• Title/Summary/Keyword: urinary tract obstruction

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Urinary Stone in Children (소아 요로 결석에 관한 연구)

  • Eun Young-Min;Rho Kwang-Sik;Kim Pyung-Kil;Han Sang-Won
    • Childhood Kidney Diseases
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    • v.1 no.1
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    • pp.60-66
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    • 1997
  • Even though the urinary stones are rare in children, careful observation and monitoring are necessary because the incidence has been increasing. This study is aimed to document the characteristics of urinary stones in children including the symptoms, diagnosis, with or without urinary tract infection, other urinary tract anomaly and treatment. 45 patients under the age of 15 years with urinary stones hospitalized during Jan. 1986 to Jun. 1996 at Severance Hospital were reviewed retrospectively. Patients' mean age was 6.5 years and sex ratio (male : female) was 5.4:1. The most common symptom was gross hematuria. Stones accompanied with urinary tract infection was 46.7%, and stones associated with urinary tract anomaly was 35.6%. Extracorporeal shock wave lithotripsy, percutaneous nephrolithotorny, hydration and diuretics were the treatment modality used. Urinary stone were found to be a significant cause of urinary tract obstruction in children, requiring prompt diagnosis and treatment. Although KUB, IVP, and ultrasonography were commonly used to make the diagnosis, many cases were detected only by ultrasonographic study.

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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.

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.

Prostatic Urethral Polyp Causing Lower Urinary Tract Obstruction: Report of A Case (하부요로폐쇄를 일으킨 전립선부 요도폴립 1례)

  • Lee, Dong-Heon;Suh, Jun-Kyu;Kim, Young-Soo;Park, Tong-Choon;Nam, Hae-Joo;Choi, Won-Hee;Lee, Tae-Sook;Lee, Kyung-Chul
    • Journal of Yeungnam Medical Science
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    • v.2 no.1
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    • pp.249-252
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    • 1985
  • Polyps of the male urethra are relatively uncommon lesions. They usually arise from the prostatic urethra mostly verumontanum or Just lateral to the verumontanum. Posterior urethral polyp often presents with hematuria, hemospermia and sometimes lower urinary tract obstruction. We recently experienced a pedunculated prostatic urethral polyp in a 63-year-old man who complained of gross total hematuria and difficult micturition for several years. On rectal examination the prostate was slightly enlarged with normal consistency. Excretory urogram showed a round filling defect in the right side of the bladder neck measuring about $2{\times}2cm.$ in size. Cystourethroscopy revealed trabeculation of the vesical wall, mild bilateral prostatic hypertrophy and a round cystic mass with a long stalk arising from the prostatic floor 1 cm. Proximal to the verumontanum which caused ball-valve obstruction in the bladder neck. This pedunculated polypoid mass was then resected at its base with resectoscope and was removed transurethrally using Lowsley's grasping forceps. The specimen was proved as fibrous polyp histologically.

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A Case of Severe Hyperammonemic Encephalopathy Caused by Urinary Tract Infection in Obstructive Uropathy

  • Mun, Bo Gyung;Lee, Joo Hoon;Park, Young Seo;Jung, Jiwon
    • Childhood Kidney Diseases
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    • v.25 no.2
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    • pp.112-116
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    • 2021
  • Hyperammonemia is mainly caused by diseases related to liver failure. However, there are also non-hepatic causes of hyperammonemia, such as urinary tract infection (UTI) due to urease-producing organisms. Urease production by these bacteria induces a hydrolysis of urinary urea into ammonia that can cross the urothelial cell membrane and diffuse into blood vessels, leading to hyperammonemia. Delayed diagnosis and treatment of hyperammonemia can lead to lethal encephalopathy that can cause brain damage and life-threatening conditions. In the presence of obstructive uropathy, UTI by urease-producing bacteria can lead to more severe hyperammonemia due to enhanced resorption of ammonia into the systemic circulation. In this report, we present a case of acute severe hyperammonemic encephalopathy leading to brain death due to accumulation of ammonia in blood caused by Morganella morganii UTI in a 10-year-old girl with cloacal anomaly, causing obstructive uropathy even after multiple corrections.

Evaluation of Extraosseous Abnormalities Detected in Bone Scan ($^{99m}Tc-Methylene$ Diphosphonate (MDP)골(骨)스캔에서 골격외(骨格外) 섭취(攝取) 및 신요로계(腎尿路系) 이상소견(異常所見)에 관(關)한 연구(硏究))

  • Rhim, Sang-Moo;Park, Ran-Jae;Kim, Byung-Tae;Lee, Myung-Chul;Cho, Bo-Yeon;Lee, Hong-Kyu;Koh, Chang-Soon
    • The Korean Journal of Nuclear Medicine
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    • v.16 no.1
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    • pp.31-39
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    • 1982
  • The purpose of the present study is to evaluate the clinical and diagnostic significance of incidental findings of renal and urinary tract abnormalities, and extraosseous uptake of bone scans. The authors analyzed bone scans using $^{99m}Tc-MDP$(methylene diphosphonate) in 1238 cases of bone disease from April, 1979 to March, 1981. The results obtained were as follows. 1. Total extraosseous abnormalities were 112 cases (9%), which include 64 cases (5%) of renal and urinary tract abnormalities and 48 case(4%) of other extraosseous uptakes. 2. Renal and urinary tract abnormalities were 32 cases(50%) of obstruction, 14 cases(22%) of nonvisualization, 6 cases of space occupying lesion in kidney, 8 cases of kidney displacement and 4 cases of urinary bladder deformities. 3. Other extraosseous uptakes were 16 cases (33%) of body fluid collection, 15 cases of tumor uptake, 9 cases of free pertechnetate uptake and 8 others.

