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2.
Top Companion Anim Med ; 36: 22-24, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31472725

RESUMEN

A 4-month-old, intact male, domestic longhair cat was admitted with a 2-month history of abdominal distention. Physical examination revealed a mild inspiratory distress and a large palpable intraabdominal mass, in an otherwise bright and alert cat. Abdominal ultrasonography revealed a large hypoechoic cystic structure compatible with hydronephrosis or a renal cyst. On exploratory celiotomy, hydronephrosis of the right kidney was documented and ureteronephrectomy was performed. Histopathology of the excised tissues revealed severe stenosis in the proximal ureteral lumen without evidence of obstructive material, a normal ureteral epithelium and severe atrophy of the renal cortex and medulla, supporting the diagnosis of congenital unilateral ureteral stenosis. The cat recovered uneventfully and 8 months later was in excellent clinical condition. Congenital ureteral stenosis with secondary hydronephrosis may occur rarely in cats and should be included in the differential diagnosis of progressive abdominal distention in young cats.


Asunto(s)
Enfermedades de los Gatos/congénito , Hidronefrosis/veterinaria , Obstrucción Ureteral/veterinaria , Animales , Enfermedades de los Gatos/diagnóstico , Enfermedades de los Gatos/cirugía , Gatos , Hidronefrosis/congénito , Hidronefrosis/diagnóstico , Masculino , Resultado del Tratamiento , Ultrasonografía/veterinaria , Obstrucción Ureteral/congénito , Obstrucción Ureteral/diagnóstico , Obstrucción Ureteral/cirugía
3.
Nan Fang Yi Ke Da Xue Xue Bao ; 39(5): 547-553, 2019 May 30.
Artículo en Chino | MEDLINE | ID: mdl-31140418

RESUMEN

ObjectiveTo explore the application of radiomic analysis in differential diagnosis of renal cell carcinoma in patients with hydronephrosis and renal calculi using supervised machine learning methods.MethodThe abdominal CT scan data were retrospectively analyzed for 66 patients with pathologically confirmed hydronephrosis and renal calculi, among whom 35 patients had renal cell carcinoma. In each case 18 non-texture features and 344 texture features were extracted from the region of interest (ROI). Infinite feature selection (InfFS)-based forward feature selection method coupled with support vector machine (SVM) classifier was used to select the optimal feature subset. SVM was trained and performed the prediction using the selected feature subset to classify whether hydronephrosis with renal calculi was associated with renal cell carcinoma.ResultsA total of 12 texture features were selected as the optimal features. The area under curve (AUC), accuracy, sensitivity, specificity, false positive rate and false negative rate of the SVM- InfFS model for predicting accompanying renal tumors in patients with hydronephrosis and calculi were 0.907, 81.0%, 70.0%, 90.9%, 9.1%, and 30.0%, respectively. The diagnostic accuracy, sensitivity, specificity, false positive and false negative rates by the clinicians provided with these classification results were 90.5%, 80.0%, 100%, 0.00%, and 20.0%, respectively.ConclusionThe computer-aided classification model based on supervised machine learning can effectively extract the diagnostic information and improve the diagnostic rate of renal cell carcinoma associated with hydronephrosis and renal calculi.


Asunto(s)
Carcinoma de Células Renales , Hidronefrosis , Cálculos Renales , Neoplasias Renales , Carcinoma de Células Renales/diagnóstico , Diagnóstico Diferencial , Humanos , Hidronefrosis/diagnóstico , Neoplasias Renales/diagnóstico , Estudios Retrospectivos
4.
Int Urol Nephrol ; 51(6): 909-915, 2019 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-30955138

RESUMEN

PURPOSE: To evaluate the predictive role of maternal urinary CA 19-9 as a non-invasive marker for diagnosing antenatal posterior urethral valve (PUV). METHODS: A total of 40 women in the third pregnancy trimester were enrolled. Case group (group A) consisted of 20 women with a diagnosis of antenatal PUV. Twenty women with similar gestational age, fetal sex, normal US, and no history of congenital anomalies were chosen as a control group (group B). Maternal urine samples were collected and urinary CA 19-9 was measured in both groups. The correlations between maternal urinary CA 19-9 and APD (measured during pregnancy and the initial evaluation of the newborn) were assessed. CA 19-9 level in first urine of neonates was also evaluated. RESULTS: The mean ± SD of maternal urine CA 19-9 was higher in PUV group compared to the control group (131.6 ± 23.8 vs. 13 ± 2.7 U/mL). In addition, there was a significant correlation between maternal urinary CA 19-9 and the APD measured at the third trimester (p < 0.001) and the initial evaluation of fetus after birth according to SFU grading system (p < 0.001). However, no significant difference was found between gestational age and urinary CA 19-9 level (p = 0.34). There was also a significant correlation between the CA 19-9 level in first urine of neonates and CA 19-9 level of maternal urine (p < 0.001). CONCLUSIONS: This is the first time that maternal urinary CA 19-9 has been applied as a noninvasive and practical diagnostic marker in antenatal PUV.


