Ureterostomy
Urinary Diversion
Encyclopedias as Topic
Spinal Cord Injuries
Surgical Stomas
Cynomolgus polyoma virus infection: a new member of the polyoma virus family causes interstitial nephritis, ureteritis, and enteritis in immunosuppressed cynomolgus monkeys. (1/81)
Polyoma virus infection causes acute interstitial nephritis and ureteral stenosis in humans but has rarely been noted in other species. In the present study, a hitherto unknown polyoma virus was detected in 12 of 57 cynomolgus monkeys after 3 to 11 weeks of immunosuppression given to promote acceptance of renal allografts or xenografts. This virus, termed cynomolgus polyoma virus (CPV), is antigenically and genomically related to simian virus 40 (SV40). The tubular epithelial nuclei of the collecting ducts in the medulla and cortex reacted with an antibody for the SV40 large T antigen and by electron microscopy contained densely packed paracrystalline arrays of 30- to 32-nm diameter viral particles. A polymerase chain reaction analysis of DNA extracted from affected kidneys detected polyoma virus sequences using primers for a highly conserved region of the large T antigen of polyoma virus. Sequence analysis showed 7 base substitutions and 3 to 5 deletions in the 129-nucleotide segment of amplified products, compared with the corresponding portion of SV40, yielding 84% homology at the amino acid level. CPV caused interstitial nephritis in six renal allografts, a xenograft kidney, and six native kidneys. Infected animals showed renal dysfunction and had tubulointerstitial nephritis with nuclear inclusions, apoptosis, and progressive destruction of collecting ducts. CPV was detected in the urothelium of graft ureters, associated with ureteritis and renal infection. Viral infection was demonstrable in smooth muscle cells of the ureteric wall, which showed apoptosis. One animal had diarrhea and polyoma virus infection in the smooth muscle cells of the muscularis propria of the intestine. Spontaneous resolution occurred in one case; no animal had virus detected in tissues more than 3 months after transplantation. Thus, immunosuppression predisposes cynomolgus monkeys to a polyoma virus infection with clinical consequences quite similar to BK virus infection in humans, including renal dysfunction. We also suggest that this may be the pathogenetic basis for the significant incidence of late onset, isolated ureteral stenosis observed in these recipients. (+info)Endovascular management of ureteroarterial fistula. (2/81)
Ureteroarterial fistulas, although rare, appear to be increasing in frequency. Because open surgical repair may be difficult and associated with significant risk for complications, endovascular intervention may provide an attractive treatment alternative. We review the diagnosis and management of a ureteroarterial fistula and iliac pseudoaneurysm that presented with massive hematuria during ureteral stent removal. The patient was treated by means of the percutaneous embolization of the right hypogastric artery and placement of an expanded polytetrafluoroethylene stent-graft. Endovascular stent-graft placement may serve as a safe and practical alternative in the treatment of these patients, whose cases are challenging. (+info)Laparoscopic or open surgery for living donor nephrectomy. (3/81)
BACKGROUND: The anterior extraperitoneal approach for living donor nephrectomy has been used in more than 700 living cases in the unit and proved to be safe for the donor. In 1998, laparoscopic nephrectomy was introduced as an option when technically feasible. We found it essential to investigate the consequences of the new technique. SUBJECTS AND METHODS: One hundred living donor kidney transplantations were performed from 1998 to June 2000, 45 with laparoscopic, 55 with open nephrectomy. The donors took part in a structured interview 4 weeks after the donation and their responses were categorized in three classes. RESULTS: In each group, one recipient had delayed initial function. The serum creatinine levels after 3 and 7 days or the GFR values after 6 months did not differ. One graft has been lost following laparoscopic nephrectomy and four after open surgery. For the laparoscopy donors, the median number of post-operative days in hospital was 5.0 days (range 2-9), vs 6.0 (4-8) after open surgery (NS). The requirement of opoid analgesics post-operatively was 5.0 doses (1-22) vs 6.0 (1-38) (P=0.02); and after 4 weeks, 23 of 45 laparoscopic donors were free of pain vs eight of 55 open nephrectomy donors (P=0.0004). Approximately one-third of all donors felt some restriction of physical activity and the majority complained of impaired physical energy. There were no differences between the groups. The duration of sick-leave after laparoscopic surgery was median 6 (2-19) weeks vs 7 (1-16) (NS). CONCLUSIONS: Laparoscopic nephrectomy is safe. Less post-operative pain is a definite advantage for the donor. (+info)Management of symptomatic ureteric stumps laparoscopically. (4/81)
