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

OBJECTIVETo evaluate magnetic resonance urography (MRU) in the diagnosis of urinary tract obstruction after renal transplantation.

METHODSA total of 31 patients with suspected urinary tract obstruction after renal transplantation were examined, and the results were compared with those from surgery and B-ultrasound examination.

RESULTSThe urinary tract after renal transplantation was clearly shown using MRU, and all patients were clearly diagnosed by MRU. Imaging results were consistent with those from surgery.

CONCLUSIONSMRU is suitable for detecting urinary tract obstruction after renal transplantation. It is a alternative method for IVP and CT in patients with renal function impairment and uremia.

Humans ; Kidney Transplantation ; Magnetic Resonance Imaging ; methods ; Ureteral Obstruction ; diagnosis ; Urinary Tract ; pathology ; Urography ; methods

Animals ; Epithelial-Mesenchymal Transition ; Fibrosis ; Kidney ; pathology ; Kidney Tubules ; cytology ; Male ; Rats ; Rats, Sprague-Dawley ; Ureteral Obstruction ; pathology

OBJECTIVETo investigate the clinical features and management of ureteral endometriosis.

METHODSPatients surgically and histologically diagnosed as ureteral endometriosis from January 2001 to January 2007 in Peking Union Medical College Hospital were retrospectively reviewed.

RESULTSTen patients were diagnosed as ureteral endometriosis among 7561 cases with surgically and histologically proved diagnosis of endometriosis, with an incidence of 0.132%. Nine out of 10 patients were extrinsic ureteral endometriosis and concomitant with severe pelvic endometriosis, and the other was intrinsic ureteral endometriosis. Hormone therapy failed in 2 patients with urinary tract obstruction. Ureterolysis was performed in 6 patients and ureterectomy was performed in 4 patients. One case of ureteral recurrence was observed in a postmenopausal woman without hormonal replacement therapy who received laparoscopic ureterolysis and hysterectomy with bilateral adnexectomy. No relapse was observed in the other 9 patients.

CONCLUSIONSUreteral endometriosis is a rare entity. The upper urinary tract should be evaluated in patients with severe endometriosis, even in postmenopausal women. The treatment of ureteral endometriosis usually requires surgery, while ureterolysis should not be performed in patients with extensive disease. As a form of adjuvant therapy of surgery, hormonal therapy is an appropriate option.

Adult ; Diagnosis, Differential ; Endometriosis ; complications ; pathology ; therapy ; Female ; Humans ; Middle Aged ; Retrospective Studies ; Ureter ; pathology ; Ureteral Obstruction ; etiology

Aged ; Female ; Humans ; Kidney Pelvis ; pathology ; surgery ; Rupture, Spontaneous ; diagnosis ; etiology ; surgery ; Ureteral Calculi ; complications ; diagnosis ; surgery ; Ureteral Obstruction ; complications ; diagnosis ; surgery

Today, percutaneous nephrostomy and other related renal procedures are routine in most hospitals. This technique provides safe, rapid and direct access to the upper urinary tract for various diagnostic and therapeutic maneuvers. It has become a vital tool for the urologists who have been able to diagnose and treat ever more diverse pathologies of the urinary tract without open operation. Percutaneous nephrostomy was done on 276 cases with advanced malignancy and benign conditions during the period of March, 1985 to December, 1993. We were successful in using percutaneous nephrostomy as urinary diversion to ureteral obstruction or urinary leakage in 27l cases( 98% ). In four fifths of patients, obstruction was due to neoplasm, with the cervical cancer the leading cause. The post-nephrostomy complications were bleeding in 10 cases, enterocutaneous fistula in 4, perinephric abscess in 3 and sepsis in 1. Percutaneous nephrostomy proved to be ideally suited in condition of obstructive uropathy and urine leakage.
Abscess ; Hemorrhage ; Humans ; Intestinal Fistula ; Nephrostomy, Percutaneous* ; Pathology ; Pregnenolone Carbonitrile ; Sepsis ; Ureteral Obstruction ; Urinary Diversion ; Urinary Tract ; Uterine Cervical Neoplasms

OBJECTIVETo investigate the therapeutic effect of baicalin at different doses administered for different periods of time in the treatment of renal interstitial fibrosis in rats with unliateral ureteral obstruction (UUO) and related mechanisms.

METHODSSixty-four Sprague-Dawley rats were randomly divided into sham-operation, model, low-dose baicalin, and high-dose baicalin groups, and each group was further randomly divided into 7-day and 14-day groups (n=8 each). Left ureteral ligation was used to establish the rat model of UUO. Hematoxylin and eosin staining was used to observe the pathological changes in the kidney. ELISA was used to measure the serum levels of transforming growth factor-β1 (TGF-β1), Notch1, and Jagged1. Immunohistochemistry was used to measure the expression of TGF-β1 and Notch1. The Pearson correlation analysis was used for correlation analysis.

RESULTSHematoxylin and eosin staining showed inflammatory cell infiltration and edema in renal interstitium, tubular dilation and structure disorder, degeneration and necrosis of renal tubular epithelial cells, and a basically normal structure of the glomeruli on days 7 and 14 in the model group, and these lesions were alleviated in the low- and high-dose baicalin groups. Compared with the sham-operation group, the model group had a significantly higher serum level of TGF-β1 and a significantly higher number of TGF-β1-positive cells in renal tissues on days 7 and 14 (P<0.05). Compared with the model group at the same time points, the high- and low-dose baicalin groups had a significantly lower serum level of TGF-β1 and a significantly lower number of TGF-β1-positive cells in renal tissues on days 7 and 14 (P<0.05). The serum level of Jagged1 showed no significant differences between any two groups on days 7 and 14 (P>0.05). The serum level of TGF-β1 was positively correlated with that of Notch1 (r=0.650, P<0.01), and the serum level of Notch1 was positively correlated with that of Jagged1 (r=0.727, P<0.01). TGF-β1 level in renal tissues was also positively correlated with the number of Notch1-positive cells (r=0.743, P<0.01).

