Megacalicosis is a primary disease of renal calyces which were dilated without evidence of obstruction. Since its first description by Puigvert in 1963, megacalicosis has been described in many literatures. Recently we experienced a case of bilateral congenital megacalicosis with right lower ureteral obstruction. Herein we report our case with brief review of literatures.
Ureteral Obstruction

No abstract available.
Ureteral Obstruction* ; Uterine Prolapse*

The coexistence of an obstruction at the ipsilateral ureteropelvic and ureterovesical junctions is rare, the diagnosis of which is not usually made preoperatively. In such cases, the second obstruction can be recognized by the intraoperative findings or on postoperative urologic examinations. Here, three cases of the coexistence of these two conditions are reported.
Diagnosis ; Hydronephrosis ; Ureteral Obstruction

Objectives: This study aimed to determine the surgical predictive value of both SFU and UTD classifications in a specific subset of patients presenting with high-grade (SFU 3 and 4; UTD P2 and P3) UPJO-like hydronephrosis on prenatal ultrasound. Furthermore, this study also aimed to determine the likelihood of spontaneous resolution of high grade UPJO-like hydronphrosis based on both grading systems. Methods: Patients who presented with high-grade hydronephrosis on prenatal ultrasound based on the SFU grading system (Grades 3 and 4) were included in this study. The prenatal renal ultrasounds of these patients were reclassified by a single interpreter according to the UTD classification. Logistic regression was used to test the predictive value of SFU and UTD; ROC curves were plotted accordingly. Kaplan-Meier curves were used to model time to operation and mean time to operation was computed with a 95% confidence interval. Breslow Test was used to determine significant differences in survival curves across the different SFU grades and UTD classifications. Results: Of the 163 patients in the database who presented with prenatal hydronephrosis, 25 patients presented with high-grade UPJO-like hydronephrosis (50 renal units). Logistic regression revealed that the SFU grading system was able to explain only 18.7% of the variance of the occurrence of pyeloplasty, thus, was a poor predictor of the occurrence of surgery. In contrast, logistic regression of the UTD classification was able to explain 47.3% of the occurrence of pyeloplasy with an accuracy of 86% making it a good predictor of surgical intervention. Both SFU and UTD classifications were poor predictors of spontaneous resolution. Mean time to pyeloplasty from the time of diagnosis was 2.98 years (95% CI: 2.45-3.53) Kaplan-Meier curve analysis for the time of pyeloplasty for the SFU grading system revealed no significant difference in the time to operation among the different SFU grades (p=0.110) while for the UTD classification, there was a significant difference in time to pyeloplasty across the different UTD classes with the higher classes correlating to a shorter time to pyeloplasty. (p<0.05) Conclusion The UTD classification system is a good predictor of surgery in patients presenting with high-grade UPJO-like hydronephrosis on prenatal ultrasound with a predictive accuracy of 86%. High-grade hydronephrosis based on the UTD classification equates to a shorter time to surgical intervention from the time of diagnosis necessitating closer follow-up of these patients.
Ureteral Obstruction ; Hydronephrosis

No abstract available.
Collagen* ; Interferons* ; Ureter* ; Ureteral Obstruction*

In situ extracorporeal shock wave lithotripsy(ESWL) monotherapy was performed in 75 cases with ureteral stones using the Modulith SL 20 electromagnetic lithotriptor between December 1990 and July 1991. The results obtained were as follows: 1. The locations of stones were upper ureter in 36 (48%) cases, midureter in 4 (5.3%) and lower ureter in 35 (46.7%). 2. The average number of ESWL was 1.27 sessions. 3. The number of ESWL sessions increased in accordance with increment of stone size. 4. The success rate was 97.2% in upper ureteral. 100% in midureteral, and 97.1% in lower ureteral stones. 5. The final success rate according to stone size was not significantly different. 6. Success rate decreased relatively in cases of complete ureteral obstruction by stones. Therefore, in situ ESWL monotherapy is considered to be a convenient safe, and efficient procedure as the first applicable method for the treatment of all ureteral stones regardless of stone size and location, because the multiple repeated ESWL monotherapy increases the success rate without ureteral deterioration.
Magnets ; Shock ; Ureter* ; Ureteral Obstruction

PURPOSE: To determine the usefulness of transrectal ultrasound (TRUS) and to compare TRUS with intravenousurography (IVU) in the evaluation of distal ureteral calculi. MATERIALS AND METHODS: TRUS and IVU were perfomed in 24 patients with distal ureteral calculi. Using TRUS, we evaluated the presence and size of calculus, type of ureteral jet at the affected site and diameter of ureter proximal to calculus, and using IVU evaluated the presence and size of calculus, degree of ureteral obstruction, and degree of hydroureter. TRUS and IVU findings, were compared. RESULTS: In each patient, TRUS detected calculus of the distal ureter ; in only 18cases (75%),were the calculi demonstrated with IVU. In 18 cases where calculi were detected by both modalities, average calculus size was 4.5 X 3.0mm (longest and shortest dimensions) by IVU, and 6.1 X 3.7 mm by TRUS. Betwee TRUS and IVU(p<0.05) there was a statistically significant difference in the longest dimension of calculi. Color Doppler imaging revealed three patterns of ureteral jets in TRUS : normal periodic jet (7 cases) ; continuous low-levelflow (8 cases) ; and no detectable jet (9 cases). There was a positive correlation between type of ureteral jetson TRUS and between degree of obstruction on IVU (r=0.59, p<0.05). There was, however, no significant correlation between diameter of ureter proximal to calculus on TRUS and degree of hydroureter on IVU (r=0.32, p>0.05). CONCLUSION: TRUS appears to be a useful adjunctive method for the evaluation of distal ureteral calculus.
Calculi ; Humans ; Ultrasonography* ; Ureter* ; Ureteral Calculi* ; Ureteral Obstruction ; Urography*

Surgical results of 34 children (68 ureters) who underwent Cohen ureteral reimplantation in the last 6 years were evaluated. All children were followed at least 4 months after the operation. Indication for the repair consisted of vesicoureteral reflux in 22 children, obstructive megaureter in 8 children and ureterocele in 4 children. The underlying problems in 55 ureters ( 94.8% ) were successfully corrected. Surgical failures were persistent reflux in 2 ureters, new ipsilateral reflux in 1 ureter and contralateral reflux in 1 ureter. However, no ureteral obstruction was noticed in this series. In conclusion, the Cohen cross trigonal technique was a safe and effective method of ureteral reimplantation in children.
Child* ; Humans ; Replantation* ; Ureter* ; Ureteral Obstruction ; Ureterocele ; Vesico-Ureteral Reflux

Emphysematous pyelonephritis is a rare complication of severe acute pyelonephritis and the spontaneous appearance of gas in and around renal parenchyma. It most commonly in the diabetic patient with or without ureteral obstruction. We present one case of emphysematous pyelonephritis treated by incision and drainage in a 48 year old diabetic man.
Drainage ; Humans ; Middle Aged ; Pyelonephritis* ; Ureteral Obstruction

Idiopathic retroperitoneal fibrosis is proliferation of fibrous tissue with inflammatory process due to unknown etiology, that may involve the ureters and other retroperitoneal structures. The majority of reported cases have been treated surgically by ureterolysis or intraperitonealization of the ureters. Recently, successful management of retroperitoneal fibrosis by administration of steroids also has been reported. We report two cases of patients who underwent successful treatment of an idiopathic retroperitoneal fibrosis with high dose steroids therapy.
Humans ; Retroperitoneal Fibrosis* ; Steroids* ; Ureter ; Ureteral Obstruction