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1.
Urologiia ; (1): 90-94, 2021 Mar.
Artículo en Ruso | MEDLINE | ID: mdl-33818942

RESUMEN

PURPOSE: In order to determine the role and significance of functional magnetic resonance urography (fMRU) in the diagnosis of ureteropelvic junction obstruction (UPJO), a comparative analysis of the results of fMRU and dynamic renal scintigraphy (DRS) was carried out. MATERIALS AND METHODS: From January 2017 to December 2019, fMRU and diuretic DRS were performed in 36 patients (mean age 89+/-63 months). Boys - 26 (72.2%), girls - 10 (27.8%). Left-sided hydronephrosis was detected in 23 (63.9%) children, right-sided in 12 (33.3%) patients, and bilateral lesions in 1 (2.8%) patient (2 renal units (RU)). Antenatal hydronephrosis was detected in 9 (25%) patients, and postnatally in 27 (75%) patients. According to ultrasound data, grade II hydronephrosis occurred in 11 (29.8%) RU, grade III - in 21 RU (56.7%), and grade IV - in 5 RU (13.5%) according to the SFU classification. A diuretic test was performed in 26 patients. RESULTS: Median and quartiles of differential renal function (DRF) according to fMRU data on the affected side were 37% [29; 43], and according to DRS - 46% [40;49]. When performing fMRU, a positive diuretic test was detected in 20 patients, 5 patients - negative and 1 patient - doubtful, and according to the DRS data, 12 patients had a positive test, 10 patients - negative and 4 patients - doubtful. Differences in DRF between fMRU and DRS varied between 0.7-33%. The average value of differences in DRF on the affected side was 11.3+/-8.5%. When comparing the results of DRF on the affected side, a moderate correlation was found on the Cheddock scale (r=0.59, p<0.05) between fMRU and DRS data. In comparison of the DRF using the Wilcoxon test, statistically significant differences were revealed (p<0,05). SUMMARY: Our experience demonstrates the high potential of fMRU in terms of replacing the classical methods of diagnosis of UPJO in children, taking into account the high correlation coefficients between the results of fMRU and DRS. Standardization of the fMRU protocol will increase the diagnostic relevance of information and in the future will make fMRU the only necessary study to determine management tactics for patients with UPJO.


Asunto(s)
Hidronefrosis , Obstrucción Ureteral , Niño , Femenino , Humanos , Hidronefrosis/diagnóstico por imagen , Lactante , Pelvis Renal/diagnóstico por imagen , Espectroscopía de Resonancia Magnética , Masculino , Embarazo , Cintigrafía , Estudios Retrospectivos , Obstrucción Ureteral/diagnóstico por imagen , Urografía
2.
Urologiia ; (1): 103-106, 2021 Mar.
Artículo en Ruso | MEDLINE | ID: mdl-33818944

RESUMEN

Late diagnosis of renal tuberculosis leads to complications that cannot be eliminated by treatment. A clinical observation of renal tuberculosis, complicated by total ureteral obliteration, in a comorbid patient is presented. He underwent planned bowel substitution of the right ureter. In the postoperative period, pyelonephritis developed, which was resolved by drug therapy. In this case, there is the correct tactics of outpatient urologists. When hydronephrosis was diagnosed, a nephrostomy tube was put, which allowed to preserve the kidney, Then the patient was immediately referred to a phthisiatrician to exclude urogenital tuberculosis. In the local TB dispensary, the patient did not have the opportunity to receive necessary treatment, and he was transferred to the TB Research Institute of Ministry of Health of Russia, where a reconstructive laparoscopic procedure was performed.


Asunto(s)
Hidronefrosis , Tuberculosis Renal , Tuberculosis Urogenital , Uréter , Humanos , Hidronefrosis/cirugía , Masculino , Federación de Rusia , Tuberculosis Renal/complicaciones , Tuberculosis Renal/tratamiento farmacológico , Tuberculosis Renal/cirugía , Tuberculosis Urogenital/complicaciones , Tuberculosis Urogenital/diagnóstico , Tuberculosis Urogenital/cirugía
3.
Urologiia ; (1): 126-130, 2021 Mar.
Artículo en Ruso | MEDLINE | ID: mdl-33818948

RESUMEN

The article describes such fundamental and applied aspects of pathogenesis and clinical manifestations of such rare disease as endometriosis of ureters. Frequent involvement of left ureter in its pelvic part, close to distal colon, associated with its inflammatory diseases followed by leaky gut syndrome with bacterial spread to the fallopian tube causing its inflammation and dysfunction, provoking menstrual reflux and predisposing to affection of left ovary, peritoneum and contact spread of endometriosis to ureteral wall. This mechanism fits to the regurgitation theory of endometriosis. Surgery is the gold standard for endometriosis treatment and more beneficial, comparing with conservative treatment and essential for prevention of such dangerous complications as hydronephrosis and renal failure. But the early and in-time diagnostic of endometriosis depend on gynecologists, not urologist, that characterizes endometriosis as significant interdisciplinary problem. In the article symptoms, that must cause concern for this rare pathology are thoroughly described.


