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impact of distal ureter

Shadi Al-Bahri, Esther Cha, Gregory Burgoyne
INTRODUCTION: With any abdominal surgery in a difficult abdomen, the procedure is filled with potential hazards. In addition to a prolonged operative time, there is a risk of enterotomy or damage to blood vessels and ureters. An irradiated pelvis increases this risk and may cause additional morbidity such as delayed healing. An impacted foreign body can also be a challenging problem to deal with alone but when combined with a difficult abdomen can make the problem impossible. PRESENTATION OF CASE: A 67 year-old male presented with a small bowel obstruction secondary to a foreign body impacted in the distal...
2017: International Journal of Surgery Case Reports
Charalampos Fragkoulis, Athanasios Pappas, Georgios I Papadopoulos, Georgios Stathouros, Aristodimos Fragkoulis, Konstantinos Ntoumas
OBJECTIVES: To evaluate the impact of distal ureter management on oncological results after open nephroureterectomy (ONU) comparing transurethral resection of the intramural ureter to conventional open excision, as controversy still exists about the method of choice for managing the distal ureter and bladder cuff during ONU. PATIENTS AND METHODS: We retrospectively collected data from 378 patients who underwent ONU for upper urinary tract transitional cell carcinoma (UUT-TCC) from 1988 to 2009...
March 2017: Arab Journal of Urology
Albert Carrion, Jorge Huguet, Eduard García-Cruz, Laura Izquierdo, Laura Mateu, Mireia Musquera, Maria José Ribal, Antonio Alcaraz
Objective The aims of this study were to identify clinical, intraoperative and pathological prognostic factors for predicting extraurothelial recurrence and cancer-specific survival (CSS) in patients with upper urinary tract urothelial carcinoma (UTUC) who had undergone laparoscopic radical nephroureterectomy (LRNU), and to investigate the site-specific patterns of recurrence and the associated outcomes. Materials and methods A retrospective revision was undertaken of 117 consecutive patients who had undergone transperitoneal LRNU for UTUC between 2007 and 2012...
August 2016: Scandinavian Journal of Urology
Hani H Nour, Samir E Elgobashy, Amr Elkholy, Ahmad M Kamal, Mohamed Ali, Mamdouh A Roshdy, Ahmad G Elbaz, Essam Riad
No doubt, Bilharzial ureters are complicated by distal stricture due to precipitation of Bilharzial ova in distal ureter. These cases are associated with poorly functioning and grossly hydronephroic kidneys that hinder endoscopic manipulation of the coexistent distal, high burden, long standing impacted stones. Thus, laparoscopic uretrolithotomy was performed in 51 bilharzial patients with distal ureteric stones 4 trocars were used. The ureter was opened directly over the stone and the stone was extracted. A double-J stent was inserted into the ureter which was closed by 4-0 polyglactin running suture...
August 2015: Journal of the Egyptian Society of Parasitology
Hani H Nour, Samir E Elgobashy, Amr Elkholy, Ahmad M Kamal, Mamdouh A Roshdy, Ahmad G Elbaz, Essam Riad
OBJECTIVE: To determine the efficacy and safety of the laparoscopic management of an impacted distal ureteric stone in a bilharzial ureter, as bilharzial ureters are complicated by distal stricture caused by the precipitation of bilharzial ova in the distal ureter. These cases are associated with poorly functioning and grossly hydronephrotic kidneys that hinder the endoscopic manipulation of the coexistent distal high burden of, and long-standing, impacted stones. PATIENTS AND METHODS: We used laparoscopic ureterolithotomy, with four trocars, to manage 51 bilharzial patients (33 men and 18 women; mean age 40...
September 2015: Arab Journal of Urology
C S Cooper, S E Alexander, K Kieran, D W Storm
INTRODUCTION: For children with VUR the grade of vesicoureteral reflux (VUR) remains one of the most predictive factors relative to outcome. However, the subjective nature of the currently accepted international reflux grading system (IRGS) leads to inter-observer variation. The potential of a direct measurement of the distal ureter on the voiding cystourethrogram (VCUG) normalized to the L1-L3 vertebral body distance (ureteral diameter ratio - UDR) to augment the ability of IRGS to predict the ultimate clinical outcome has previously been reported in a group of 79 children...
August 2015: Journal of Pediatric Urology
Xiaoqing Wang, Hongli Shan, Jixue Wang, Yuchuan Hou, Jianxun Ding, Qihui Chen, Jingjing Guan, Chunxi Wang, Xuesi Chen
A tubular poly(ε-caprolactone) (PCL)/poly(lactide-co-glycolide) (PLGA) ureteral stent composed of nanofibers with micropores was fabricated by double-needle electrospinning. The stent was ureteroscopically inserted into six Changbai pigs, and the commercial polyurethane Shagong(®) stent was inserted into four pigs as control. Intravenous pyelography revealed that the PCL/PLGA stent gradually degraded from the distal end to proximal terminal, and all stents were completely degraded at 10 weeks post-insertion...
