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Upj obstruction

John M Gatti, Sable Amstutz, Paul R Bowlin, Heidi A Stephany, J Patrick Murphy
PURPOSE: Open dismembered pyeloplasty is the preferred repair for ureteropelvic junction (UPJ) obstruction. Minimally invasive techniques have been applied to the original open approach, but no clear advantage has been shown to these technological advances. We evaluate outcomes between transperitoneal laparoscopic (LP) and open pyeloplasty (OP) in children. METHODS: All children aged 1 to 18 years with UPJ obstruction requiring operative repair were offered enrollment in the study...
October 17, 2016: Journal of Urology
Yuichiro Yamazaki, Woo Jin Kim, Sayaka Akiyama, Takashi Ikeda
PURPOSE: The aim of this study was to compare the results of the retroperitoneoscopic assisted pyeloplasty (RASP) using EZ access (silicone rubber cap) with open dismembered pyeloplasty (ODP) in children. METHODS: A retrospective review was performed of patients treated for ureteropelvic junction (UPJ) obstruction with either RASP or ODP from 2010 to 2015. For patients with RASP, two 5-mm trocars were placed in the EZ access. The UPJ was dissected retroperitoneoscopically and dismembered pyeloplasty was performed extracorporeally...
September 23, 2016: Journal of Pediatric Surgery
Franck Boizard, Valérie Brunchault, Panagiotis Moulos, Benjamin Breuil, Julie Klein, Nadia Lounis, Cécile Caubet, Stéphanie Tellier, Jean-Loup Bascands, Stéphane Decramer, Joost P Schanstra, Bénédicte Buffin-Meyer
Although capillary electrophoresis coupled to mass spectrometry (CE-MS) has potential application in the field of metabolite profiling, very few studies actually used CE-MS to identify clinically useful body fluid metabolites. Here we present an optimized CE-MS setup and analysis pipeline to reproducibly explore the metabolite content of urine. We show that the use of a beveled tip capillary improves the sensitivity of detection over a flat tip. We also present a novel normalization procedure based on the use of endogenous stable urinary metabolites identified in the combined metabolome of 75 different urine samples from healthy and diseased individuals...
October 3, 2016: Scientific Reports
Farouk M Nasser, Ahmed M Shouman, Mohammed S ElSheemy, Mohammed A Lotfi, Waseem Aboulela, Mohamed El Ghoneimy, Mohammed Abdelwahab, Ahmed I Shoukry, Waleed Ghoneima, Hany Morsi, Hesham Badawy
OBJECTIVES: To compare outcome of dismembered-pyeloplasty in infants with and without external nephro-ureteric stent (ENUS) for treatment of congenital ureteropelvic junction obstruction (UPJ-O). METHODS: This is a parallel, randomized comparative study between October 2013 and September 2014. 30 infants ≤6 months old with UPJ-O indicated for dismembered-pyeloplasty were randomly assigned (block randomization, closed envelope method) into two groups; group-A (stentless) and group-B (ENUS)...
September 28, 2016: Urology
Nuno Fidalgo, Hugo Pinheiro, Frederico Ferronha, Jorge Morales, Luís Campos Pinheiro
The retrocaval ureter is a rare congenital entity, classically managed with open pyeloplasty techniques. The experience obtained with the laparoscopic approach of other more frequent causes of ureteropelvic junction (UPJ) obstruction has opened the method for the minimally invasive approach of the retrocaval ureter. In our paper, we describe a clinical case of a right retrocaval ureter managed successfully with laparoscopic dismembered pyeloplasty. The main standpoints of the procedure are described. Our results were similar to others published by other urologic centers, which demonstrates the safety and feasibility of the procedure for this condition...
2016: Case Reports in Urology
Amanda J Lee, Noemi Polgar, Josephine A Napoli, Vanessa H Lui, Kadee-Kalia Tamashiro, Brent A Fujimoto, Karen S Thompson, Ben Fogelgren
Congenital obstructive nephropathy (CON) is the most prevalent cause of pediatric chronic kidney disease and end-stage renal disease. The ureteropelvic junction (UPJ) region, where the renal pelvis transitions to the ureter, is the most commonly obstructed site in CON. The underlying causes of congenital UPJ obstructions remain poorly understood, especially when they occur in utero, in part due to the lack of genetic animal models. We previously showed that conditional inactivation of Sec10, a central subunit of the exocyst complex, in the epithelial cells of the ureter and renal collecting system resulted in late gestational bilateral UPJ obstructions with neonatal anuria and death...