Asunto(s)
Endometriosis , Hidronefrosis , Laparoscopía , Uréter , Enfermedades Ureterales , Endometriosis/complicaciones , Endometriosis/cirugía , Femenino , Humanos , Hidronefrosis/diagnóstico por imagen , Hidronefrosis/etiología , Hidronefrosis/cirugía , Uréter/diagnóstico por imagen , Uréter/cirugía , Enfermedades Ureterales/etiología , Enfermedades Ureterales/cirugía
4.
Am J Case Rep ; 22: e931404, 2021 Apr 27.
Artículo en Inglés | MEDLINE | ID: mdl-33905403

RESUMEN

BACKGROUND Perinephric hematomas are rare, especially following ureteral stent placement. Etiologies of perinephric hematomas include post-extracorporeal shockwave lithotripsy, Wunderlich syndrome, and renal cell carcinoma, none of which occurred in our patient, who underwent stent replacement. Subcapsular renal hematoma, rather than a perinephric hematoma, can occur following double-J ureteral stent placement. Also, renal parenchymal perforation leading to perinephric hematoma development are complications of double-J ureteral stent placement. Herein, we present a case of a perinephric hematoma following a double-J ureteral stent placement for a ureteral obstruction causing hydronephrosis. CASE REPORT A 43-year-old woman with type 2 diabetes mellitus, hypertension, systemic lupus erythematosus, and recurrent nephrolithiasis presented to our hospital with left flank pain of a 1-day duration. The patient was found to have an obstructive kidney stone causing hydronephrosis. She underwent stent placement and then developed a perinephric hematoma days later. Typically, hematomas are treated conservatively and have spontaneous resolution. The patient received 2 weeks of intravenous antibiotics and 2 more weeks of oral antibiotics, and failed conservative treatment. She re-presented to our hospital 3 days after discharge. Upon the second admission, a perinephric drain was placed. The patient was given another course of antibiotics and was discharged 18 days later. CONCLUSIONS A perinephric hematoma is a rare complication after ureteral stent placement. Perinephric hematoma development can be decreased by controlling blood pressure, treating preoperative urinary tract infections, and shortening operating time during ureteroscopy. It is important to reevaluate potential causes of continued abdominal pain with laboratory testing and repeat imaging.


Asunto(s)
Diabetes Mellitus Tipo 2/complicaciones , Hematoma/etiología , Hidronefrosis/etiología , Pielonefritis/complicaciones , Stents/efectos adversos , Obstrucción Ureteral/complicaciones , Adulto , Femenino , Hematoma/diagnóstico por imagen , Humanos , Cálculos Renales , Complicaciones Posoperatorias , Resultado del Tratamiento , Cálculos Ureterales/terapia , Obstrucción Ureteral/diagnóstico por imagen , Ureteroscopía
5.
J Am Vet Med Assoc ; 258(7): 740-747, 2021 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-33754813

RESUMEN

CASE DESCRIPTION: An 8-month-old 41.2-kg (90.6-lb) sexually intact male Dogue de Bordeaux with urinary incontinence and signs of nausea was referred for further evaluation and treatment of bilateral hydronephrosis, hydroureter, and ectopic ureters. CLINICAL FINDINGS: Clinicopathologic analyses revealed urine specific gravity and serum concentrations of urea nitrogen and creatinine within reference limits. Abdominal ultrasonography and CT revealed unilateral abdominal cryptorchidism, ureters that bilaterally passed dorsal to and appeared compressed by the external iliac arteries (retroiliac ureters), and bilateral hydronephrosis, hydroureter, and ectopic ureters. On CT, minimal uptake of contrast medium by the right kidney indicated either a lack of renal function or ureteral obstruction. TREATMENT AND OUTCOME: The dog underwent exploratory laparotomy, right ureteronephrectomy, left neoureterocystostomy, bilateral castration, and incisional gastropexy without complication and was discharged 2 days postoperatively. Eleven days after surgery, the dog had improved but continued urinary incontinence, improved left hydronephrosis and hydroureter, and serum concentrations of urea nitrogen and creatinine within reference limits. At 24 months after surgery, the dog was reportedly clinically normal, other than having persistent urinary incontinence. CLINICAL RELEVANCE: To our knowledge, this was the first report of a dog with retroiliac ureters and compression-induced ureteral obstruction with secondary hydroureter and hydronephrosis. Retroiliac ureters should be considered as a differential diagnosis in young dogs with ureteral obstruction. Our findings indicated that a good outcome was possible for a dog with retroiliac ureters treated surgically; however, the presence of additional congenital anomalies should be considered and may alter the prognosis in dogs with retroiliac ureters.