Asunto(s)
Antígeno CA-19-9/orina , Enfermedades Fetales/diagnóstico , Hidronefrosis/diagnóstico , Diagnóstico Prenatal/métodos , Uretra/anomalías , Adulto , Biomarcadores/orina , Femenino , Humanos , Hidronefrosis/complicaciones , Valor Predictivo de las Pruebas , Embarazo , Pronóstico
6.
Rev. Hosp. Ital. B. Aires (2004) ; 39(1): 19-21, mar. 2019. ilus., graf.
Artículo en Español | LILACS | ID: biblio-1022121

RESUMEN

La policitemia primaria es producida por una mutación adquirida o heredada en las células progenitoras de los glóbulos rojos, mientras que la poliglobulia secundaria está relacionada con un aumento de la eritropoyetina sérica como respuesta a la hipoxia tisular o a la producción autónoma tumoral. Hace más de medio siglo que se conoce que la hidronefrosis puede actuar como una rara causa de eritrocitosis debido al aumento de producción de eritropoyetina por un riñón que censa una disminución de oxígeno, mecanismo también observado en la estenosis de la arteria renal y en los quistes renales. Se describe a continuación el caso de un paciente de 38 años con poliglobulia atendido en el Hospital Italiano de San Justo (Argentina), que presenta como hallazgo una hidronefrosis unilateral severa y cuya resolución quirúrgica a través de una nefrectomía revierte el cuadro hematológico de base. (AU)


Primary polycythemia is produced by an acquired or inherited mutation in progenitor cells of red blood cells, while secondary polyglobulia is related to an increase in serum erythropoietin in response to tissue hypoxia or autonomous tumor production. Since the middle of the twentieth century, the hydronephrosis is known to be a rare etiology of secondary polycythemia, with increased erythropoietin production caused by diminished oxygen sensing by the kidney, also seen in renal artery stenosis and kidney cysts. We describe a case of a 38 year old patient with polycythemia studied in the "Hospital Italiano de San Justo" (Argentina) that presented an incidental severe unilateral hydronephrosis, and nephrectomy was carried out as a final resolution of the hematological disorder. (AU)


Asunto(s)
Humanos , Animales , Masculino , Adulto , Persona de Mediana Edad , Policitemia/diagnóstico , Pielonefritis/diagnóstico , Infecciones Urinarias/complicaciones , Eritropoyetina/sangre , Hidronefrosis/diagnóstico , Nefrectomía/tendencias , Policitemia/complicaciones , Policitemia/etiología , Pielonefritis/sangre , Obstrucción de la Arteria Renal/patología , Dolor de la Región Lumbar , Hipoxia-Isquemia Encefálica/patología , Eritrocitos/fisiología , Enfermedades Renales Quísticas/patología , Disuria , Fiebre , Hidronefrosis/cirugía , Hidronefrosis/complicaciones , Anemia , Nefrectomía/métodos
7.
J Coll Physicians Surg Pak ; 29(2): 141-144, 2019 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-30700353

RESUMEN

OBJECTIVE: To determine colour doppler and serum biomarkers spectrum in children with congenital hydronephrosis. STUDY DESIGN: An observational study. PLACE AND DURATION OF STUDY: Department of Pediatric Nephrology, West China 2nd University Hospital of Sichuan University and Key Laboratory of Birth Defects and Related Disease of Women and Children (Sichuan University), China, from January to December 2017. METHODOLOGY: A total of 95 children with hydronephrosis were selected as case group. According to the degree of hydronephrosis, the patients were divided into mild hydronephrosis group, moderate hydronephrosis group, and severe hydronephrosis group. Forty children with normal renal function were selected as normal comparison group. Peak systolic velocity (Vmax), end diastolic velocity (Vmin), resistance index (RI), pulsatility index (PI), and serum cystatin C (CysC), ß2-microglobulin (ß2-MG), and 1-microglobulin (ß1-MG) of all subjects in both groups were recorded and compared. RESULTS: The Vmax, Vmax of main renal artery (MRA) and interlobar renal artery (IRA) in case group were lower than those of normal group (all p<0.001). RI of MRA and IRA in case group were higher than those of normal control group (both p<0.001). There were no significant differences in the PI of MRA and IRA between the two groups (p=0.700, and 0.250 respectively). The levels of serum CysC, ß2-MG and α1-MG in normal control group, mild hydronephrosis group, moderate hydronephrosis group, and severe hydronephrosis group were significantly different (all p<0.001), and the levels of serum CysC, ß2-MG, α1-MG were also different in children with different degrees of hydronephrosis. CONCLUSION: Combined detection of colour doppler and serum biomarkers CysC, ß2-MG and α1-MG in the diagnosis of renal damage in congenital hydronephrosis is feasible and reliable.


