• Title/Summary/Keyword: Ureteral

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Renal function is associated with prognosis in stent-change therapy for malignant ureteral obstruction

  • Yoon, Ji Hyung;Park, Sejun;Park, Sungchan;Moon, Kyung Hyun;Cheon, Sang Hyeon;Kwon, Taekmin
    • Investigative and Clinical Urology
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    • v.59 no.6
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    • pp.376-382
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    • 2018
  • Purpose: The authors performed this study to investigate the risk factors for predicting stent failure and to evaluate its impact on prognosis. Materials and Methods: Between January 2002 and March 2017, we retrospectively reviewed 117 consecutive patients who underwent retrograde ureteral stenting and exchanging at least once every 3 months for malignant ureteral obstruction. The patients were classified according to their pre-stenting chronic kidney disease (CKD) stage. The factors affecting stent failure were analyzed using a logistic regression model. Overall survival (OS) was estimated, and the prognostic significance of each variable was estimated using Cox proportional-hazards regression modeling. Results: Before stenting, 91 patients were CKD stages 1-3 and 26 patients were CKD stages 4-5. These two groups differed significantly only in pre-stenting estimated glomerular filtration rate (eGFR), bilateral obstruction, and pre-stenting pyuria. Among the 117 patients, stent failure occurred in 30 patients (25.6%), and there were no differences between the groups. Pre-stenting pyuria and post-stenting complications were significant predictors of stent failure. There were 79 deaths in total, including 56 in the CKD stages 1-3 group and 23 in the CKD stages 4-5 group. In the multivariate analysis predicting patient OS, pre-stenting eGFR and post-stenting disease progression were significant factors. Conclusions: Internal ureteral stenting was effective for maintaining renal function in malignant ureteral obstruction. However, it did not restore renal function, which is related to the prognosis of the patients. Therefore, to improve patients' renal function and prognosis, patients who require stenting must be quickly recognized and treated.

Upregulation of Renin-angiotensin, Endothelin and C-type Natriuretic Peptide in Rat Glomerulus with Bilateral Ureteral Obstruction

  • Bae, Eun-Hui;Kim, Soo-Wan
    • The Korean Journal of Physiology and Pharmacology
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    • v.10 no.6
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    • pp.343-347
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    • 2006
  • The present study was designed to investigate the effects renin-angiotensin-aldosterone system (RAAS), endothelin (ET) and local natriuretic peptide (NP) system for glomerulopathy induced in the experimental bilateral ureteral obstructive rats. Sprague-Dawley male rats ($200{\sim}220g$ body weight) were bilaterally obstructed by ligation of the proximal ureters for 24 hours. Control rats were treated in the same ways, except that no ligature was made. The glomeruli were isolated from cortex by graded sieve methods, and the mRNA expressions of local renin-angiotensin system (RAS), aldosterone synthase (CYP11B2), endothelin-1 (ET-1) and NP system were determined by real-time polymerase chain reaction. Following the bilateral ureteral obstruction, the mRNA expressions of renin, angiotensin converting enzyme 1 as well as ET-1 were increased, while that of angiotensin converting enzyme 2 was not changed. The expressions of CYP11B2 and angiotensin II receptors were not changed. C-type natriuretic peptide (CNP) expression was increased, while its receptors (natriuretic peptide receptor-B) were not changed. We suggest that the upregulation of local RAS and ET playa role in the progressive glomerular injury, and that the enhanced CNP activity also plays a compensatory role in obstructive uropathy in the glomerulus.

Bilateral Ectopic Ureters of a Dog: the First Clinical Trial of a Surgical Method by Extension of Ureteral Stoma in the Bladder Neck (개의 양측성 요관이소증: 방광목개구부 확장술의 첫 임상시도)

  • Mi-young An;Ingo Nolte
    • Journal of Veterinary Clinics
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    • v.16 no.1
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    • pp.222-225
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    • 1999
  • 난소를 제거한 57개월령의 golden retrieve개가 심한 배뇨실금을 나타내며 양측성 요관이소증으로, 좌측에는 통상적인 새요관개구술(neoureterostomy)로 방광삼각지대에 새로운 요관개구부를 만들었고 방광목에 위치한 우측요관의 개구부는 그 부위를 확장만 시킴으로써 수술 후 배뇨실금 증상을 교정할 수 있었다. 방광목확장개구수술방법은 본 증례에서 처음으로 개에 시도되어 좋은 수술결과를 나타내었고 요관개구부가 방광목인 이소증 치료에 효과가 있을 것으로 생각되며 지속적인 임상적용과 관찰이 요구된다.

