Ureteropelvic junction avulsion caused by blunt trauma is a rare condition which is often diagnosed after some delay. Herein, we report a case of traumatic ureteropelvic junction avulsion which has been treated successfully by end to end pyeloureterostomy.
Kidney Pelvis ; Ureter ; Wounds and Injuries

Retrocaval ureter is a rare congenital anomaly that causes symptomatic hydronephrosis. Despite difficulties in the intracorporeal suturing, a retrocaval ureter is thought to be a good candidate for laparoscopic surgery, especially from the cosmesis. Laparoscopic ureteroureterostomy has advantages compared to conventional open surgery in terms of less pain, decreased blood loss, smaller operative wound and shorter hospital stay. Herein, we report our initial experience of laparoscopic ureteroureterostomy in a patient with a retrocaval ureter.
Humans ; Hydronephrosis ; Laparoscopy ; Length of Stay ; Retrocaval Ureter* ; Sutures ; Ureter ; Wounds and Injuries

Exteriorization of the ureteral stump in nephrectomy was devised by Dr. William Mayo and was clinically applied for the treatment of renal tuberculosis by Dr. John K. Lattimer. The method was used in eighteen cases of nephrectomy with successful results at our clinic during the past two years. Ureteral Exteriorization is considered one of the most reasonable methods of preventing possible local infection at the operative wound during and after nephrectomy of a severely infected kidney. We believe that instillation or continuous irrigation of antibacterial solutions through the exteriorized ureteral stump is a simple and useful procedure for the treatment of residual infection of the urinary tract after nephrectomy.
Kidney ; Nephrectomy* ; Tuberculosis, Renal ; Ureter* ; Urinary Tract ; Wounds and Injuries

The majority of ureteric injury is iatrogenic during surgical procedures especially pelvic and retroperitoneal operations. Approximately 10% of ureteric injury is associated with colorectal procedures. The major cause is anatomical anomaly. The types of injuries mainly include contusion, clamp injury, ligation injury, cautery, cut injury and distorted traction to an acute angle. The injuries are mainly located in the lower segment of the ureter. An accurate evaluation of the risk of ureteric injury before rectal cancer operation, a better understanding of anatomy in both normal and abnormal conditions, and ureteral stent placement, are important methods to prevent ureteric injury. Primary repair is the best treatment option.
Humans ; Intraoperative Complications ; prevention & control ; Rectal Neoplasms ; surgery ; Ureter ; injuries

BACKGROUNDThe delayed diagnosis of pelvi-ureteric junction (PUJ) disruption in children following blunt abdominal trauma can result in loss of function of the involved kidney. We examined the potential for kidney preservation and the limits of diagnostic delays.

METHODSA retrospective review of 17 cases of PUJ disruption at Beijing Children's Hospital from 1993 to 2009 was done with respect to diagnosis, treatment and follow-up.

RESULTSThe interval from trauma to diagnosis of PUJ disruption was (52 ± 52) days. If one case with nephrectomy was excluded, the interval from trauma to diagnosis was (40 ± 20) days. The average time between injury and first treatment was (49 ± 25) days. Pelvi-ureteric reanastomosis and caliceal ureterostomy were performed separately in 11 and 4 patients, respectively. Ileal replacement for ureter injuries was finally performed in one patient. Hydronephrosis of the injured kidney was reduced and the function improved in 15 out of 17 patients (88%). Only one patient received nephrectomy and the nephrectomy rate was 5.9%.

CONCLUSIONDifferential renal function at the PUJ disruption side can be saved and the rate of nephrectomy reduced by appropriate surgery if the time to diagnosis and first treatment is limited to within two months.

Abdominal Injuries ; complications ; surgery ; Child ; Child, Preschool ; Female ; Humans ; Kidney ; injuries ; surgery ; Kidney Pelvis ; injuries ; surgery ; Male ; Retrospective Studies ; Ureter ; injuries ; surgery ; Ureteral Obstruction ; etiology ; surgery

The dismembered Foley Y-plasty and Anderson-Hynes pyeloplasty are in principle the same operation for the correction of hydronephrosis secondary to obstruction at ureteropelvic junction. The differences between the former and the letter are that Anderson used a downward and continuous 0000 suture for a watertight closure, while Foley proposed upward and interrupted 0000 sutures about 2mm. apart for accurate tissue approximation and minimal interference with wound margin blood supply. We used downward and interrupted 0000 suture so-called modified dismembered pyeloplasty as mixed type, with a use of nephrostomy and stenting in 6 cases of hydronephrosis secondary to ureteropelvic obstruction during the period from January, l978 to June, l979. They were observed for 6 to l8 months and the results were as follows: 1) Hydronephrosis secondary to ureteropelvic obstruction was caused by congenital stricture in 4 kidneys, aberrant vessel in 1 kidney and congenital stricture with aberrant vessel in 1 kidney. 2) Of 2 cases of aberrant vessel, one was cut and the other not cut because of ischemia of corresponding lower pole. 3) In all case, Ureteral stenting was done with nephrostomy. But complication, such as urinary 1eakage, did not occurred in any cases. 4) On the follow up, the result was fair in 1 case and good in others.
Constriction, Pathologic ; Follow-Up Studies ; Hydronephrosis* ; Ischemia ; Kidney ; Stents ; Sutures ; Ureter ; Wounds and Injuries

