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Neslihan Karakurt, Nesrin Beşbaş, Ali Cansu Bozacı, Yelda Bilginer, Hasan Serkan Doğan, Serdar Tekgül
This study was performed to evaluate the role of postnatal ultrasonography (US) in predicting the final diagnosis and need of surgery of antenatal hydronephrosis patients. One hundred and twenty six renal units (RUs) of 76 patients with diagnosis of antenatal hydronephrosis (ANH) were studied. An early postnatal US no later than the first week of life was requested. Voiding cystourethrography (VCUG) and/or diuretic renogram (MAG3) was performed in children who had persistent or worsening hydronephrosis to make a certain diagnose of etiology...
November 2015: Turkish Journal of Pediatrics
Morihiro Nishi, Kazumasa Matsumoto, Tetsuo Fujita, Masatsugu Iwamura
INTRODUCTION: To evaluate the efficacy of laparoscopic pyeloplasty (LPP) for lower functioning kidney, we investigated the outcome of this procedure for patients with ureteropelvic junction obstruction with decreased renal function, defined as less than 20% split renal function. PATIENTS AND METHODS: Between October 1998 and June 2015, we performed transperitoneal dismembered LPP in 224 patients. Among them, 15 patients with less than 20% split renal function were included in this study...
October 14, 2016: Journal of Endourology
Subramanian Vaidyanathan, Azi Samsudin, Gurpreet Singh, Peter L Hughes, Bakul M Soni, Fahed Selmi
INTRODUCTION: Paraplegic patients are at greater risk of developing complications following ureteroscopic lithotripsy because of urine infection associated with neuropathic bladder, difficulties in access due to altered anatomy of urinary bladder and urethra, spinal curvature, spasticity, and contractures. We report the occurrence of large subcapsular hematoma following ureteroscopy and discuss lessons we learn from this case. CASE REPORT: A 48-year-old male patient with spina bifida underwent ureteroscopy with laser lithotripsy and ureteric stenting for left ureteric stone and staghorn calculus with hydronephrosis; laser lithotripsy was repeated after 3 months; both procedures were performed by a senior urologist and did not result in any complications...
2016: International Medical Case Reports Journal
Manoj Kumar, Sanjeet Kumar Singh, Sohrab Arora, Varun Mittal, Nitesh Patidar, Sanjoy Kumar Sureka, M S Ansari
INTRODUCTION: The duration, methods and frequency of radiographic follow-up after pediatric pyeloplasty is not well-defined. We prospectively evaluated a cohort of children undergoing pyeloplasty to determine the method for follow-up. METHODS: Between 2000 and 2008, children undergoing pyeloplasty for unilateral ureteropelvic junction obstruction were evaluated for this study. All patients were evaluated preoperatively with protocol ultrasound (USG) and diuretic renal scan (RS)...
July 2016: Indian Journal of Urology: IJU: Journal of the Urological Society of India
Harun Ilhan, Hao Wang, Franz J Gildehaus, Carmen Wängler, Tanja Herrler, Andrei Todica, Julia Schlichtiger, Paul Cumming, Peter Bartenstein, Marcus Hacker, Alexander R Haug
BACKGROUND: Radiation-induced nephropathy is still dose limiting in radionuclide therapy of neuroendocrine tumors. We investigated the nephroprotective potential of the angiotensine converting enzyme inhibiting drug enalpril after [177Lu]-DOTATATE therapy in a murine model of radiation-induced nephropathy by renal scintigraphy. At first, the appropriate therapy activity to induce nephropathy was identified. Baseline scintigraphy (n = 12) entailed 12-min dynamic acquisitions after injection of 25 MBq [99mTc]-MAG3, which was followed by radionuclide therapy at four escalating activities of [177Lu]-DOTATATE: group (Gp) 1: 10 MBq; Gp 2: 20 MBq; Gp 3: 40 MBq; Gp 4: 65 MBq...
December 2016: EJNMMI Research
Alberto Parente, Laura Perez-Egido, Rosa Maria Romero, Ruben Ortiz, Laura Burgos, Jose Maria Angulo
PURPOSE: The aim of this study is to analyze results of retrograde endopyelotomy with cutting balloon for treatment of ureteropelvic junction obstruction (UPJO) in infants. METHODS: We routinely treat patients with UPJO under 18 months of age with retrograde high-pressure balloon dilatation of the pelviureteric junction (PUJ). During the procedure, in these cases where narrowing at the PUJ persists, endopyelotomy with cutting balloon is performed. Endopyelotomy is performed over guidewire with 5-mm Cutting Balloon™ under fluoroscopic control...