Asunto(s)
Hidronefrosis/congénito , Hidronefrosis/diagnóstico , Riñón/diagnóstico por imagen , Riñón/patología , Ultrasonografía Doppler en Color/métodos , Análisis de Varianza , Biomarcadores/sangre , Niño , Preescolar , China , Estudios de Cohortes , Cistatinas/sangre , Estudios de Factibilidad , Femenino , Estudios de Seguimiento , Hospitales Universitarios , Humanos , Lactante , Masculino , Medición de Riesgo , Sensibilidad y Especificidad , Índice de Severidad de la Enfermedad
8.
J Pediatr Surg ; 54(10): 2107-2111, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-30686521

RESUMEN

AIM: To assess the long-term urologic outcomes in follow-up of patients of sacrococcygeal teratoma (SCT) using urodynamic study (UDS) in addition to clinical and radiologic evaluation. METHODS: A prospective study of clinical, radiological and urodynamic evaluation in patients with SCT who underwent resection between January 2002-June 2015 and were followed up till January 2016 was conducted. RESULTS: Total 57 patients, 42 (73.7%) females and 15 (26.3%) males with 35 (62.4%) following treatment for benign and 22 (38.5%) for malignant disease were included. Twenty-eight of 57 (49.12%) had urological problems. Clinical complaints in 21 (36.8%) patients included stress urinary incontinence-14 (66.7%), enuresis-9 (42.9%), and poor stream or dribbling of urine-6 (28.6%). Eight of 51 patients (15.7%) had abnormal ultrasound findings, which included contracted, trabeculated thick walled bladder (3), bilateral hydronephrosis (3) and significant post void residue (PVR) (6). Seven of 57 underwent micturating cystourethrogram (MCU), 5 had an abnormal report[significant PVR (4), small trabeculated bladder (3), reflux (2) and large capacity bladder (1)]. Urodynamic study was done in 27 patients, 18/27 (66.7%) had abnormalities. Six patients without any clinical or ultrasonographic abnormalities had abnormal UDS. Total 28 (49.12%) had urological comorbidities. Three patients had overactive bladder, five dysfunctional voiding, one underactive bladder and one had giggle incontinence. Children were managed by behaviour therapy and pharmacotherapy. CONCLUSION: Urodynamic evaluation could detect abnormalities in patients who had no urinary complaints or abnormality on ultrasound. The abnormalities have a potential for progressive upper tract damage. Urodynamics should be an integral part of urological surveillance in patients operated for SCT. TYPE OF STUDY: Prognostic study. LEVEL OF EVIDENCE: Level II (Prospective cohort study).


Asunto(s)
Neoplasias de la Columna Vertebral/cirugía , Teratoma/cirugía , Urodinámica/fisiología , Adolescente , Terapia Conductista/métodos , Niño , Preescolar , Femenino , Estudios de Seguimiento , Humanos , Hidronefrosis/diagnóstico , Hidronefrosis/fisiopatología , Lactante , Masculino , Estudios Prospectivos , Región Sacrococcígea , Neoplasias de la Columna Vertebral/fisiopatología , Teratoma/fisiopatología , Ultrasonografía , Enfermedades de la Vejiga Urinaria/diagnóstico , Enfermedades de la Vejiga Urinaria/fisiopatología , Vejiga Urinaria Hiperactiva/diagnóstico , Vejiga Urinaria Hiperactiva/fisiopatología , Incontinencia Urinaria/diagnóstico , Incontinencia Urinaria/fisiopatología
9.
Scand J Rheumatol ; 48(3): 239-245, 2019 May.
Artículo en Inglés | MEDLINE | ID: mdl-30270709

