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1.
Vet Med Sci ; 10(5): e1562, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-39042576

RESUMO

The presentation and investigation of a levopositioned caudal vena cava, a rare congenital vascular abnormality seen mainly in Bernese Mountain Dogs, which resulted in ureteral compression, hydronephrosis and hydroureter. Surgical transection, transposition and anastomosis were performed to reposition the circumcaval ureter. A 19-month-old male neutered Bernese Mountain Dog was presented with a 13-month history of vague signs including intermittent abdominal pain, inappetence and diarrhoea, which were poorly responsive to medical management. Abdominal ultrasound revealed left-sided hydronephrosis and hydroureter. Further investigation included abdominal computed tomography and pre- and post-intravenous iodinated contrast, which revealed a levopositioned caudal vena cava with associated ureteral displacement to a circumcaval position, resulting in ureteral compression and proximal dilation affecting both the proximal ureter and the left kidney. The patient was also found to have concomitant gall bladder agenesis. Surgery was performed to transect, transpose and anastomose the ureter in a normal anatomical position, and the patient made an excellent clinical recovery. All gastrointestinal signs resolved within 2 weeks of surgery and remained resolved 12 months later. Follow-up ultrasound and pyelography were performed at 4-month post-surgery, revealing a mild improvement in the hydronephrosis and hydroureter. Although rare, circumcaval ureter should be considered a differential in dogs presenting with hydroureter and hydronephrosis, especially Bernese Mountain Dogs.


Assuntos
Doenças do Cão , Hidronefrose , Ureter , Veia Cava Inferior , Animais , Cães , Masculino , Hidronefrose/veterinária , Hidronefrose/cirurgia , Hidronefrose/etiologia , Doenças do Cão/cirurgia , Doenças do Cão/diagnóstico por imagem , Veia Cava Inferior/anormalidades , Veia Cava Inferior/cirurgia , Ureter/anormalidades , Ureter/cirurgia , Doenças Ureterais/veterinária , Doenças Ureterais/cirurgia , Doenças Ureterais/congênito
2.
Eur J Pediatr ; 183(5): 2029-2036, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38441661

RESUMO

Primary non-refluxing megaureter (PMU) is a congenital dilation of the ureter which is not related to vesicoureteral reflux, duplicated collecting systems, ureterocele, ectopic ureter, or posterior urethral valves and accounts for 5 to 10% of all prenatal hydronephrosis (HN) cases. The etiology is a dysfunction or stenosis of the distal ureter. Most often PMU remains asymptomatic with spontaneous resolution allowing for non-operative management. Nevertheless, in selective cases such as the development of febrile urinary tract infections, worsening of the ureteral dilatation, or reduction in relative renal function, surgery should be considered. CONCLUSION: Ureteral replantation with excision of the dysfunctional ureteral segment and often ureteral tapering is the gold-standard procedure for PMU, although endoscopic treatment has been shown to have a fair success rate in many studies. In this review, we discuss the natural history, follow-up, and treatment of PMU. WHAT IS KNOWN: • PMU is the result of an atonic or stenotic segment of the distal ureter, resulting in congenital dilation of the ureter, and is frequently diagnosed on routine antenatal ultrasound. WHAT IS NEW: • Most often, PMU remains asymptomatic and clinically stable, allowing for non-operative management. • Nevertheless, since symptoms can appear even after years of observation, long-term ultrasound follow-up is recommended, even up to young adulthood, if hydroureteronephrosis persists. • Ureteral replantation is the gold standard in case surgery is needed. In selected cases, however, HPBD could be a reasonable alternative.


Assuntos
Reimplante , Ureter , Humanos , Reimplante/métodos , Ureter/anormalidades , Ureter/cirurgia , Doenças Ureterais/terapia , Doenças Ureterais/diagnóstico , Doenças Ureterais/congênito , Doenças Ureterais/cirurgia , Procedimentos Cirúrgicos Urológicos/métodos , Hidronefrose/etiologia , Hidronefrose/diagnóstico , Hidronefrose/terapia , Seguimentos
3.
Urology ; 159: 210-213, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34728334

RESUMO

We describe a case of congenital giant megaureter in a 16-year-old female. She presented with a 5-day history of abdominal distention, right flank pain and tenderness. Right pyelonephritis was suspected. Computerized tomography showed a large cystic abdominal mass with no appreciably functioning left kidney causing secondary compression of the contralateral right ureter. A left upper nephroureterectomy was performed, draining over 3.5 L of fluid. Our experience suggests that congenital giant megaureter should be considered in the differential for pediatric patients presenting with a cystic abdominal mass.