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Diagnostic Imaging of Urological Diseases in Dogs (개에서 비뇨기계 질환의 진단영상)

  • 장동우;정주현;장진회;정우조;원성준;이기창;최호정;이희천;윤화영
    • Journal of Veterinary Clinics
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    • v.18 no.4
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    • pp.459-464
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    • 2001
  • Excretory urography is a procedure where opacification of the kidneys, renal pelvic diverticula, ureters, and urinary bladder is a result of renal excretion of an intravenously administered iodinated contrast agent providing both anatomical and functional assessment. And ultrasonography is a non-invasive modality to evaluate the important anatomic information concerning the size, shape, and internal architecture of kidney even in the presence of impaired renal function or abdominal fluid. We describe four dogs with urological signs diagnosed with excretory urography and ultrasonography. Parients showed a variety of clinical signs including vomiting, hematuria, anorexia, abdominal pain, and abdominal distension. The hydronephrosis was diagnosed in case 1, 2, and 3 that had pelvic dilation, dilation of pelvic recesses, ureteral dilation. In case 3, proximal ureteral rupture was diagnosed with evidence of contrast media leakage was seen in proximal ureter. In case 4, the rupture of urinary bladder was diagnosed with leakage of contrast media through its ventral portion.

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Hypertensive Encephalopathy in a 10-year-old Boy with Ureteral Stone (10세 남아에서 생긴 요관 결석에 의한 고혈압성 뇌병증)

  • Kim Yong-Joo;Kang Hoon-Chul;Koo Ja-Wook
    • Childhood Kidney Diseases
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    • v.8 no.1
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    • pp.51-56
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    • 2004
  • Hypertensive encephalopathy is an acute neurologic syndrome that occurs in association with abrupt and marked elevation of blood pressure and is characterized by headache, vomiting, seizure, visual disturbances and altered mental status. Hypertensive encephalopathy is most commonly associated with renal disease in children, including acute glomerulonephritis, reno-vascular hypertension, and end-stage renal disease. Hypertensive encephalopathy associated with nephrolithiasis has not been reported. We have experienced a 10-year-old boy with hypertensive encephalopathy associated with ureteral stone.

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Ultrasonographic Findings in 132 Cases of Renal Disease (신질환(腎疾患) 132례(例)의 초음파진단(超音波診斷))

  • Han, Hye-Jin;Kim, Kang-Sueck
    • The Journal of the Korean life insurance medical association
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    • v.3 no.1
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    • pp.187-208
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    • 1986
  • The conclusions which was acquired one renal cell carcinoma and renal disease 132 cases that was tested renal echogram among 4,499 cases for recent 16 months at medical department, Dae Han Kyoyuk Insurance company from August, 1984 to November, 1985 are as follows: 1. On bur ultrasonography, the echo of tumor was demonstrated with echogenicity as compared with renal parenchyme. 2. The case was stage I by Robson's modification method for pathologic histology. 3. There is no fever, typical triad of renal cell carcinoma and the result of serum biochemical test was within normal limit. 4. The frequency with disease was renal cell carcinoma(0.76%), ureteral stone(1.5%), multicystic kidney(2.27%), hydroureter(2.27%), Bilateral poly cystic kidney(4.55%), hydronephrosis(4.55%), renal agenesis(6.06%) renal calculi(18.18%), simple cyst(60.61%). 5. The frequency with age was 55/1200 case(4.58%) in $41{\sim}50$ years, 13/296 cases(4.39%) in $51{\sim}60$ years, 43/2144 cases(2.01%) in $31{\sim}40$ years, 14/791 cases(1.77%) in $21{\sim}30$ years, 7/53 cases(1.32%) more than 61 years and 0/15(0%) under 20 years. 6. The affected site of renal agenesis 8 cases was right side all. 7. In total renal disease 132 cases, the affected site of 126 cases except bilateral polycystic kidney 6 cases was right kidney 72 cases, left kidney the proportion of right to left 1.6:1 8. In total renal disease 132 cases except bilateral polycystic kidneys 6 cases, the patients affected with both side kidneys were 14 cases. 9. The affection rate with sex in total renal disease 132 cases was 98/2860 cases in male, 34/1819 cases in female and the former was about 2 times than the latter. 10. Classifying the stone with part, nephrolithiasis 24 cases were appeared high frequency, on the contray, ureteral stone 2 cases. 11. 2 cases of ureteral stone developed complication, hydronephrosis and hydroureter. 12. The linear array type transducer was not helpful for the diagnosis of lower ureteral calculi but for the lower ureteral calculi, we could see the stone with high echo in accompanying with acoustic shadowing. 13. In 24 cases of renal calculi, both side nephrolithiasis was 3 cases(12.5%). 14. In renal calculi, solitary stone could be seen extremely much and the number of stone was so much variable from 2 to 10. 15. In 26 cases with renal calculi and ureteral stone, the common clinical manifestation was a intermittent and slight pain. 16. In 80 cases of renal cyst, as one's get older, the affection rate of cyst extremely rised. 17. In bilateral polycystic kidney, large cyst had septum on the whole. 18. The patients with complication were 14 cases(10.6%) of total patients.