2016: Scientific Reports
Jialu Liu, Li Sun, Qian Shen, Xiaohui Wu, Hong Xu
BACKGROUND: Disruption of ROBO2 in humans causes vesicoureteral reflux (VUR)/congenital anomalies of the kidney and urinary tract (CAKUT). PiggyBac (PB) is a DNA transposon, and its insertion often reduces-but does not eliminate-gene expression. The Robo2 insertion mutant exhibited non-dilating VUR, ureteropelvic junction obstruction (UPJO) not found in reported models. We studied the incidence and outcomes of VUR/CAKUT in this mutant and explored the relationship between Robo2 gene expression and the occurrence and severity of VUR/CAKUT...
2016: BMC Nephrology
Sabrina Thalita Reis, Kátia R M Leite, Nayara Izabel Viana, Roberto Iglesias Lopes, Caio Martins Moura, Renato F Ivanovic, Marcos Machado, Francisco Tibor Denes, Amilcar Giron, William Carlos Nahas, Miguel Srougi, Carlo C Passerotti
BACKGROUND: Ureteropelvic junction obstruction (UPJO) diagnosed prenatally occurs in 1:150 - 1:1200 pregnancies. Although many studies investigating the molecular changes of this obstructed segment have been performed, the underlying mechanisms are still unclear. The role of extracellular matrix (ECM) components remains controversial, and the investigations in the field of ECM changes, might help the better understanding of the pathogenesis of this common condition. The aim of the present study was to investigate for the first time in the literature whether MMP9 and its specific inhibitors, TIMP1 and RECK, are expressed in a reproducible, specific pattern in UPJ...
2016: BMC Urology
Omer Yilmaz, Nalan Nese, Mustafa Dalgic, Gonca P Kesici, Abdulkadir Genc, Can Taneli, Cuneyt Gunsar, Aydın Sencan, Hasan Cayirli, Aydın Isisag
OBJECTIVES: To compare pathological samples obtained from cases that underwent surgery for ureteropelvic junction (UPJ) obstruction with samples obtained during autopsies of subjects.  METHODS: Retrospectively, 42 patients who had undergone surgery due to UPJ obstruction (group 1) were included in the study. Histopathological and immunohistochemical features for sonic hedgehog (SHH), TBX18, and TSHZ3 of UPJ were evaluated and findings were compared with 20 autopsy cases (group 2)...
July 2016: Saudi Medical Journal
M S Silay, A F Spinoit, S Undre, V Fiala, Z Tandogdu, T Garmanova, A Guttilla, A A Sancaktutar, B Haid, M Waldert, A Goyal, E C Serefoglu, E Baldassarre, G Manzoni, A Radford, R Subramaniam, A Cherian, P Hoebeke, M Jacobs, B Rocco, R Yuriy, Fabio Zattoni, R Kocvara, C J Koh
INTRODUCTION: Minimally invasive pyeloplasty (MIP) for ureteropelvic junction (UPJ) obstruction in children has gained popularity over the past decade as an alternative to open surgery. The present study aimed to identify the factors affecting complication rates of MIP in children, and to compare the outcomes of laparoscopic (LP) and robotic-assisted laparoscopic pyeloplasty (RALP). MATERIALS AND METHODS: The perioperative data of 783 pediatric patients (<18 years old) from 15 academic centers who underwent either LP or RALP with an Anderson Hynes dismembered pyeloplasty technique were retrospectively evaluated...
August 2016: Journal of Pediatric Urology
Nathan Osbun, Jonathan S Ellison, Thomas S Lendvay
INTRODUCTION: Fibroepithelial polyps of the ureter are a rare cause of asymptomatic and symptomatic upper urinary tract obstruction in children. While these lesions can often be managed endoscopically, large or multifocal polyps may preclude such an approach. OBJECTIVE: We aim to describe our institutional experience with robot-assisted laparoscopic treatment of ureteral polyps and show that a robotic approach is an effective alternative for large or multifocal polyps...
August 2016: Journal of Endourology
Rajendra B Nerli, Prasad V Magdum, Shridhar C Ghagane, Murigendra B Hiremath, Mallikarjuna Reddy
BACKGROUND: Over the past three decades, laparoscopic surgery has become a well-established alternative to open surgery in the management of ureteropelvic junction (UPJ) obstruction. Currently, several efforts are being made, aimed at further reducing the morbidity associated with conventional laparoscopy. We report our experience with modified umbilical port laparoscopic pyeloplasty in children. MATERIALS AND METHODS: Children presenting with hydronephrosis secondary to UPJ obstruction formed the study group...
