Pelvic lipomatosis is a rare condition characteristized by the deposition of an excessive amount of benign adipose tissue in the bony pelvis. Tile proliferating adipose tissue may compress the pelvic viscera in varying degrees, including the pelvic portion of the ureters. Occasionally, marked bilateral ureteral obstruction may lead to the development of uremia. Computed tomography is emerging as useful diagnostic adjuvants in the confirmation of pelvic lipomatosis. A case of pelvic lipomatosis studied by CT and conventional radiography is presented.
Adipose Tissue ; Lipomatosis* ; Pelvis ; Radiography ; Uremia ; Ureter ; Ureteral Obstruction ; Viscera

Adult ; Foreign Bodies ; diagnostic imaging ; Humans ; Male ; Radiography ; Stents ; adverse effects ; Ureter

Purpose: The aim of this study was to compare the efficacy, safety and compliance of ureteroscopic stone removal (URS) patients who were treated with extracorporeal shock wave lithotripsy (ESWL) for large (>10mm) proximal ureteral stones. Materials and Methods: We reviewed 123 patients who were treated for upper ureteral stones (>10mm) between January 2000 and March 2005. URS and ESWL were performed in 51 and 72 patients, respectively. Success was defined as the patients achieving a stone-free status on radiography at 1 month after treatment. We analyzed the success rates of stone removal, the reasons for failure and the complication rates of each procedure. Results: The overall success rate of URS was 90.2%. For the ESWL treatments, the overall success rates after the first, second, third and more sessions were 47.2%, 61.1%, 76.4% and 81.9%, respectively. Notably, the stone free rate of the URS group was better than that of the 1st, 2nd and 3rd session ESWL group (p<0.05). The complication rate of URS was 24.0% and that of ESWL was 22.2%; the difference was not statistically significant (p<0.05). Conclusions: In this study, URS achieved an excellent stone free rate and a similar complication rate to that of ESWL for treating large (>10mm) upper ureteral calculi. Thus, this procedure should be considered as first line therapy for large (>10mm) upper ureteral stones. In addition, for the proper selection of patients for ESWL and URS, analysis of the cost effectiveness, compliance and recurrence rates of the two groups should be done in the future.
Compliance ; Cost-Benefit Analysis ; Humans ; Lithotripsy* ; Radiography ; Recurrence ; Shock* ; Ureter* ; Ureteral Calculi ; Ureteroscopes

Abnormalities, Multiple ; diagnostic imaging ; Adult ; Female ; Humans ; Kidney Calculi ; diagnostic imaging ; Radiography ; Ureter ; abnormalities ; diagnostic imaging

Crossed renal ectopia is a condition in which a kidney is located on the side opposite of its ureteral insertion. Ninety percent of crossed ectopic kidneys are fused to their ipsilateral uncrossed renal unit. Crossed renal ectopia without fusion is rare, with only 62 patients reported in the literature to date. These kidneys may suffer iatrogenic injury during an unrelated surgical intervention. The injury, unless self-limiting, may necessitate the removal of the ectopic kidney. We present a unique case of a dual injury, renal as well as ureteric, in a crossed ectopic kidney without fusion that was successfully managed without surgical excision.
Adult ; Choristoma/radiography/*therapy ; Humans ; *Iatrogenic Disease ; Kidney/*abnormalities/injuries/radiography ; Male ; Stents ; Tomography, X-Ray Computed ; Ureter/abnormalities/injuries/radiography

A case of Wilms' tumor in a 67 year-old female is presented. The tumor totally replaced the left kidney with extension to Gerota's fascia, the adrenal gland and ureter, with tumor thrombi in the left renal vein. Multiple bony metastases to the skull, shoulder, rib, ilium, acetabulum and femur were noted also. Microscopically, the tumor was composed predominantly of blastemal tissue with diffuse anaplasia with areas of tubular differentiation and chondroid elements. Clear cell nests were found in the proximal ureter with gradual maturation downward.
Aged ; Bone Neoplasms/secondary ; Case Report ; Female ; Human ; Kidney/pathology ; Kidney Neoplasms/*pathology/radiography ; Nephroblastoma/*pathology/radiography ; Tomography, X-Ray Computed ; Ureter/pathology