Assuntos
Doenças Ureterais/diagnóstico , Dor Abdominal/etiologia , Adolescente , Dilatação Patológica/complicações , Dilatação Patológica/congênito , Feminino , Humanos , Doenças Ureterais/complicações , Doenças Ureterais/congênito , Doenças Ureterais/patologia
4.
BMC Urol ; 21(1): 152, 2021 Nov 08.
Artigo em Inglês | MEDLINE | ID: mdl-34749695

RESUMO

BACKGROUND: Midureteral stenosis is very rare in children and can cause congenital hydronephrosis. We report our experience treating children with congenital midureteral stenosis at our center, focusing on the differences in preoperative diagnosis and treatment compared with other congenital obstructive uropathies. METHODS: We retrospectively reviewed the medical records of 26 children diagnosed with congenital midureteral stenosis at our center between January 2007 and December 2020, such as preoperative examination methods, intraoperative conditions, and postoperative follow-up results. RESULTS: Of the 1625 children treated surgically for ureteral narrowing, only 26 (1.6%) were diagnosed with midureteral stenosis, including 15 infants and 11 children. Eighteen (69.2%) were boys, 13 (50%) were affected on the left side, and 23 (88.5%) had isolated ureteral stenosis. Overall, 13 (50%) of the children presented with prenatal hydronephrosis, and 13 (50%) presented with abdominal pain or a mass. All the children had undergone urinary ultrasound and intravenous urography preoperatively; the diagnostic rate of ultrasound was 92.3%. Only 7 (26.9%) children had undergone pyelography. All the children had undergone surgery. The ureteral stenotic segment was less than 1 cm long in 25 (96.2)% of the children. The mean follow-up duration was 22 months (range: 6-50 months). One child developed anastomotic strictures. Urinary tract obstruction was relieved in the other children without long-term complications. CONCLUSIONS: Congenital midureteral stenosis is rare, accounting for 1.6% of all ureteral obstructions, and its diagnosis is crucial. Urinary ultrasound has a high diagnostic rate and should be the first choice for midureteral stenosis. Retrograde pyelography can be used when the diagnosis is difficult, but routine retrograde pyelography is not recommended. Congenital ureteral stenosis has a relatively short lesion range, largely within 1 cm. The treatment is mainly resection of the stenotic segment and end-to-end ureteral anastomosis, with a good prognosis.


Assuntos
Constrição Patológica/congênito , Constrição Patológica/diagnóstico por imagem , Doenças Ureterais/congênito , Doenças Ureterais/diagnóstico por imagem , Criança , Pré-Escolar , Constrição Patológica/complicações , Constrição Patológica/cirurgia , Feminino , Humanos , Hidronefrose/etiologia , Masculino , Estudos Retrospectivos , Ultrassonografia , Doenças Ureterais/complicações , Doenças Ureterais/cirurgia , Obstrução Ureteral/etiologia , Urografia
6.
Urology ; 139: 171-174, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-31958533

RESUMO

A case of bilateral ureteropelvic junction (UPJ) disruptions in a patient with bilateral duplication anomalies is presented. A UPJ disruption with a duplication anomaly has not been reported let alone bilateral duplication anomalies. The unrecognized duplication anomalies led to isolated and obstructed upper pole segments that were managed by bilateral heminephrectomies. A nephrocutaneous fistula developed after one of the heminephrectomies that was successfully managed using a method of percutaneous fulguration and fibrin sealant. In UPJ disruption cases, the possibility of a duplicated collecting system should be considered as an unrecognized duplication may complicate management and prolong recovery.


