MyMedR

Fulltext Observation of ureteric diameter in negative intravenous urogram in hospital universiti kebangsaan malaysia

Wong SL, Abdul Hamid H

Malays J Med Sci, 2010 Apr;17(2):4-9.

This study observed the widest ureteric diameter in negative intravenous urogram (IVU) examinations using low osmolar contrast media.

Matched MeSH terms: Ureter

International Alliance of Urolithiasis guideline on retrograde intrarenal surgery

Zeng G, Traxer O, Zhong W, Osther P, Pearle MS, Preminger GM, et al.

BJU Int, 2023 Feb;131(2):153-164.

PMID: 35733358 DOI: 10.1111/bju.15836

OBJECTIVES: To set out the second in a series of guidelines on the treatment of urolithiasis by the International Alliance of Urolithiasis that concerns retrograde intrarenal surgery (RIRS), with the aim of providing a clinical framework for urologists performing RIRS.

MATERIALS AND METHODS: After a comprehensive search of RIRS-related literature published between 1 January 1964 and 1 October 2021 from the PubMed database, systematic review and assessment were performed to inform a series of recommendations, which were graded using modified GRADE methodology. Additionally, quality of evidence was classified using a modification of the Oxford Centre for Evidence-Based Medicine Levels of Evidence system. Finally, related comments were provided.

RESULTS: A total of 36 recommendations were developed and graded that covered the following topics: indications and contraindications; preoperative imaging; preoperative ureteric stenting; preoperative medications; peri-operative antibiotics; management of antithrombotic therapy; anaesthesia; patient positioning; equipment; lithotripsy; exit strategy; and complications.

CONCLUSION: The series of recommendations regarding RIRS, along with the related commentary and supporting documentation, offered here should help provide safe and effective performance of RIRS.

Matched MeSH terms: Ureter*; Ureteroscopy/methods

Fulltext Renal autotransplantation after an iatrogenic left ureteric injury

Neo EN, Zulkifli Z, Sritharan S, Lee BC, Nazri J

Med J Malaysia, 2007 Jun;62(2):164-5.

PMID: 18705455

We report a case of renal autotransplantation performed successfully for an iatrogenic ureteric injury with loss of 9 cm of ureteric length. The surgical options available for management of ureteric injuries are discussed, varying from a simple re-anastomosis to the more complex renal autotransplantation.

Matched MeSH terms: Ureter/injuries*; Ureter/surgery

Fulltext Iatrogenic ureteric injuries

Lei CC, Abdullah MM, Abdullah K

Med J Malaysia, 1991 Jun;46(2):163-70.

PMID: 1839421

Damage to the lower ureters during pelvic surgery is a serious and well-recognised complication. This iatrogenic injury, when undetected intra-operatively, continues to give rise to significant patient morbidity. In 1987, this Department was referred 18 cases of iatrogenic ureteric injuries. 16 patients were from gynaecologic surgery and 2 patients were from general surgery. Only 4 cases (24%) were detected and referred intra-operatively. 13 patients presented post-operatively with various symptoms viz., anuria, loin pain and urinary leak per vagina. Good recovery of urinary function was achieved in all cases after urological intervention, usually by ureteric re-implantation.

Matched MeSH terms: Ureter/injuries*; Ureter/radiography

Fulltext Bifid blind-ending ureter--a case report

Lam HS

Singapore Med J, 1991 Feb;32(1):84-6.

PMID: 2017715

An interesting case of bifid blind-ending ureter occurring in a young Indian girl is reported. She presented with severe recurrent right iliac fossa pain for which she underwent appendicectomy which did not resolve her symptoms. Subsequent urological investigation--IVU and retrograde pyeleogram--revealed the genuine diagnosis. Surgical excision of the blind-ending branch was successful in relieving the intractable pain. A review of the literature on this uncommon congenital urological problem is outlined stating its clinical significance and treatment options.

Matched MeSH terms: Ureter/abnormalities*; Ureter/surgery

Fulltext Ureter triplication with contra-lateral partial duplex system

Mubarak MY, Zainun AR, Rohaya M

Med J Malaysia, 2009 Sep;64(3):236-7.

PMID: 20527276 MyJurnal

Ureteral triplication is a rare congenital anomaly of the urinary tract. We report a case of ureteral triplication with contralateral partial kidney duplication in a patient with right loin pain. The development and types of ureteral triplication and the features of type 2 ureteral triplication on intravenous urography and magnetic resonance urography are described.

Matched MeSH terms: Ureter/abnormalities*; Ureter/radiography

Avulsed ureter

Dublin N, Razack AH

ANZ J Surg, 2003 Apr;73(4):254-5.