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Transurethral Dormia Dislodging in Patients with Lower Ureteral Stone (하부 요관결석 환자에서 Dormia Stone Dislodger를 이용한 경뇨도적 요관배석술의 의의)

  • Kim, Eun-Gill;Suh, Jun-Kyu;Kim, Young-Soo;Park, Tong-Choon
    • Journal of Yeungnam Medical Science
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    • v.2 no.1
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    • pp.81-85
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    • 1985
  • Management of the small lower ureteral stone has been attempted by either transurethral manipulation or expectant therapy. To date, however, the choice of proper method has depended mostly on clinician's preference, and the effectiveness of the transurethral stone manipulation has remained controversial Herem we evaluated the effectiveness of the transurethral stone manipulation, using with the Dormia dislodger, in 37 patients with lower ureteral stone less than 10mm in greatest diameter. The results are summarized as follows. 1. The overall success rate was 68% (25 of 37 patients); Immediate delivery of the stone was observed in 16 of 37 patients. In another 5 patients the stone was removed at the time when the indwelled ureteral catheter was taken out. In the remaining 4 patients the stone passed spontaneously within a week following the procedure. 2. Higher success rate was observed in smaller stone; 79% in less than 4 mm, 58% in 4-6 mm, and 33% in 6-10mm in it's greatest diameter, respectively. 3. The morbidity rate was 8.1% (3 of 37 patients); In one patient a broken basket was retained In the ureter, which was removed at the time of ureterolithotomy. In another patient a ureteral stricture requiring periodic dilation was complicated. And In the other patient persistent hematuria was observed, which was relieved by conservative management. These results suggest that transurethral manipulation might have to be initially applied to unremittingly painful patients with small lower ureteral stone.

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Take advantage of ESWL in comparison measurement of Proximal stone against Mid Ureteral Stone according to its provability of pulverization (ESWL을 이용한 Proximal, Mid Ureteral Stone의 쇄석시 각 조건에 대한 쇄석율의 비교 측정)

  • Kang, Kwang-Soo;Lee, Sang-Bok;Lee, Jun-Haeng
    • Journal of the Korean Society of Radiology
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    • v.4 no.1
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    • pp.11-17
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    • 2010
  • A urolithiasis, also called calculus, is one of the brutal illnesses, which has constantly harassed humanbeings from time immemorial. However, there is no appropriate method of prevention so far. So, Urological therapy must be followed upon those patients. The biggest problem of urolithiasis is usually causing harsh pain, fever, and throw up. The pain would be more intensified when something came through the ureter or the moment of convulsion caused beyond transmission of urinary calculus. Even strong painkillers, such as fentanyl and Pethidine, can not handle those harshly pain easily. Therefore, a prompt action of medical check up and its therapy must be required to those patients. This thesis paper has put the accent on the specific therapy, known as ESWL (Extracorpereal Shock Wave Lithotripsy), which have generated quite optimum resolution to patients, who received harsh pain from Proximal ureteral stone and Mid ureteral stone and because of its low provability of pulverization. The results of the experiment confirmed that the stone, located between Proximal and Mid ureter, has lower provability of pulverization than distal ureter, because its accuracy rate on shock wave, in respect of breathing, are low. However, decrease in discharge interval have enhanced provability of pulverization. it can also intensify probability of pulverization and its safety by discharging high power with appropriate intervals, and that is more efficient than discharging low power with frequent time.

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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Assessment of Relapsing Urolithiasis from K43 with Erosive Gastritis (미란성 위염 환자 K43에서 재발성 요로 결석에 관한 연구)

  • 김재웅
    • The Korean Journal of Food And Nutrition
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    • v.10 no.1
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    • pp.44-52
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    • 1997
  • Nephrolithiasis is the most common disorder of the urinary tract in hospitalized patients, more frequently increased in 30~50 years of age, more common in males than in females, prior right stone to left side, and than upper ureteral stone is found in cultural country, while lower ureteral stone is increased in uncultural country. Stone components are classified as calcium oxalate, calcium phosphate, magnesium ammonium phosphate, uric acid, cystine, and their mixed stone, respectively. According to the pathophysiology of urinary stones, supersaturation/crystalization of inorganic salt concentration in urine, organic matrix, inhibitor deficiency, and epitaxy theory could be based on the stone formation. Not only hypercalciuria, hyperparathyroidism, hyperoxaluria, hyperuricosuria, and cystinuria, but also renal tubular acidosis, hypervitaminosis D, and peptic ulcer, are significantly associated with nephrolithiasis. In this study upper ureteral stone component were analyzed with chemical analysis, infrared spectrum, and image analyzer from K43 patient wit erosive gastritis. As the results, mixed stone of calcium oxalate dihydrate and calcium phosphate apatite was identified, the values of clinical test in blood and urine maintained normal revels. The relapsing urinary stone from K43 have no correlation between factors for stone formation reported early, also have no evidence for risk from erosive gastritis.

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