Cases reported "Hydronephrosis"

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1/84. Congenital ureteral diverticulum coexistent with hydronephrosis caused by vascular compression involving the uterine artery and umbilical ligament: report of a case.

    Coexistence of congenital ureteral diverticulum and hydronephrosis caused by vascular compression is a rare entity. The authors experienced a case of congenital ureteral diverticulum coexistent with hydronephrosis caused by aberrant vascular compression by uterine and umbilical arteries in a 14-year-old girl. The authors could not diagnose accurately this abnormality preoperatively by 3-dimensional computed tomography. After partial ureterectomy, including resection of the saccular lesion and ureteroneocystostomy, the frequency of urinary tract infection decreased.
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2/84. An unusual cause of urinary retention: a primary retrovesical echinococcal cyst.

    We present a patient with symptoms of frequency, a mild decrease in urinary stream, and urinary retention due to a huge hydatid cyst located in the retrovesical region. Chest radiography and abdominal computed tomography did not reveal any other site of hydatid disease involvement. Since the cyst was in intimate contact with the seminal vesicles and the vasa deferentia, part of the hydatid sac wall adherent to these structures was left behind during the surgical excision. The patient was free of voiding symptoms, and no other episode of urinary retention had occurred at 6 months of follow-up. Pelvic computed tomography did not reveal recurrence of hydatid disease at 6 months postoperatively.
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3/84. Robot assisted laparoscopic nephrectomy.

    PURPOSE: The feasibility and safety of remote laparoscopic surgery using a surgical telemanipulator have been demonstrated in laboratory experience and recently in clinical practice. To our knowledge we report the first robot assisted, laparoscopic nephrectomy in a human. MATERIALS AND methods: A 77-year-old woman was diagnosed with a nonfunctioning hydronephrotic right kidney due to ureteropelvic junction obstruction. Robot assisted, transperitoneal right laparoscopic nephrectomy was performed. RESULTS: Complete dissection was successfully performed with the robot. The renal pedicle was dissected without any problem, and the artery and vein were individually ligated. operative time was 200 minutes, anesthesia time was 245 minutes and blood loss was less than 100 ml. convalescence was uneventful. Histological examination confirmed the preoperative diagnosis. CONCLUSIONS: We report the technical feasibility of robot assisted laparoscopic nephrectomy in humans. Current technology needs further improvement and its actual usefulness for patient treatment must be established by large clinical trials. Technological improvements and future telecommunication networks should open new avenues in surgery, namely remote telesurgery.
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4/84. Candida infection associated with a solitary mycotic common iliac artery aneurysm.

    We report on a case of an isolated common iliac artery aneurysm infected by candida albicans. To our knowledge, only one other case of this condition has been reported. The patient, a 49-year-old man with diabetes mellitus and a history of fungal urinary tract infections, had recurrent right knee pain and swelling. The knee effusion grew C albicans. Mild right hydronephrosis and a 4.6-cm aneurysm of the right common iliac artery without involvement of the aorta or iliac bifurcation was revealed by means of a computed tomography scan. The aneurysm wall was inflammatory, and there was associated purulence at the time of operation. The right ureter was densely adherent to the anterior aspect of the aneurysm, but could be palpated and dissected free because of a ureteral stent that was placed before the surgical incision. The aneurysm was resected, and the proximal and distal margins were oversewn without graft placement. C albicans was found in the resected aneurysm. The patient recovered without limb-threatening ischemia or claudication, but the distance he could walk remained limited because of right knee symptoms. The aneurysm may have formed by direct extension of infection from the right ureter or by hematogenous or lymphatic spread. This case raises interesting issues about operative strategies and etiology.
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5/84. Persisting active and proliferative intrinsic ureteral endometriosis under GNRH agonists therapy: a case with immunohistological study.

    We report the case of a 30-year-old patient who underwent a segmental ureteral resection with ureteroureterostomy because of the presence of a left ureterohydronephrosis caused by an intrinsic ureteral endometriotic lesion. Preoperatively, the patient received a 3 months course of GNRH agonists. The serum estradiol level was at 12 pg/ml at the moment of surgery. histology and immunohistochemistry performed on the resected specimen showed the presence of numerous large haemorrhagic endometriotic foci containing very high levels of alpha-estrogen and progesterone nuclear receptors, a high Ki-67 labeling index and a strong positivity for EGF-receptor. This is the first report of immunohistochemical study performed on ureteral endometriosis preoperatively treated with GNRH agonists. Because hormonal treatments are often prescribed in the treatment of ureteral endometriosis, clinicians should be aware of the possibility of persisting very active and proliferative ureteral endometriotic lesions even under treatment with GNRH agonists and very low levels of circulating estradiol.
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keywords = operative
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6/84. Development of a large bladder calculus on sutures used for pubic bone closure following extrophy repair.

    bladder exstrophy is a rare congenital condition that occurs in 1 to 30,000 live births. Primary bladder closure is usually performed in the first days of life in conjunction with an iliac osteotomy in order to achieve a more secure bladder closure. We report a case of a large bladder stone with secondary right-sided hydronephrosis in a 3-year-old child who underwent exstrophy repair at the age of 7 months. During the exstrophy repair a no. 1 braided, polyester, non-absorbable suture was used to close the pubic bones and served as a nidus for intravesical stone formation. This case substantiates the lithogenic nature of non-absorbable sutures in contact with urine as well as the need for close post-operative follow-up in these patients.
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7/84. Unusual presentation of cecoureterocele.

    A three-year-old female had a nephroureterectomy for a hydronephrotic left kidney with a total duplicated collecting system. Postoperatively urinary retention developed which was found to be secondary to a previously nonobstructive cecoureterocele. A brief review of cecoureteroceles is given along with the possible cause of this unusual presentation.
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8/84. Bilateral hydroureter and hydronephrosis causing renal failure due to a procidentia uteri: a case report.

    We report a case of complete uterine prolapse that resulted in bilateral hydroureter, hydronephrosis, and renal dysfunction. The nonoperative reduction of the prolapse with a vaginal pessary reversed the obstructive uropathy and ameliorated renal function. The lower urinary tract should be imaged in patients with complete uterine prolapse. If present, obstructive uropathy should be relieved by the reduction of the prolapse before irreversible renal damage occurs.
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keywords = operative
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9/84. Late ureteral conduit urinary leak as a presentation of urothelial carcinoma of the ureter.

    Urinary leakage at the ureteroenteric anastomosis in patients with urinary diversion is a rare complication that usually occurs in the early postoperative period, regardless of the indication for surgery. To our knowledge, ureteroenteric urinary leaks that occur late in the postoperative period have not been described. We present a unique case of a late ureteroenteric anastomotic leak within an ileal conduit that occurred as a result of recurrent urothelial carcinoma of the ureter at the site of anastomosis.
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keywords = operative
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10/84. Clinics in diagnostic imaging (73). Left hydronephrosis due to pelvi-ureteric junction obstruction.

    A full-term male infant was antenatally diagnosed to have left hydronephrosis. Post natal ultrasonography (US) and diuretic renography confirmed the diagnosis of left pelvi-ureteric junction obstruction. His clinical course was complicated by one episode of urinary tract infection. Serial US and diuretic renography showed no improvement in the obstruction. The patient underwent an Anderson-Hynes pyeloplasty at nine months of age with no post-operative complications. The diagnosis and management of antenatally-diagnosed hydronephrosis are discussed.
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