Ureteropelvic junction obstruction is one of the common causes of hydronephrosis in infancy and childhood. Most cases of ureteropelvic junction obstruction are diagnosed prenatally and are usually asymptomatic. Although less common, older children can experience ureteropelvic junction obstruction that presents with symptoms including flank or abdominal pain. Here, we present the case of a nine-year-old healthy girl who had repeated flank pain and abdominal symptoms, with mild left hydronephrosis, for several months. Computed tomography that was performed during the period of acute flank pain revealed aggravated hydronephrosis on her left kidney, which was secondary to an ureteropelvic junction obstruction. She underwent laparoscopic pyeloplasty, and a crossing vessel that passed the ureteropelvic junction was identified. In addition, we reviewed the current literature of this rare entity.
Abdominal Pain ; Child ; Female ; Flank Pain ; Humans ; Hydronephrosis ; Kidney ; Ureteral Diseases ; Ureteral Obstruction

A clinical observation was made on 20 ureteral diseases in 17 pediatric patients who had been admitted to the Department of Urology, Hanyang University Hospital, from May 1972 to February 1982, and the following results were obtained. 1. Pediatric patients with ureteral diseases were 17 of 2584 total urologic patients giving a ratio of 0.6%, and of 359 total pediatric patients 4.7%. 2. The preschool children (1 to 6 years of age) were most frequently seen (14.2%). The proportion of male to female was 3.3:1. 3. The most common disease was congenital UPJ obstruction (60%). The other diseases were UVJ obstruc tion, V-U reflux, ureterocele with complete double ureter subsequently. 4. The most common manifestation included flank pain in 9 cases, fever and chilling in 7 cases, hemturia in 5 cases, gastrointestinal syruptome in 5 cases, palpable mass in 4 cases subsequently. 5. The most common associated disesses were 2 cases of the renal stone in UPJ obstruction. 6. Of the 20 cases, 12 cases underwent dismembered pyeloplasty, 4 cases ureteroneocyst0stomy, 2 cases heminephrectomy with ureterectomy. The remained 2 cases were treated with conservatively.
Child, Preschool ; Female ; Fever ; Flank Pain ; Humans ; Male ; Ureter* ; Ureteral Diseases* ; Ureterocele ; Urology

Primary vesicoureteral reflux, distal ureteral obstruction or stricture and injuries are the main indications for the ureteroneocystostomy There are several operative techniques in ureteroneocystostomy and these should be antireflux to preserve renal function. To prevent the reflux, sufficient submucosal length, minimum ureteral manipulation, adequate butters and making the new orifice near the trigone are stressed. We performed ureteroneocystostomy in 19 patients(20 ureters) in last 10 years. We evaluate the preoperative state, operative technique, postoperative course and follow up of these cases and report with the review of the articles Results were 1. 19 cases included 5 VUR, 6 ureteral injuries by transabdominal hysterectomy, 3 bladder tumors involving ureteral orifices, 2 ureteroceles with obstruction and 3 chronic inflammatory strictures. 2. Ureteroneocystostomy were done by Cohen in 4, Glenn-Anderson in 2, Politano-Leadbetter in 3, Boari-Kuss in 5, Paquin in 2 and fish-mouth in 3 cases 3. Ureteral stent and suprapubic cystostomy were made in all cases but one. Duration of stenting was 4-14 days and cystostomy was 6-14 days. 4. There were improvements in 16 cases, but failed in 2 ureters of reflux cases.
Butter ; Constriction, Pathologic ; Cystostomy ; Follow-Up Studies ; Hysterectomy ; Stents ; Ureter ; Ureteral Obstruction ; Ureterocele ; Urinary Bladder Neoplasms ; Vesico-Ureteral Reflux

