Background: Cervical cancer is the second most common malignancy among Filipino women. The recent 2018 FIGO guidelines recommend imaging in cases of grossly invasive disease to determine the presence of hydronephrosis, which would immediately classify the disease as at least stage IIIB. CT and MRI are state-of-the-art modalities that can provide such information; however, these are costly and may not be accessible in areas with limited resources. Sonography is a safe and inexpensive alternative in this regard.

Objective: This study aimed to evaluate the diagnostic performance of renal sonography in identifying the presence of ureteral obstruction or hydronephrosis among patients with grossly invasive cervical cancer, with non-enhanced CT as the reference standard.

Methods: A blinded, prospective study was conducted among patients diagnosed with grossly invasive cervical cancer from the Philippine General Hospital. Participants underwent same-day evaluation with both renal sonography and non-enhanced CT. The presence of either ureteral obstruction or hydronephrosis secondary to cervical cancer was independently determined. The sensitivity, specificity, positive predictive value, and negative predictive value of renal sonography were calculated, with non-enhanced CT as the reference standard.

Results: A total of 127 participants were enrolled. The mean age was 46 years, with a range of 24 to 65 years. The majority had stage IIB (41.7%) and stage IIIB (52.0%) disease. On non-enhanced CT, 46 (36.2%) showed evidence of ureteral obstruction or hydronephrosis, while 81 (63.8%) had negative results. On renal sonography, 46 (36.2%) had positive results, and 81 (63.8%) had negative findings. The sensitivity, specificity, and positive and negative predictive values of sonography were 91.3%, 95.1%, 91.3%, and 95.1%, respectively. Among patients with stage IIIB disease, sonography was shown to have higher sensitivity and specificity of 92.1% and 96.4%, respectively. Meanwhile, among patients with stage IB to IIB disease, its sensitivity and specificity were 87.5% and 94.3%, respectively.

Conclusion: Renal sonography has high sensitivity and specificity in the diagnosis of ureteral obstruction or hydronephrosis in patients with grossly invasive cervical cancer. Its sensitivity is higher when used in patients with stage IIIB disease, compared with those having lower-stage tumors.

Child ; Humans ; Inflammation ; Neoplasms, Muscle Tissue ; Ureteral Neoplasms

Pelvic visceral pain associated with both cancer and chronic benign conditions may be alleviated by superior hypogastric plexus block (SHPB). The complications of SHPB include infection, bleeding, or intravascular injection because of the adjacent location of the iliac vessel to the route of needle insertion, and pelvic visceral damage. However, acute ureteral obstruction leading to acute renal failure (ARF) as a complication of SHPB has not been reported to date in the literature. We report a patient with ARF that resulted from acute ureteral obstruction following SHPB performed for the relief of lower abdominal pain and tenesmus in metastatic ureter cancer.
Abdominal Pain ; Acute Kidney Injury ; Hemorrhage ; Humans ; Hypogastric Plexus* ; Needles ; Ureteral Neoplasms ; Ureteral Obstruction* ; Visceral Pain

The recurrence of renal cell carcinoma (RCC) in the remnant urothelium is rare, and in this paper we report a case in which the condition recurred in the remnant ureter five years after radical nephrectomy. The recurrent mass was seen on retrograde ureterograms as polypoid filling defect, and on CT images as soft tissue mass-like density. In view of the radiologic and pathologic findings, we believe that in this case, the mechanism of intraureteral recurrence was direct implantation.
Carcinoma, Renal Cell* ; Nephrectomy* ; Recurrence* ; Ureter ; Ureteral Neoplasms ; Urothelium

Hodgkin Disease ; Humans ; Male ; Middle Aged ; Ureteral Neoplasms

Tumor of the ureter is malignant and rare, but recently the incidence rate was progressively increased due to developed methods of diagnostic procedures. Here, we report two cases of ureteral cancer combined with urinary stones in the department of urology, Seoul Red Cross Hospital, with some literatures.
Incidence ; Red Cross ; Seoul ; Ureter* ; Ureteral Neoplasms ; Urinary Calculi ; 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

We report a case of primary fibroepithelial polyps (FEPs) in the middle of both ureters in a patient with advanced gastric cancer and acute renal failure. Ureteral FEPs are rare benign lesions, and multiple, bilateral lesions are extremely rare. To our knowledge, this report is the seventh case of bilateral FEPs in the literature. Our case has clinical implications because FEPs should be considered as a cause of ureteral obstruction inducing acute renal failure in advanced gastric cancer.
Acute Kidney Injury/*etiology ; Aged ; Humans ; Male ; Neoplasms, Fibroepithelial/*pathology ; *Polyps/complications/pathology ; Stomach Neoplasms/*pathology ; Ureteral Neoplasms/*pathology ; Ureteral Obstruction/*pathology

Bone Neoplasms ; pathology ; Carcinoma, Neuroendocrine ; pathology ; Humans ; Osteosarcoma ; pathology ; Ureter ; pathology ; Ureteral Neoplasms ; pathology

We report a case of primary small cell carcinoma of the ureter with squamous cell and transitional cell carcinomatous components associated with ureteral stone, which is unique in that the patient has remained free of tumor recurrence for 36 months after the surgery without adjuvant chemotherapy or radiotherapy. A 60-yr-old man presented himself with a right flank pain. Computed tomography revealed an ill-defined mass and a stone in the lower one third of the right ureter, and hydronephroureterosis above the stone-impacted site. The patient underwent right nephroureterectomy and stone removal. Upon gross examination, a 3.8 x 1.8 x 1.2 cm white and partly yellow mass was noted in the anterior part of the ureter, resulting in indentation of the ureteral lumen on the posterior side. Light microscopic examination revealed that the mass was mainly composed of small cell carcinoma, and partly squamous cell and transitional cell carcinomatous components. The overlying ureteral mucosa and renal pelvis also contained multifocal dysplastic transitional epithelium and transitional cell carcinoma in situ. There was no vascular invasion, and the surgical margins were free of tumor. The small cell carcinomatous component was positive for chromogranin, neuron specific enolase, synaptophysin, and pancytokeratin but negative for high molecular-weight cytokeratin (K-903) by immunohistochemistry.
Carcinoma, Small Cell/*pathology ; Carcinoma, Transitional Cell/*pathology ; Case Report ; Human ; Male ; Middle Age ; Neoplasms, Squamous Cell/*pathology ; Tomography, X-Ray Computed ; Ureteral Calculi/*pathology ; Ureteral Neoplasms/*pathology