Asunto(s)
Enfermedades de los Perros , Hidronefrosis , Uréter , Obstrucción Ureteral , Incontinencia Urinaria , Animales , Enfermedades de los Perros/cirugía , Perros , Hidronefrosis/etiología , Hidronefrosis/cirugía , Hidronefrosis/veterinaria , Masculino , Uréter/cirugía , Obstrucción Ureteral/veterinaria , Incontinencia Urinaria/etiología , Incontinencia Urinaria/cirugía , Incontinencia Urinaria/veterinaria
6.
Medicine (Baltimore) ; 100(6): e24182, 2021 Feb 12.
Artículo en Inglés | MEDLINE | ID: mdl-33578522

RESUMEN

ABSTRACT: Cervical cancer is a common malignancy in women. The presence of hydronephrosis in patients with cervical cancer can be a challenging clinical problem. The appropriate management of these patients and the prediction of their outcomes are concerns among gynecologists, urologists, medical oncologists, radiation oncologists, and nephrologists. We enrolled a total of 2225 patients with cervical cancer over a 12-year period from the nationwide database of Taiwan's National Health Insurance Bureau. Among them, 445 patients had concomitant hydronephrosis. The remaining 1780 patients without hydronephrosis were randomly enrolled as a control group for the analysis of associated factors. The results indicated that the proportions of patients with hypertension, chronic kidney disease, and diabetes were significantly higher in the hydronephrosis group. The hydronephrosis group showed a higher all-cause mortality than the non-hydronephrosis group (adjusted hazard ratio 3.05, 95% confidence interval 2.24-4.15, P < .001). The rates of nephrectomy and stone disease were also significantly higher in the hydronephrosis group. A higher percentage of other cancers was also observed in the hydronephrosis group than in the non-hydronephrosis group (12.36% vs 8.99%, respectively). This study shows that cervical cancer with hydronephrosis may have a higher morbidity and mortality than cervical cancer without hydronephrosis. Other factors such as human papilloma virus vaccination, smoking, and cancer staging need to be further studied.


Asunto(s)
Hidronefrosis/etiología , Neoplasias del Cuello Uterino/complicaciones , Neoplasias del Cuello Uterino/mortalidad , Neoplasias del Cuello Uterino/patología , Adulto , Anciano , Estudios de Casos y Controles , Estudios de Cohortes , Comorbilidad , Manejo de Datos , Diabetes Mellitus/epidemiología , Femenino , Humanos , Hipertensión/epidemiología , Cálculos Renales/epidemiología , Persona de Mediana Edad , Nefrectomía/estadística & datos numéricos , Evaluación del Resultado de la Atención al Paciente , Insuficiencia Renal Crónica/epidemiología , Estudios Retrospectivos , Taiwán/epidemiología , Catéteres Urinarios/estadística & datos numéricos , Neoplasias del Cuello Uterino/prevención & control
9.
Hinyokika Kiyo ; 67(1): 27-30, 2021 Jan.
Artículo en Japonés | MEDLINE | ID: mdl-33535294

RESUMEN

A 41-year-old female who suffered local recurrence of cervical cancer after receiving chemoradiotherapy underwent radical hysterectomy, radical vaginal resection, and pelvic and paraaortic lymph node dissection. After surgery, bilateral hydronephrosis due to right ureteral stenosis and left uretero-vaginal fistula occurred. We therefore placed a bilateral ureteral stent. Thereafter, we continued to replace the bilateral ureteral stent once every 3 months, but the replacement of the right ureteral stent became impossible three years after the initial placement. We thus performed bilateral upper urinary tract reconstruction using an ileal ureter with the aim of both eliminating the left ureteral vaginal fistula and resolving the right ureteral stricture.


