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Ureteral duplex

M K Arevalo, J C Prieto, N Cost, G Nuss, B J Brown, L A Baker
INTRODUCTION: Symptomatic pediatric ureterocele has diverse manifestations, making evidence-based management impractical. Thus, detailed visualization of ureterocele anatomy prior to first surgical incision is invaluable. Retrograde ureterocelogram (RUC) is a simple, underutilized radiologic technique that can be performed during cystoscopy. This study sought to determine whether RUC changes surgical management by more accurately depicting the complex ureteral and ureterocele anatomy, compared with renal ultrasound (US) and voiding cystourethrography (VCUG)...
September 17, 2016: Journal of Pediatric Urology
Alok Sharma, Kushaljit Singh Sodhi, Akshay Kumar Saxena, Anmol Bhatia, Prema Menon, Katragadda L N Rao, Niranjan Khandelwal
AIMS: To compare intravenous urography (IVU) and magnetic resonance urography (MRU) in the preoperative evaluation of pelvi-ureteric junction obstruction (PUJO) in children. MATERIALS AND METHODS: A total of 35 children up to 10 years of age in whom unilateral or bilateral PUJO were suspected on ultrasonography were enrolled in this prospective study. All children underwent IVU and MRU, and the findings were compared. RESULTS: Of the 70 kidneys evaluated, 14 (20%) were not visualized on IVU because of nonexcretion of contrast, whereas all the 70 (100%) kidneys were visualized on MRU...
October 2016: Journal of Indian Association of Pediatric Surgeons
Wei Liu, Liujuan Zhang, Rui Ma, Rongde Wu
BACKGROUND: Duplex kidney is a common congenital anomaly of the urinary tract, while ureteropelvic junction obstruction (UPJO) in lower unit of duplex kidney is rare. Surgical treatment can be challenging in such cases. The aim was to report our experience in managements of UPJO in lower moiety of duplex kidney. METHODS: Among the pediatric patients with duplex system from 2007-2013, 7 children were diagnosed with UPJO in lower moiety. Their medical records were retrospectively analyzed, mainly focused on anatomic aspects and operation details...
August 18, 2016: International Journal of Surgery
Michael J Biles, Julia B Finkelstein, Mark V Silva, Sarah M Lambert, Pasquale Casale
INTRODUCTION: Robotic technology has been increasingly utilized for complicated reconstructive surgeries in pediatric urology, such as ureteroureterostomy (UU). The literature is limited regarding the performance of minimally invasive UU in children, and the existing published series utilize indwelling ureteral stents. We sought to report on our pediatric experience with robot-assisted laparoscopic (RAL)-UU using a temporary ureteral catheter in duplex systems with ureteral ectopia. METHODS: A retrospective chart review was performed of all pediatric patients who underwent RAL-UU at a single institution over a 2-year period...
October 2016: Journal of Endourology
Tito Palmela Leitão, Ricardo Pereira E Silva, Sónia Barata, Adalgisa Guerra, Filipa Osório
INTRODUCTION: Although laparoscopy is widely established for ablative urologic procedures, pelvic reconstructive procedures are still mostly performed by open-surgery. As urologists continue to introduce advanced laparoscopic skills to reconstructive urologic procedures, we present our experience with a laparoscopic psoas hitch double ureteral re-implantation in a patient with an ureterovaginal fistula and an ipsilateral duplex urinary system. MATERIALS AND METHODS: A 42-year-old patient presented with continuous involuntary urine loss from the vagina after an abdominal hysterectomy...
April 2016: Surgical Technology International
Canan Kocaoglu
PURPOSE: We aimed at evaluating the efficacy and complications of two bulking substances: dextranomer/hyaluronic acid copolymer(Dx/Ha;Dexell®) versus polyacrylate polyalcohol copolymer(PPC;Vantris®) in subureteric injection treatment of children with high grades (grades IV-V) vesicoureteral reflux(VUR). METHODS: Data of patients undergoing endoscopic treatment of high grade VUR (January 2009-August 2015) were retrospectively investigated. Patients with high grade VUR caused by posterior urethral valve, duplex system, paraureteral diverticula and neurogenic bladder were excluded...