AIM: To study the advantage of excision of the distal symptomatic ureteric stumps with the retroperitoneal laparoscopic approach. METHODS: Four patients who had failed to settle their symptoms with the initial conservative management were included in the study. All underwent excision of the distal symptomatic ureteric stumps with the retroperitoneal laparoscopic approach and then received prophylactic antibiotics. RESULTS: We have achieved better results than those reported in the literature in terms of operating time (mean 1 h 45 min), blood loss (< 10 mL), postoperative recovery (within 12 h) and hospital stay (< 48 h). CONCLUSION: Retroperitoneal laparoscopic excision is a safe, simple and effective method in the management of symptomatic ureteric stumps. (+info)Arterio-ureteral fistula--a systematic review. (5/81)
OBJECTIVE: To review published reports on arterio-ureteral fistula. METHOD: Literature search. RESULTS: Eighty cases were identified. Primary fistulas were mainly seen in combination with aortoiliac aneurysmal disease. Secondary fistulas were seen after pelvic cancer surgery, often with radiation, fibrosis and ureteral stenting or after vascular surgery with synthetic grafting. The dominating symptom is massive haematuria, often with circulatory impairment. The clue to a rapid and correct diagnosis is a high degree of suspicion. Most frequently diagnosis has been obtained through angiography or pyelography. When there is a ureteral stent manipulation it will often provoke bleeding and lead to diagnosis. The fistula must be excluded and a vascular reconstruction made. Most frequently this has been obtained through occlusion of the fistula and an extra-anatomic reconstruction (femoro-femoral crossover). Recently stent-grafting has been successfully used but follow-up is short. CONCLUSION: Arterio-ureteral fistula is rare and should be suspected in patients with complicated pelvic surgery and massive haematuria, especially where rigid ureteral stents have been placed. (+info)Unenhanced spiral CT in acute ureteral colic: a replacement for excretory urography? (6/81)
OBJECTIVE: To compare the usefulness of unenhanced spiral CT (UCT) with that of excretory urography (EU) in patients with acute flank pain. MATERIALS AND METHODS: Thirty patients presenting with acute flank pain underwent both UCT and EU. Both techniques were used to determine the presence, size, and location of urinary stone, and the presence or absence of secondary signs was also evaluated. The existence of ureteral stone was confirmed by its removal or spontaneous passage during follow-up. The absence of a stone was determined on the basis of the clinical and radiological evidence. RESULTS: Twenty-one of the 30 patients had one or more ureteral stones and nine had no stone. CT depicted 22 of 23 calculi in the 21 patients with a stone, and no calculus in all nine without a stone. The sensitivity and specificity of UCT were 96% and 100%, respectively. EU disclosed 14 calculi in the 21 patients with a stone and no calculus in eight of the nine without a stone. UCT and EU demonstrated secondary signs of ureterolithiasis in 15 and 17 patients, respectively. CONCLUSION: For the evaluation of patients with acute flank pain, UCT is an excellent modality with high sensitivity and specificity. In near future it may replace EU. (+info)Pelvic fistulas complicating pelvic surgery or diseases: spectrum of imaging findings. (7/81)
Pelvic fistulas may result from obstetric complications, inflammatory bowel disease, pelvic malignancy, pelvic radiation therapy, pelvic surgery, or other traumatic causes, and their symptoms may be distressing. In our experience, various types of pelvic fistulas are identified after pelvic disease or pelvic surgery. Because of its close proximity, the majority of such fistulas occur in the pelvic cavity and include the vesicovaginal, vesicouterine, vesicoenteric, ureterovaginal, ureteroenteric and enterovaginal type. The purpose of this article is to illustrate the spectrum of imaging features of pelvic fistulas. (+info)Incidental diagnosis of diseases on un-enhanced helical computed tomography performed for ureteric colic. (8/81)
