The double J ureteral stent (D-J stent) represents the ureteral catheter widely used nowadays. The main purpose of the D-J stent is to resolve ureteral obstruction caused by intraureteral or extra-ureteral etiologies. Indications of D-J stents have been extended and it has become one of the most important surgical instruments that protect the kidney and ureter. The ideal D-J stent should be easy to insert and remove and should not cause any adverse effects in vivo. In addition, it has to function well. However, there has been no immaculate D-J stent because our body conceives the ureteral stent as a foreign object and numerous developments are being made in order to overcome it. Vesicoureteral reflux, one of the adverse effects of the D-J stent, is the most troublesome adverse effect because it may scar the renal parenchyma, leading to permanent deterioration of renal function. This review is to discuss adverse effects of ureteral stents and to present the novel antireflux D-J stent that may reduce vesicoureteral reflux.
Cicatrix ; Kidney ; Postoperative Complications ; Prosthesis Design ; Stents ; Surgical Instruments ; Ureter ; Ureteral Obstruction ; Urinary Catheters ; Vesico-Ureteral Reflux

PURPOSE: Laparoscopic pyeloplasty was developed as a minimally invasive alternative to an open procedure for the treatment of ureteropelvic junction (UPJ) obstruction. We present our experience with the first 30 consecutive cases of laparoscopic pyeloplasty performed at our institution. MATERIALS AND METHODS: We studied 30 patients with ureteropelvic junction obstructions who underwent laparoscopic pyeloplasty between March 2004 and March 2009. Of the 30 patients, 5 patients underwent robot-assisted laparoscopic pyeloplasty (RALP) since April 2008. Patients were divided into 4 groups according to operative procedure: group 1, early laparoscopic pyeloplasty-dismembered (E/LP-D, n=9); group 2, late laparoscopic pyeloplasty-dismembered (L/LP-D, n=9); group 3, laparoscopic pyeloplasty-Fenger's method (LP-F, n=7); and group 4, RALP (n=5). RESULTS: The mean age of the patients was 34.0+/-12.8 years (range, 17-61 years). A crossing vessel was present in 37.9% of cases. Mean follow-up was 30+/-14 months (range, 11-62 months). Mean operative time was 267.3+/-78.7 minutes (range, 154-460 minutes), and the average length of the postoperative hospital stay was 4.6+/-1.6 days (range, 3-10 days). There were no intraoperative complications or transfusion. The success rate was 73.3%. The success rates of E/LP-D, L/LP-D, LP-F, and RALP were 6/9 (66.7%), 7/9 (77.8%), 5/7 (71.4%), and 4/5 (80%), respectively, without significant difference (p>0.05). Operation time and length of hospital stay were shorter in the L/LP-D group than in the E/LP-D group. CONCLUSIONS: Laparoscopic pyeloplasty may be an alternative treatment for an ureteropelvic junction obstruction, but the technical complexity of the procedure has made it difficult for many surgeons to adopt. RALP is a technically feasible management option for UPJ obstruction.
Follow-Up Studies ; Glycosaminoglycans ; Humans ; Intraoperative Complications ; Laparoscopy ; Length of Stay ; Operative Time ; Robotics ; Ureteral Obstruction

We evaluated the urological complications in 200 renal transplantations performed in the Department of Urology, Catholic Medical College between March 1969 and April 1986. The following results were obtained; 1. Of 200 cases of recipient 151 cases were male and 49 cases were female. 2. The ureteroneocystostomy was performed as the method of modified Politano-Leadbetter (intravesical approach) in 66 cases and modified Mackinnon (extravesical approach) in 134 cases. 3. Our incidence of urological complications in 200 renal transplantations was 7%1l4 cases). Postoperative complications developed in Il of the 66(l6.7%) who underwent intravesical ureteroneocystostomy and 3 of the 134(2.2%) who underwent extravesical ureteroneocystomy. 4. The details of the complications were as follows: 6 were ureteral obstruction, 5 ureteral leakage, 2 urine leakage from anastomosis site and 1 was bleeding from anastomosis site. 5. Operative method for urological complications were ureteroureterostomy (10) in ureteral obstruction(6) and ureteral leakage (4), ureteroneocystostomy (1) in ureteral leakage, simple suture (2) in bleeding(1) and urine leakage from anastomosis site(2).
Female ; Hemorrhage ; Humans ; Incidence ; Kidney Transplantation* ; Male ; Postoperative Complications ; Sutures ; Ureter ; Ureteral Obstruction ; Urology