October 2016: Journal of Pediatric Surgery
J O Lynch, A Cox, B Rawal, S Shelmerdine, N Vasdev, A Patel
A 60-year-old woman with a history of breast cancer presented with bilateral obstruction of bilaterally duplicated renal collecting systems secondary to extrinsic compression from metastatic pelvic lymphadenopathy. Bilateral JJ ureteric stents were inserted, resulting in some improvement of renal function but a failure to normalise completely. Repeat computed tomography demonstrated bilateral duplex collecting systems with persisting obstruction of the undrained moieties. Selective puncture was performed to decompress the obstructed renal moieties for bilateral nephrostomy catheter insertion...
April 2016: Annals of the Royal College of Surgeons of England
Subramaniyan Ramanathan, Devendra Kumar, Maneesh Khanna, Mahmoud Al Heidous, Adnan Sheikh, Vivek Virmani, Yegu Palaniappan
Congenital abnormalities of the kidney and urinary tract (CAKUT) include a wide range of abnormalities ranging from asymptomatic ectopic kidneys to life threatening renal agenesis (bilateral). Many of them are detected in the antenatal or immediate postnatal with a significant proportion identified in the adult population with varying degree of severity. CAKUT can be classified on embryological basis in to abnormalities in the renal parenchymal development, aberrant embryonic migration and abnormalities of the collecting system...
February 28, 2016: World Journal of Radiology
Fatih Akbulut, Metin Savun, Burak Ucpinar, Murat Sahan, Burak Arslan, Faruk Ozgor, Abdulmuttalip Simsek, Ahmet Yalcın Berberoglu, Murat Baykal, Murat Binbay
Duplex collecting systems are the most commonly encountered anomaly of the urinary system. Complete duplex system with an H shaped ureter is a very rare situation. There are only two reported H ureter cases in the literature. Herein, we aimed to present an H shaped ureter case, which was identified while performing ureterorenoscopy to a 48-year-old female patient due to a right distal ureteral stone.
2016: Case Reports in Urology
Ilkka Pietilä, Renata Prunskaite-Hyyryläinen, Susanna Kaisto, Elisavet Tika, Albertien M van Eerde, Antti M Salo, Leonardo Garma, Ilkka Miinalainen, Wout F Feitz, Ernie M H F Bongers, André Juffer, Nine V A M Knoers, Kirsten Y Renkema, Johanna Myllyharju, Seppo J Vainio
The Wnts can be considered as candidates for the Congenital Anomaly of Kidney and Urinary Tract, CAKUT diseases since they take part in the control of kidney organogenesis. Of them Wnt5a is expressed in ureteric bud (UB) and its deficiency leads to duplex collecting system (13/90) uni- or bilateral kidney agenesis (10/90), hypoplasia with altered pattern of ureteric tree organization (42/90) and lobularization defects with partly fused ureter trunks (25/90) unlike in controls. The UB had also notably less tips due to Wnt5a deficiency being at E15...
2016: PloS One
Bo-Kyung Je, Hee Kyung Kim, Paul S Horn
OBJECTIVE: The objective of our study was to evaluate the incidence and spectrum of renal complications and of extrarenal diseases and syndromes in children with horseshoe kidney (HSK). MATERIALS AND METHODS: The clinical data and imaging studies of 380 subjects (median age, 2.8 years) diagnosed with HSK over a 24-year period were reviewed: 366 children and young adults and 14 fetuses, one of whom died in utero. All renal complications and extrarenal diseases and syndromes were documented...
December 2015: AJR. American Journal of Roentgenology
Ciro Esposito, Maria Escolino, Go Miyano, Paolo Caione, Fabio Chiarenza, Giovanna Riccipetitoni, Atsuyuki Yamataka, Antonio Savanelli, Alessandro Settimi, Francois Varlet, Dariusz Patkowski, Mariapina Cerulo, Marco Castagnetti, Holger Till, Rosaria Marotta, Angela La Manna, Jean-Stephane Valla
PURPOSE: To compare the outcome of laparoscopic and retroperitoneoscopic approach for partial nephrectomy in infants and children with duplex kidneys. METHODS: Data of 102 patients underwent partial nephrectomy in a 5-year period using MIS procedures were analyzed. Fifty-two children underwent laparoscopic partial nephrectomy (LPN), and 50 children underwent retroperitoneoscopic partial nephrectomy (RPN). Median age at surgery was 4.2 years. Statistical analysis was performed using χ (2) test and Student's t test...