2015: International Journal of Nanomedicine
L Mateu, J Huguet, A Carrión, E García-Cruz, L Izquierdo, M Musquera, M J Ribal, A Alcaraz
OBJECTIVES: To analyze the predictors for bladder recurrence (BR) after nephroureterectomy (NU) for upper urinary tract tumors (UUTT), as well as its pathological characteristics, outcomes and impact on survival. MATERIAL AND METHODS: Retrospective study of 117 patients who underwent laparoscopic nephroureterectomy by UUTT between 2007-2012 at our center. The potential predictors for BR were analyzed using Cox regression; Kaplan-Meier curves were employed to study survival...
October 2015: Actas Urologicas Españolas
Linjin Li, Yue Pan, Zhiliang Weng, Wenshuo Bao, Zhixian Yu, Feng Wang
PURPOSE: The aim of this study was to compare the efficacy and safety between pneumatic and holmium:yttrium-aluminum-garnet (Ho:YAG) laser in the treatment of patients with ureteral stones located in the middle and distal ureter. PATIENTS AND METHODS: We conducted a prospective study in recruiting 982 eligible patients from 2009 to 2012. Patients were randomly divided into two groups-the pneumatic lithotripsy (PL) group or the Ho:YAG laser lithotripsy (LL) group...
August 2015: Journal of Endourology
William D Aiken, Peter B Johnson, Richard G Mayhew
INTRODUCTION: A woman with bilateral complete ureteral duplication with stones simultaneously obstructing both limbs of the left double ureter is presented. A search of the English medical literature suggests that this is the first reported case. Based on the initial difficulty accessing the stones via ureteroscopy we make recommendations regarding how this rare problem should be approached if encountered. PRESENTATION OF CASE: A 37-year old woman with left-sided flank pain was discovered on CT scan to have bilateral complete ureteral duplication and three stones obstructing both limbs of the left double ureter...
2015: International Journal of Surgery Case Reports
Anil Kapoor, Shawn Dason, Christopher B Allard, Bobby Shayegan, Louis Lacombe, Ricardo Rendon, Niels-Erik Jacobsen, Adrian Fairey, Jonathan Izawa, Peter Black, Simon Tanguay, Joseph Chin, Alan So, Jean-Baptiste Lattouf, David Bell, Fred Saad, Darrell Drachenberg, Ilias Cagiannos, Yves Fradet, Abdulaziz Alamri, Wassim Kassouf
INTRODUCTON: Radical nephroureterectomy for upper tract urothelial carcinoma (UTUC) must include some form of distal ureter management to avoid high rates of tumour recurrence. It is uncertain which distal ureter management technique has the best oncologic outcomes. To determine which distal ureter management technique resulted in the lowest tumour recurrence rate, we analyzed a multi-institutional Canadian radical nephroureterectomy database. METHODS: We retrospectively analyzed patients who underwent radical nephroureterectomy with distal ureter management for UTUC between January 1990 and June 2010 at 10 Canadian tertiary hospitals...
November 2014: Canadian Urological Association Journal, Journal de L'Association des Urologues du Canada
Senol Adanur, Hasan Riza Aydin, Fatih Ozkaya, Tevfik Ziypak, Ozkan Polat
BACKGROUND: We aimed to assess the effectiveness of semi-rigid ureteroscopy and holmium laser lithotripsy in the treatment of impacted ureteral stones in children. MATERIAL/METHODS: We evaluated a total of 32 children under the age of 18 years treated with ureteroscopic holmium laser lithotripsy for impacted ureteral stones between January 2005 and July 2013. Their stone-free state was defined as the absence of any residual stone on radiologic evaluation performed 4 weeks postoperatively...
November 21, 2014: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Jens U Berli, John R Montgomery, Dorry L Segev, Lloyd E Ratner, Warren R Maley, Matthew Cooper, Joseph K Melancon, James Burdick, Niraj M Desai, Nabil N Dagher, Bonnie E Lonze, Susanna M Nazarian, Robert A Montgomery
BACKGROUND: In this study, we present our experience with ureteral complications requiring revision surgery after renal transplantation and compare our results to a matched control population. METHODS: We performed a retrospective analysis of our database between 1997 and 2012. We divided the cases into early (<60 d) and late repairs. Kaplan-Meier and Cox proportional hazards models were used to compare graft survival between the intervention cohort and controls generated from the Scientific Registry of Transplant Recipients data set...