Assuntos
Fístula Cutânea , Eletrocoagulação/métodos , Rim , Nefrectomia , Complicações Pós-Operatórias/terapia , Ureter , Doenças Ureterais , Fístula Urinária , Adolescente , Fístula Cutânea/etiologia , Fístula Cutânea/terapia , Feminino , Humanos , Rim/diagnóstico por imagem , Rim/patologia , Nefropatias/etiologia , Nefropatias/terapia , Nefrectomia/efeitos adversos , Nefrectomia/métodos , Cuidados Pós-Operatórios/métodos , Tomografia Computadorizada por Raios X/métodos , Resultado do Tratamento , Ultrassonografia/métodos , Ureter/anormalidades , Ureter/diagnóstico por imagem , Doenças Ureterais/congênito , Doenças Ureterais/diagnóstico , Doenças Ureterais/cirurgia , Fístula Urinária/etiologia , Fístula Urinária/terapia , Urografia/métodos
7.
Urology ; 139: 175-178, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-31958536

RESUMO

We experienced an extremely rare case of ureteral sextuplication with a blind-ending ureter originating from the upper pole. The patient had 6 separate ureters and 6 renal pelvises with 1 ureteral orifice on the left. The left kidney was hypoplastic and its differential function was 6.5%. The patient underwent definitive surgical treatment to repair the anomaly (ureteroureterostomy and reimplantation of the formed ureter). The surgery was successful and the postoperative course was uneventful. We herein report the first such case in the English-language literature and discuss the etiology of this ureteral anomaly, the method of diagnostic imaging, and the treatment.


Assuntos
Rim , Procedimentos de Cirurgia Plástica , Reimplante/métodos , Ureter , Doenças Ureterais , Atrofia/diagnóstico , Atrofia/etiologia , Pré-Escolar , Tomada de Decisão Clínica , Humanos , Rim/diagnóstico por imagem , Rim/patologia , Rim/fisiopatologia , Testes de Função Renal/métodos , Pelve Renal/diagnóstico por imagem , Pelve Renal/cirurgia , Imageamento por Ressonância Magnética/métodos , Masculino , Cintilografia/métodos , Procedimentos de Cirurgia Plástica/métodos , Resultado do Tratamento , Ultrassonografia/métodos , Ureter/anormalidades , Ureter/diagnóstico por imagem , Ureter/cirurgia , Doenças Ureterais/congênito , Doenças Ureterais/diagnóstico , Doenças Ureterais/fisiopatologia , Doenças Ureterais/cirurgia , Urografia/métodos
8.
J Pathol ; 248(4): 452-463, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-30916783

RESUMO

The establishment of the peristaltic machinery of the ureter is precisely controlled to cope with the onset of urine production in the fetal kidney. Retinoic acid (RA) has been identified as a signal that maintains the mesenchymal progenitors of the contractile smooth muscle cells (SMCs), while WNTs, SHH, and BMP4 induce their differentiation. How the activity of the underlying signalling pathways is controlled in time, space, and quantity to activate coordinately the SMC programme is poorly understood. Here, we provide evidence that the Zn-finger transcription factor GATA2 is involved in this crosstalk. In mice, Gata2 is expressed in the undifferentiated ureteric mesenchyme under control of RA signalling. Conditional deletion of Gata2 by a Tbx18cre driver results in hydroureter formation at birth, associated with a loss of differentiated SMCs. Analysis at earlier stages and in explant cultures revealed that SMC differentiation is not abrogated but delayed and that dilated ureters can partially regain peristaltic activity when relieved of urine pressure. Molecular analysis identified increased RA signalling as one factor contributing to the delay in SMC differentiation, possibly caused by reduced direct transcriptional activation of Cyp26a1, which encodes an RA-degrading enzyme. Our study identified GATA2 as a feedback inhibitor of RA signalling important for precise onset of ureteric SMC differentiation, and suggests that in a subset of cases of human congenital ureter dilatations, temporary relief of urine pressure may ameliorate the differentiation status of the SMC coat. © 2019 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.