Asunto(s)
Hidronefrosis , Uréter , Obstrucción Ureteral , Adulto , Constricción Patológica , Femenino , Humanos , Íleon , Uréter/cirugía , Obstrucción Ureteral/etiología , Obstrucción Ureteral/cirugía
10.
PLoS One ; 16(1): e0231233, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33449930

RESUMEN

Chronic kidney disease leads to high morbidity rates among humans. Kidney transplantation is often necessary for severe symptoms; however, options for new curative treatments are desired because of donor shortage. For example, it has been established that the kidneys can efficiently generate urine after transplantation of the metanephros, ureter, and bladder as a group. After transplantation, the urine can indirectly flow into the recipient's bladder using a stepwise peristaltic ureter system method where the anastomosis is created via the recipient's ureter for urinary tract reconstruction. However, the growth of the regenerated metanephros varies significantly, whereas the time window for successful completion of the stepwise peristaltic ureter system that does not cause hydronephrosis of the metanephros with bladder (ureter) is quite narrow. Therefore, this study was conducted to periodically and noninvasively evaluate the growth of the transplanted metanephros, ureter, and bladder in rats through computed tomography and ultrasonography. The ultrasonographic findings highly correlated to the computed tomography findings and clearly showed the metanephros and bladder. We found that the degree of growth of the metanephros and the bladder after transplantation differed in each case. Most of the rats were ready for urinary tract reconstruction within 21 days after transplantation. Optimizing the urinary tract reconstruction using ultrasonography allowed for interventions to reduce long-term tubular dilation of the metanephros due to inhibited overdilation of the fetal bladder, thereby decreasing the fibrosis caused possibly by transforming growth factor-ß1. These results may be significantly related to the long-term maturation of the fetal metanephros and can provide new insights into the physiology of transplant regeneration of the metanephros in higher animals. Thus, this study contributes to the evidence base for the possibility of kidney regeneration in human clinical trials.


Asunto(s)
Fibrosis/patología , Hidronefrosis/fisiopatología , Regeneración/fisiología , Sistema Urinario/fisiopatología , Sistema Urinario/cirugía , Anastomosis Quirúrgica/métodos , Animales , Femenino , Hidronefrosis/cirugía , Riñón/patología , Riñón/cirugía , Trasplante de Riñón/métodos , Masculino , Embarazo , Ratas , Ratas Endogámicas Lew , Trasplantes/fisiopatología , Trasplantes/cirugía
13.
BMJ Case Rep ; 14(1)2021 Jan 19.
Artículo en Inglés | MEDLINE | ID: mdl-33468632

RESUMEN

A 53-year-old man presented with lower urinary tract symptoms and recurrent urinary tract infections since last 3 years without being investigated or treated properly. Examination revealed a hard mobile lump in the pelvis, and blood investigations showed raised serum creatinine of 2.9 mg/dL. Subsequent urgent ultrasound scan showed a large urinary bladder stone with bilateral hydroureteronephrosis, and X-ray kidney, ureter and bladder demonstrated a 9 cm×6 cm elliptical radio-opaque shadow in the pelvis. He underwent emergency admission followed by open cystolithotomy on the next day. He was discharged after 48 hours with a urethral catheter. After 2 weeks, his renal function recovered completely; repeat ultrasound scan revealed complete resolution of hydronephrosis. Urethral catheter was removed following a normal cystogram. Uroflowmetry after 6 weeks revealed underlying bladder outlet obstruction, and he was started on alpha blocker which improved his urinary flow.


Asunto(s)
Hidronefrosis/etiología , Obstrucción Ureteral/etiología , Cálculos de la Vejiga Urinaria/complicaciones , Cálculos de la Vejiga Urinaria/diagnóstico , Humanos , Hidronefrosis/diagnóstico por imagen , Hidronefrosis/cirugía , Masculino , Persona de Mediana Edad , Obstrucción Ureteral/diagnóstico por imagen , Obstrucción Ureteral/cirugía , Cálculos de la Vejiga Urinaria/cirugía
15.
Int Braz J Urol ; 47(1): 159-168, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33047921