PMID: 12662241

Matched MeSH terms: Ureter/injuries*; Ureter/surgery*; Ureteroscopy/adverse effects*

Fulltext Retrocaval Ureter: Report of 2 Different Clinical Spectrums

Khairul Asri, Malinda, Tee, S.C., Sundram, Woo, S.

Malaysian Journal of Medicine and Health Sciences, 2014;10(1):39-42.

MyJurnal

etrocaval ureter is a relatively rare anomaly where ureteric obstruction may occur as a result of ureter passes behind the inferior vena cava (IVC), hence, compressing it between the IVC and the vertebrae. We report 2 cases of retrocaval ureter with different presentations. One patient was managed surgically with minimally invasive approach and the other was managed conservatively.

Matched MeSH terms: Ureter; Ureteral Obstruction; Retrocaval Ureter

Traumatic rupture of the ureter at the pelvi-ureteric junction in a congenital hydronephrotic kidney

Roe TN

Med J Malaya, 1969 Mar;23(3):203-7.

PMID: 4240075

Matched MeSH terms: Ureter/injuries*

Fulltext Retrocaval ureter: the importance of intravenous urography

Hassan R, Aziz AA, Mohamed SK

Malays J Med Sci, 2011 Oct;18(4):84-7.

PMID: 22589677

Retrocaval ureter is a rare cause of hydronephrosis. Its rarity and non-specific presentation pose a challenge to surgeons and radiologists in making the correct diagnosis. Differentiation from other causes of urinary tract obstruction, especially the more common urolithiasis, is important for successful surgical management. Current practice has seen multislice computed tomography (MSCT) rapidly replaces intravenous urography (IVU) in the assessment of patients with hydronephrosis due to suspected urolithiasis, especially ureterolithiasis. However, MSCT, without adequate opacification of the entire ureter, may allow the physician to overlook a retrocaval ureter as the cause of hydronephrosis. High-resolution IVU images can demonstrate the typical appearance that leads to the accurate diagnosis of a retrocaval ureter. We reported a case that illustrates this scenario and highlights the importance of IVU in the assessment of a complex congenital disorder involving the urinary tract.

Matched MeSH terms: Ureter; Ureterolithiasis; Retrocaval Ureter

Fulltext Peritoneal implantation of ureter in a cadaveric kidney transplant recipient

Tan SY, Lim CS, Teo SM, Lee SH, Razack A, Loh CS

Med J Malaysia, 2003 Dec;58(5):769-70.

PMID: 15190667

We report here a case of a kidney transplant recipient in whom the ureter was initially implanted into the peritoneum. Excessive ultrafiltration volume and reversal of serum vs dialysate creatinine ratio when the patient was recommenced on continuous ambulatory peritoneal dialysis first suggested the diagnosis which was subsequently confirmed by a plain abdominal x-ray demonstrating placement of ureteric stent in the peritoneum. This rare complication was successfully corrected with surgical re-implantation of ureter into the bladder and 5 years later, the patient remains well with good graft function.

Matched MeSH terms: Ureter/surgery*

Index of suspicion with appropriate timing of CT scan helps prevent missed diagnosis in urologic trauma

Sabrina B, Tan KL, Johann FK, Andre D

Med J Malaysia, 2018 08;73(4):255-256.

PMID: 30121691 MyJurnal

Ureteric and bladder injuries are uncommon, difficult to diagnose and rarely occur in isolation. Diagnosis is often delayed or missed at presentation. Therefore, high clinical suspicion and appropriate timing of computed tomography (CT) are of paramount importance. We report two cases (ureteropelvic junction avulsion and ruptured dome of bladder) whereby the presentations were subtle and would have been missed if not for high clinical suspicion. This article discusses the problems associated with these urologic injuries, as well as how to develop a high index of suspicion based on the pattern of anatomical disruption, mechanism of injury, physiological abnormality and comorbidity.

Matched MeSH terms: Ureter/injuries*

Indications, preferences, global practice patterns and outcomes in retrograde intrarenal surgery (RIRS) for renal stones in adults: results from a multicenter database of 6669 patients of the global FLEXible ureteroscopy Outcomes Registry (FLEXOR)

Gauhar V, Chew BH, Traxer O, Tailly T, Emiliani E, Inoue T, et al.

World J Urol, 2023 Feb;41(2):567-574.

PMID: 36536170 DOI: 10.1007/s00345-022-04257-z

PURPOSE: To collect a multicentric database on behalf of TOWER research group to assess practice patterns and outcomes of retrograde intrarenal surgery (RIRS) for kidney stones.

