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Megaureter

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https://www.readbyqxmd.com/read/28479766/novel-technique-of-laparoscopic-extravesical-ureteric-reimplantation-in-primary-obstructive-megaureter
#1
Altaf Khan, Mujeebu Rahiman, Ashish Verma, Rahul Bhargava
OBJECTIVE: This study aims to demonstrate a novel laparoscopic technique of tapering megaureter without disrupting the blood supply and disconnecting the ureter. MATERIALS AND METHODS: Eight cases of primary obstructive megaureter in the age group of 14-22 years underwent laparoscopic extravesical ureteric reimplantation between August 2011 and July 2015 using our novel technique. Five patients had obstruction on left side and three on right side. Follow-up ultrasonography at 1 month and 3 months, voiding cystourethrogram (VCUG) at 3 months and intravenous urogram (IVU) at 6 months was obtained to assess the development of reflux and to look for adequate drainage of the obstructive ureter...
April 2017: Urology Annals
https://www.readbyqxmd.com/read/28476680/an-inguinal-approach-to-complex-extravesical-ureteral-reimplantation
#2
Adam S Howe, Lane S Palmer
OBJECTIVE: To report our experience in applying the Lich-Gregoir extravesical ureteral reimplantation (EVR) approach to complex cases (megaureter, duplex systems) through a small inguinal incision, with the goal of minimizing invasiveness. MATERIALS & METHODS: We reviewed the records of all patients who underwent common sheath and/or tapered EVR through an inguinal incision. Patient characteristics and reflux grade were obtained, and outcomes were assessed. The technique involved a 2 cm incision made in the lowest inguinal skin crease, standard cord exposure and lateral retraction, opening the floor of the canal to isolate the ureter...
May 2, 2017: Urology
https://www.readbyqxmd.com/read/28422037/ureteral-meatotomy-as-an-option-in-the-management-of-primary-obstructive-megaureter-in-neonates-and-infants
#3
Priscila Cardoso Braz, Fernanda Ghilardi Leão, Jovelino Quintino de Souza Leão, Luciano Silveira Onofre, Giselle Machado Campos de Oliveira, José Carnevale, Carlos Miguélez Lago
Differentiating between the cases of megaureter that require surgery and the ones in whom treatment can be delayed is challenging. A large number of surgical techniques for the treatment of POM been proposed aiming mainly to reduce renal damage by relieving the affected ureter. Resection of the affected ureteral segment followed by vesicoureteral reimplantation either with or without reduction ureteroplasty is the classic treatment, however posing a high rate of complications when performed in patients aged less than one year...
April 2017: Archivos Españoles de Urología
https://www.readbyqxmd.com/read/28166087/genitourinary-malformations-an-under-recognized-feature-of-ectrodactyly-ectodermal-dysplasia-and-cleft-lip-palate-syndrome
#4
Zerin Hyder, Victoria Beale, Ruth O'Connor, Jill Clayton-Smith
The ectodermal dysplasia and cleft lip/palate (EEC) syndrome describes the association of ectrodactyly, ectodermal dysplasia and orofacial clefting. As with many autosomal dominant disorders, there is variability in expression and not all of these three core features are present in every individual with the condition. Moreover, there may be additional associated features, which are under-recognized. One of these is the presence of genitourinary anomalies, some of which cause significant morbidity. This report details a further two patients with EEC syndrome and genitourinary involvement, including flaccid megacystis with detrusor muscle failure, bilateral hydronephrosis and megaureter, requiring significant renal and urological involvement during their childhood...
April 2017: Clinical Dysmorphology
https://www.readbyqxmd.com/read/28161229/-secondary-megaureter-a-rare-complication-of-deflux-%C3%A2-endoscopic-management-of-vesicoureteral-reflux-in-children
#5
N Boudaoud, A Line, M Pons, F Lefebvre, M A Bouche Pillon, C Francois, M L Poli Merol
Endoscopic management is the gold standard for symptomatic low-grade vesicoureteral reflux (VUR) in children. Deflux(®) (hyaluronic acid/dextranomer) injection is highly effective and has very few complications. We report on two cases of secondary megaureter after Deflux(®) injections. In the first case, a boy presented with Grade 4 VUR. He received a bilateral Deflux(®) injection with a total of three syringes. The postoperative ultrasound was normal. However, a check-up ultrasound 3 years later showed a significant ureteropyelocalyceal dilatation, with stasis and decreased renal function on scintigraphy, the reason why antireflux surgery (Cohen procedure) was performed...
February 1, 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/27979846/boari-flap-reconstruction-in-a-male-infant-with-solitary-kidney-and-associated-megaureter
#6
Durgesh Kumar Saini, Rahul Janak Sinha, Ashok Kumar Sokhal, Vishwajeet Singh
A 1-year-old male infant presented with fever and abdominal lump for 3 months with increased leucocyte count (15 300/mm(3)) and serum creatinine (0.83 mg%). Abdominal ultrasound and renal scan demonstrated solitary left kidney with dilated tortuous left ureter. Voiding cystourethrogram was unequivocal. Left percutaneous nephrostomy was placed after poor response to perurethral catheterisation. His serum creatinine dropped to 0.58 mg/dL. Subsequent percutaneous nephrostogram and CT nephrostogram showed dilated left pelvicalyceal system, dilated, tortuous left ureter...
