Pelviureteric junction obstruction and crossing vessels: pro "vascular hitch".
[Pelviureteric junction obstruction and crossing vessels: pro "vascular hitch"]. Aktuelle Urol. 2019 Nov 07;: Authors: Zahn K, Younsi NF, Stein R Abstract The vascular hitch procedure for pelviureteric junction obstruction caused by crossing lower-pole vessels is a controversial treatment option. Since this minimally-invasive technique has been introduced in patients with aberrant lower-pole vessels, multiple publications have reported successful short, intermediate and long-term outcomes. Success rates of > 90 % are similar to those of Anderson-Hynes pyeloplasty. In general, an associated intrinsic stenosis seems to be rare. Histological evidence of muscular hypertrophy may simply indicate a compensatory mechanism and may be reversible to a certain degree. To differentiate between those patients who are eligible for a vascular hitch procedure and those who should receive an initial Anderson-Hynes pyeloplasty, an intraoperative diuretic test should be performed (volume bolus plus intravenous administration of furosemide). An associated intrinsic stenosis seems to be unlikely in a funnel-like and otherwise normal-looking pelviureteric junction, decreasing hydronephrosis after mobilisation of renal pelvis and crossing vessels and effective peristalsis of the renal pelvis after intraoperative diuretic testing. The vascular hitch technique is less demanding than laparoscopic Anderson-Hynes pyeloplasty and less time-consuming with regard to...
ConclusionUreteral neuroendocrine tumors are extremely rare. Neuroendocrine markers (CD56, CgA, Syn) and epithelial markers (CKpan, CK7) are usually helpful. Grimelius special staining and electron microscopy observation can help to make a final diagnosis. Radical surgery together with postoperative adjuvant chemotherapy can improve the survival of patients. Vimentin may play a role in predicting the prognosis.
Publication date: Available online 14 December 2019Source: Urology Case ReportsAuthor(s): Ryuta Sato, Takahiro Ishikawa, Masaharu Imagawa, Hirotoshi Yonemasu, Takahiro Narimatsu, Kan MurakamiAbstractSmall cell carcinoma in the ureter is extremely rare, with few cases reported in the literature. The current report describes the case of a 63-year-old man who presented with right-side back pain. A mass was identified in the right ureter. A nephroureterectomy was performed. Subsequent microscopic examination revealed that the mass comprised a monotonous population of small cells and that the carcinoma cells were positive for c...
ConclusionsLaparoscopy is a recommended option to treat CFRE, offering all advantages of this approach.
CONCLUSIONThis study demonstrated an optimal approach for relieving upper urinary tract obstruction and acute infection in which percutaneous nephrostomy drainage is preferred for patients with severe pyonephrosis, large stones (>10 mm) with high-grade hydronephrosis, steinstrasse, or failure in retrograde ureteric stent placement, while retrograde ureteral catheterization using cystoscopy is suitable for patients diagnosed with small stones (≤10 mm) and low-grade hydronephrosis. PMID: 31796723 [PubMed - as supplied by publisher]
We report a case of small bowel herniation caused by the ureter in a woman who underwent radical hysterectomy for cervical cancer. Patient concerns: A 53-year-old woman presented with acute abdominal pain and vomiting and reported a history of radical hysterectomy for cervical cancer 6 years prior to presentation. Diagnoses: Computed tomography revealed segmental luminal dilatation of pelvic ileal loops, 2 transition zones with the beak sign in the left-sided pelvic cavity, and reduced enhancement of bowel loops. Hydronephrosis with abrupt luminal narrowing of the left distal ureter was also observed. Interventions:...
ConclusionThis video shows how deep urinary endometriosis can be performed laparoscopically. Mastering suturing is essential to avoid complications.
Pregnancy is associated with reactivation and transmission of latent polyomavirus to fetus. Polyomavirus is also known to cause ureteral stenosis and hydronephrosis.
Metastasis of prostate cancer (PCa) to renal pelvis is extremely rare. A 64-year-old man was hospitalized for increased prostate specific antigen (PSA) after radical prostatectomy. 68Ga-PSMA-11 PET/CT showed hydronephrosis caused by a mass in the left renal pelvis without significant uptake of PSMA tracer. The histopathology indicated metastatic PCa with a Gleason score of 5+5 but negative for prostate specific membrane antigen (PSMA) following nephroureterectomy. Although metastasis to renal pelvis is rare, the occurrence possibility could not be ignored when with hydronephrosis is found in prostate cancer patients.
Conclusion Inguinal herniation of the transplant ureter leading to ureteral obstruction is a rare, probably underreported, cause graft of dysfunction. Therefore, we advocate elective repair of inguinal or incisional hernias in renal transplant recipients. PMID: 31690216 [PubMed - as supplied by publisher]
ConclusionNLR and PLR are inversely associated with SSP of ureteral stones. In adjunct with other indicators, NLR and PLR are inflammatory markers that could be used in the clinical decision of ureteral stone management.