Implante uretero-vesical em ratos

Apresentar os resultados obtidos com técnica de implante ureterovesical em ratos após obstrução ureteral ipsilateral. Treze ratos foram submetidos à obstrução ureteral distal à direita e, após uma semana, realizou-se o implante desse ureter na bexiga seguido da nefrectomia contralateral. No período de observação de 4 semanas foram estudados os níveis séricos semanais de uréia e creatinina e, na quarta semana, foi realizada cistografia para pesquisa de refluxo vésico-ureteral. Nove animais sobreviveram ao período de obstrução ureteral. Observou-se aumento significativo dos valores de uréia e creatinina sérica no segundo dia pós-operatório, que regrediram para níveis semelhantes aos basais já na terceira semana de seguimento. Não foi observado refluxo vésico-ureteral à cistografia. Após o sacrifício, a avaliação da junção uretero-vesical não mostrava sinais de obstrução, havendo regressão da hidronefrose presente antes do implante ureteral. A técnica de reimplante ureteral utilizada é eficaz em proporcionar adequada drenagem do trato urinário, evitando refluxovésico-ureteral, sendo adequada para ser utilizada no estudo da recuperação da função renal após período de obstrução ureteral.

A pelvic kidney and a contralateral incomplete double collecting system with associated bilateral ectopic obstructive megaureters

A two-month old female child presenting with recurrent febrile urinary tract infection (UTI) was diagnosed to have a single-system pelvic kidney and a contralateral incomplete ureteral duplication with associated bilateral ectopic obstructive megaureters draining into the proximal urethra. Bilateral cutaneous loop ureterostomy was done at that time. Subsequently, she underwent undiversion, transuretero-pyelostomy (double left ureters to right pelvis), right ureteroneocystostomy, and augmentation ureterocystoplasty. Biopsy of the right distal ureter was consistent with megaureter with acute and chronic ureteritis. Repeat IVP post-op showed well-opacified kidneys with no signs of obstruction and a well-distended urinary bladder with moderate post-void residual urine. A high index of suspicion, coupled with meticulous physical examination and rationally combined diagnostic procedures are important to make a diagnosis of a unique combination of rare congenital urologic anomalies. (Author)

Ureterocystoplasty: Experiences in Two Cases of Posterior Urethral Valve / 대한비뇨기과학회지

Ureterocystoplasty is a known useful method for the management of selected cases with dilated ureters, high pressure and poorly compliant bladders. It precludes the potential complications of enterocystoplasty. In two cases of posterior urethral valve with urinary incontinence, bilateral dilated ureters, and poorly compliant bladders, we performed ureterocystoplasties using dilated lower end of the ureter after transuretero-ureterostomy and ureteral reimplantation. Both patients were almost continent day and night. The bladder capacities and compliances were improved. There was no deterioration of renal functions. In conclusion, we suggest that the ureterocystoplasty using dilated distal ureter after transureteroureterostomy is an appropriate procedure in selected cases of posterior urethral valve.