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Felix Blasl, Wolfgang H Rösch, Mark Koen, Mircia-Aurel Ardelean, Anne-Karoline Ebert
OBJECTIVE AND INTRODUCTION: Cowper's syringocele is a cystic dilation of the bulbourethral gland duct, initially defined by Maizels et al. in 1983. Although obstructive and non-obstructive types of this rare anomaly are described, clinical symptoms are highly unspecific. Therefore, we report 12 cases of children and young adults diagnosed with Cowper's syringocele to further clarify clinical course, comorbidity and treatment strategies. STUDY DESIGN: We retrospectively collected clinical data of 12 children and young adults from birth to 18...
October 8, 2016: Journal of Pediatric Urology
Wei Liu, Guoqiang Du, Feng Guo, Rui Ma, Rongde Wu
PURPOSE: To describe a modified ureteral orthotopic reimplantation method in infant with primary obstructive megaureter (POM) and report our initial experience. METHODS: Thirteen children with POM (range 1-7 months) underwent modified transvesical ureteral implantation surgery. Treatment consists of transecting the ureter proximal to the obstruction and performing orthotopic reimplantation in end freely fashion with distal ureter protruding into the bladder, providing dilated ureteral diameter: ureteral exposure length in bladder ratio of 1:1...
September 2, 2016: International Urology and Nephrology
Tamer M Abou Youssif, Ahmed Fahmy, Hazem Rashad, Mohammed Adel Atta
OBJECTIVES: To present a novel ureteric re-implantation technique for primary obstructed megaureter (POM) that ensures success in the short- and long-term, as conventional techniques are not ideal for megaureters especially in children, with ureteric stenosis and reflux being common complications after re-implantation. PATIENTS AND METHODS: Between 2009 and 2012, 22 paediatric patients with POM were enrolled. We performed a new technique for re-implantation of these ureters to ensure minimal incidence of ureteric strictures and easy subsequent endoscopic access...
June 2016: Arab Journal of Urology
P Rubenwolf, J Herrmann-Nuber, M Schreckenberger, R Stein, R Beetz
PURPOSE: Primary non-refluxing megaureter (pMU) is a multifaceted and challenging congenital pathology of the urinary tract. We report our 23-year experience with this anomaly in terms of presentation, diagnostic work-up and management. MATERIALS AND METHODS: We retrospectively reviewed the medical records of 212 children diagnosed with pMU between 1986 and 2009 at our institution. Mean follow-up was 45.17 (0-192) months. RESULTS: Of the total, 168 (79 %) children presented with upper urinary tract dilation on perinatal ultrasound screening...
November 2016: International Urology and Nephrology
Bernhard Haid, Christa Strasser, Tanja Becker, Mark Koen, Christoph Berger, Judith Roesch, Jannik Stuehmeier, Barbara Schlenck, Wolfgang Horninger, Josef Oswald
INTRODUCTION: Although cross-trigonal ureteral reimplantation (Cohen) is a commonly used technique in children, it represents a non-physiological transfer of the ureteral orifices and may prove challenging with regard to endoscopic ureteral operations in later life. In 1964, Mathisen described an alternative method of ureteral reimplantation with lateralization of the neohiatus, creating an orthotopic course of the submucosal ureter. We have evaluated success and complication rates of both techniques that were applied sequentially at our departments...
July 7, 2016: Journal of Pediatric Urology
Sarah Kuipers, Eric H J R van der Horst, Jonathan I M L Verbeke, Arend Bökenkamp
The endoscopic STING procedure using Deflux is a common and minimal invasive treatment for vesicoureteral reflux. Herein we present the case of an 11-year-old girl with loin pain and de novo hydronephrosis and megaureter on the left. Ultrasound and plain abdominal X-ray demonstrated a calcification at the ureterovesical junction. She had been treated with Deflux injections 5 years before. The clinical quiz addresses the differential diagnosis, workup, and pathogenesis of calcifications at the ureterovesical junction following endoscopic reflux therapy...
2016: Global Pediatric Health
Marcel Drlík, Hana Flogelová, Kubát Martin, Tomášek Jan, Zerhau Pavel, Šmakal Oldřich, Novák Ivo, Komarc Martin, Kočvara Radim
INTRODUCTION: Low initial differential renal function (DRF) in patients with primary non-refluxing megaureter (PNRM) is considered an indication for surgery as are an increase of dilatation and symptoms. OBJECTIVE: We hypothesized that low DRF is not necessarily a result of obstruction, but may be due to impaired development of the upper urinary tract. Thus, in the absence of symptoms, there is a low risk for further loss of renal function. This study aimed to assess whether initially low DRF is a reliable indicator of obstruction...
