Hidronefrosis gigante: a propósito de dos casos con distintas etologías / Giant hydronephrosis: about two cases with different etologies

La hidronefrosis gigante se considera una entidad rara, caracterizada por la presencia de al menos 1 litro de líquido dentro del sistema pielocalicial, más frecuente en pacientes masculinos, generalmente asintomático. Se presenta el caso de una paciente femenina de 85 años de edad quien refiere desde hace 6 años dolor lumbar izquierdo y aumento de la circunferencia abdominal; en la TAC abdomino-pélvica contrastada se evidencia bolsa hidronefrótica izquierda gigante con corteza renal adelgazada que no concentra ni elimina el contraste. Se presenta el caso de paciente masculino de 85 años de edad quien refiere desde hace 5 años aumento de la circunferencia abdominal y la TAC abdomino-pélvica contrastada muestra importante dilatación del riñón y sistema colector derecho secundario a litiasis ureteral. A ambos pacientes se les practicó nefrectomía simple. Con respecto a la hidronefrosis gigante, la etiología más frecuente es la estenosis de la unión ureteropélvica seguido por la patología litiásica y tumoral; es importante considerar esta entidad como diagnóstico diferencial en caso de masas quísticas abdominales(AU)

Giant hydronephrosis is considered a rare entity, characterized by the presence of at least 1 liter of fluid within the pielocalicial system; is more frequent in males and often asymptomatic. We present an 85-year-old female patient who has a 6-year complain of left lumbar pain associated with increase in abdominal circumference. On CT scan, a giant left hydronephrotic pouch is evidenced, with a thinned renal wall that does not concentrate or eliminate contrast. We present a 61 year-old male who refers a 5-year asymptomatic increase in abdominal circumference. The CT scan reveals significant dilatation of the kidney and right collecting system secondary to ureteral lithiasis. Both patients undergo simple nephrectomy. The most frequent etiology of giant hydronephrosis is ureteropelvic junction stenosis followed by lithiasic and tumor pathology. It is important to consider this entity as a differential diagnosis in the case of abdominal cystic masses(AU)

A Case of Giant Hydronephrosis Hidden by Obesity in an 11-year-old Boy

Giant hydronephrosis (GH) is a rare urological entity and usually presents with more than a liter of fluid in the collecting system. It may mimic a progressive and benign abdominal cystic tumor. We report a case of GH in an 11-year-old obese boy who presented with abdominal distension and dyspnea on exercise. Hydronephrosis was caused by ureteropelvic junction obstruction, with 2,300 mL of fluid in the collecting system. Diagnostic and therapeutic features of this case are discussed, with reference to current literature.

A Case of Giant Hydronephrosis Hidden by Obesity in an 11-year-old Boy

Giant hydronephrosis (GH) is a rare urological entity and usually presents with more than a liter of fluid in the collecting system. It may mimic a progressive and benign abdominal cystic tumor. We report a case of GH in an 11-year-old obese boy who presented with abdominal distension and dyspnea on exercise. Hydronephrosis was caused by ureteropelvic junction obstruction, with 2,300 mL of fluid in the collecting system. Diagnostic and therapeutic features of this case are discussed, with reference to current literature.

Clinical efficacy evaluation of retroperitoneal and transperitoneal laparoscopic nephrectomy for nonfunctional kidney with giant hydronephrosis / 中国医师进修杂志

Objective To evaluate the technical feasibility and clinical efficacy of retroperitoneal and transperitoneal laparoscopic nephrectomy for nonfunctional kidney with giant hydronephrosis. Methods The clinical data of retroperitoneal group (26 patients) and transperitoneal group (23 patients) who underwent laparoscopic nephrectomy for nonfunctional kidney with giant hydronephrosis were analyzed retrospectively. Compared with operating time,kidney size, blood loss, postoperative intestinal function recovery time, postoperative hospital stay and operative efficacy of the two groups. Results All the operations were performed successfully. Operating time,kidney size and blood loss were not significantly different between two groups(P＞ 0.05). While in retroperitoneal group, postoperative intestinal function recovery time and postoperative hospital stay were significantly reduced than those in transperitoneal group [( 18.0 ± 1.2)h vs. (48.0 ±2.0) h, (5.5± 1.6) d vs. (7.5 ± 1.6) d](P＜0.05). All patients were followed up 1 -3months,no abnormal. Conclusions The retroperitoneal and transperitoneal laparoscopic nephrectomy for nonfunctional kidney with giant hydronephrosis can be performed efficiently and effectively. Retroperitoneal laparoscopic is better than transperitoneal laparoscopic on postoperative recovery aspects.