METHODS: Inclusion criteria: age ≥ 18 years, normal renal/calyceal system anatomy, calculi of any size, number, and position.

STUDY PERIOD: January 2018 and August 2021. Stone-free status: absence of fragments > 2 mm, assessed post procedure according to the local protocol (KUB X-Ray and/or ultrasound or non-contrast CT scan).

RESULTS: Twenty centers from fifteen countries enrolled 6669 patients. There were 4407 (66.2%) men. Mean age was 49.3 ± 15.59 years. Pain was the most frequent symptom indication for intervention (62.6%). 679 (10.2%) patients underwent RIRS for an incidental finding of stones. 2732 (41.0%) patients had multiple stones. Mean stone size was 10.04 ± 6.84 mm. A reusable flexible ureteroscope was used in 4803 (72.0%) procedures. A sheath-less RIRS was performed in 454 (6.8%) cases. Holmium:YAG laser was used in 4878 (73.1%) cases. A combination of dusting and fragmentation was the most common lithotripsy mode performed (64.3%). Mean operation time was 62.40 ± 17.76 min. 119 (1.8%) patients had an intraoperative injury of the ureter due to UAS insertion. Mean postoperative stay was 3.62 ± 3.47 days. At least one postoperative complication occurred in 535 (8.0%) patients. Sepsis requiring intensive care admission occurred in 84 (1.3%) patients. Residual fragments were detected in 1445 (21.7%) patients. Among the latter, 744 (51.5%) patients required a further intervention.

CONCLUSION: Our database contributes real-world data to support to a better understanding of modern RIRS practice and outcomes.

Matched MeSH terms: Ureter*; Ureteroscopy/methods

Fulltext Ureteral stricture formation after ureteroscope treatment of impacted calculi: a prospective study

Fam XI, Singam P, Ho CC, Sridharan R, Hod R, Bahadzor B, et al.

Korean J Urol, 2015 Jan;56(1):63-7.

PMID: 25598938 DOI: 10.4111/kju.2015.56.1.63

Urinary calculi is a familiar disease. A well-known complication of endourological treatment for impacted ureteral stones is the formation of ureteral strictures, which has been reported to occur in 14.2% to 24% of cases.

Matched MeSH terms: Ureter/pathology*; Ureter/ultrasonography; Ureteral Calculi/therapy*; Ureteroscopy/adverse effects*; Ureterolithiasis/surgery*

Fulltext Iatrogenic ureter injuries: eleven years experience in a tertiary hospital

Mahendran HA, Singam P, Ho C, Goh EH, Tan GH, Zuklifli MZ

Med J Malaysia, 2012 Apr;67(2):169-72.

PMID: 22822637 MyJurnal

Iatrogenic ureteric injuries are rare complications of abdomino-pelvic surgery but associated with high morbidity from infection and possible loss of renal function. A successful repair is related to the timing of diagnosis, site of injury and method of repair. This study was a retrospective review of outcomes of iatrogenic ureteric injury and factors contributing to successful operative repair. Twenty consecutive cases referred to the Urology Unit of the UKM Medical Center during an 11-year period from 1998 to 2009 were reviewed. Thirteen patients were diagnosed intraoperatively and underwent immediate repair. Seven patients had delayed diagnosis but also underwent immediate repair. In our series, there was no significant difference in outcome between injuries diagnosed intraoperatively versus injuries with delayed diagnosis. There was significant difference in the outcomes between methods of ureteric repair where ureter reimplantation via psoas hitch or Boari flap yielded better results than primary end-to-end anastomosis Three patients suffered loss of renal function from unsuccessful ureter repair. We conclude that all iatrogenic ureteric injury should be repaired immediately in the absence of overt sepsis. Ureter reimplantation using a Boari flap or psoas hitch is preferred to the end-to-end anastomosis especially when there is delayed diagnosis

Matched MeSH terms: Ureter/injuries*; Ureter/surgery*

Fulltext Total proximal ureter substitution using buccal mucosa

Fahmy O, Schubert T, Khairul-Asri MG, Stenzl A, Gakis G

Int J Urol, 2017 04;24(4):320-323.

PMID: 28208217 DOI: 10.1111/iju.13307

The surgical treatment of a long proximal ureteral stricture is a challenging situation for reconstructive surgeons. Despite the underlying morbidities, ileal interposition and autotransplantation are the options available to treat complex cases of long segment ureteral stricture. Buccal mucosa has shown excellent results in urethroplasty. However, its use in ureteral reconstruction is infrequent. We report on a 64-year-old female patient with multiple comorbidities and prior abdominal surgeries for Crohn's disease who underwent a successful total substitution of a long segment of the proximal ureter using buccal mucosa. Regular postoperative isotope scans showed improvement in renal function. Based on the pleasant outcome of this case and review of the literature, buccal mucosa might be a viable option with low morbidity in selected cases.