During 5 years, from January 1976 to December 1980, clinical observation on management of ureteral stones was made on 169 admitted patients with ureter stones. Following results were obtained. 1) Among total 1054 in-patients, 169 cases (16.0%) had ureteral stones, and male to female ratio was 2 : 1. 2) Patients with 20-40 of his age was half. 3) On seasonal distribution, it was most prevalent on Summer. 4) 113 cases were located on lower ureter, and laterality was even. 5) Most common symptoms were renal colic and hematuria (91.8%) 6) Ureterolithotomy was done in 127 cases. In 86 cases of lower ureter stones, less than 1cm in size. conservative fluid therapy and cystoscopic extraction was successful in 44 cases. 7) Post-operative complications were urinary leaking (16 cages), wound infection(12 cases), hematuria (3 cases), ureteral stricture (1 case), and pyelonephritis (1 case).
Constriction, Pathologic ; Female ; Fluid Therapy ; Hematuria ; Humans ; Male ; Pyelonephritis ; Renal Colic ; Seasons ; Ureter* ; Wounds and Injuries

Ureteroileocecal sigmoidostomy is a method of continent urinary diversion which can protect the upper urinary tact from urinary reflux and infection, without external collecting devices and concomitant catheterization as in other forms of urinary diversion. Recently, we experienced 7 cases of ureteroileocecal sigmoidostomy in bladder cancer. Of them, 3 cases of immediate complications (retroperitoneal urinoma, wound disruption and ureteral obstruction ) were developed, but they could be corrected with prolonged placement of rectal tube or corrective surgery. And then, ureteral reflux, upper urinary tract infection and incontinence were not observed. So, ureteroileocecal sigmoidostomy is an attractive method of continent urinary diversion in selected cases.
Catheterization ; Catheters ; Ureter ; Ureteral Obstruction ; Urinary Bladder Neoplasms ; Urinary Diversion ; Urinary Tract Infections ; Urinoma ; Wounds and Injuries

Ureteroileocecal sigmoidostomy is a method of continent urinary diversion which can protect the upper urinary tact from urinary reflux and infection, without external collecting devices and concomitant catheterization as in other forms of urinary diversion. Recently, we experienced 7 cases of ureteroileocecal sigmoidostomy in bladder cancer. Of them, 3 cases of immediate complications (retroperitoneal urinoma, wound disruption and ureteral obstruction ) were developed, but they could be corrected with prolonged placement of rectal tube or corrective surgery. And then, ureteral reflux, upper urinary tract infection and incontinence were not observed. So, ureteroileocecal sigmoidostomy is an attractive method of continent urinary diversion in selected cases.
Catheterization ; Catheters ; Ureter ; Ureteral Obstruction ; Urinary Bladder Neoplasms ; Urinary Diversion ; Urinary Tract Infections ; Urinoma ; Wounds and Injuries

We have performed experimental bilateral extravesical Ureteroneocystostomy in dogs. The technique of procedure was as follows : A longitudinal myotomy incision was made near the bladder dome directed forward the bladder neck for 2cm and then separated to allow the mucosa to pout. A 1 cm incision was then made in the bladder mucosa at the distal end of the detrusor incision. Excess ureter was excised and the ureter spatulated for 1 cm. A 6-0 Prolene suture was then placed at each apex and fullthickness of ureter anastomosed to the bladder mucosa in one layer with a continuous, nonlocking stitch. The myotomy incision was then closed over the ureter with interrupted 4-0 chromic catgut. The surgical wound was closed without drains. The roentgenographic findings and gross findings of the ureter and kidney were observed on the 3 wks after the operation For microscopic observation of the ureteroneocystostomy site were observed. The results are as follows: 1. Retrograde cystographic finding showed on ureterovesical reflux in 6 dogs. 2. Intravenous urographic findings were no hydronephrosis and dye were well drained into the bladder, except 1 dog which showed severe hydronephrosis on right kidney and mild hydronephrosis on left kidney. 3. Gross findings of ureter and kidney revealed no obstruction and renal enlargement, except one dog showed incomplete bilateral obstruction on ureteroneocystostomy site.
Animals ; Catgut ; Dogs* ; Hydronephrosis ; Kidney ; Mucous Membrane ; Neck ; Polypropylenes ; Sutures ; Ureter ; Urinary Bladder ; Wounds and Injuries