BACKGROUND: Patients presenting in the emergency room with flank pain suggestive of acute ureteric colic may have alternative underlying conditions mimicking ureteric stones. An early diagnosis and appropriate treatment for other causes of flank pain is important. The majority of centers around the world are increasingly using un-enhanced helical CT (UHCT) for evaluation of ureteric colic. This study was conducted to determine the incidence and spectrum of significant incidental diagnoses established or suggested on UHCT performed for suspected renal/ureteric colic. METHODS: Urologist and radiologist reviewed 233 consecutive UHCT, performed for suspected renal/ureteral colic along with assessment of the medical records. Radiological diagnoses of clinical entities not suspected otherwise were analyzed. All other relevant radiological, biochemical and serological investigations and per-operative findings were also noted. RESULTS: Ureteral calculi were identified in 148 examinations (64%), findings of recent passage of calculi in 10 (4%) and no calculus in 75 examinations (32%). Overall the incidental findings (additional or alternative diagnosis) were found in 28 (12%) CT scans. Twenty (71%) of these diagnoses were confirmed by per-operative findings, biopsy, and other radiological and biochemical investigations or on clinical follow up. CONCLUSION: A wide spectrum of significant incidental diagnoses can be identified on UHCT performed for suspected renal/ureteral colic. In the present series of 233 consecutive CT examinations, the incidence of incidental diagnosis was 12%. (+info)Ureteral diseases refer to a range of conditions that affect the ureters, which are the thin tubes that carry urine from the kidneys to the bladder. These diseases can cause various symptoms such as pain in the side or back, fever, and changes in urinary patterns. Here are some examples of ureteral diseases:
1. Ureteral stricture: A narrowing of the ureter that can be caused by scarring, inflammation, or tumors. This can lead to a backup of urine, which can cause kidney damage or infection.
2. Ureteral stones: Small, hard mineral deposits that form in the ureters and can cause pain, nausea, and blood in the urine.
3. Ureteral cancer: A rare type of cancer that affects the ureters and can cause symptoms such as abdominal pain, weight loss, and bloody urine.
4. Ureteral reflux: A condition in which urine flows backward from the bladder into the ureters, causing infection and kidney damage.
5. Ureteral trauma: Injury to the ureters can occur due to accidents, surgeries, or other medical procedures. This can lead to bleeding, scarring, or blockages in the ureters.
Treatment for ureteral diseases depends on the specific condition and its severity. Treatment options may include medications, surgery, or minimally invasive procedures such as stenting or balloon dilation.
Ureterostomy is a surgical procedure that creates an opening from one or both ureters, the tubes that carry urine from the kidneys to the bladder, to the abdominal wall. This allows urine to bypass the bladder and be expelled through the opening, called a stoma, into a collection device or onto the skin where it can be absorbed by a pad or diaper.
Ureterostomy is typically performed as a temporary measure in cases of severe bladder injury, infection, or obstruction that cannot be immediately corrected. It may also be used as a permanent solution for patients with congenital abnormalities or conditions that prevent the normal flow of urine through the bladder.
There are two main types of ureterostomy: cutaneous and uretero-cutanoeostomy. In a cutaneous ureterostomy, the ureter is brought directly to the abdominal wall and sutured in place. In a uretero-cutanoeostomy, a piece of intestine is used to create a conduit between the ureter and the abdominal wall.
Like any surgical procedure, ureterostomy carries risks such as bleeding, infection, and injury to surrounding organs. Patients who undergo this procedure will require close monitoring and follow-up care to ensure proper healing and function of the stoma.
Urinary diversion is a surgical procedure that involves the creation of a new way for urine to leave the body, bypassing the native urinary system. This is typically performed in individuals who have damaged or removed urinary systems due to conditions such as cancer, severe trauma, or congenital abnormalities.
There are several types of urinary diversions, including:
1. Ileal Conduit: A segment of the small intestine (ileum) is used to create a passageway for urine to flow from the ureters to an external collection bag or pouch worn on the abdomen.