We evaluated the complications of intravesical and extravesical ureteroneocystostomy in 125 renal transplantations performed in the Department of Urology, Catholic Medical College between March 1969 and July 1982. The following results were obtained: 1. Of 125 cases of the recipient 105 cases were male and 20 cases were female. 2. Intravesical ureteroneocystostomy was performed by Politano-Leadbetter method in 66 cases and extravesical ureteroneocystostomy by the similar ones reported by MacKinnon in 59 cases. 3. Our incidence of urological complications in the 125 renal transplantations was 9.7% (12 cases). 4. Postoperative complications developed in 11 of the 66 who underwent intravesical ureteroneocystostomy and in 1 of the 59 who underwent extravesical ureteroneocystostomy. 5. The details of the complications were as follows: 6 were ureteral obstruction, 4 ureteral leakage, 1 bleeding from anastomosis site and 1 was urine leakage from anastomosis site. 6. Operative methods for urological complications were ureteroureterostomy in ureteral obstruction 161 and ureteral leakage (3), ureteroneocystostomy in ureteral leakage (1), simple suture in bleeding (1) and urine leakage (1) from anastomosis site. 7. This method of extravesical ureteroneocystostomy in renal transplantation was easy and fast and has a low complication.
Female ; Hemorrhage ; Humans ; Incidence ; Kidney Transplantation* ; Male ; Postoperative Complications ; Sutures ; Ureter ; Ureteral Obstruction ; Urology

From June 1989 to October 1991. 52 patients with renal staghorn calculi (34 with incomplete staghorn renal calculi and I8 with complete staghorn calculi) underwent extracorporeal shock wave lithotripsy. monotherapy by Northgate SD-3 Iithotriptor. Of 52 patients, 27 were treated without preoperative double-J stenting. while 25 underwent double-J stenting before extracorporeal shock wave lithotripsy. The mean shock waves per patients were gradually increased in proportion to stone burdens rather than the insertion of double-J stent. The average duration of hospitalization was shorter for The group who received prophylactic double-J stenting. The incidence of postoperative complications such as ureteral obstruction, colic, fever decreased in double-J stenting group, but was not statistically significant (p>0.05). 62% (32 cases) of the patients were free of stones after 6 months but double-J stenting did not influence the rate free of stones.
Calculi* ; Colic ; Fever ; Hospitalization ; Humans ; Incidence ; Kidney Calculi ; Lithotripsy* ; Postoperative Complications ; Shock* ; Stents* ; Ureteral Obstruction

OBJECTIVE: To investigate the clinical features and outcome of hydronephrosis induced by retroperitoneal fibrosis (RPF), and to evaluate the effect of corticosteroid based therapy combined with surgical intervention of ureteral obstruction. METHODS: A total of 17 RPF patients with hydronephrosis hospitalized in Peking University International Hospital from May 2016 to December 2019 were analyzed retrospectively. RESULTS: The median age was 56 (53, 65) years, the male to female ratio was 2.4 : 1, and the disease duration was 4.00 (0.83, 8.00) months. The initial symptoms included back pain (9 cases), abdominal pain (6 cases), oliguria (2 cases) and lower limb edema (3 cases). Eight patients presented left hydronephrosis, 1 right hydronephrosis and 8 bilateral hydronephrosis. C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were both elevated in 13 patients (76.5%, n=17). Immunoglobin (Ig) G4 increased in 5 cases (29.4%, n=17). IgG, IgE and IgA increased in 4 cases (30.8%, n=13), 4 cases (30.8%, n=13) and 1 case (7.7%, n=13), respectively. Among 12 patients who underwent biopsy, 3 patients were diagnosed with IgG4-relate disease. The level of IgG4 in the tissues varied, 6 cases expressed less than 10 per high power field (HPF) or no expression (50.0%). Only 2 cases expressed 10-30/HPF (16.7%), and 4 cases revealed more than 30/HPF (33.3%). Among the 17 patients with ureteral obstruction, no urinary drainage procedure was needed in 4 patients who had mild ureteral obstruction, whereas, ureteral stenting was carried out in the other 13 cases before drug treatment. Time was too short to evaluate the effect of urinary drainage procedures in 4 patients. For the rest, ureterolysis had to be performed in 3 cases after failed ureteral stent insertion. Successful drain removal was accomplished in all of these 9 patients and the mean time to drain removal was (6.7±3.0) months. In addition, 10 patients had complete medical records after an average follow-up time of 5 (3-13) months. Levels of ESR, CRP, IgG4, IgG, IgE, IgA were 54.0 (36.3, 98.5) mm/h, 26.8 (8.7, 53.0) mg/L, 1.34 (0.55, 3.36) g/L, 16.3 (13.0, 21.1) g/L, 40.5 (31.4, 203.0) IU/mL, 2.51 (1.82, 3.25) g/L at baseline, which all decreased predominantly after treatment. ESR, CRP, IgG4, IgG, IgE and IgA dropped by 38.5 (23.5, 54.3) mm/h (P < 0.01), 23.0 (5.5, 52.0) mg/L (P < 0.05), 0.92 (0.40, 2.85) g/L (P < 0.01), 6.5 (1.7, 9.1) g/L (P < 0.05), 23.7 (4.8, 162.0) IU/mL (P < 0.05) and 0.77 (0.32, 1.26) g/L (P < 0.05), respectively. Size of mass measured by CT/MRI imaging became smaller significantly and hydronephrosis relieved. CONCLUSION Onset of RPF is insidious and lack of specific initial symptoms. Corticosteroid based therapy combined with surgical intervention of relieving obstruction is effective.
Aged ; Female ; Humans ; Hydronephrosis/etiology* ; Male ; Retroperitoneal Fibrosis/complications* ; Retrospective Studies ; Ureter ; Ureteral Obstruction