A Giant Hydronephrosis in Adult / 대한신장학회잡지

The term of giant hydronephrosis in adults, is applied when the collecting system contains more than 1,000 mL of fluid. The commonest cause of asymptomatic giant hydronephrosis in early adult life is congenital ureteropelvic stenosis. Giant hydronephrosis in adults is uncommon and often clinically misdiagnosed, because clinical characteristics are vague and generalized symptom. We presented a giant hydronephrosis associated with ureter stricture on 31 years old male.

The application of laparoscopy in kidney preserving surgery for the treatment of savage giant hydro-nephrosis / 中华泌尿外科杂志

Objective To evaluate the application and initial experience of laparoscopy in kidneypreserving surgery for savage giant hydronephrosis. Methods This series included 6 cases of savage gianthydronephrosis (2 men and 4 women;age range,15 -57 years;mean age,28 years).Of them 5 cases weredetected when visiting doctors due to flank pain,abdominal mass,and the rest one by B-ultrasound duringpregnancy.Four cases had hydronephrosis on the left;and 2 cases,on the right.The quantity of hydronephro-sis was 2250 -8300 ml,respectively.None had development on IVU examination.Of them,3 cases had con-genital ureteropelvic junction (UPJ) obstruction;2 had multiple stones in infracalices secondary to UPJ ob-struction;1 had stones in pelvis with polyp formation.Relieving obstruction,pyeloplasty,nephroplication andnephropexy were performed via laparoscope. Results All the operations were successful.The operativetime was 2.5 -5.0 h;the blood loss was 50 -150 ml,and the mean postoperative hospital stay was 7.2 d.The postoperative follow-up ranged from 3 to 24 months. Three months after operation,B-ultrasound showedthat giant hydronephrosis was markedly relieved in 5 cases (the renal sinus separation was 1.8 m,2.0 cm,2.5 cm,2.5 cm and 2.8cm,respectively),and in the rest 1 case the kidney was slightly smaller than nor-mal.IVU examination was performed every 3 months after operation, and different degrees of developmentappeared in all cases.During the follow-up,no obvious ureteropelvic anastomotic stricture was found on retro-grade pyelography (RGP). Conclusions The protective renal treatment via laparoscopy for savage gianthydronephrosis is a feasible and minimally invasive technique that provides the same clinical and radiograph-ic results as open operation.

Giant Hydronephrosis with Contralateral Congenital Renal Agenesis: A Case Report / 대한비뇨기과학회지

We report a case of giant hydronephrosis due to congenital ureteropelvic junction obstruction in a 7-month-old female infant with contralateral renal agenesis. Congenital renal agenesis is an uncommon congenital condition that results from a failure of induction of the metanephric blastema by the ureteral bud and fifteen per cent of cases show anomalies of the contralateral kidney. An excretory urogram and abdominal CT scan of the patient revealed nonvisualization of left kidney, and a retrograde pyelogram showed markedly dilated extrarenal pelvis crossing over the mid-line because of narrowing of ureteropelvic junction. However, the other combined anomalies were not identified. A successful dismembered pyeloplasty was performed after temporary urinary diversion with percutaneous nephrostomy for 4 weeks.

Giant Hydronephrosis / 대한비뇨기과학회지

Giant hydronephrosis is a clinical entity in which errors of diagnosis are frequent due to the silent development of this pathologic state. We present a case which has been considered worthy of detailed report for various reasons. First, it was a 22 liter hydronephrosis which is, so far as can be discovered from available Korean literature, the largest that has been removed surgically. Secondly, despite of huge hydronephrosis, the patient experienced delivery.

Giant Hydronephrosis Combined with Ureteral Stone / 대한비뇨기과학회지

Urinary obstruction leads to hydronephrosis, distention of renal pelvis and calices with urine accompanying atrophy of renal parenchyma. Especially longstanding incomplete obstruction may lead to giant hydronephrosis and terminate in destruction of the organ We experienced a case of giant hydronephrosis combined with ureteral stone in 50 year old man, so we report this case with review of literatures.

Two Cases of Giant Hydronephrosis / 대한비뇨기과학회지

We experienced two cases of giant hydronephrosis which contained 1,800, 1,200 cc of urine. It was caused by renal stone and congenital ureteropelvic junction stricture.

A Case of Giant Hydronephrosis / 대한비뇨기과학회지

A giant hydronephrosis caused by ureteropelvic junction stricture in a 16-month-old male infant was presented. After the size and volume of giant hydronephrosis were estimated by retrograde pyelography, nephrectomy was performed. We report this case with review of literatures.