Assuntos
Diferenciação Celular , Fator de Transcrição GATA2/deficiência , Mesoderma/embriologia , Miócitos de Músculo Liso/fisiologia , Ureter/embriologia , Doenças Ureterais/embriologia , Animais , Biomarcadores/metabolismo , Feminino , Fator de Transcrição GATA2/genética , Masculino , Mesoderma/metabolismo , Camundongos , Transdução de Sinais , Tretinoína/metabolismo , Ureter/anormalidades , Ureter/metabolismo , Doenças Ureterais/congênito , Doenças Ureterais/metabolismo
10.
BMJ Case Rep ; 20162016 Dec 15.
Artigo em Inglês | MEDLINE | ID: mdl-27979846

RESUMO

A 1-year-old male infant presented with fever and abdominal lump for 3 months with increased leucocyte count (15 300/mm3) and serum creatinine (0.83 mg%). Abdominal ultrasound and renal scan demonstrated solitary left kidney with dilated tortuous left ureter. Voiding cystourethrogram was unequivocal. Left percutaneous nephrostomy was placed after poor response to perurethral catheterisation. His serum creatinine dropped to 0.58 mg/dL. Subsequent percutaneous nephrostogram and CT nephrostogram showed dilated left pelvicalyceal system, dilated, tortuous left ureter. A diagnosis of obstructed megaureter was made and ureteric plication and reimplantation planned. Intraoperatively, there were primitive ureteral valves until proximal one-third of the ureter. The distance between the upper ureter and bladder was ∼6 cm. This defect was bridged by Boari flap. The postoperative period was uneventful and now after 6 months of follow-up, he is doing fine.


Assuntos
Nefropatias/cirurgia , Rim/anormalidades , Procedimentos de Cirurgia Plástica/métodos , Retalhos Cirúrgicos , Ureter/anormalidades , Doenças Ureterais/cirurgia , Procedimentos Cirúrgicos Urológicos/métodos , Humanos , Lactente , Rim/cirurgia , Nefropatias/congênito , Nefropatias/diagnóstico , Masculino , Ultrassonografia , Ureter/cirurgia , Doenças Ureterais/congênito , Doenças Ureterais/diagnóstico , Urografia
11.
BMJ Case Rep ; 20162016 Dec 08.
Artigo em Inglês | MEDLINE | ID: mdl-27932430

RESUMO

A monochorionic-diamniotic twin baby presented with intrauterine growth restriction and anuria. The baby was found to have bladder agenesis, a pelvic dysplastic horseshoe kidney, vertebral anomalies, a ventricular septal defect and facial dysmorphisms. It was surprising to find no abnormalities in amniotic fluid indices prenatally, suggesting the possibility of urine output that declined as the pregnancy proceeded. Some degree of twin-to-twin transfusion of amniotic fluid was also possible, which could have rescued the oligohydramnios known to be associated with kidney and urinary tract abnormalities. It was also notable that there was no abnormality in respiratory function, especially since further investigations revealed close to no kidney function. The intrauterine growth restriction (IUGR) along with the multiple anomalies found made the baby unsuitable for dialysis and transplant, and the decision of transition to palliative care was made.


Assuntos
Anormalidades Múltiplas , Líquido Amniótico/citologia , Rim Fundido/diagnóstico , Ureter/anormalidades , Doenças Ureterais/congênito , Doenças da Bexiga Urinária/congênito , Bexiga Urinária/anormalidades , Feminino , Humanos , Recém-Nascido , Imageamento por Ressonância Magnética , Gravidez , Radiografia Abdominal , Gêmeos Monozigóticos , Ultrassonografia Pré-Natal , Doenças Ureterais/diagnóstico , Doenças da Bexiga Urinária/diagnóstico
13.
J Pediatr Urol ; 11(5): 285-6, 2015 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-26143484

