Cases reported "Ureteral Obstruction"

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1/11. pseudohypoaldosteronism associated with ureterocele and upper pole moiety obstruction.

    A 2-month-old girl was diagnosed with a febrile urinary tract infection. Subsequent studies revealed a right renal duplication anomaly with a poorly functioning upper pole moiety subtended by an intravesical ureterocele. The patient was also found to have hyperkalemia, hyponatremia, and elevated serum aldosterone. After antibiotic therapy, the urinary tract infection resolved, although the electrolyte and hormonal abnormalities persisted. At 4 months of age, a right upper pole heminephrectomy was performed. The patient's electrolyte and hormonal levels normalized. This case represents an unusual case of pseudohypoaldosteronism presenting with urinary tract infection and obstructed upper pole moiety that resolved after surgical intervention.
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keywords = ureterocele
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2/11. Duplicated collecting system with lower pole ureteropelvic junction obstruction.

    Two examples of the rare case of complete duplicated collecting system with lower pole ureteropelvic junction obstruction are described. Ureteropelvic junction obstruction (UPJO) and duplicated collecting systems seldom occur in combination. Complete duplication of the ureter may be asymptomatic or recognized when complications develop as a result of reflux into the lower pole ureter or obstruction of the upper pole with an ectopic ureterocele. It is difficult to choose an optimal therapy due to the high variability in function, degree of obstruction, damage and potential for regeneration in growing kidneys. The diagnosis and management of UPJO of the lower pole in complete duplicated collecting systems are discussed.
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keywords = ureterocele
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3/11. Outcome of the distal ureteric stump after (hemi)nephrectomy and subtotal ureterectomy for reflux or obstruction.

    OBJECTIVE: To assess the outcome of the distal ureteric stump (DUS) after (hemi)nephrectomy with subtotal ureterectomy. patients AND methods: The records of 89 patients (median age 2.7 years, range 0.25-12) who underwent nephrectomy (24) or heminephrectomy (65) with subtotal ureterectomy between 1982 and 1996 were reviewed retrospectively for symptoms caused by the DUS. The mean follow-up was 9.8 years. nephrectomy was undertaken for a poorly functioning dysplastic (in nine), scarred (in 10) or hydronephrotic (in five) kidney, and heminephrectomy for a poorly functioning upper moiety associated with ectopic ureterocele (in 26) or stenotic hydroureter (in 15), or for a poorly functioning lower moiety associated with reflux (in 24). There were 38 refluxing and 51 non-refluxing ureteric stumps. Two additional patients primarily operated elsewhere were referred with DUS symptoms. RESULTS: Only one patient had a symptomatic DUS, with recurrent haematuria and bacteriuria. The two patients referred from elsewhere presented with febrile UTIs. The first had been left with a long refluxing stump opening ectopically into the urethra, and the second with a long stump which was converted from nonrefluxing to a refluxing stump when he developed dysfunctional voiding. Surgical excision of the distal stump was curative in each case. CONCLUSIONS: The risk of a symptomatic DUS in patients who undergo subtotal ureterectomy in conjunction with (hemi)nephrectomy is very low, with no difference between refluxing and nonrefluxing stumps. Long ureteric stumps and dysfunctional voiding may cause symptoms. Because of the low morbidity associated with a short ureteric stump, we recommend subtotal ureterectomy in children who undergo (hemi)nephrectomy for reflux, vesico-ureteric obstruction or ectopic ureterocele associated with a poorly functioning kidney or kidney moiety.
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keywords = ureterocele
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4/11. Dilated ureter presenting as a cystic abdominal mass--a case report.

    A seven-month-old female child presenting with a large abdominal mass was found on investigation to have a duplex right kidney with a non-functioning obstructed upper moiety and a right ureterocele. The grossly dilated and tortuous upper moiety ureter presented as a large cystic mass on ultrasound and computed tomographic scans.
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keywords = ureterocele
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5/11. Management of obstructing ectopic ureteroceles.

    Ectopic ureteroceles are a common pediatric urologic problem requiring thoughtful management decisions. Although management algorithms have been proposed, they should serve only as a framework for therapy. More important is a thorough understanding of the problem and its implications. The authors discuss their management approach and provide several cases illustrating the spectrum of problems presented by ectopic ureteroceles and the variety of management options.
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ranking = 1.2
keywords = ureterocele
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6/11. Congenital obstructive uropathy and nodular renal blastema.

    The occurrence of nodular renal blastema and renal dysplasia was determined in a retrospective study of 75 cases of congenital obstructive uropathy. Nodular renal blastema was present in 3 upper pole nephrectomy specimens removed as a consequence of nonfunction owing to ectopic ureterocele; none was dysplastic. A more differentiated type of nodular renal blastema was present in 3 other total nephrectomy specimens, bilateral involvement in a case of posterior urethral valves and unilateral nodular renal blastema associated with ureteral atresia. This subset of differentiated nodular renal blastema was associated with renal dysplasia.
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keywords = ureterocele
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7/11. Giant obstructing calculus in the distal ureter secondary to obstruction by a ureterocele.

    A 43-year-old man presented with bilateral simple ureteroceles complicated by calculi. A huge left ureteral calculus subsequently developed, causing nonfunctioning of the left kidney. This is apparently the largest calculus associated with an orthotopic ureterocele ever reported in the literature. Its cause, diagnosis, and treatment are discussed.
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ranking = 1.2
keywords = ureterocele
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8/11. prolapse of an ectopic ureterocele into both urethra and ipsilateral orthotopic ureter.

    Ectopic ureteroceles frequently prolapse into the urethra. Inversion of ureteroceles into their own ureters has also been described. This patient showed a ureterocele which not only prolapsed into the urethra but also into the ipsilateral orthotopic ureter. We have not seen nor found a description of prolapse of a ureterocele into the ipsilateral orthotopic ureter.
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ranking = 1.6
keywords = ureterocele
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9/11. Ultrasonic evaluation of the obstructed duplex kidney.

    The problem of a duplex collecting system associated with an obstructed ectopic ureter or ureterocele is common in pediatric urology. Four such patients were studied by gray scale ultrasound which was useful in demonstrating the dilated upper pole collecting system as well as an ectopic ureter and a ureterocele. Although the diagnosis of a nonfunctioning upper pole unit in a duplex kidney is usually suggested by the urogram, ultrasound provides a noninvasive means of confirmation which is independant of function. Further, ultrasound-guided puncture with antegrade pyelography demonstrates the course of the ectopic ureter, thus providing a more complete preoperative evaluation.
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ranking = 0.4
keywords = ureterocele
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10/11. Prolapsing single orthotopic ureterocele in a boy: case report.

    Single orthotopic ureteroceles are uncommon in childhood. A recent case of such a ureterocele causing obstructive symptomatology is presented. A similar case has not been specifically reported previously.
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ranking = 1.2
keywords = ureterocele
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