A knotted ureteral stent is an extremely rare condition, with fewer than 20 cases reported in the literature; however, it is difficult to treat. We report a case in which a folded Terumo guidewire was successfully used to remove a knotted stent percutaneously without anesthesia. We also review the current literature on predisposing factors and management strategies for knotted ureteral stents.
Anti-Bacterial Agents/therapeutic use ; Humans ; Kidney Calculi/*radiography/*therapy ; Lithotripsy ; Male ; Middle Aged ; Stents/*adverse effects ; Ureter

Humans ; Male ; Middle Aged ; Radiography ; Rupture, Spontaneous ; diagnostic imaging ; etiology ; physiopathology ; Ureter ; injuries ; Urolithiasis ; complications ; diagnosis ; diagnostic imaging

Although recently, there have been introduced many new diagnostic tools such as renal scanning and renogram, intravenous urogram remains to be one of the most useful method of urological diagnosis. Therefore it seems warranted to review 363 cases of intravenous urograms performed in the department of urology, St. Mary's hospital, Catholic Medical College during the period of January, 1962 to June, 1964. Among others, especial attention was paid to 60 cases of nonvisualizing kidneys. Of 60 nonvisualizing kidneys, renal tuberculosis occupied 27 cases(45%); ureteral and renal stones 13(21.6%); hydronephrosis 9(15%) (metastatic carcinoma 6(10%)and surgical manipulation 3(5%); Wilms' tumor 5 (8.3%) chronic atrophic pyelonephritis 3(5%) ; One case each of renal cell carcinoma, cystic kidney and thrombosis of the renal artery. Inasmuch as the present study revealed renal tuberculosis to be the most common cause of nonvisualizing kidneys, it is felt that one should always consider the possibility of tuberculosis in the diagnosis of nonvisualizing kidneys in Korea. This fact should be stressed because nontuberculous pathology such as chronic pyelonephritis has been implicated to be the most frequent cause of nonvisualizing kidneys by American authors.
Carcinoma, Renal Cell ; Diagnosis ; Hydronephrosis ; Kidney Diseases, Cystic ; Kidney* ; Korea ; Pathology ; Pyelonephritis ; Radiography* ; Renal Artery ; Thrombosis ; Tuberculosis ; Tuberculosis, Renal ; Ureter ; Urology ; Wilms Tumor

PURPOSE: To characterize the course of treatment for nonmonosymptomatic enuresis with overactive bladder (OAB) in a real clinical setting. METHODS: Data from 111 OAB patients with moderate to severe enuresis were analyzed. The baseline analysis included a questionnaire, voiding diary, uroflowmetry with postvoid residual urine measurement, and plain abdominal radiography of the kidneys, ureters, and bladder (KUB). Following standard urotherapy for 1 month, anticholinergic medication was administered with or without laxatives. Desmopressin was added if there was a partial response to OAB. Patients were followed every 3 months to evaluate the status of OAB and enuresis. Multivariate analysis was performed to identify predictors associated with the lack of complete response (CR) in enuresis at 12 months. RESULTS: Following 12 months of treatment, 64% and 88% of patients experienced at least partial response in enuresis and OAB, respectively. Urgency improved more quickly than enuresis, supporting the need to address daytime symptoms before enuresis. Seventy-nine patients (71%) had fecal impaction on KUB and/or subjective constipation. The combination of anticholinergics with either laxatives or desmopressin fared better than anticholinergics alone. Daytime incontinence and anticholinergics-only treatment were associated with a lack of CR during 12 months of treatment. CONCLUSIONS: The data confirmed the validity of addressing OAB before treating enuresis. The results of this study also highlight the need to address fecal impaction. Patients should be counseled about the need for a prolonged course of treatment before starting treatment. Anticholinergics should be accompanied with either desmopressin or laxatives for better control of enuresis.
Cholinergic Antagonists ; Constipation ; Deamino Arginine Vasopressin ; Enuresis* ; Fecal Impaction ; Humans ; Kidney ; Laxatives ; Multivariate Analysis ; Radiography, Abdominal ; Ureter ; Urinary Bladder ; Urinary Bladder, Overactive*