2016: Frontiers in Pediatrics
Jacob T Ark, Christopher R Mitchell, Tracy P Marien, S Duke Herrell
OBJECTIVES: To use basic measurements on contrasted computerized tomography (CT) to reliably determine whether a kidney with UPJO is definitively functional (>30% differential real function [DRF]) or nonfunctional (<10% DRF), obviating the need for nuclear medicine renogram (RG) to determine DRF. METHODS: This is a single institution, retrospective cohort of patients diagnosed with UPJO who underwent either pyeloplasty or nephrectomy between December 2004 and December 2014...
July 19, 2016: Urology
Mandy Rickard, Luis H Braga, Shreyas Gandhi, John-Paul Oliveria, Jorge Demaria, Armando J Lorenzo
OBJECTIVE: to compare pyeloplasty outcomes in children with and without SNDRF defined as >55% differential renal function (DRF) in children with ureteropelvic junction obstruction (UPJO). METHODS: Our prospectively-collected pyeloplasty database (2008-15) was reviewed (n=151). A total of 140/151 (93%) patients had pre-operative renograms and 26/140(19%) were found to have SNDRF (DRF ≥55%). Of 151 patients, 51(34%) had pre and post-operative renograms allowing determination of change ≥5% in function...
July 20, 2016: Urology
M Rickard, L H Braga, J-P Oliveria, R Romao, J Demaria, A J Lorenzo
INTRODUCTION: Renograms are frequently obtained post-pyeloplasty in patients with residual hydronephrosis to confirm adequate drainage. Recent evidence suggests that percent improvement in antero-posterior diameter (PI-APD) ≥38 is predictive of success. We sought to further explore PI-APD ranges that would allow identification of patients who would benefit from ultrasound (US) monitoring alone vs. post-operative renal scan, and those more likely to develop recurrent ureteropelvic junction obstruction (rUPJO)...
August 2016: Journal of Pediatric Urology
Gopal Pathuri, Andria F Hedrick, Vibhudutta Awasthi, Benjamin D Cowley, Hariprasad Gali
Ortho-[(131)I]iodohippurate [(131)I]OIH (marketed as Hippuran I 131), a gold standard for radionuclide renography, and [(123)I]OIH were in clinical use for decades. Here we radiolabeled OIH with (124)I (a positron emitter) to combine the desirable biological properties of OIH and to enable the use of positron emission tomography (PET) for renography. [(124)I]OIH was synthesized with a slight modification to a previously reported method for the kit preparation of [(123)I]OIH based on the Cu(II) catalyzed isotope-exchange reaction...
September 2016: Applied Radiation and Isotopes
María Fernández-Ibieta, Leonardo Nortes-Cano, María José Guirao-Piñera, Gerardo Zambudio-Carmona, Jose Ignacio Ruiz-Jiménez
INTRODUCTION: Long-term evolution of residual hydronephrosis after successful pyeloplasty is not common. In this report, we have studied new ultrasound parameters, and have investigated the frequency of residual hydronephrosis. We highlight alternative radiation-free monitoring of pediatric pyeloplasties with ultrasound alone. PATIENTS AND METHODS: Children who had undergone successful open Anderson-Hynes pyeloplasties in the period 2001-2010 were followed up. Exclusion criteria included non-clearly obstructed renography scans (tracer clearance half-time < 20 min), crossing vessels, failed pyeloplasty, bilateral disease, other renal concomitant anomaly, absence of ultrasound measurements, and loss to follow up (<1 year)...
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
Alberto Parente, Jose-Maria Angulo, Rosa Romero, Laura Burgos, Ruben Ortiz
AIM: To assess if calibration of the ureteropelvic junction (UPJ) using a high-pressure balloon inflated at the UPJ level in patients with suspected crossing vessels (CV) could differentiate between intrinsic and extrinsic stenosis prior to laparoscopic vascular hitch (VH). MATERIALS AND METHODS: We reviewed patients with UPJO diagnosed at childhood or adolescence without previous evidence of antenatal or infant hydronephrosis (10 patients). By cystoscopy, a high-pressure balloon is sited at the UPJ and the balloon inflated to 8-12 atm under radiological screening...
