• Title/Summary/Keyword: Ureteral

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Continuous Epidural Analgesia of Lidocaine and Morphine for the Management of Ureteral Calculi (Lidocaine 및 Morphine경막외차단에 의한 뇨관 결석의 치험)

  • Cho, Gong-Lae;Hur, Nam-Jin;Roh, Un-Suk;Cho, Sung-Kung;Lee, Sang-Hwa
    • The Korean Journal of Pain
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    • v.2 no.1
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    • pp.21-25
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    • 1989
  • For the simple operations of the perineal region, caudal, epidural and saddle blocks of analgesia are preferable anesthesia techniques in men. But, if the operations shoud be delayed or the physicians are willing to observe and manipulate the patients for a couple of days, as in the ureteral stone manipulation, continuous epidural analgesia will be a reliable method. The authors have observed 36 male patients of ureteral calculi with continuous lumbar epidural analgesia for the purpose of elimination of an undesirable pain sensation which was associated with the transurethral cystoscopic manipulation. The results were as follows: 1) In most cases, the anesthetics used were 1% lidocaine 20 ml through the $L_{3-4}$ and $L_{4-5}$ interspace with 4~6cm of catheter tip advancement mainly to cephalad. 2) There was no motor weakness or paralysis in the lower extremities except some numbness and paresthesia on the perineal area. 3) Besides the various minor complications, there were no problems in respiration with small doses of morphine extradurally. 4) Among them, four cases of ureteral calculi dropped into the bladder spontaneously due to the epidural technique during transportation of the patients from the pain clinic to the urology out-clinic. One case of calculi was dropped by the aid of instrumentation at the ward, and twelve cases of calculi were removed directly by Dormia stone basket in the scopic room. For the remaining patients, we deduced that their calculi was be evacuated out because there were no complaints were notified after discharge.

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Retrograde balloon dilation as a therapeutic option for post-gynecologic surgery ureteral stricture followed by ureteroureterostomy: a comparative study regarding stricture length

  • Lim, Geon Woo;Yu, Young Dong;Choi, Kyung Hwa;Rhee, Seung Ryeol;Park, Dong Soo;Hong, Young Kwon
    • Journal of Yeungnam Medical Science
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    • v.35 no.2
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    • pp.179-186
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    • 2018
  • Background: To evaluate the success rate of balloon dilation and the factors possibly influencing the outcomes of balloon dilation for the ureteric strictured portion of ureteroureterostomy (UUS) site in patients with post-gynecologic surgeries. Methods: A single institution data base was screened for the patients who received balloon dilation for a treatment of ureteral stricture diagnosed after gynecologic surgery. Overall 114 patients underwent primary intra-operative UUS due to ureteral injury during gynecologic surgery. Among them, 102 patients received balloon dilation, and their medical records were retrospectively reviewed. Success of balloon dilation was defined as the condition that requires no further clinical interventions after 6 months from balloon dilation. Results: The ureter injury rate of women treated with open radical abdominal hysterectomy was highest (32 cases, 31.4%). 60 patients (60.8%) showed successful outcomes regarding dilation. All patients underwent technically successful dilation with a full expansion of balloon during the procedure, but 40 patients (39.2%) were clinically unsuccessful as they showed a recurrence of ureteral stricture on the previous balloon dilation site after the first dilation procedure. Univariate logistic regression analyses showed that stricture length >2 cm was a significant predictor of successful dilation (odds ratio, 0.751; 95% confidence interval, 0.634-0.901; p-value, 0.030), but it failed to achieve independent predictor status in multivariate analysis. Conclusion: Balloon dilation can an effective alternative treatment option for strictured portion of the primary UUS in post-gynecologic surgery patients when its length is <2 cm.

IDH2 gene deficiency accelerates unilateral ureteral obstruction-induced kidney inflammation through oxidative stress and activation of macrophages