PURPOSE: We have endeavored to find the factors predicting the success of ureteral stenting before cystoscopic retrograde ureteral catheterization in the patients with malignant ureteral obstruction. MATERIALS AND METHODS: 38 patients(51 kidneys) were analyzed, who were treated by retrograde ureteral stenting or percutaneous nephrostomy due to ureteral obstruction in non-urologic malignancy during the past 3 years. The sorts of primary tumors were cervix cancer in 14 cases(18 kidneys), stomach cancer in 12 cases(18 kidneys), colo-rectal cancer in 7 cases(9 kidneys), ovary cancer in 4 cases(5 kidneys), and endometrial cancer in 1 case(1 kidney). The cause of the ureteral obstruction was direct tumor invasion in 26 kidneys, lymphadenopathy in 23 kidneys and post radiation therapy in 2 kidneys. Retrograde ureteral stenting had failed in 22 kidneys(ureteral orifice could not be found in 14 kidneys, guide wire could not be advanced in 8 kidneys). RESULTS: Among the 51 kidneys, 29 kidneys(57%) were succeeded, and 22 kidneys(43%) were failed in retrograde ureteral catheterization. In fourteen of 22 kidneys(64%) ureteral orifice could not identified due to hemorrhage and edema of mucosa of bladder, and in 8 kidneys(36%) ureteral catheter could not be advanced to the renal pelvis. The cause of failure of the retrograde ureteral catheterization were direct tumor invasion in 10/26 kidneys(39%), and lymphnode enlargement in 4 of 23 kidneys(17%)(p=0.0007). According to the presence of ureteral obstructive symptoms, 8/29 kidneys(28%) were with the presence of ureteral obstruction symptoms, whereas 14/22 kidneys(64%) were failed with the absence of ureteral obstructive symptoms(p=0.0051). Of the obstruction site, 4/21 kidneys(19%) of upper to mid ureteral obstruction and 18/30 kidneys(79%) of lower ureteral obstruction were failed(p=0.0056). Of the degree of hydronephrosis, 18/47 kidneys(38%) of mild to moderate degree of hydronephrosis and 4/4 kidneys(100%) of severe hydronephrosis were failed(p=0.0022). CONCLUSIONS: This study shows that direct tumor invasion to the ureter, asymptomatic ureteral obstruction, lower ureteral obstruction, and high grade hydronephrosis were regarded as a high failure factors for the retrograde ureteral catheterization. Thus, we should not hesitate to choose percutaneous nephrostomy, in such condition that makes difficult for retrograde ureteral catheterization in malignant ureteral obstruction patients.
Edema ; Endometrial Neoplasms ; Female ; Hemorrhage ; Humans ; Hydronephrosis ; Kidney ; Kidney Pelvis ; Lymphatic Diseases ; Mucous Membrane ; Nephrostomy, Percutaneous ; Ovarian Neoplasms ; Stents* ; Stomach Neoplasms ; Ureter* ; Ureteral Obstruction* ; Urinary Bladder ; Urinary Catheterization ; Urinary Catheters ; Uterine Cervical Neoplasms

OBJECTIVE: To investigate the efficacy of terpene compound drug (pinene, camphene, borneol, anethole, fenchone and cineol in olive oil) in facilitating spontaneous passage of ureteral calculi

METHODS: Systematic literature search of the MEDLINE, EMBASE, OVID, Science Direct, Proquest, Google scholar, Cochrane Library databases and rference lists of related literature was done without language restriction. Trials on ureterolithiasis medical expulsive therapy (MET) that compare terpene compound drug versus placebo/control group or alpha-blockers were identified. Articles retrieved were critically appraised by two independent reviewers according to Cochrane Collaboration recommendations. Data from included studies were extracted for calculation of risk ratio (RR) and 95% confidence interval (CI). Effect estimates were pooled using Mantel-Haenszel method with random effect model. Inter-study heterogeneity and publication bias were assessed. The PRISMA guidelines for meta-analysis reporting were followed.

RESULTS: Five trials (total of 344 subjects) of adequate methodological quality were included. Pooled effect estimates from homogenous studies showed that compared to placebo/ control group, patients treated with terpene compound drug had significantly higher ureteral calculi expulsion rate (pooled RR: 1.34; 95% CI 1.12, 1.61). Analysis of studies that compare terpene compound drug with alpha-blockers showed no significant difference (pooled RR: 0.79; 95% CI 0.59, 1.06), although significant inter-study heterogeneity was noted. Only minor gastrointestinal adverse effect was reported on terpene compound drug use.

CONCLUSIONS: The results suggest that terpene compound drug as MET is effective in promoting passage of ureterolithiasis. High quality large-scale RCTs comparing alpha-blockers and terpene compound drug are warranted to make a more definitive conclusion.