January 2016: International Braz J Urol: Official Journal of the Brazilian Society of Urology
Suriyanto, Eddie Y K Ng, Xian Jue Say, C E David Ng, Xuexian Sean Yan, S Dinesh Kumar
OBJECTIVE: The aim of this study was to investigate the accuracy of using a newly developed index, the ratio of urine outflow to renal pelvis volume U/V2 (1/s), in evaluating renal obstruction and determining the severity of obstruction. PATIENTS AND METHODS: A total of 42 patients' renograms (80 kidneys) were studied. Compartmental modelling was used to model the behaviour of tracers flowing through the kidney. The derived model led to the formation of the normalized urine flow rate U/V2...
September 2016: Nuclear Medicine Communications
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
Gyanendra Sharma, Anshu Sharma, Vivian Yee-Fong Leung, Winnie Chiu-Wing Chu
OBJECTIVE: To evaluate patients who had undergone pyeloplasty for pelviureteric junction obstruction, by measuring the anteroposterior diameter (APD) of the renal pelvis in supine and prone positions, and determine whether a decrease in APD in prone position can exclude obstruction in dilated renal system. MATERIALS AND METHODS: From January 2012 to December 2013, patients who had undergone pyeloplasty were evaluated by ultrasound in two centers. The difference of APD of the renal pelvis in supine and prone positions was obtained...
January 2016: Indian Journal of Radiology & Imaging
Frederic H Fahey, Sonja I Ziniel, Dacie Manion, Amanda Baker, S Ted Treves
UNLABELLED: We sought to describe the practice of pediatric nuclear medicine at general hospitals in the United States and to assess the impact of dose awareness campaigns such as Image Gently. METHODS: A web-based survey was developed that requested information regarding hospital type, whether the hospital practices pediatric nuclear medicine, and the hospital's method for determining the administered activity for children. The survey invitation was emailed to a sample of general hospitals with more than 300 beds, excluding dedicated pediatric, veterans, psychiatric, and rehabilitation hospitals...
September 2016: Journal of Nuclear Medicine: Official Publication, Society of Nuclear Medicine
Igor Sorokin, Rebecca L O'Malley, Brian K McCandless, Ronald P Kaufman
INTRODUCTION: Intracorporeal suturing is considered to be the most challenging aspect of laparoscopic and robotic surgery. To overcome this problem, barbed self-retaining sutures have been effectively employed in various minimally invasive endourologic surgeries. However, the use of this suture has been recently cautioned for pyeloplasty due to a high failure rate. Our objective was to report our experience using barbed suture during robotic pyeloplasty. METHODS: We retrospectively identified 13 consecutive patients who underwent robotic pyeloplasty with a barbed monofilament (4-0 V-Loc™) suture for the ureteropelvic anastomosis from 2011 to 2014...
June 2016: Journal of Endourology
Ilya Gorbachinsky, Kyle Wood, Marc Colaco, Sij Hemal, Jayadev Mettu, Majid Mirzazadeh, Dean G Assimos, Jorge Gutierrez-Aćeves
PURPOSE: Renal function following percutaneous nephrolithotomy has long been a concern to urologists, especially in the setting of multi-tract access. We determined whether the risk of renal injury after multi-tract percutaneous nephrolithotomy was greater than after a single access approach. MATERIALS AND METHODS: We retrospectively reviewed the records of 307 consecutive patients treated with percutaneous nephrolithotomy from 2011 to 2012 at Wake Forest Health...
July 2016: Journal of Urology
Carina Mari Aparici, Sukhkarn N Bains, David Carlson, Jesse Qian, Douglas Liou, David Wojciechowski, Jacob Werner, Sana Khan, Cameron Kroll, Manreet Sandhu, Nhan Nguyen, Randall Hawkins
Many patients with hepatorenal syndrome (HRS) end up receiving a combined liver and kidney transplant (CKLT) with preservation of native kidneys, specially type 1 HRS since is characterizes by a very rapid deterioration of renal function. Eventually, most of the patients regain renal function, but it is unknown if this is due to the transplanted kidney, the recovery of native renal function, or both. The aim of this study is to evaluate if there is recovery of native renal function in patients with HRS following CKLT...
January 2016: World Journal of Nuclear Medicine
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