RESUMEN

PURPOSE: Epidemiological studies reported conflicting results about preoperative hydronephrosis in upper tract urothelial carcinoma (UTUC). This study aimed to investigate the association between preoperative hydronephrosis and pathologic features and oncologic outcomes in patients with UTUC treated by radical nephroureterectomy (RNU). MATERIALS AND METHODS: This was a retrospective, single-center cohort study of 377 patients treated by RNU without perioperative chemotherapy between January 2001 and December 2014. Logistic regression, Cox regression, and survival analyses were performed. RESULTS: Among the 226 patients with high-grade UTUC, 132 (58%) had preoperative hydronephrosis. Multivariable logistic regression revealed that hydronephrosis was independently associated with advanced pT stage (P=0.017) and lymph node or lymphovascular invasion (P=0.002). Median follow-up was 36 months (interquartile range: 20-48 months). The 3- and 5-year overall survival (OS) rates in patients with hydronephrosis were significantly lower than in those without hydronephrosis (both P <0.001). The 3- and 5-year cancer-specific survival (CSS) rates in patients with hydronephrosis were significantly lower than in those without hydronephrosis (both P=0.001). Hydronephrosis was independently associated with OS and CSS (P=0.001 and P=0.004, respectively). Among the 151 patients with low-grade UTUC, hydronephrosis was not associated with pathologic features and postoperative survival. CONCLUSIONS: Preoperative hydronephrosis was significantly associated with adverse pathologic features and postoperative survival in patients with high-grade UTUC.


Asunto(s)
Carcinoma de Células Transicionales , Hidronefrosis , Neoplasias Urológicas , Carcinoma de Células Transicionales/complicaciones , Carcinoma de Células Transicionales/cirugía , Estudios de Cohortes , Humanos , Pronóstico , Estudios Retrospectivos , Neoplasias Urológicas/complicaciones , Neoplasias Urológicas/cirugía
16.
Artículo en Inglés | MEDLINE | ID: mdl-33010454

RESUMEN

BACKGROUND: Several studies revealed alterations of single sphingolipid species, such as chain length-specific ceramides, in plasma and serum of patients with kidney diseases. Here, we investigated whether such alterations occur in kidney tissue from patients and mice suffering from renal fibrosis, the common endpoint of chronic kidney diseases. METHODS: Human fibrotic kidney samples were collected from nephrectomy specimens with hydronephrosis and/or pyelonephritis. Healthy parts from tumor nephrectomies served as nonfibrotic controls. Mouse fibrotic kidney samples were collected from male C57BL/6J mice treated with an adenine-rich diet for 14 days or were subjected to 7 days of unilateral ureteral obstruction (UUO). Kidneys of untreated mice and contralateral kidneys (UUO) served as respective controls. Sphingolipid levels were detected by LC-MS/MS. Fibrotic markers were analyzed by TaqMan® analysis and immunohistology. RESULTS: Very long-chain ceramides Cer d18:1/24:0 and Cer d18:1/24:1 were significantly downregulated in both fibrotic human kidney cortex and fibrotic murine kidney compared to respective control samples. These effects correlate with upregulation of COL1α1, COL3α1 and αSMA expression in fibrotic human kidney cortex and fibrotic mouse kidney. CONCLUSION: We have shown that very long-chain ceramides Cer d18:1/24:0 and Cer d18:1/24:1 are consistently downregulated in fibrotic kidney samples from human and mouse. Our findings support the use of in vivo murine models as appropriate translational means to understand the involvement of ceramides in human kidney diseases. In addition, our study raises interesting questions about the possible manipulation of ceramide metabolism to prevent progression of fibrosis and the use of ceramides as potential biomarkers of chronic kidney disease.


Asunto(s)
Ceramidas/metabolismo , Hidronefrosis/metabolismo , Pielonefritis/metabolismo , Esfingolípidos/metabolismo , Obstrucción Ureteral/metabolismo , Actinas/genética , Actinas/metabolismo , Adenina/administración & dosificación , Anciano , Animales , Biomarcadores/metabolismo , Ceramidas/clasificación , Colágeno Tipo I/genética , Colágeno Tipo I/metabolismo , Colágeno Tipo III/genética , Colágeno Tipo III/metabolismo , Modelos Animales de Enfermedad , Femenino , Fibrosis , Regulación de la Expresión Génica , Humanos , Hidronefrosis/inducido químicamente , Hidronefrosis/genética , Hidronefrosis/patología , Riñón/metabolismo , Riñón/patología , Metabolismo de los Lípidos/genética , Masculino , Ratones , Ratones Endogámicos C57BL , Persona de Mediana Edad , Pielonefritis/inducido químicamente , Pielonefritis/genética , Pielonefritis/patología , Esfingolípidos/clasificación , Obstrucción Ureteral/genética , Obstrucción Ureteral/patología
19.
Clin Nucl Med ; 46(1): 88-89, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33181737

RESUMEN

We report a case of a 56-year-old woman who underwent Tc-DTPA renal scintigraphy for the evaluation of a right pelviureteric junction calculi, which incidentally showed radiotracer uptake in a giant liver hemangioma. The initial scintigraphic images showed a large lobulated lesion with peripheral uptake of radiotracer at the right abdominal region, resembling a large hydronephrotic kidney. However, the pattern of progression of the radiotracer, coupled with the clinical history and available corresponding radiologic images, confirmed the uptake to be that of a giant liver hemangioma.


