tract correlates with the degree of anterior-posterior diameter (APD) according to the gestational age. Detection of urologic anomalies prenatally permits fetal interventions that avoid complications in rare cases of bladder outlet obstruction with oligohydramnios even though their final benefits still remain controversial. There is no clear consensus on the extent and mode of postnatal imaging after a diagnosis of ANH. US is the mainstay of the postnatal evaluation and helps guide further testing with voiding cystourethrography (VCUG) and diuretic renography. Although most algorithms continue to recommend generous VCUG for identification of lower urinary tract anomalies, VCUG may be safely reserved for high grade ANH cases or any grade of ANH with dilated distal ureter without increasing the risk of urinary tract infection (UTI). There are conflicting studies about efficacy of postnatal prophylactic antibiotics. It still seems reasonable to consider use of a prophylactic antibiotic to prevent infant UTIs in high-risk populations, such as females and uncircumcised males with high grades of hydronephrosis, hydroureteronephrosis, or vesicouretral reflux.

Gastrointestinal Duplications in Childhood (소아의 위장관 중복증)

  • Kim, Dae-Yeon;Kim, Seong-Chul;Kim, In-Koo
    • Advances in pediatric surgery
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    • v.7 no.1
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    • pp.26-30
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    • 2001
  • Gastrointestinal duplications are rare congenital malformation that may require surgical intervention in the neonate, infant, and occasionally the older child. Symptoms produced by duplications vary according to their location, size, type and histology. We report the clinical characteristics and the surgical results of 9 cases of the gastrointestinal duplications treated at at Asan Medical Center between 1989 and 2000. Five patients were boys and four were girls; age of patients ranged from 5 days to 10 years. Eight duplications were cystic and one was tubular. One involved the stomach; five were in the ileum, and two in the cecum. The most common presentation was intestinal obstruction. There was associated anomaly in one patient, pulmonary sequestration and double ureter. Ectopic gastric mucosa was found in two. All patients underwent surgical resection. There was no perioperative mortality or morbidity. Although gastrointestinal duplication is a rare entity. consideration of associated anomalies and being familiar with the anatomy and clinical features are required for adequate management. In cystic form. complete excision is recommended but planned surgery is required for long segment tubular lesion.

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