July 2016: World Journal of Urology
Daniel Herz, Jennifer Smith, Daryl McLeod, Megan Schober, Janae Preece, Paul Merguerian
INTRODUCTION: Surgical management of duplex renal anomaly (DRA) is complex because of individual anatomic variation, competing priorities of vesicoureteral reflux (VUR) and ureteral obstruction present in the same child, the varied differential function of the different renal moieties, and the presence of voiding dysfunction and recurrent urinary tract infection (UTI). Robot-assisted laparoscopic (RAL) surgical management has been under-reported in this group of children but is becoming a viable alternative to traditional open surgery...
February 2016: Journal of Pediatric Urology
Francesco Simoni, Nicola Vitturi
We present the case of a 75-year-old woman with sepsis. She was evaluated with bedside ultrasound with a diagnosis of pyonephrosis, and subsequently underwent a TC scan that showed a pelvic-ureteric junction obstruction (PUJO) in a duplicated renal system. PUJO associated with duplex kidney, while relatively frequent in children, is a rare condition in adults, and may lead to severe complications as in this case.
September 2015: Journal of Ultrasound
S Moralıoğlu, A Cerrah Celayir, O Bosnali
INTRODUCTION/OBJECTIVE: The dynamic hydrodistention (HD) classification is a basic and objective way of rating the ureteral orifice opening. This study evaluated the value of hydrodistention of the ureteral orifice in the diagnosis of vesicoureteral reflux (VUR). MATERIAL AND METHODS: Between January 2012 and March 2013 the HD grade in 106 ureters was prospectively assigned. A 9.5-Fr rigid cystoscope with a 0-degree lens was used in all procedures. Warm saline was used and the irrigation bag was placed approximately 1 m above the bladder level on full flow...
December 2015: Journal of Pediatric Urology
B N Cezarino, R I Lopes, L M Oliveira, F T Dénes, M Srougi
INTRODUCTION: A duplex renal collecting system is a common congenital anomaly in children. Continuous dribbling (especially if after the toilet-training period) should raise suspicion of the presence of an ectopic ureter, which is most often associated with ureteral duplication. This video will demonstrate the complete diagnostic work-up necessary in these cases. CASE REPORT: A 10-year-old girl presented with continuous dribbling. Ultrasonography and computerized tomography depicted a duplex system on the left side, with the upper pole ureter ectopically inserting into the vaginal cavity and good upper pole renal parenchyma...
October 2015: Journal of Pediatric Urology
Hasan Serkan Dogan, Mesut Altan, Burak Citamak, Ali Cansu Bozaci, Artan Koni, Serdar Tekgul
INTRODUCTION: Among the interventional treatment modalities for vesicoureteral reflux (VUR), endoscopic subureteric injection seems to be the least invasive method with acceptable outcomes when applied in appropriate patients. OBJECTIVE: The aim of the presented study is to investigate the parameters which may affect the outcomes of endoscopic injection and to compare the efficacy of two different bulking agents both composed of dextranomer-hyaluronic acid copolymer...
April 2015: Journal of Pediatric Urology
Rena D Malik, Joseph J Pariser, Mohan S Gundeti
PURPOSE: To compare our renal and clinical outcomes for robot-assisted laparoscopic heminephrectomy (RAL-HN) in the pediatric population with duplicated systems with those of current contemporary open and laparoscopic series. PATIENTS AND METHODS: Sixteen children underwent RAL-HN from 2009 to 2014. Data were collected via retrospective chart review including demographics, preoperative and postoperative imaging, operative time, estimated blood loss (EBL), length of stay (LOS), complications, and renal outcomes...
December 2015: Journal of Endourology
Ashlea J Doery, Eileen Ang, Michael R Ditchfield
INTRODUCTION: Duplex kidneys are common, mostly asymptomatic and of no clinical significance. However, they can be associated with significant pathology, often with long-term morbidity. There is minimal literature on the review of the duplex kidney, its associated anomalies and complications. The purpose of this paper is to review our experience of imaging the spectrum of abnormalities associated with duplex kidneys in the paediatric population and correlate this with contemporary literature...
April 2015: Journal of Medical Imaging and Radiation Oncology
Yong Seung Lee, Young Jae Im, Sang Hee Shin, Rosito T Bascuna, Ji Yong Ha, Sang Won Han
OBJECTIVE: To report our experience of common sheath reimplantation (CSR) for ectopic ureterocele (EU) combined with ureteral duplication, describing success rates and postoperative complications, along with risk factors for developing postoperative incontinence. METHODS: When the upper tract approach is not indicated in patients with EU, a bladder-level approach, involving either CSR or total reconstruction, is the remaining option. However, concerns exist about the high morbidity of bladder-level approaches...
February 2015: Urology
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