  • Kim, Jee In;Noh, Mi Ra;Yoon, Ga-Eun;Jang, Hee-Seong;Kong, Min Jung;Park, Kwon Moo
    • The Korean Journal of Physiology and Pharmacology
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    • v.25 no.2
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    • pp.139-146
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    • 2021
  • Mitochondrial NADP+-dependent isocitrate dehydrogenase 2 (IDH2) produces NADPH, which is known to inhibit mitochondrial oxidative stress. Ureteral obstruction induces kidney inflammation and fibrosis via oxidative stress. Here, we investigated the role and underlying mechanism of IDH2 in unilateral ureteral obstruction (UUO)-induced kidney inflammation using IDH2 gene deleted mice (IDH2-/-). Eight- to 10-week-old female IDH2-/- mice and wild type (IDH2+/+) littermates were subjected to UUO and kidneys were harvested 5 days after UUO. IDH2 was not detected in the kidneys of IDH2-/- mice, while UUO decreased IDH2 in IDH2+/+ mice. UUO increased the expressions of markers of oxidative stress in both IDH2+/+ and IDH2-/- mice, and these changes were greater in IDH2-/- mice compared to IDH2+/+ mice. Bone marrow-derived macrophages of IDH2-/- mice showed a more migrating phenotype with greater ruffle formation and Rac1 distribution than that of IDH2+/+ mice. Correspondently, UUO-induced infiltration of monocytes/macrophages was greater in IDH2-/- mice compared to IDH2+/+ mice. Taken together, these data demonstrate that IDH2 plays a protective role against UUO-induced inflammation through inhibition of oxidative stress and macrophage infiltration.

Ureterosciatic hernia causing obstructive uropathy successfully managed with minimally invasive procedures

  • Kim, Yeong Uk;Cho, Jae Ho;Song, Phil Hyun
    • Journal of Yeungnam Medical Science
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    • v.37 no.4
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    • pp.337-340
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    • 2020
  • Ureterosciatic hernia is extremely rare. In ureteral herniation, ureter prolapses occur through either the greater or lesser sciatic foramen. Atrophy of the piriformis muscle, hip joint diseases, and defects in the parietal pelvic fascia are predisposing factors for the development of ureterosciatic hernia. Most symptomatic patients have been treated surgically, with conservative treatment reserved only for asymptomatic patients. To the best of our knowledge, long-term follow-up outcomes after ureterosciatic hernia management are sparse. In this paper, we report the case of a 68-year-old woman who presented with colicky left abdominal pain. After computed tomography (CT) scan and anterograde pyelography, she was diagnosed ureterosciatic hernia with obstructive uropathy. We performed ureteral balloon dilatation and double-J ureteral stent placement. After this minimally invasive procedure, CT scan demonstrated that the left ureter had returned to its normal anatomical position without looping into the sciatic foramen. The patient remained asymptomatic with no adverse events 7 years after the minimally invasive procedures. This brief report describes ureterosciatic hernia successfully managed with minimally invasive procedures with long-term follow-up outcomes.

The Effects of Music Therapy on Anxiety and Pain in Patients with Retrograde Ureteral Stenting under Local Anesthesia (음악요법이 국소마취 요관부목술 환자의 불안과 통증에 미치는 효과)

  • Chae, Su-Jeong;Yang, Soo;Park, Ho-Ran
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.14 no.2
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    • pp.173-180
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    • 2007
  • Purpose: The present study was done to examine the effect of music therapy on anxiety and pain in patients for whom a ureteral stent was inserted under local anesthesia. Method: The participants in this study were 22 patients who received a ureteral stent at the Day Surgery Center of C University Hospital during the period from May to October in 2006. The patients were divided into a control group (n=11) and an experimental group (n=11). For the experimental group, music was played according to their musical preference using headphones. The music was provided from the point when the patient took the posture for the operation and was covered with a sterilized drape to the point when the cystoscope was removed after finishing the operation. The control group was only provided with ordinary nursing services. Results: The results show that the provision of music therapy to these patients is effective in reducing the patients' salivary cortisol and Vas-anxiety score and stabilizing their systolic blood pressure. Conclusion: We conclude that music therapy can be actively used as a nursing intervention for reducing anxiety in patients who receive operations under local anesthesia.

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Primary Ureteral Transitional Cell Carcinoma in a Dog (개에서 발생한 원발성 요관 이행세포암종 증례)

  • Kim, Seong-soo;Lee, Jeo-soon;Yun, Soo-kyung;Kim, Su-yeon;Oh, Hyun-jung;Sohn, Jung-min;Jung, Sun-young;Kim, Bo-eun;Ji, Seo-yeoun;Kim, Dae-yong;Kim, Wan-hee;Yoon, Jung-hee;Choi, Min-cheol
    • Journal of Veterinary Clinics
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    • v.32 no.5
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    • pp.459-463
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    • 2015
  • A 14-year-old, castrated male mixed-breed dog weighing 9 kg was presented for hematuria and dysuria. Abdominal ultrasound showed unilateral hydronephrosis and hydroureter with focal thickening of the ureteral wall. Surgical exploration revealed an intraluminal mass arising from the proximal left ureter. Mass resection was performed. Histopathology of the ureteral mass was consistent with a papillary transitional cell carcinoma. The patient recovered well post-operatively, but was diagnosed with another tumor three months later, this time in the right kidney. Fine-needle aspiration cytology of the renal mass revealed an epithelial cell tumor with mesenchymal features.