RESUMO

INTRODUCTION: A duplex renal collecting system is a common congenital anomaly in children. Continuous dribbling (especially if after the toilet-training period) should raise suspicion of the presence of an ectopic ureter, which is most often associated with ureteral duplication. This video will demonstrate the complete diagnostic work-up necessary in these cases. CASE REPORT: A 10-year-old girl presented with continuous dribbling. Ultrasonography and computerized tomography depicted a duplex system on the left side, with the upper pole ureter ectopically inserting into the vaginal cavity and good upper pole renal parenchyma. A careful urethrocystoscopy showed a topic right ureteral orifice and a topic lower pole left ureteral orifice. Retrograde pyelography was performed and displayed normal left lower pole anatomy. A vaginography was performed, which showed reflux to the ectopic ureter. Vaginoscopy clearly identified the ectopic ureteral orifice. A guide wire was introduced through this meatus and retrograde contrast injection confirmed the diagnosis of an ectopic ureter. RESULTS: At laparoscopy, a larger upper pole ureter and a normal lower pole ureter on the left side were identified. A termino-lateral ureteroureteral anastomosis was performed. After the procedure, the child reported immediate resolution of urinary dribbling. CONCLUSION: In order to optimize its surgical correction, efforts should be made to appropriate localization of the ectopic ureter.


Assuntos
Cistoscopia/métodos , Laparoscopia/métodos , Tomografia Computadorizada por Raios X/métodos , Ureter/anormalidades , Doenças Ureterais/cirurgia , Urografia/métodos , Procedimentos Cirúrgicos Urológicos/métodos , Criança , Diagnóstico Diferencial , Feminino , Humanos , Ureter/cirurgia , Doenças Ureterais/congênito , Doenças Ureterais/diagnóstico
14.
Urology ; 86(1): 187-91, 2015 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-26142606

RESUMO

INTRODUCTION: To demonstrate the novel technique of laparoscopic intravesical detrusorrhaphy with ureteral plication for megaureter. TECHNICAL CONSIDERATIONS: From December 2012 to June 2014, 11 patients with primary unilateral megaureter underwent laparoscopic intravesical detrusorrhaphy with ureteral plication. By a transvesicoscopic approach using a 3-port technique, the ureter was mobilized and plicated with a 6F Foley catheter. After dissection of the bladder mucosa in a semilunar shape, the detrusor was incised vertically and repaired underneath the mobilized ureter to create a submucosal tunnel. The ureter was covered with bladder mucosa, and the ureteral orifice was anastomosed to its orthotopic neoureteric orifice. The mean age of the included patients at the time of surgery was 9.18 years (range, 12 months-24 years). All surgeries were successfully completed without open conversion, with a mean operation time of 214 minutes including preoperative evaluation. All patients tolerated the procedure without any complications. Within the mean follow-up duration of 12.6 months (range, 5-24 months), no complications related to the surgery were reported, and no vesicoureteral reflux was detected in the operated side on postoperative voiding cystourethrography. The distal ureteral diameter was significantly reduced (from 21.1 to 11.6 mm), and the grade of hydronephrosis was decreased on postoperative ultrasonography without deterioration of renal function. CONCLUSION: In this study, laparoscopic intravesical detrusorrhaphy with ureteral plication demonstrated successful short-term outcomes in management of megaureter in children and adults. Our technique can be an effective and feasible surgical option in the treatment of megaureter.


Assuntos
Cistoscopia/métodos , Laparoscopia/métodos , Procedimentos de Cirurgia Plástica/métodos , Ureter/anormalidades , Doenças Ureterais/cirurgia , Procedimentos Cirúrgicos Urológicos/métodos , Adolescente , Adulto , Criança , Pré-Escolar , Feminino , Seguimentos , Humanos , Lactente , Masculino , Duração da Cirurgia , Estudos Retrospectivos , Resultado do Tratamento , Ureter/cirurgia , Doenças Ureterais/congênito , Adulto Jovem
15.
Urology ; 86(1): e3-4, 2015 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-26142610

RESUMO

Transcaval ureter is a rare congenital anomaly characterized by an inferior cava vein duplication producing a vascular ring around the right ureter, usually determining hydroureteronephrosis. The knowledge of this vascular anomaly on imaging examinations permits to avoid erroneous diagnosis of retroperitoneal masses or adenopathy and preoperatively advise the surgeon of potential sources of complications. We describe a case of transcaval ureter studied with multidetector computed tomography. To our knowledge, this is the first case in which computed tomography multiplanar and volume-rendering reconstructions show this rare anomaly.


