scholarly journals The comparison of magnetic resonance urography with the combination of diuretic renal scintigraphy and urinary ultrasound in the diagnosis and follow up of ureteropelvic junction obstruction

2015 ◽  
Vol 2 (3) ◽  
pp. 215
Author(s):  
Murat Ciloglu ◽  
Mehmet Bilgehan Yuksel ◽  
Berk Burgu ◽  
Omer Suat Fitoz ◽  
Yakup Tarkan Soygur
Keyword(s):  
Magnetic Resonance ◽  
Ureteropelvic Junction Obstruction ◽  
Renal Scintigraphy ◽  
Ureteropelvic Junction ◽  
Magnetic Resonance Urography

Pediatric ureteropelvic junction obstruction: can magnetic resonance urography identify crossing vessels?

2015 ◽  
Vol 45 (12) ◽  
pp. 1788-1795 ◽  
Author(s):  
Kushal R. Parikh ◽  
Matthew R. Hammer ◽  
Kate H. Kraft ◽  
Vesna Ivančić ◽  
Ethan A. Smith ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Ureteropelvic Junction Obstruction ◽  
Ureteropelvic Junction ◽  
Magnetic Resonance Urography ◽  
Crossing Vessels

Outcome of Percutaneous Nephrostomy in Children With Ureteropelvic Junction Obstruction

2020 ◽  
Vol 20 (2) ◽  
pp. 61-64
Author(s):  
Mohammad Mahfuzur Rahman Chowdhury ◽  
Rifat Zaman ◽  
Md Amanur Rasul ◽  
Akm Shahadat Hossain ◽  
Shafiqul Alam Chowdhury ◽  
...  
Keyword(s):  
Renal Function ◽  
Low Dose ◽  
Ureteropelvic Junction Obstruction ◽  
Percutaneous Nephrostomy ◽  
Ureteropelvic Junction ◽  
College Hospital ◽  
Medical College ◽  
Split Renal Function

Introduction and objectives: Congenital ureteropelvic junction obstruction (UPJO) is the most common cause of hydronephrosis. Management protocols are based on the presence of symptoms and when the patient is asymptomatic the function of the affected kidney determines the line of treatment. Percutaneous nephrostomy (PCN) became a widely accepted procedure in children in the 1990s. The aim of the study was to evaluate the results of performing percutaneous nephrostomy (PCN) in all patients with UPJO and split renal function (SRF) of less than 10% in the affected kidney, because the management of such cases is still under debate. Methods:This prospective clinical trial was carried out at Dhaka Medical College Hospital from January 2014 to December 2016. Eighteen consecutive patients who underwent PCN for the treatment of unilateral UPJO were evaluated prospectively. In these children, ultrasonography was used for puncture and catheter insertion. Local anesthesia with sedation or general anesthesia was used for puncture. Pig tail catheters were employed. The PCN remained in situ for at least 4 weeks, during which patients received low-dose cephalosporin prophylaxis. Repeat renography was done after 4 weeks. When there was no significant improvement in split renal function (10% or greater) and PCN drainage (greater than 200 ml per day) then nephrectomies were performed otherwise pyeloplasties were performed. The patients were followed up after pyeloplasty with renograms at 3 months and 6 months post operatively. Results: All the patients had severe hydronephrosis during diagnosis and 14 patients with unilateral UPJO were improved after PCN drainage and underwent pyeloplasty. The rest four patients that did not show improvement in the SRF and total volume of urine output underwent nephrectomy. In the patients with unilateral UPJO who improved after PCN drainage, the SRF was increased to 26.4% ±8.6% (mean± SD) after four weeks and pyeloplasty was performed. At three and six months follow-up, SRF value was 29.2% ±8.5% and 30.8.2% ±8.8% respectively. Conclusion: Before planning of nephrectomy in poorly functioning kidneys (SRF < 10%) due to congenital UPJO, PCN drainage should be done to asses improvement of renal function. Bangladesh Journal of Urology, Vol. 20, No. 2, July 2017 p.61-64

scholarly journals Management of ureteropelvic junction obstruction in horseshoe kidneys by an assortment of laparoscopic options

2015 ◽  
Vol 9 (11-12) ◽  
pp. 775 ◽  
Author(s):  
Pejman Shadpour ◽  
H. Habib Akhyari ◽  
Robab Maghsoudi ◽  
Masoud Etemadian
Keyword(s):  
Ureteropelvic Junction Obstruction ◽  
Left Kidney ◽  
Operation Time ◽  
Ureteropelvic Junction ◽  
Laparoscopic Pyeloplasty ◽  
Referral Centre ◽  
Laparoscopic Management ◽  
The Mean ◽  
Crossing Vessels