Renal and Ureteral Fusion in a Calf with Atresia Ani

  • Jeong, Won-Il;Lee, Cha-Soo;Kim, Seok-Jae;Kim, Jin-Hyun;Jeong, Kyu-Shik
    • Proceedings of the Korean Society of Veterinary Pathology Conference
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    • 2002.11a
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    • pp.138-138
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    • 2002
  • A 10-day old male calf exhibited multiple congenital anomalies of the urinary and gastrointestinal tracts, including renal fusion (horseshoe kidney), ureteral fusion, rectovesicular fistula, and atresia ani. The single kidney was fused at the caudal poles. The left kidney and cranial half of right kidney were shrunken, while the remaining lobules were hypertrophic. Ureters were fused cranially and bifurcated caudally. The terminal rectum was narrowed and connected with the bladder. The anus was imperforate. The cause of these anomalies could not be determined. This is the first report of this constellation of congenital anomalies in a calf.

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Radiogyaphic and Ultrasonographic Diagnosis of Pyelonephritis in 2 dogs (개에서 신우신염의 방사선학적 및 초음파학적 진단 2례)

  • 이기창;최민철
    • Journal of Veterinary Clinics
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    • v.19 no.3
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    • pp.371-374
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    • 2002
  • A female 8-year-old Pug weighing 7.3 kg and a female 10-year-old Maltese dog weighing 3.5 kg showing anorexia and vomiting for a few weeks were referred to Veterinary Medical leaching Hospital, Seoul National University. Radiographic findings were an enlarged right kidney in a pug dog and a radiopaque material on the right ureteral region lateral to the third lumbar vertebrae with indefinite right kidney contour in a Maltese dog, repectively. Excretory urography performed in a Pug dog revealed a poor opacified enlarged right kidney with absent of pelvic recesses and pelvic dilation with proximal ureteral dilation on contralateral kidney. Ultrasonographic findings were enlarged kidney with dilated pelvis and echogenic sediment within the medulla in both dogs and especially an engorged proximal ureter and a thin rim of functional renal tissue remains in a Maltese dog. Those diagnostic findings indicated high possibility of pyelonephritis and these were confirmed by pathologic examination. Radiography and ultrasonography, although not giving final diagnosis for pyelonephritis, are useful for assessment and diagnosis of pyelonephritis.

Extraosseous Uptake of Ureteral Transitional Cell Cancer on $^{99m}Tc-MDP$ Bone Scan (뇨관(尿管) 이행세포암종(移行細胞癌腫)에 $^{99m}Tc-MDP$가 섭취(攝取)된 1예(一例))

  • Ahn, Il-Min;Rhim, Sang-Moo;Sohn, In;Lee, Myung-Chul;Cho, Bo-Youn;Koh, Chang-Soon;Kim, Kyung-Do
    • The Korean Journal of Nuclear Medicine
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    • v.16 no.1
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    • pp.79-82
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    • 1982
  • A case of extraosseous uptake of ureteral transitional cell Cancer on $^{99m}Tc-MDP$ bone scan was experienced. The Hot spot seemed to be caused by the tumor uptake of $^{99m}Tc-MDP$ ifself.

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A Case of Left Ureteral Obstruction due to Acute Appendicitis (충수염으로 속발된 요관폐색증 1례)

  • Jeong, Kang-Seok;Sung, Myong-Soon;Choi, Kwang-Hae
    • Journal of Yeungnam Medical Science
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    • v.26 no.1
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    • pp.56-62
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    • 2009
  • Appendicitis is a common cause of acute abdomen in pediatrics. Periappendiceal abscesses are frequently found in the pediatric population. Acute appendicitis in children can, at times, be a difficult clinical diagnosis because of its highly variable history? and physical manifestations and its unpredictable course. Despite the uncertainty of the diagnosis, appendicitis demands prompt treatment because of the risk of perforation, which occurs in approximately one third of cases. Urological manifestations of appendicitis and appendiceal abscess can vary. Acute appendicitis presenting with ureteral stenosis and hydronephrosis is very rare. Here, we report a case of acute appendicitis with perforation and left hydronephrosis in a 3-year-old female. This case presents a 3-year-old girl with dysuria having hydronephrosis that originated from a perforated appendix.

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