Assuntos
Tomografia Computadorizada Multidetectores/métodos , Ureter/anormalidades , Ureter/diagnóstico por imagem , Doenças Ureterais/diagnóstico por imagem , Malformações Vasculares/complicações , Veia Cava Inferior/anormalidades , Diagnóstico Diferencial , Humanos , Masculino , Pessoa de Meia-Idade , Doenças Ureterais/congênito , Obstrução Ureteral/diagnóstico por imagem , Obstrução Ureteral/etiologia , Malformações Vasculares/diagnóstico por imagem , Veia Cava Inferior/diagnóstico por imagem
16.
Khirurgiia (Mosk) ; (10): 68-72, 2014.
Artigo em Russo | MEDLINE | ID: mdl-25484154

RESUMO

UNLABELLED: Objectives. To compare the results of laparoscopic and open heminephrectomy for kidneys duplication in children. Materials and methods. 42 patients underwent laparoscopic heminephrectomy and 20 patients underwent open heminephrectomy for non-functioning kidney moiety. Transperitoneal access with 3-4 trocars was used in the first group. Retrospective analysis of demographic, intra- and postoperative parameters, developed complications was performed. RESULTS: The mean operative duration was 127 minutes (90-205) and 120 minutes (100-219) in laparoscopic and open surgery groups, respectively. There were not intraoperative complications and need for conversion in laparoscopic group. Two children required additional surgery for perirenal cyst and ureteric stump inflammation. Hemotransfusion after open surgery was performed in 2 cases. Complications included pleural sine laceration and complete function loss of remaining moiety. The mean hospital stay was 7.2 days (5-12) and 11.5 days (8-17) in laparoscopic and open surgery groups, respectively. CONCLUSIONS: Laparoscopic transperitoneal heminephrectomy can be successfully used in children. Duration of laparoscopic and open interventions is comparable. But hospital stay is less in case of laparoscopic interventions.


Assuntos
Nefropatias , Laparoscopia , Nefrectomia , Complicações Pós-Operatórias , Sistema Urinário , Criança , Pré-Escolar , Pesquisa Comparativa da Efetividade , Feminino , Humanos , Nefropatias/congênito , Nefropatias/fisiopatologia , Nefropatias/cirurgia , Laparoscopia/efeitos adversos , Laparoscopia/métodos , Masculino , Nefrectomia/efeitos adversos , Nefrectomia/métodos , Duração da Cirurgia , Complicações Pós-Operatórias/classificação , Complicações Pós-Operatórias/prevenção & controle , Resultado do Tratamento , Doenças Ureterais/congênito , Doenças Ureterais/fisiopatologia , Doenças Ureterais/cirurgia , Sistema Urinário/anormalidades , Sistema Urinário/cirurgia , Urodinâmica
17.
Urology ; 84(2): 475-7, 2014 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-24975714

RESUMO

Paraureteral diverticula are rare in pediatric population. We here present a bladder stone in the congenital paraureteral diverticulum presenting with vesicoureteral reflux. To the best of our knowledge, stone formation in paraureteral diverticulum has not been reported previously. A 5-year-old boy was admitted with the complaint of dysuria. Abdominal ultrasonography revealed a bladder stone in a diverticulum arising from right posterolateral wall and a small right kidney. Voiding cystourethrogram confirmed large bladder diverticulum with vesicoureteral reflux. Cystoscopy revealed a giant stone in the paraureteral diverticulum. The stone was removed with open diverticulectomy and right Cohen ureteroneocystostomy was performed.


Assuntos
Divertículo/congênito , Divertículo/complicações , Doenças Ureterais/congênito , Doenças Ureterais/complicações , Cálculos da Bexiga Urinária/etiologia , Pré-Escolar , Humanos , Masculino
18.
J Pediatr Urol ; 10(6): 1089-94, 2014 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-24881807