2. Continent Urinary Reservoir: A pouch-like reservoir is created using a segment of the intestine, which is then connected to the ureters. The patient periodically empties the reservoir through a stoma (opening) in the abdominal wall using a catheter.
3. Orthotopic Neobladder: A pouch-like reservoir is created using a segment of the intestine, which is then connected to the urethra, allowing for normal urination through the native urethral opening.
These procedures can significantly improve the quality of life for patients with severe urinary system damage or disease, although they do come with potential complications such as infections, stone formation, and electrolyte imbalances.
An encyclopedia is a comprehensive reference work containing articles on various topics, usually arranged in alphabetical order. In the context of medicine, a medical encyclopedia is a collection of articles that provide information about a wide range of medical topics, including diseases and conditions, treatments, tests, procedures, and anatomy and physiology. Medical encyclopedias may be published in print or electronic formats and are often used as a starting point for researching medical topics. They can provide reliable and accurate information on medical subjects, making them useful resources for healthcare professionals, students, and patients alike. Some well-known examples of medical encyclopedias include the Merck Manual and the Stedman's Medical Dictionary.
Urination, also known as micturition, is the physiological process of excreting urine from the urinary bladder through the urethra. It is a complex process that involves several systems in the body, including the urinary system, nervous system, and muscular system.
In medical terms, urination is defined as the voluntary or involuntary discharge of urine from the urethra, which is the final pathway for the elimination of waste products from the body. The process is regulated by a complex interplay between the detrusor muscle of the bladder, the internal and external sphincters of the urethra, and the nervous system.
During urination, the detrusor muscle contracts, causing the bladder to empty, while the sphincters relax to allow the urine to flow through the urethra and out of the body. The nervous system plays a crucial role in coordinating these actions, with sensory receptors in the bladder sending signals to the brain when it is time to urinate.
Urination is essential for maintaining the balance of fluids and electrolytes in the body, as well as eliminating waste products such as urea, creatinine, and other metabolic byproducts. Abnormalities in urination can indicate underlying medical conditions, such as urinary tract infections, bladder dysfunction, or neurological disorders.
Spinal cord injuries (SCI) refer to damage to the spinal cord that results in a loss of function, such as mobility or feeling. This injury can be caused by direct trauma to the spine or by indirect damage resulting from disease or degeneration of surrounding bones, tissues, or blood vessels. The location and severity of the injury on the spinal cord will determine which parts of the body are affected and to what extent.
The effects of SCI can range from mild sensory changes to severe paralysis, including loss of motor function, autonomic dysfunction, and possible changes in sensation, strength, and reflexes below the level of injury. These injuries are typically classified as complete or incomplete, depending on whether there is any remaining function below the level of injury.
Immediate medical attention is crucial for spinal cord injuries to prevent further damage and improve the chances of recovery. Treatment usually involves immobilization of the spine, medications to reduce swelling and pressure, surgery to stabilize the spine, and rehabilitation to help regain lost function. Despite advances in treatment, SCI can have a significant impact on a person's quality of life and ability to perform daily activities.
A surgical stoma, also known simply as a stoma, is a surgically created opening on the surface of the body that allows for the passage of bodily waste. This procedure is typically performed when a person has a malfunctioning or diseased organ in the digestive or urinary system that cannot be effectively treated or repaired.
In a colostomy or ileostomy, which are common types of surgical stomas, a portion of the colon or small intestine is brought through an opening in the abdominal wall to create a new pathway for waste to exit the body. The stoma may be temporary or permanent, depending on the underlying condition and the success of any additional treatments.
After surgery, patients with a stoma will need to wear a pouching system to collect and contain the waste that is expelled through the stoma. This can take some getting used to, but with proper care and support, most people are able to adjust to life with a stoma and maintain a good quality of life.
Urinary Bladder Neoplasms are abnormal growths or tumors in the urinary bladder, which can be benign (non-cancerous) or malignant (cancerous). Malignant neoplasms can be further classified into various types of bladder cancer, such as urothelial carcinoma, squamous cell carcinoma, and adenocarcinoma. These malignant tumors often invade surrounding tissues and organs, potentially spreading to other parts of the body (metastasis), which can lead to serious health consequences if not detected and treated promptly and effectively.