January 2016: African Journal of Paediatric Surgery: AJPS
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
Ajit Sawant, Gaurav Kasat, Prakash Pawar, Ashwin Tamhankar
Patients with ureteropelvic junction (UPJ) obstruction can present with flank pain or hematuria. We present 20-year-old male presenting with acute pain in lumbar and right fossa with tenderness and guarding, this case was clinically mimicking general surgical emergency. On computed tomography with urography and angiography, there was 15 cm × 11 cm × 10 cm size non-enhancing hyperdense lesion (average Hounsfield units - +64) in right renal pelvis suggestive of hematoma. Patient's diethylenetriaminepentaacetic acid diuretic renography was suggestive of right kidney glomerular function rate of 48...
April 2016: Urology Annals
Katarzyna Pilch, Przemysław Jaźwiec, Krystian Truszkiewicz, Paweł Gać
Ureteropelvic junction obstruction (UPJO) is defined as an impedance in the normal flow of urine from the renal pelvis into the proximal ureter. This leads to an increase urine pressure in the pelvicalyceal system and as a consequence cause hydronephrosis and damage of renal parenchyma. Presence of anomalous vessels crossing the ureter (crossing vessels) is one of the many reasons of UPJ obstruction. We report a case of 32-year-old female patient with chronic abdominal pain and recurrent episodes of pyelonephritis in the past...
2016: Przegla̧d Lekarski
Alice Faure, Kevin London, Grahame Hh Smith
OBJECTIVES: To describe the drainage and functional outcome following paediatric pyeloplasty, one week after stent removal (seven to nine weeks after pyeloplasty) using diuretic renography. PATIENTS AND METHODS: Between 2009 and 2014, we assessed the functional and drainage outcomes on mercaptoacetyltriglycine (MAG-3) diuretic renograms from 66 children (69 kidneys) who underwent modified dismembered Anderson-Hynes pyeloplasty for UPJ obstruction. Stents were left in place for 6 to 8 weeks and postoperative renal units were evaluated with MAG-3 renogram one week after stent removal...
April 22, 2016: BJU International
Tuna Mut, Ömer Acar, Tayfun Oktar, Işın Kılıçaslan, Tarık Esen, Haluk Ander, Orhan Ziylan
INTRODUCTION: Based on current knowledge, it is possible to have an initial diagnosis of intrinsic or extrinsic ureteropelvic junction obstruction (UPJO) based solely on clinical and imaging findings. However, it may not be possible to strictly discriminate an intrinsic case with an additional extrinsic component from a primarily intrinsic stenosis because of lower pole aberrant vessels. These two disorders may coexist or trigger each other. Herein, we aimed to compare the histological changes observed in intrinsic and extrinsic types of UPJO...
August 2016: Journal of Pediatric Urology
Marshall C Strother, Phillip Mucksavage
Ureteropelvic junction obstruction (UPJO) is a common congenital abnormality that often presents in adulthood. Open dismembered pyeloplasty was considered the gold standard for the management of this condition; however, recent advancements in laparoscopic and robotic surgery have dramatically shifted the landscape to more minimally invasive techniques. A literature search of ureteropelvic junction obstruction, pyeloplasty, endopyelotomy, laparoscopic pyeloplasty, robotic pyeloplasty, and microlaparoscopic pyeloplasty was performed...
May 2016: Current Urology Reports
M L Garcia-Roig, J D Grattan-Smith, A M Arlen, E A Smith, A J Kirsch
INTRODUCTION: Magnetic resonance urography (MRU) has proven to be useful in the setting of complex urologic anatomy. Prune belly syndrome (PBS) patients are known to have malformed and highly variable urinary tract anatomy due to significant dilation and renal dysplasia. OBJECTIVE: To further characterize the renal and ureteral anatomy and renal function in patients with PBS via MRU. STUDY DESIGN: Children with PBS undergoing MRU (2006-2011) were identified...
April 2016: Journal of Pediatric Urology
Heather L Hopf, Clinton D Bahler, Chandru P Sundaram
OBJECTIVE: To describe the long-term outcomes of robot-assisted laparoscopic pyeloplasty (RALP) for the correction of ureteropelvic junction (UPJ) obstruction. METHODS: A retrospective electronic medical record review of RALPs from October 2002 to July 2014 was performed, with additional follow-up for patients released from regular urological care obtained by phone. RALP success was defined as resolution of symptoms of UPJ obstruction, improved hydronephrosis radiographically, or resolution of obstruction on follow-up Tc-99m mercaptoacetyltriglycine renal scan, intravenous pyelogram, or Whitaker test...
April 2016: Urology
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