December 15, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27951542/critical-analysis-of-a-series-of-early-inguinal-ureterostomies-are-they-useful-and-how-well-are-they-tolerated
#7
Aurore Bouty, Yan Lefevre, Luke Harper, Antoine Tran, Pierre Vergnes, Eric Dobremez
INTRODUCTION: The study aimed to evaluate the advantages of temporary inguinal ureterostomy in the management of neonates with uropathies and early or recurrent pyelonephritis. PATIENTS AND METHODS: We performed a retrospective analysis of all patients who underwent ureterostomies between 1989 and 2012, with specific regards to indications and outcomes. We also performed a survey of parents to evaluate their acceptance of diversion. RESULTS: We included 18 patients (12 primary high-grade vesicoureteral reflux [VUR] and 6 primary obstructive megaureters [MUs])...
2017: Urologia Internationalis
https://www.readbyqxmd.com/read/27867850/minimal-access-surgery-in-the-management-of-pediatric-urolithiasis
#8
Ana Catarina Fragoso, Henry Steyaert, Pierre Arnaud, Ciro Esposito, Jose Estevao-Costa, Jean-Stephane Valla
BACKGROUND: In contrast to adult patients, a relatively large number of open surgical procedures are still needed in the treatment of urolithiasis in children. Since almost all open surgical techniques may be reproduced by minimal access surgery (MAS), there is a rationale to apply the latter in the management of pediatric urolithiasis. Our study aimed to assess the feasibility and outcome of MAS in the treatment of pediatric urinary calculi. METHODS: The charts of patients with urolithiasis submitted to MAS between 1994 and 2007 were retrospectively reviewed...
October 2016: Translational pediatrics
https://www.readbyqxmd.com/read/27842760/-laparoscopic-ureterovesical-repair-for-megaureter-treatment
#9
Sergio Landa-Juárez, Alejandra Guerra-Rivas, Ramón Salgado-Sangri, Ana María Castillo-Fernandez, Hermilo de la Cruz-Yañez, Carlos Garcia-Hernandez
BACKGROUND: An alternative treatment for obstructive and refluxing obstructive megaureter with ureterovesical junction maintenance through laparoscopy is proposed. MATERIAL AND METHODS: The series consists of 8 cases, all of them studied because of prenatal hydronephrosis or febrile urinary tract infection. Seven were diagnosed with obstructive megaureter and one with obstructive refluxing megaureter. The procedure consisted in incising the stenotic portion of the ureter longitudinally and maintaining its posterior wall attached to the bladder, the anterior wall of the ureter was anastomosed transversally to the bladder mucosa in order to liberate the obstruction...
November 11, 2016: Cirugia y Cirujanos
https://www.readbyqxmd.com/read/27836442/intravesical-ureteric-reimplantation-for-primary-obstructed-megaureter-in-infants-under-1-year-of-age
#10
Emily Jude, Aniruddh Deshpande, Andrew Barker, Japinder Khosa, Naeem Samnakay
PURPOSE: This study aimed to assess the outcome of intravesical ureteric reimplantation for primary obstructed megaureter (POM) performed in infants under 1 year of age. MATERIALS AND METHODS: A retrospective cohort study was carried out of all infants undergoing intravesical ureteric reimplantation surgery for POM at two pediatric centers in the 12 years between 2003 and 2014. Outcomes were compared with those of children aged over 1 year undergoing intravesical reimplantation for POM during this period...
February 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/27746247/cowper-s-syringocele-a-rare-differential-diagnosis-of-infravesical-obstruction-in-boys-and-young-adults
#11
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...
February 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/27590133/modified-ureteral-orthotopic-reimplantation-method-for-managing-infant-primary-obstructive-megaureter-a-preliminary-study
#12
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...
December 2016: International Urology and Nephrology
https://www.readbyqxmd.com/read/27493810/the-embedded-nipple-an-optimal-technique-for-re-implantation-of-primary-obstructed-megaureter-in-children
#13
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
https://www.readbyqxmd.com/read/27492776/primary-non-refluxive-megaureter-in-children-single-center-experience-and-follow-up-of-212-patients
#14
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
https://www.readbyqxmd.com/read/27430662/evaluation-of-mathisen-s-technique-for-ureteral-reimplantation-in-children-with-primary-vesicoureteral-reflux
#15
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...
December 2016: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/27408905/prevesical-calcification-and-hydronephrosis-in-a-girl-treated-for-vesicoureteral-reflux
#16
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
https://www.readbyqxmd.com/read/27349149/isolated-low-initial-differential-renal-function-in-patients-with-primary-non-refluxing-megaureter-should-not-be-considered-an-indication-for-early-surgery-a-multicentric-study
#17
MULTICENTER STUDY
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
https://www.readbyqxmd.com/read/27344079/pregnancy-and-foetal-outcomes-following-anti-tumor-necrosis-factor-alpha-therapy-a-prospective-multicentre-study
#18
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
https://www.readbyqxmd.com/read/27321555/effects-of-transforming-growth-factor-on-the-developing-embryonic-ureter-an-in-vitro-megaureter-model-in-mice
#19
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...
October 2016: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/27284903/surgical-management-of-pediatric-vesicoureteral-reflux-a-comparative-study-between-endoscopic-laparoscopic-and-open-surgery
#20
MULTICENTER STUDY
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
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