Asunto(s)
Hemangioma/diagnóstico por imagen , Hidronefrosis/diagnóstico por imagen , Neoplasias Hepáticas/diagnóstico por imagen , Pentetato de Tecnecio Tc 99m , Diagnóstico Diferencial , Femenino , Humanos , Persona de Mediana Edad , Cintigrafía
20.
Beijing Da Xue Xue Bao Yi Xue Ban ; 52(6): 1069-1074, 2020 Dec 18.
Artículo en Chino | MEDLINE | ID: mdl-33331315

RESUMEN

OBJECTIVE: To investigate the clinical features and outcome of hydronephrosis induced by retroperitoneal fibrosis (RPF), and to evaluate the effect of corticosteroid based therapy combined with surgical intervention of ureteral obstruction. METHODS: A total of 17 RPF patients with hydronephrosis hospitalized in Peking University International Hospital from May 2016 to December 2019 were analyzed retrospectively. RESULTS: The median age was 56 (53, 65) years, the male to female ratio was 2.4 : 1, and the disease duration was 4.00 (0.83, 8.00) months. The initial symptoms included back pain (9 cases), abdominal pain (6 cases), oliguria (2 cases) and lower limb edema (3 cases). Eight patients presented left hydronephrosis, 1 right hydronephrosis and 8 bilateral hydronephrosis. C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were both elevated in 13 patients (76.5%, n=17). Immunoglobin (Ig) G4 increased in 5 cases (29.4%, n=17). IgG, IgE and IgA increased in 4 cases (30.8%, n=13), 4 cases (30.8%, n=13) and 1 case (7.7%, n=13), respectively. Among 12 patients who underwent biopsy, 3 patients were diagnosed with IgG4-relate disease. The level of IgG4 in the tissues varied, 6 cases expressed less than 10 per high power field (HPF) or no expression (50.0%). Only 2 cases expressed 10-30/HPF (16.7%), and 4 cases revealed more than 30/HPF (33.3%). Among the 17 patients with ureteral obstruction, no urinary drainage procedure was needed in 4 patients who had mild ureteral obstruction, whereas, ureteral stenting was carried out in the other 13 cases before drug treatment. Time was too short to evaluate the effect of urinary drainage procedures in 4 patients. For the rest, ureterolysis had to be performed in 3 cases after failed ureteral stent insertion. Successful drain removal was accomplished in all of these 9 patients and the mean time to drain removal was (6.7±3.0) months. In addition, 10 patients had complete medical records after an average follow-up time of 5 (3-13) months. Levels of ESR, CRP, IgG4, IgG, IgE, IgA were 54.0 (36.3, 98.5) mm/h, 26.8 (8.7, 53.0) mg/L, 1.34 (0.55, 3.36) g/L, 16.3 (13.0, 21.1) g/L, 40.5 (31.4, 203.0) IU/mL, 2.51 (1.82, 3.25) g/L at baseline, which all decreased predominantly after treatment. ESR, CRP, IgG4, IgG, IgE and IgA dropped by 38.5 (23.5, 54.3) mm/h (P < 0.01), 23.0 (5.5, 52.0) mg/L (P < 0.05), 0.92 (0.40, 2.85) g/L (P < 0.01), 6.5 (1.7, 9.1) g/L (P < 0.05), 23.7 (4.8, 162.0) IU/mL (P < 0.05) and 0.77 (0.32, 1.26) g/L (P < 0.05), respectively. Size of mass measured by CT/MRI imaging became smaller significantly and hydronephrosis relieved. CONCLUSION: Onset of RPF is insidious and lack of specific initial symptoms. Corticosteroid based therapy combined with surgical intervention of relieving obstruction is effective.


Asunto(s)
Hidronefrosis , Fibrosis Retroperitoneal , Uréter , Obstrucción Ureteral , Anciano , Femenino , Humanos , Hidronefrosis/etiología , Masculino , Fibrosis Retroperitoneal/complicaciones , Estudios Retrospectivos
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