Matched MeSH terms: Ureter/pathology; Ureter/transplantation*; Ureteral Obstruction/surgery*

Fulltext Ureterovaginal fistula: A complication of a vaginal foreign body

Lo TS, Jaili SB, Ibrahim R, Kao CC, Uy-Patrimonio MC

Taiwan J Obstet Gynecol, 2018 Feb;57(1):150-152.

PMID: 29458888 DOI: 10.1016/j.tjog.2017.12.026

OBJECTIVE: To know the diagnostic tools and proper management of ureterovaginal fistula following neglected vaginal foreign body in order to achieve optimal outcome.

CASE REPORT: A case of ureterovaginal fistula associated with a neglected vaginal foreign body. The patient was complaining of a foul-smelling vaginal discharge and lower abdominal pain. On vaginal examination, a hard and large foreign body was found. Examination under anesthesia was performed, and an aerosol cap was removed from her vagina. The patient developed urinary incontinence after removal of the foreign body. Subsequent work-up demonstrated the presence of a right ureterovaginal fistula. The patient underwent an abdominal ureteroneocystostomy. At one year follow up, the patient had fully recovered.

CONCLUSION: Ureterovaginal fistula following neglected vaginal foreign body is a serious condition. Early diagnosis, treatment of infection and proper surgical management can improve the outcome and decrease complications.

Matched MeSH terms: Ureter/pathology; Ureter/surgery; Ureteral Diseases/complications*; Ureteral Diseases/etiology; Ureteral Diseases/surgery

Fulltext Magnetic resonance urography in duplex kidney with ectopic ureteral insertion

Thambidorai CR, Anuar Z

J Indian Assoc Pediatr Surg, 2011 Jul;16(3):115-7.

PMID: 21897576 DOI: 10.4103/0971-9261.83500

This is a report on the use of magnetic resonance urography (MRU) in a 6-year-old girl who presented with urinary incontinence. She had a left duplex kidney with poorly functioning upper moiety and ectopic insertion of the dilated upper pole ureter. MRU has been shown to be superior to conventional imaging techniques in delineating poorly functioning moieties of duplex kidneys and ectopic ureters.

Matched MeSH terms: Ureter

Fulltext An unusual presentation of a rare rhabdomyosarcoma of urinary bladder and prostate - case report

Shanggar, K., Muhilan, P., Dublin, N., Lee, George E.G., Azad Hassan, A.R.

JUMMEC, 2007;10(2):57-59.

MyJurnal

Rhabdomyosarcoma of the genitourinary tract is rare and predominantly affects paediatric patients. We present an unusual case of such a lesion in an adult with extensive occupation of the bladder cavity by the lesion, resulting in bilateral ureteric obstruction, without evidence of ureteric outlet invasion. We outline the unusual CT and macroscopic appearance of this lesion. We also discuss the literature data and management strategies of rhabdomyosarcoma of the genitourinary tract.

Matched MeSH terms: Ureter; Ureteral Obstruction

Urogenital Vascular Anomalies with Bilateral Kinking of Ureter: A Case Report

Tadipi S, Sadashiv R, Muralidharan S, Pimid M

Malays J Med Sci, 2015 Nov;22(6):67-70.

PMID: 28223889

Variations in the urogenital vascular anomalies in the abdomen are very common. However, they warrant attention due to their importance in operative, diagnostic, and endovascular procedures. During routine dissection of abdomen in a male cadaver, unique urogenital vascular anomalies were observed. On the right side, the right renal artery was found to be originated from the abdominal aorta at the level of L2 and divided into five branches; the right testicular artery and inferior suprarenal artery originated from the lower branch. We also observed, accessory renal artery arising from abdominal aorta at the level of L3 and double renal veins on right side. On the left side, we found left renal artery originating from the abdominal aorta at the level of L2 and divided into two branches. Double testicular (medial and lateral) arteries were also observed. In addition to these vascular variations, bilateral kinking of ureter at the pelviureteric junction was also observed. Although the variations in the origin of urogenital vessels in the abdomen are common, deeper understanding of the urogenital vascular variations and their relations to adjacent structures is significant during surgical and radiological procedures.

Matched MeSH terms: Ureter

Displaying publications 1 - 20 of 34 in total