August 2016: Journal of Pediatric Urology
Ariela Hoxha, Antonia Calligaro, Emma Di Poi, Susanna Peccatori, Maria Favaro, Teresa Del Ross, Roberta Ramonda, Chiara Grava, Bernd Raffeiner, Paola Ravagni, Salvatore De Vita, Amelia Ruffatti
OBJECTIVE: As many inflammatory rheumatic diseases affect patients in childbearing age, some concern has been expressed about the safety of biologic drugs during pregnancy. This study evaluated the effects of anti-tumor necrosis factor alpha (TNFα) agents on pregnancy/foetal outcomes. METHODS: Thirty-eight pregnancies were followed prospectively from November 2008 to February 2015. Information about the patients' exposure to anti-TNFα, disease activity, DMARD therapy, pregnancy/foetal outcomes were registered...
June 22, 2016: Joint, Bone, Spine: Revue du Rhumatisme
E Ozturk, O Telli, M I Gokce, C Ozcan, T M Okutucu, T Soygur, B Burgu
INTRODUCTION: It is generally agreed that the cause of a megaureter is narrowing at the vesicoureteral junction, with a functional obstruction arising from an aperistaltic, juxtavesical segment that is unable to transport urine at an acceptable rate. Histological examinations of megaureter specimens have reported several histological analyses, and the pathogenic role of transforming growth factor is still a matter of speculation. OBJECTIVE: To evaluate whether transforming growth factor-beta (TGF-β) and its receptors (TGFRs) are expressed during ureterovesical junction (UVJ) and lower ureter development in mice, and whether exogenous TGF-β might postpone the maturation of smooth muscle cells, in the pathogenesis of megaureter using an embryonic organ-culture model...
June 6, 2016: Journal of Pediatric Urology
Ciro Esposito, Maria Escolino, Manuel Lopez, Alessandra Farina, Mariapina Cerulo, Antonio Savanelli, Angela La Manna, Maria Grazia Caprio, Alessandro Settimi, Francois Varlet
AIM: Our retrospective study compared the results of three surgical procedures for correction of pediatric vesicoureteral reflux (VUR): open Cohen, laparoscopic Lich-Gregoir reimplantation (LEVUR), and endoscopic subureteric injection (STING) procedure. METHODS: We analyzed 90 patients (50 girls, 40 boys, average age 4.86 years) operated in two centers of pediatric surgery for VUR. Exclusion criteria were Grade 1 VUR, Grade 5 VUR with megaureters requiring ureteral tapering, secondary VUR, and patients already operated for VUR...
July 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Michael E Chua, Jessica M Ming, Walid A Farhat
Diagnostic imaging in pediatric urology has traditionally relied upon multiple modalities based on availability, use of ionizing radiation, and invasiveness to evaluate urological anomalies. These modalities include ultrasonography, voiding cystourethrography, fluoroscopy and radionuclide scintigraphy. Magnetic resonance urography (MRU) has become increasingly useful in depicting more detailed abdominal and pelvic anatomy, specifically in duplex collecting systems, ectopic ureter, ureteropelvic junction (UPJ) obstruction, megaureter and congenital pelvic anomalies...
May 2016: Pediatric Radiology
S Yu Sichkar, I I Afukov, O V Koshko, N V Yeliseeva
Introduction of local anesthetic proved application of epidural (EP) as an effective and safe way of an analgesia in intra- and the post-operational period and now it is widely applied at children of all age groups (1). However there is a number of contraindications for application of this type of an analgesia. At children till 6 months lower dosages of a ropivacain of 2 mg/kg are applied, considering their age features. At the phenomena of system toxicity infusion of 20% lipofundin is applied. The child has an age 1...
January 2016: Anesteziologiia i Reanimatologiia
Allison A Eubanks, Hector M Gonzalez
BACKGROUND: Vaginal cysts are a common finding. The differential diagnosis includes epidermal inclusion, Bartholin gland, Gartner duct, and Skene gland cysts and Müllerian anomalies. Rarely, leiomyomas, cancers, or ectopic ureters or megaureters are found. CASE: A 31-year-old woman, gravida 3 para 3, presented with a 12-year history of intermittent abdominal pain and involuntary loss of urine. She was diagnosed with ectopic vaginal megaureter after evaluation and subsequently underwent a nephroureterectomy with a marsupialized distal ureter...
May 2016: Obstetrics and Gynecology
Mohan S Gundeti, William R Boysen, Anup Shah
BACKGROUND: Robot-assisted laparoscopic extravesical ureteral reimplantation (RALUR-EV) is being adopted at large pediatric urology centers in the United States, but currently there is not consensus on surgical technique to facilitate the best possible outcomes. OBJECTIVE: To describe technique modifications that may lead to improved radiographic vesicoureteral reflux (VUR) resolution. DESIGN, SETTING, AND PARTICIPANTS: Between December 2008 and February 2015, a single surgeon performed RALUR-EV at an academic medical center...