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Congenital Urinary Tract Anomalies Associated with Urinary Tract Infection in Infants and Children (요로감염증과 연관된 방광요관역류 이외의 선천성 요로계 이상에 관한 고찰)

  • Chung So-Hee;Kim Jung-Sim;Kim Hyun-Jung;Lee Mi-Na;Uhm Mee-Ryung;Jin Dong-Kyu;Shin Hwa-Sook
    • Childhood Kidney Diseases
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    • v.3 no.2
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    • pp.180-186
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    • 1999
  • Purpose : It has been well known that urinary tract infection(UTI) in infants and children is frequently associated with vesicoureteral reflux(VUR). However, the publishied papers dealing with congenital anomalies associated with UTI emphasized the importance of VUR only. The aim of our study was to evaluate the type, incidence and spectrum of urologic anomalies associated with UTI. Methods : Medical records of clinical, bacteriologic and radiologic study were assessed retrospectively in 65 infants or children with documented UTI who were admitted to the Department of Pediatrics, Samsung Seoul Hospital from March 1996 to February 1998. Results : Spectrum of anomalies were associated with UTI as follows: VUR(n=23), both ectopic kidney(n=1), ureterovesical junction(UVJ) obstruction(n=1), multicystic dysplastic kidney(n=1), ureteropelvic junction(UPJ) obstruction with hydronephrosis(n=1), hutch diverticulum(n=1), UPJ stenosis(n=1), posterior urethral valve(n=1), urachal remnant(n=1) and bladder diverticula(n=1). Congenital urinary anomalies other than VUR were detected in 9 children among 65 patients with UTI(13.8%). 4 children among 9 congenital urinary anomalies other than VUR were combined with VUR. Sex distribution with congenital urinary anomalies other than VUR was more prevalent in male than female (7 males : 2 females). Age distribution at the time of UTI was less than 5 years in most patient (under 1 year in 1 patient, 1-2 year in 5 patients, 3-5 year in 1 patient, and above 5 year in 2 patients). And age distribution at the time of UTl associated with VUR was less than 5 years in most patient (under 1 year in 6 patients, 1-2 year in 8 patients, 3-5 year in 5 patients, and above 5 year in 4 patients), too Conclusion : Because congenital urinary anomalies other than VUR are seen in as high as 13.8% of patients, more careful evaluation of all possible congenital urinary anomalies as well as VUR is mandatory in pediatric patient with UTI.

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Routine double-J stenting for live related donor kidney transplant recipients: It doesn't serve the purpose, but does it serve a better purpose?

  • Kumar, Vikash;Punatar, Chirag B;Jadhav, Kunal K;Kothari, Jatin;Joshi, Vinod S;Sagade, Sharad N;Kamat, Madhav H
    • Investigative and Clinical Urology
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    • v.59 no.6
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    • pp.410-415
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    • 2018
  • Purpose: Despite meticulous techniques, surgical complications continue to be problematic in kidney transplant recipients. Role of routine stenting to reduce complications is controversial. In this study, we compare incidence of early urological complications, lymphoceles, urinary tract infections (UTI) and graft function; with or without double-J stenting. Materials and Methods: All patients who underwent live related donor renal transplantation from February 2014 to February 2016 were included. Transplants prior to February 2015 were without routine stenting; subsequent transplants were with routine stenting. Patients with neurogenic bladder, previously operated bladder and delayed or low urinary output were excluded. Followup was for at least three months. Descriptive statistics was performed for all parameters. Chi square test and Fisher's Exact test were used for qualitative variables. For quantitative variables, Mann-Whitney test was used to test median difference and independent samples t-test for mean difference. The p-value ${\leq}0.05$ was considered significant. Results: We analysed 74 patients (34 stented and 40 non-stented). There was no difference in the incidence of urinary leak, anastomotic obstruction, lymphoceles or UTI (p>0.4 for all comparisons). However, mean estimated glomerular filtration rate at sixth day, 14th day, one month and two months were 76.1 vs. 61.5 (p=0.025), 72.1 vs. 56.6 (p=0.005), 79.4 vs. 63.1 (p=0.002) and 82.0 vs. 63.3 (p=0.001) in the stented versus non-stented groups. Conclusions: Placement of ureteral stent in renal transplant does not significantly affect the incidence of early urinary complications or UTI. However, graft function is significantly better in stented recipients, at least in the short term.

Acute Onset of Intracerebral Hemorrhage due to Autonomic Dysreflexia

  • Eker, Amber;Yigitoglu, Pembe Hare;Ipekdal, H. Ilker;Tosun, Aliye
    • Journal of Korean Neurosurgical Society
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    • v.55 no.5
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    • pp.277-279
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    • 2014
  • Autonomic dysreflexia is a clinical emergency syndrome of uncontrolled sympathetic output that can occur in patients who have a history of spinal cord injury. Despite its frequency in spinal cord injury patients, central nervous system complications are very rare. We report a man with traumatic high level incomplete spinal cord injury who suffered hypertensive right thalamic hemorrhage secondary to an episode of autonomic dysreflexia. Prompt recognition and removal of the triggering factor, the suprapubic catheter obstruction which led to hypertensive attack, the patient had a favorable functional outcome after the resorption of the hematoma and effective rehabilitation programme.