RESUMO

OBJECTIVE: A simplified approach for the surgical management of symptomatic ectopic ureters, associated with a non-functioning upper moiety, with laparoscopic ureteric clipping is presented in this research paper. MATERIALS AND METHODS: Prospectively collected data on nine consecutive girls with ectopic ureters associated with urinary incontinence who underwent laparoscopic clipping between February 2011 and December 2013. Surgical technique consisted of cystoscopy and insertion of ureteral catheter in the lower pole ureter to aid in identification and clipping of the ectopic ureter, which was achieved by standard trans-peritoneal laparoscopy. RESULTS: Median age was eight years (range 4-17 years). Diagnosis was based on clinical findings, which were supported by: ultrasound (US), nuclear scans and magnetic resonance urography in Cases 9, 8 and 5, respectively. Bilateral complete duplication was present in two patients; the combination of cystoscopy and laparoscopy allowed adequate identification of the ectopic ureter causing incontinence in both. All nine patients were immediately dry after surgery and remain asymptomatic after a maximum follow up of 27 months. Eight out of nine patients had developed some degree of asymptomatic upper pole hydronephrosis on follow-up US. CONCLUSION: Laparoscopic clipping holds promise as a simple alternative to other more-complex surgical procedures in the treatment of incontinence due to an ectopic ureter. Despite favorable and encouraging initial results, further follow up is warranted in order to determine the fate of expected associated upper-pole hydronephrosis.


Assuntos
Rim/anormalidades , Laparoscopia/métodos , Ureter/anormalidades , Doenças Ureterais/complicações , Incontinência Urinária/cirurgia , Procedimentos Cirúrgicos Urológicos/métodos , Adolescente , Criança , Pré-Escolar , Cistoscopia , Feminino , Seguimentos , Humanos , Ligadura/métodos , Estudos Prospectivos , Ureter/cirurgia , Doenças Ureterais/congênito , Doenças Ureterais/diagnóstico , Incontinência Urinária/diagnóstico , Incontinência Urinária/etiologia , Urografia
19.
BMJ Case Rep ; 20142014 May 23.
Artigo em Inglês | MEDLINE | ID: mdl-24859560

RESUMO

Summary Hutch diverticula are rare congenital diverticula. The general consensus is that they occur secondary to a congenital failure of normal muscle development around the ureteral orifice where Waldeyer sheath anatomically covers the space between the intravesical ureter and muscular layer of the bladder. Our case highlights the radiological appearance of Hutch diverticula and the need for contrast-enhanced imaging to enable accurate evaluation and diagnosis. It illustrates how the presence of periureteric diverticula can contribute to ureteric obstruction and calculus formation; complicate the interpretation of renal tract imaging and the subsequent management of renal calculi.


Assuntos
Divertículo/diagnóstico por imagem , Hidronefrose/diagnóstico por imagem , Doenças Ureterais/diagnóstico por imagem , Obstrução Ureteral/diagnóstico por imagem , Ureterolitíase/diagnóstico por imagem , Meios de Contraste , Cistoscopia , Divertículo/complicações , Divertículo/congênito , Humanos , Hidronefrose/etiologia , Masculino , Pessoa de Meia-Idade , Doenças Ureterais/complicações , Doenças Ureterais/congênito , Obstrução Ureteral/complicações , Obstrução Ureteral/cirurgia , Ureterolitíase/complicações , Ureterolitíase/cirurgia , Ureteroscopia , Urografia/métodos
20.
Vet Clin North Am Small Anim Pract ; 44(2): 343-53, 2014 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-24580995

RESUMO

Ectopic ureters are the most common cause of urinary incontinence in young dogs but should be considered as a differential in any incontinent dog for which the history is not known. Ectopic ureters can be diagnosed with excretory urography, fluoroscopic urethrography or ureterography, abdominal ultrasonography, cystoscopy, helical computed tomography, or a combination of these diagnostic procedures. Other congenital abnormalities can also occur in dogs with ectopic ureters, including renal agenesis or dysplasia, hydronephrosis, and/or hydroureter and vestibulovaginal anomalies; therefore, the entire urinary system must be evaluated with ultrasonography if cystoscopy is the only other diagnostic tool used before surgery. Novel surgical techniques and adjunctive medical management have improved the prognosis for dogs with urinary ectopia.


Assuntos
Doenças do Cão/congênito , Ureter/anormalidades , Doenças Ureterais/veterinária , Animais , Doenças do Cão/diagnóstico , Doenças do Cão/cirurgia , Cães , Doenças Ureterais/congênito , Doenças Ureterais/cirurgia
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