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

Clinical observation was made on 30 patients of obstructive uropathy who were performed antegrade pyelography in Department of Urology, Catholic Medical College, during the period from 1971 to 1976. It revealed antegrade pyelography is the most useful diagnostic procedure and accurate to demonstrate the morphology, site and cause of the obstructive lesion, and it leads to adequate procedure of operation. The results were as follows: 1. Non-visualized kidney (10 cases) and hydronephrotic kidney (23 cases) on intravenous pyelography were definitely diagnosed by antegrade pyelography. Non-visualized kidney (10 cases) on intravenous pyelography was distinctly diagnosed as hydronephrosis (7 cases) and hydronephrosis combined with caliceal destruction (3 cases) , and hydronephrotic kidney (23 cases) on intravenous pyelography was diagnosed as hydronephrosis (16 cases) and hydronephrosis associated with caliceal destruction (7 cases) 2. The main cause of obstructive uropathy revealed renal tuberculosis (15 cases), congenital ureteropelvic junction stricture (3 cases) and ureteral stone (3 cases) etc. 3. 32 cases of all 33 cases were noted ureteral obstruction. In these 32 cases, the sites of ureteral obstruction were lower 1/3 of the ureter (20 cases), upper 1/3 of the ureter (8 cases) and multiple ureteral obstruction (4 cases). 4. With definite diagnosis by antegrade pyelography, adequate operation could be performed; nephrectomy (11 cases), ureteral re-implantation (7 cases), nephrostomy (6 cases), cutaneous ureterostomy (5 cases) and pyeloplasty (2 cases).
Constriction, Pathologic ; Diagnosis ; Humans ; Hydronephrosis ; Kidney ; Nephrectomy ; Tuberculosis, Renal ; Ureter ; Ureteral Obstruction ; Ureterostomy ; Urography* ; Urology

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

Retroperitoneal fibrosis is a fibroproliferative process involving the retroperitoneum. It may be idiopathic or can be caused by methysergide ingestion, perianeurysmal inflammation, a leaking aneurysm, urinoma or irradiation. The symptoms and signs of retroperitoneal fibrosis are variable, and for diagnosis, imaging is therefore essential. The typical imaging finding is a fibrotic lesion in front of the lower vertebrae with ureteral obstruction. Atypical lesions, however, may occur in other parts of the retroperitoneum. The aim of this report is to describe the clinical features and various imaging findings of etroperitoneal fibrosis.
Aneurysm ; Diagnosis ; Eating ; Fibrosis ; Inflammation ; Methysergide ; Retroperitoneal Fibrosis* ; Spine ; Ureteral Obstruction ; Urinoma

PURPOSE: We assessed the significance of renal resistive index (RI) in the diagnosis of unilateral ureteral obstruction in children. MATERIALS AND METHODS: Duplex Doppler ultrasonography was performed in 4 children with unilateral ureteral obstruction which was proved by excretory urography, diuretic renal scan, and/ or pressure flow study. Renal RI values and RI ratios were calculated. RESULTS: They were 3 males and one female 4 to 26 months old. In all cases, mean RI values of obstructed kidneys were higher than 0.70 which was discriminatory level for obstruction in adults. In contralateral normal kidneys, RI values were widely distributed (0.61 to 0.79). Mean RI values of obstructed kidneys were larger than that of contralateral normal kidneys, and RI ratios were larger than 1.11 in all patients. CONCLUSION: We believe that the comparison of RI value between obstructed and contralateral normal kidney is valuable in the diagnosis of unilateral ureteral obstruction in children, and that RI ratio is also significantly. A prospective study with a larger number of patients is required to confirm this finding.
Adult ; Child* ; Child, Preschool ; Diagnosis ; Female ; Humans ; Kidney ; Male ; Ultrasonography, Doppler, Duplex ; Ureter* ; Ureteral Obstruction* ; Urography