A Clinical Observation on 13 Cases of Giant Hydronephrosis / 대한비뇨기과학회지

A clinical observation was performed on 13 cases of giant hydronephrosis in the Department of Urology, College of Medicine, Hanyang University from May 1972 to March 1981 The results are as follows; 1) In 13 cases of giant hydronephrosis 6 cases were male and 7 cases female, 2nd decade was most common. 2) Side of giant hydronephrosis; Rt. side: 4 cases, Lt. side: 9 cases. 3) The most common etiology of giant hydronephrosis was congenital UPJ stricture (53.8%). 4) The details of the symptoms as follows; 12 cases were flank mass, 5 fever and chillness, 4 frequency of urination, 3 hematuria, 2 abdominal distention and 1 oliguria. 5) Renal function test (B.U.N., creatinine) was normal except 1 case of solitary kidney with neurogenic bladder. 6) In 4 cases out of giant hydronephrosis were compensatory hydronephrotic change on contralateral kidney and 8 cases normal. 7) The operative procedures were as follows; 11 cases were nephrectomy, 1 case pyeloplasty and 1 case nephrostomy.

Clinical Observation on Giant Hydronephrosis / 대한비뇨기과학회지

A clinical observation was made on five cases of giant hydronephrosis during recent 5 years. The results were as follows: 1. The most common cause of giant hydronephrosis was congenital ureterovesical juncture stricture (3 cases). 2. The male and female ratio was 3 : 2 and age incidence was predominated in children. 3. Positive urinary bacterial culture was obtained in 2 patients among the 5 patients but no growth was observed in the culture of hydronephrotic content in all cases. 4. Operative procedure was nephroureterctomy in all cases and no complication accompanied.

A Giant Hydronephrosis Associated with Staghorn Calculus / 대한비뇨기과학회지

One case of giant hydronephrosis associated with staghorn calculus was presented in 65 year old man. It`s containing fluid was about 4,000ml in amount. We reported this cases with a brief review of the literature.

A Clinical Observation of Giant Hydronephrosis / 대한비뇨기과학회지

A clinical observation was made on twenty-one cases of giant hydronephrosis experienced in recent 10 years. And the following results were obtained. 1. The most common cause of giant hydronephrosis was congenital uretero-pelvic juncture stricture (11 cases). 2. The ratio of male to female was 16:5. 3. The main signs and symptoms were flank mass (15 cases) and flank pain (10 cases). 4. The volume of content was over 3,000cc in seven cases. 5. Nephrectomy or nephroureterectomy was performed in all cases except one.

Horseshoe Kidney associated with Giant Hydronephrosis / 대한비뇨기과학회지

A case of 26 years old male having horseshoe kidney associated with giant hydronephrosis due to aberrant vessel was presented with a brief review of the literatures. The patient was managed by division of isthmus and nephrectomy with good result.

A Clinical Observation on 15 Cases of Giant Hydronephrosis / 대한비뇨기과학회지

A clinical observation was made on fifteen cases of giant hydronephrosis during recent 10 years. The results are as follows: 1. In 15 cases of giant hydronephrosis, congenital UPJ stricture was most common in etiology by 9 cases. 2. The male and female ratio was 13:2. No difference was noted in location (Rt 8, Lt7). 3. In 9 cases of giant hydronephrosis with congenital UPJ stricture, 5 cases were under the age of 20 years old. 4. Renal function (BUN, Ccr) was normal except 2 cases of renal tuberculosis. 5. In 4 cases out of 15, cystoscopic findings were normal. 6. Blood pressure was normal in all cases. 7. In 7 cases out of 15, the cystic content was more than 3000cc in amount. All of the 7 cases were congenital UPJ stricture patients. 8. In 7 cases out of giant hydronephrosis with congenital UPJ stricture, the contralateral side renal pelvis was ampullary type. 9. Operative procedures were nephrectomy or nephroureterectomy in all cases.

Giant Hydronephrosis: Report of a Case / 대한비뇨기과학회지

We experienced a case of giant hydronephrosis which contained 6,500 cc of urine. It was caused by congenital ureteropelvic junction stenosis.

A Case Report of Giant Hydronephrosis / 대한비뇨기과학회지

A case of 23 year old male having giant hydronephrosis (7,100ml) associated with congenital stricture at ureteropelvic junction was presented with a brief review of the literatures. This case was confirmed with antegrade pyelography and ureteronephrectmy was performed.

1 Case of Giant Hydronephrosis Associated with Hypertension / 대한비뇨기과학회지

A case of congenital giant hydronephrosis with capacity of 3, 700cc associated with hypertension was reported. Nephrectomy was done by lumbar approach in lateral position. Removed kidney showed marked cystic dilatation and marked ureteropelvic junction stricture. Hypertension was disappeared 3 days after operation.