Introduction: We report our experience with laparoscopic management of ureteropelvic junction obstruction in horseshoe kidneys.Methods: Between February 2004 and March 2014, 15 patients with horseshoe kidneys and symptomatic ureteropelvic junction obstruction underwent laparoscopic management at our national referral centre. Depending on the anatomy and presence of obtrusive vessels or isthmus, we performed either dismembered, Scardino or Foley YV pyeloplasty, or Hellstrom vessel transposition. Patients were initially evaluated by ultrasonography, then diuretic scintiscan at 4 to 6 months, and followed by yearly clinical and sonographic exams.Results: This study included 11 male and 4 female patients between the ages of 4 to 51 year (average 17.7). The left kidney was involved in 12 patients (80%). Operation time was 129 minutes (range: 90–186), and patients were discharged within 2.8 days (range: 1–6). Although 8 (53.3%) patients had crossing vessels, of which 6 required transposing, the Hellstrom technique was solely used in 3 cases, of which notably 1 case failed to resolve and required laparoscopic Hynes within the next year. Eight cases underwent dismembered pyeloplasty, 2 Foley YV, 1 Scardino flap and 1 required isthmectomy and vessel suspension. At the mean follow-up of 60 (range: 18–120) months, the overall success rate was 93.3%.Conclusions: To our knowledge, this represents the largest report on laparoscopic pyeloplasty for horseshoe kidneys, providing the longest follow-up. Our findings confirm prior reports supporting laparoscopy and furthermore show that despite the prevalence of crossing vessels, transposition alone is seldom sufficient.

Comments on a case of ureteropelvic junction obstruction with late progression in an adult female

2021 ◽  
Vol 88 (3) ◽  
pp. 247-250
Author(s):  
Carlo Gandi ◽  
Angelo Totaro ◽  
Riccardo Bientinesi ◽  
Emilio Sacco
Keyword(s):  
Renal Function ◽  
Natural History ◽  
Conservative Treatment ◽  
Gold Standard ◽  
Ureteropelvic Junction Obstruction ◽  
Ureteropelvic Junction ◽  
Case Description ◽  
Diuretic Renogram ◽  
History Of

Introduction: Ureteropelvic junction obstruction is a pathology typically diagnosed in childhood. Nevertheless, some clinically silent cases may be unnoticed until adulthood. Case description: We report the case of a 53-year-old female with hydronephrosis due to ureteropelvic junction stenosis diagnosed in the adulthood, who subsequently developed obstruction with progressive worsening of renal function without symptoms. Conclusion: The natural history of ureteropelvic junction obstruction is still obscure. Diuretic renogram is the gold standard for diagnosis and follow-up of ureteropelvic junction obstruction, but is weak in predicting the evolution of the disease, especially in patients with vague symptoms. Conservative treatment of adult patient with equivocal ureteropelvic junction obstruction seems reasonable, but requires a close clinical follow-up and strict patient compliance in order to promptly identify significant obstruction.

scholarly journals Reverse Tubularized Pelvis Flap Method for the Treatment of Long Segment Ureteropelvic Junction Obstruction

2019 ◽  
Vol 29 (2) ◽  
pp. 128-133 ◽  
Author(s):  
Haluk Sarihan ◽  
Hatice Sonay Yalçın Comert ◽  
Mustafa İmamoğlu ◽  
Dilek Basar
Keyword(s):  
Blood Supply ◽  
Ureteropelvic Junction Obstruction ◽  
Good Health ◽  
Distal Portion ◽  
Ureteropelvic Junction ◽  
Absorbable Suture ◽  
Distal Ureter ◽  
Upj Obstruction ◽  
Age Range

Objective: The most common cause of urinary obstruction is ureteropelvic junction (UPJ) obstruction. In short stenosis, a dismembered pyeloplasty is performed, but for long segment stenosis, the procedure is not well defined. We present the reverse flap ureteroplasty method, which we prepared from the pelvis for use in long segment UPJ obstruction. Methods: Between 2007 and 2016, we operated on 6 cases (4 males, 2 females) with an age range of 2–6 months. After reaching the UPJ region, depending on the length of the long segment obstruction, a flap measuring 25–35 mm in length was prepared from the pelvis so that its width would be 10–12 mm on the pelvis side and 10 mm in the distal portion. It was then reversed and tubularized with an absorbable suture over a 10-French nelaton catheter. The end of this ureter and the end of the distal ureter were spatulated and anastomosed. A double J and minivac drain were used in each case. Results: There were no complications in the postoperative period of all our patients. They were all discharged with good health. Follow-up with renal ultrasonography showed that the anteroposterior diameters were decreased and that parenchymal thicknesses had returned to normal. Secondary stenosis, flap necrosis, and retraction did not develop. Conclusion: Because the blood supply of the pelvis is increased in patients with UPJ obstruction, a reverse flap of adequate length with preserved blood supply can be achieved and tubularized. We suggest that this method will be appropriate for the treatment of long segment UPJ obstruction.

Sign in / Sign up

Export Citation Format

Share Document