March 29, 2016: European Urology
Elisa Tassano, Sara Janis, Alberto Canepa, Elisabetta Zanotto, Corrado Torello, Giorgio Gimelli, Cristina Cuoco
We describe a 19-month-old male presenting with right stenotic megaureter, anemia and thrombocytopenia, cardiac and ophthalmologic abnormalities. Analysis with array-based comparative genomic hybridization (aCGH) revealed an interstitial deletion of about 2.4 Mb of chromosome 11q24.2q24.3. We compared the phenotype of our patient with that of recently reported patients studied by aCGH, who showed an overlapping deletion. We also analysed the gene content of the deleted region in order to investigate the possible involvement of specific genes in the clinical phenotype...
August 2016: Journal of Applied Genetics
Luis H Braga, Jennifer D'Cruz, Mandy Rickard, Kizanee Jegatheeswaran, Armando J Lorenzo
PURPOSE: We examined data on a cohort of patients with primary nonrefluxing megaureter to determine risk factors for febrile urinary tract infection, indications for surgery and time to resolution. MATERIALS AND METHODS: The records of patients younger than 24 months with primary nonrefluxing megaureter were prospectively captured from 2008 to 2015. Six a priori defined variables were studied, including gender, circumcision status, hydronephrosis SFU (Society for Fetal Urology) grade (low--1 and 2 vs high--3 and 4), continuous antibiotic prophylaxis use, ureteral dilatation (greater than 11 mm) and tortuosity...
April 2016: Journal of Urology
Marija Radulović, Dragan Pucar, Ljiljana Jauković, Marija Sisić, Zoran Krstić, Boris Ajdinović
BACKGROUND/AIM: The controversy over the postnatal management of infants with antenataly detected hydronephrosis (ANH) still exists. We presented the results of diuretic 99mTc diethylenetriamine pentaacetic acid (DTPA) renography in 30 infants with the antenatal diagnosis of unilateral renal pelvic dilatation. The aim of this study was to assess the renal function determined by the pattern of drainage and split renal function (SRF) on diuretic renography and to correlate these findings with anteroposterior pelvic diameter (APD) estimated by ultrasonography...
December 2015: Vojnosanitetski Pregled. Military-medical and Pharmaceutical Review
Mingming Yu, Geng Ma, Zheng Ge, Rugang Lu, Yongji Deng, Yunfei Guo
BACKGROUND: Congenital giant megaureter (CGM) is uncommon in the pediatric population. The major clinical presentations are marked protruberances and abdominal cysts. CASE PRESENTATION: We reported a case of CGM with almost the whole left ureter dilation accompanied with a 1 cm stricture at the entrance of the bladder and renal dysplasia, immediately compressing the contralateral ureter and causing bilateral hydronephrosis for the first time. At one-stage of the operation, a left nephrostomy with a right ureterolysis were performed, and a poor left kidney function was found...
2016: BMC Urology
Samuel Nef, Thomas J Neuhaus, Giuseppina Spartà, Marcus Weitz, Kathrin Buder, Josef Wisser, Rita Gobet, Ulrich Willi, Guido F Laube
UNLABELLED: Congenital anomalies of the kidney and urinary tract are common findings on fetal ultrasound. The aim of this prospective observational study was to describe outcome and risk factors in 115 patients born 1995-2001. All prenatally diagnosed children were stratified into low- and high-risk group and followed postnatally clinically and by imaging at defined endpoints. Risk factors were evaluated using odds ratios. Neonatal diagnosis included pelvi-ureteric junction obstruction (n = 33), vesicoureteral reflux (n = 27), solitary mild pelvic dilatation (postnatal anteroposterior diameter 5-10 mm; n = 25), and further diagnosis as primary obstructive megaureter, unilateral multicystic dysplastic kidney, renal dysplasia and posterior urethral valves...
May 2016: European Journal of Pediatrics
Futoshi Matsui, Kenji Shimada, Fumi Matsumoto, Koji Yazawa, Satoko Matsuyama, Takuya Ito
INTRODUCTION: To overcome the tension of anastomosis between ureter and bladder for complex ureteroneocystostomy in children, we describe a novel technique utilizing an ipsilateral umbilical ligament (occluded umbilical artery) to fix the bladder. TECHNICAL CONSIDERATIONS: From July 1991 to December 2013, 18 patients (13 girls, 5 boys) underwent our technique for complex ureteroneocystostomy. Median age at surgery was 61 months. The main indications for surgery were ectopic ureter in 9 patients, primary obstructive megaureter in 3, and persistent vesicoureteral reflux after surgery in 2...
April 2016: Urology
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