January 2015: Clinical Transplantation
Stephan Seklehner, Ortwin Heißler, Paul F Engelhardt, Claus Riedl
OBJECTIVES: To evaluate the impact of retrograde pyelography (RPG) in patients treated with ureteroscopy (URS) for ureteral calculi. METHODS: Retrospective analysis of patients treated with and without RPG prior to URS at a single institution from 2010 to 2013. Assessment of stone-free rates and intraoperative complications. RESULTS: Out of 469 URS, 211 (45%) were done with and 258 (55%) without RPG. Complete stone removal was achieved in 86...
2015: Urologia Internationalis
Hyoung Keun Park, Sung Hyun Paick, Hyeong Gon Kim, Yong Soo Lho, Sangrak Bae
PURPOSE: To minimize stent-related symptoms, the proximal part of the Polaris™ stent is composed of a firm material and its distal part is composed of a soft material. The aim of this study was to compare stent-related symptoms of Polaris and Percuflex® stents and to assess the impacts of these stents on quality of life. PATIENTS AND METHODS: A total of 144 patients were randomized to a "test" group (Polaris; n=64) or a "conventional" group (Percuflex; n=80) at the time of ureteral stent insertion after ureteroscopic stone removal surgery...
March 2015: Journal of Endourology
D A Lazica, A S Brandt, S Roth
Open surgical reconstruction of the ureter is a urological procedure with a potentially high risk of complications. The correct selection of patients and time of operation are important aspects regarding the treatment strategy. Position and length of the affected ureter segment to be reconstructed determine the surgical intervention possibilities. The psoas hitch procedure is a well-established technique for distal reconstruction of the ureter where most iatrogenic injuries occur. In more proximal or complex defects, several procedures are available...
July 2014: Der Urologe. Ausg. A
V Elalouf, J Klap, N-B Delongchamps, S Conquy, M Sibony, D Saighi, M Peyromaure, T Flam, M Zerbib, E Xylinas
INTRODUCTION: Upper urinary tract urothelial carcinoma (UTUC) is a rare disease. Thus, little evidence-based data are available to guide clinical decision-making. The aim of the study was to provide an overview of the currently available prognostic factors for UTUC. MATERIAL AND METHODS: A systematic literature search was conducted using the PubMed databases to identify original articles regarding prognostic factors in patients with UTUC. RESULTS: We divided the prognostic factors for UTUC in four different categories: clinical factors, preoperative characteristics, intraoperative/surgical factors and postoperative/pathologic factors...
December 2013: Progrès en Urologie
Onder Canguven, Mustafa Boz, Mustafa Bulbul, Ahmet Selimoglu, Selami Albayrak
INTRODUCTION: Ureteroscopy has improved from the first use of ureteroscope in the 1970' s. Although the success rate increased in the last years, new treatment techniques are being developed for impacted and large proximal ureter stones (2). Pneumatic lithotripsy has high efficiency with low complication rates. However, in case of steinstrasse and large (> 1 cm) ureter stones, fragmented small stones may obstruct insertion of a ureteroscope after initial lithotripsy. In order to triumph over this issue, multiple ureteroscopic passages and manipulations needed for extraction of these small stones by forceps or basket catheters...
September 2013: International Braz J Urol: Official Journal of the Brazilian Society of Urology
Hoon Jang, Seung Mo Yuk, Jong Ok Kim, Dong Seok Han
BACKGROUND: Extrapulmonary small cell carcinomas have been reported in a variety of organs, and their incidence in the genitourinary tract is second only to that in the gastrointestinal tract. To date, however, only a few cases of small cell carcinoma of the ureter have been reported. Because the extreme rarity of this type of carcinoma, its clinical behaviour, diagnostic methods, and effective treatment modalities have not yet been determined. CASE PRESENTATION: A 59-year-old man presented with a 1-month history of painless gross haematuria...
2013: World Journal of Surgical Oncology
Atsushi Okada, Takahiro Yasui, Kazumi Taguchi, Kazuhiro Niimi, Yasuhiko Hirose, Shuzo Hamamoto, Ryosuke Ando, Yasue Kubota, Yukihiro Umemoto, Keiichi Tozawa, Shoichi Sasaki, Yutaro Hayashi, Kenjiro Kohri
To evaluate the efficacy of company-initiated training of urologists on shock wave lithotripsy (SWL) treatment results, we retrospectively assessed 602 patients who underwent SWL in Nagoya City University Hospital between January 2004 and June 2011 using Lithotripter S (Dornier MedTech, Japan). Training-provided by a training specialist of the company in June 2010-focused on the targeting of renal and proximal ureter stones with a combination of radiography and ultrasonography (US). The stretcher wedges were positioned in the semi-prone position or the semi-supine position for middle and distal ureter stones, respectively...
November 2013: Urolithiasis
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