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

By using antegrade pyelography which was modified from Casey and Goodwin technique, we examined nine patients in whom accurate roentgenographic diagnosis could not be made by excretory or retrograde pyelography. Diagnosis established were three cases of hydronephrosis due to ureteral calculi, three of pyonephrosis due to renal tuberculosis, one of pyonephrosis due to carcinoma of the ureter, one case of pyonephrosis due to carcinoma of the uretero-pelvic junction and one of pyonephrosis due to ureteral obstruction This is the first report of antegrade pyelography in cases of pyonephrotic renal tuberculosis. No complications occurred during or after examinations. In selected cases of hydronephrosis and pyonephrosis, antegrade pyelography is a safe and new diagnostic procedure to other accepted methods of urography.
Diagnosis ; Humans ; Hydronephrosis ; Pyonephrosis ; Tuberculosis, Renal ; Ureter ; Ureteral Calculi ; Ureteral Obstruction ; Urography*

PURPOSE: This study was conducted to compared unenhanced helical computerized tomography (CT) with intravenous urography (IVU) in the evaluation of acute flank pain. MATERIALS AND MTHODS: Between April 2000 and April 2001, 59 patients with acute flank pain suspected of having urolithiasis underwent an unenhanced helical CT followed by an IVU. Two independent consultation urologic radiologists randomly assessed these patients for the presence, size and location of the calculus, ureteral dilatation and secondary sign of a ureteral obstruction. Of the 59 patients, 45 had a calculus confirmed on removal or a documented passage of a stone. The absence of a calculus was based on a clinical and radiological follow up with clinical resolution. RESULTS: CT revealed all 62 calculi from 45 patients and no calculus in 14 of the patients with a 98.4% sensitivity and a 100% specificity. IVU demonstrated 36 calculi from 35 patients and no calculus in 14 of the patients with a 57.1% sensitivity and a 100% specificity. Both CT and IVU demonstrated the secondary signs of a ureteral obstruction in 34 and 31 patients, respectively. The cost of the helical CT was 4-5 times higher than that of the IVU. CONCLUSIONS: Unenhanced helical CT is an accurate, safe, and a rapid technique for assessing acute flank pain and evaluate the choice for patients who would otherwise require a IVU for diagnosis but with a lower cost.
Calculi ; Diagnosis ; Dilatation ; Flank Pain* ; Follow-Up Studies ; Humans ; Sensitivity and Specificity ; Tomography, Spiral Computed ; Ureteral Calculi ; Ureteral Obstruction ; Urography* ; Urolithiasis

PURPOSE: This study was conducted to compared unenhanced helical computerized tomography (CT) with intravenous urography (IVU) in the evaluation of acute flank pain. MATERIALS AND MTHODS: Between April 2000 and April 2001, 59 patients with acute flank pain suspected of having urolithiasis underwent an unenhanced helical CT followed by an IVU. Two independent consultation urologic radiologists randomly assessed these patients for the presence, size and location of the calculus, ureteral dilatation and secondary sign of a ureteral obstruction. Of the 59 patients, 45 had a calculus confirmed on removal or a documented passage of a stone. The absence of a calculus was based on a clinical and radiological follow up with clinical resolution. RESULTS: CT revealed all 62 calculi from 45 patients and no calculus in 14 of the patients with a 98.4% sensitivity and a 100% specificity. IVU demonstrated 36 calculi from 35 patients and no calculus in 14 of the patients with a 57.1% sensitivity and a 100% specificity. Both CT and IVU demonstrated the secondary signs of a ureteral obstruction in 34 and 31 patients, respectively. The cost of the helical CT was 4-5 times higher than that of the IVU. CONCLUSIONS: Unenhanced helical CT is an accurate, safe, and a rapid technique for assessing acute flank pain and evaluate the choice for patients who would otherwise require a IVU for diagnosis but with a lower cost.
Calculi ; Diagnosis ; Dilatation ; Flank Pain* ; Follow-Up Studies ; Humans ; Sensitivity and Specificity ; Tomography, Spiral Computed ; Ureteral Calculi ; Ureteral Obstruction ; Urography* ; Urolithiasis

Aortoiliac aneurysm is a rare cause of ureteral obstruction. We report a case of perianeurysmal fibrosis(PAF) associated with aortoiliac aneurysm resulting in hydronephrosis. CT and MRI findigns of PAF are presented. In patient with hydronephrosis of unknown cause, PAF should be included among the differential diagnosis. The diagnosis of PAF is easily made with CT and MRI findings.
Aneurysm ; Diagnosis ; Diagnosis, Differential ; Humans ; Hydronephrosis* ; Magnetic Resonance Imaging ; Retroperitoneal Fibrosis* ; Ureteral Obstruction