The lower ureter is not so frequent site of the urinary tract obstruction. In lower ureteral obstruction, the obstruction should be relieved by any method for maintaining renal parenchyme. A clinical studies were made on the 24 ureters of the lower ureteral obstruction. This studies were mainly focused on the method of management by internal stent indwelling. The following results were obtained. 1. In etiology, acquired lower ureteral strictures were most common ; tuberculosis in 10 ureters, radiation in 6 ureters, pelvic lymphadenopathy in 4 ureters, and iatrogenic stricture in 3 ureters. Congenital UVJ stricture was only one ureter. 2. In the method of management, open surgeries were done in 10 ureters and endourologic methods in 14 ureters. 3. In 5 failures of the first management, open surgeries were done in 3 ureters and endourologic methods in 2ureters. The tuberculosis was the most of their etiology. 4. Complications in internal stent indwelled cases were flank pain, severe vesical irritation, migration into the bladder and the obstruction of the lumen of stent.
Constriction, Pathologic ; Flank Pain ; Lymphatic Diseases ; Stents* ; Tuberculosis ; Ureter* ; Ureteral Obstruction* ; Urinary Bladder ; Urinary Tract

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

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

A clinica1 observation was made on the 14 inpatient cases of ureteral obstruction which were not originated from calculi or tuberculous nature in the Department of Urology, Korea University College of Medicine during the period of 1 year from Sep. 1973 to Aug. 1974, and following results were obtained: 1. As to the origin of the obstruction, 4 cases of ureteral fibrosis, 2 cases of aberrant vessel, and one congenital ureteral stricture, one ureteral tumor, one ureterocele, one periureteral fibrosis, and one case of ureteral ligation during the radical total hysterectomy. 2. As to the location of the ureteral stricture, the upper ureter in 9 cases. middle ureter in o2e case and lower ureter in 4 cases. 3. The surgical treatment employed were nephrectomy in 6 cases, pyeloplasty in 5, ureteroneocystostomy in 1, ureteral dilation in 1 and transurethral resection in 1 case.
Calculi ; Constriction, Pathologic ; Fibrosis ; Humans ; Hysterectomy ; Inpatients ; Korea ; Ligation ; Nephrectomy ; Ureter* ; Ureteral Obstruction* ; Ureterocele ; Urology

OBJECTIVE: To explore the impacts of delayed ureteral stent removal on the quality of life (QoL) and mental health of urinary calculi postoperative patients due to the corona virus disease 2019(COVID-19) pandemic. METHODS: The demographic and clinical data of patients with ureteral stent placement after urinary endoscopic lithotripsy and returned to Peking University People's Hospital for stent removal from December 2019 to June 2020 were collected. Ureteral stent symptoms questionnaire (USSQ) score and the outcome 20-item self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were collected to estimate the QoL and mental status. The USSQ consisted of 44 questions in 6 domains (including urinary symptom, physical pain, general health, work performance, sexual function, and ureteral stent related infection). For most questions in each domain, its score was a five-point Likert-type scale from 1 to 5, and a small proportion of questions was quantified by 1 to 4 or 1 to 7 scale. SAS and SDS both contained 20 questions used to assess a patient's level of anxiety and depression. Its scoring for each item was on a four-point Likert-type scale from 1 to 4. A total score (ranging from 20 to 80) was the main statistical indicator. The level of clinical anxiety and depression was quantified by using standard scores (total score multiplied by 1.25 to produce integers). And the multi-group structural equation model was constructed by analysis of moment structure (AMOS) analysis. RESULTS: Overall, 71 patients were enrolled for analysis. It was found that the median duration of ureteral stent time differed significantly between the control and delayed groups for 32 (30, 33) d and 94.5 (88, 103) d, respectively. The delayed group resulted in higher scores in the USSQ multidimensional, which included urinary symptoms, general health, work performance and ureteral stent related infections. Anxiety and depression were also significantly serious in the delayed group than in the control group. A longer indwelling time of a ureteral stent could exacerbate the effects of urinary symptoms and physical pain on work performance (P=0.029 < 0.05). Among them, the patients with severe urinary symptoms leading to poor work performance were most significantly affected by prolonged ureteral stent duration time (CR=2.619>1.96). CONCLUSION Patients with delayed ureteral stent removal due to the COVID-19 had resulted in worse QoL and mental status. Stents related symptoms are more severe in patients with higher anxiety and depression degree during COVID-19. To improve the QoL and mental health of patients after urinary calculi surgery during COVID-19, it is still not recommended to prolong the stent duration time or corresponding intervention measures should be taken.
Humans ; Quality of Life ; Pandemics ; COVID-19/epidemiology* ; Ureter/surgery* ; Urinary Calculi ; Pain ; Ureteral Diseases ; Stents ; Surveys and Questionnaires ; Ureteral Calculi