CONCLUSIONSBaicalin can alleviate renal interstitial fibrosis in UUO rats, probably by inhibiting Notch1 signaling pathway and the expression of TGF-β1.

Animals ; Fibrosis ; Flavonoids ; therapeutic use ; Immunohistochemistry ; Kidney ; pathology ; Male ; Rats ; Rats, Sprague-Dawley ; Receptor, Notch1 ; analysis ; Transforming Growth Factor beta1 ; analysis ; Ureteral Obstruction ; pathology

To investigate the effects of mycophenolate mofetil (MMF) on the process of renal interstitial fibrosis, unilateral ureteral obstruction (UUO) model was established in rats. Twenty Sprague-Dawley rats underwent UUO and received vehicle (n = 10) or MMF (20 mg.kg-1.d-1, by daily gastric gavage, n = 10) during a period of 5 days following surgery, and the additional 10 rats were served as sham-operated group. The rats were killed 5 days after surgery. Immunohistochemistry was performed on renal tissue for proliferating cell nuclear antigen (PCNA), alpha-smooth muscle actin (alpha-SMA) and type I and III collagen (col I, col III). Histological studies were also done by MASSON staining. Five days after surgery, proliferating cells in tubules, interstitium as well as interstitial myofibroblast (MyoF) infiltration and interstitial col I, col III deposition were all significantly reduced by MMF treatment. MMF also alleviated the histological changes of UUO rats. These results suggested that the reduction of interstitial MyoF infiltration may be an important event by which MMF prevents renal injury caused by UUO and MMF could be used to limit the progression of renal fibrosis.
Animals ; Female ; Fibrosis ; Kidney ; pathology ; Kidney Diseases ; etiology ; pathology ; prevention & control ; Mycophenolic Acid ; analogs & derivatives ; pharmacology ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Ureteral Obstruction ; complications

To investigate the effects of mycophenolate mofetil (MMF) on the process of renal interstitial fibrosis, unilateral ureteral obstruction (UUO) model was established in rats. Twenty Sprague-Dawley rats underwent UUO and received vehicle (n = 10) or MMF (20 mg.kg-1.d-1, by daily gastric gavage, n = 10) during a period of 5 days following surgery, and the additional 10 rats were served as sham-operated group. The rats were killed 5 days after surgery. Immunohistochemistry was performed on renal tissue for proliferating cell nuclear antigen (PCNA), alpha-smooth muscle actin (alpha-SMA) and type I and III collagen (col I, col III). Histological studies were also done by MASSON staining. Five days after surgery, proliferating cells in tubules, interstitium as well as interstitial myofibroblast (MyoF) infiltration and interstitial col I, col III deposition were all significantly reduced by MMF treatment. MMF also alleviated the histological changes of UUO rats. These results suggested that the reduction of interstitial MyoF infiltration may be an important event by which MMF prevents renal injury caused by UUO and MMF could be used to limit the progression of renal fibrosis.
Fibrosis ; Kidney/*pathology ; Kidney Diseases/etiology ; Kidney Diseases/pathology ; Kidney Diseases/*prevention & control ; Mycophenolic Acid/*analogs & derivatives ; Mycophenolic Acid/*pharmacology ; Random Allocation ; Rats, Sprague-Dawley ; Ureteral Obstruction/*complications

PURPOSE: We undertook this study to evaluate the incidence, risk factors, management, and outcome of postoperative ureteral obstruction after endoscopic treatment for vesicoureteral reflux (VUR). MATERIALS AND METHODS: Ninety patients undergoing endoscopic treatment for VUR were retrospectively reviewed and classified into two groups according to ureteral obstruction: the nonobstruction group (83 cases, 122 ureters; mean age, 7.0+/-2.8 years) and the obstruction group (7 cases, 10 ureters; mean age, 6.2+/-8.1 years). We analyzed the following factors: age, sex, injection material, laterality, voiding dysfunction, constipation, renal scarring, preoperative and postoperative ultrasound findings, endoscopic findings, injection number, and injection volume. Additionally, we reviewed the clinical manifestations, natural course, management, and outcome of ureteral obstruction after endoscopic treatment. RESULTS: The incidence of ureteral obstruction after endoscopic treatment was 7.6% (10/132 ureters). The type of bulking agent used and injection volume tended to be associated with ureteral obstruction. However, no significant risk factors for obstruction were identified between the two groups. Three patients showed no symptoms or signs after the onset of ureteral obstruction. Most of the patients with ureteral obstruction experienced spontaneous resolution within 1 month with conservative therapy. Two patients required temporary ureteral stents to release the ureteral obstruction. CONCLUSIONS: In our experience, the incidence of ureteral obstruction was slightly higher than in previous reports. Our study identified no predictive risk factors for developing ureteral obstruction after endoscopic treatment. Although most of the ureteral obstructions resolved spontaneously within 1 month, some cases required drainage to relieve symptoms or to prevent renal function deterioration.
Adolescent ; Child ; Child, Preschool ; Cystoscopy/*adverse effects ; Drainage ; Female ; Humans ; Hydronephrosis/etiology ; Male ; Postoperative Period ; Prognosis ; Remission, Spontaneous ; Retrospective Studies ; Risk Factors ; Stents ; Ureteral Obstruction/*etiology/pathology/therapy ; Vesico-Ureteral Reflux/*surgery