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

PURPOSE: We evaluated the diagnostic usefulness of the renal resistive index in acute unilateral ureteral obstruction. MATERIALS AND METHODS: Our study consisted of 26 patients, with 52 kidneys, who presented with unilateral acute ureteral obstruction documented with excretory urography, and 20 men with both kidneys normal. The contralateral nonobstructed kidneys served as control. All patients underwent Doppler ultrasonography for determination of the resistive index (RI) and the difference between RI of the corresponding and contralateral kidney (deltaRI). RI and deltaRI were considered positive for obstruction at values of 0.70 or greater and 0.04 or greater, respectively. We calculated the sensitivity, specificity, and positive predictive values of RI and deltaRI for the diagnosis of acute ureteral obstruction. RESULTS: Kidneys with ureteral obstruction (n=26) had a mean RI of 0.73+/-0.05, contralateral normal kidneys (n=26) had a mean RI of 0.63+/-0.04, a significant difference (p<0.05). Similarly, the mean deltaRI of the patients was significantly higher than that of men with both normal kidneys (0.08+/-0.006 versus 0.02+/-0.004, respectively). The sensitivity for RI was 70%, the specificity was 82%. The corresponding values for deltaRI were 88% and 93%, respectively. The positive predictive values were 85% and 91%, respectively. CONCLUSIONS: Renal resistive index measurements are not valuable for the definite diagnosis of acute obstructive uropathy. Nevertheless, they are helpful in situations in which invasive radiologic study is undesirable.
Diagnosis ; Humans ; Kidney ; Male ; Sensitivity and Specificity ; Ultrasonography, Doppler ; Ureter* ; Ureteral Obstruction* ; Urography

Bilateral fibroepithelial polyps of the ureter are scarcely seen benign mesodermal tumor that occurs most often at the proximal ureter. Most patients present with either hematuria due to necrosis at urethral polyp of flank pain secondary to partial ureteral obstruction. The Diagnosis may be established with intravenous pyelography, retrograde pyelography, ureteroscopy and CT. Local resection is the treatment of choice. We report a case of bilateral fibroepithelial polyps of the ureter with a brief review of literatures.
Diagnosis ; Flank Pain ; Hematuria ; Humans ; Mesoderm ; Necrosis ; Polyps* ; Ureter* ; Ureteral Obstruction ; Ureteroscopy ; Urography

PURPOSE: To evaluate the usefulness of the impedance index of the renal vein for the diagnosis of acute obstructive uropathy in rabbits. MATERIALS AND METHODS: Ligation of the left ureter was done in 12 rabbits. Doppler sonography of the interlobar veins in both kidneys was checked before and 30 minutes, 1, 3, 6, 9 and 24 hours after ureteral ligation. The venous impedance index [(peak flow signal-least flow signal)/peak flow signal]was compared between the obstructed and non-obstructed kidneys for all periods. The change in the impedance index after ureteral ligation was also compared between the obstructed and non-obstructed kidneys. RESULTS: A decrease in the impedance index of the intrarenal vein was observed starting from 30 mins after ureteral ligation, and the index remained low up to 24 hours after ureteral ligation. The obstructed kidneys had a significantly lower impedance index than the contralateral kidneys for all six of the postligation measurements (p< 0.05). There were significant differences in the change of impedance index after ureteral ligation between the obstructed and non-obstructed kidneys (p< 0.05). CONCLUSION: The impedance index of the intrarenal vein was significantly decreased in the obstructed kidneys. The measurement of the impedance index of the intrarenal vein using Doppler sonography could provide a useful method of diagnosing obstructive uropathy.
Diagnosis ; Electric Impedance* ; Kidney ; Ligation ; Rabbits* ; Renal Veins* ; Ureter* ; Ureteral Obstruction* ; Veins

Endometriosis is a rare cause of an ureteral obstruction. We report a case of intrinsic ureteral endometriosis resulting in severe hydroureteronephrosis. The diagnosis of ureteral endometriosis may be considered in women with flank pain and ureteric obstruction within true pelvis.
Diagnosis ; Endometriosis* ; Female ; Flank Pain ; Humans ; Lesser Pelvis ; Ureter* ; Ureteral Obstruction