Ureteral obstruction may develop in immunocompromised patients with an Aspergillus fungal infection. Infections can progress to invasive aspergillosis, which is highly lethal. We report a case of a 56-year-old man with alcoholic cirrhosis of the liver and diabetes. He had ureteral aspergilloma, discovered as a saprophytic whitish mass. It was treated by ureteroscopic removal, however, he refused antifungal treatment. His condition progressed to invasive aspergillosis, and died from sepsis and hepatorenal syndrome.
Aspergillosis/diagnosis/*etiology ; Diabetes Complications ; Fatal Outcome ; Humans ; Immunocompromised Host ; Liver Cirrhosis, Alcoholic/complications ; Male ; Middle Aged ; Ureteral Diseases/diagnosis/*etiology ; Ureteral Obstruction/diagnosis/etiology

Aged ; Female ; Humans ; Kidney Pelvis ; pathology ; surgery ; Rupture, Spontaneous ; diagnosis ; etiology ; surgery ; Ureteral Calculi ; complications ; diagnosis ; surgery ; Ureteral Obstruction ; complications ; diagnosis ; surgery

No abstract available.
Child ; Humans ; Hydronephrosis/*congenital/diagnosis/etiology ; Male ; Multicystic Dysplastic Kidney/diagnosis/*etiology ; Polyps/*complications/diagnosis/surgery ; Ureteral Diseases/complications/diagnosis/surgery ; Ureteral Obstruction/diagnosis/*etiology

PURPOSE: The aim of this study was to compare cure rates and complications of polydimethylsiloxane (Macroplastique(R)) and dextranomer/hyaluronic acid copolymer (Deflux(R)) in the treatment of vesicoureteral reflux (VUR). MATERIALS AND METHODS: From April 2001 to March 2008, 29 boys and 42 girls (total of 115 ureters) with a mean age of 6 years who had undergone endoscopic subureteral transurethral injection for VUR were enrolled. A single subureteral injection of Macroplastique was performed in 31 ureters in 23 children (group I; grade II: 4; grade III: 12; grade IV: 9; grade V: 6), and a single subureteral injection of Deflux was performed in 84 ureters in 48 children (group II; grade II: 24; grade III: 14; grade IV: 25; grade V: 21). Renal ultrasound was done 1 day after injection, and voiding cystourethrography (VCUG) was done at 3 months. Successful reflux correction was defined as absent or grade I reflux on follow-up VCUG. RESULTS: No significant difference in success rates was observed between group I and group II [80.6% (25/31) vs. 78.6% (66/84), respectively, p>0.05]. The following postoperative complications developed: ureteral obstruction in 2 ureters of group I and 3 ureters of group II, asymptomatic urinary tract infection in 3 patients of group I and 2 patients of group II, and bladder calcification by erosion or mucosal necrosis in 2 patients of group I. CONCLUSIONS: Despite differences in material properties, both Macroplastique and Deflux were safe for the treatment of children with VUR. Because of the risk of bladder mucosal necrosis and substantial decreases in volume after implantation, long-term follow-up is required.
Child ; Dextrans ; Dimethylpolysiloxanes ; Follow-Up Studies ; Humans ; Hyaluronic Acid ; Necrosis ; Postoperative Complications ; Ureter ; Ureteral Obstruction ; Urinary Bladder ; Urinary Tract Infections ; Vesico-Ureteral Reflux