RESUMEN

OBJECTIVES: Idiopathic retroperitoneal fibrosis (iRPF) is an uncommon disease with inflammatory features. Most patients have good prognosis but some may relapse or even progress to chronic renal failure. The aims of the study were to investigate the prognosis of a large cohort of iRPF patients and explore the risk factors for poor outcomes. METHODS: All patients with a definite diagnosis of iRPF in Peking University First Hospital between 1 January 2003 and 31 December 2016 were enrolled. Their clinical and laboratory data at diagnosis and subsequent follow-up visits were collected. The endpoint of follow-up was defined as disease relapse or the last follow-up. RESULTS: In total, 155 iRPF patients (45 females, 110 males) with a mean ± sd age of 55.1 ± 12 years at diagnosis were enrolled. The median duration of follow-up was 45.3 (0.1-169.2) months. During the whole follow-up, 27/153 (17.6%) patients encountered at least one relapse. Higher baseline erythrocyte sedimentation rate (ESR) was associated with a higher risk of relapse [p = 0.021, odds ratio (OR) = 1.016, 95% confidence interval (CI) 1.002-1.029]. A longer course of glucocorticoid treatment was associated with a lower risk of relapse (p = 0.030, OR = 0.948, 95% CI 0.904-0.995). Patients with a permanent presence of hydronephrosis were more likely to develop renal atrophy (33/154 vs 19/51, χ2 = 5.069, p = 0.024). CONCLUSIONS: Higher baseline ESR and a shorter course of glucocorticoid treatment seemed to be predictors of relapse in iRPF patients. Prompt release of hydronephrosis to prevent kidney atrophy is very important for preserving renal function and improving the prognosis.


Asunto(s)
Glucocorticoides/uso terapéutico , Hidronefrosis , Fallo Renal Crónico , Fibrosis Retroperitoneal , Adulto , Sedimentación Sanguínea , China/epidemiología , Femenino , Estudios de Seguimiento , Humanos , Hidronefrosis/diagnóstico , Hidronefrosis/etiología , Fallo Renal Crónico/diagnóstico , Fallo Renal Crónico/etiología , Fallo Renal Crónico/prevención & control , Pruebas de Función Renal/métodos , Masculino , Persona de Mediana Edad , Pronóstico , Recurrencia , Fibrosis Retroperitoneal/sangre , Fibrosis Retroperitoneal/diagnóstico , Fibrosis Retroperitoneal/tratamiento farmacológico , Fibrosis Retroperitoneal/epidemiología , Medición de Riesgo
10.
Int Urol Nephrol ; 51(2): 215-222, 2019 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-30483999

RESUMEN

OBJECTIVE: We want to study whether the degree of fibrosis in the mild and severe hydronephrosis is different, and whether the irrigation pressure will affect the fibrosis of the hydronephrosis. METHODS: Animal models of mild and severe hydronephrosis in the left kidney were established: 72 healthy C57BL/6 mice were randomly divided into nine groups (eight in each group). The N group was used as a control group, and 0 mmHg pressure perfusion was given. The M and S groups were used as mild and severe hydronephrosis groups, respectively. The mild and severe hydronephrosis groups were subdivided into eight subgroups, M0-M3 and S0-S3. Among them, groups 0, 1, 2, and 3 were perfused with 0 mmHg, 20 mmHg, 60 mmHg, and 100 mmHg, respectively. We investigated the effects of irrigation pressures on renal fibrosis in mild (group M) and heavy (group S) hydronephrosis by quantitative real-time polymerase chain reaction, Western blot analysis, Masson staining and immunohistochemistry staining in mouse models. RESULTS: Compared with group N, EMT and ECM deposits were significantly aggravated in both the mild and severe hydronephrosis groups, TGF-ß signaling pathway-related molecules significantly changed too. In terms of ECM deposition, S2 and S3 are significantly increased compared to S0.The EMT of M2 and M3 changed significantly compared with M0; the EMT of S1, S2 and S3 changed significantly compared with S0.The molecules related to TGF-ß signaling pathway also changed: M0 and S0 changed significantly compared with N; M1, M2 and M3 changed significantly compared with M0; compared with S0, S1, S2 and S3 changed significantly. CONCLUSION: Compared with mild hydronephrosis, renal fibrosis in severe hydronephrosis is more severe and its tolerance to perfusion pressure is lower. These changes may be related to the TGF-ß signalling pathway.


Asunto(s)
Cadherinas/metabolismo , Hidronefrosis , Enfermedades Renales , Riñón/patología , Proteínas Smad/metabolismo , Factor de Crecimiento Transformador beta/metabolismo , Animales , Modelos Animales de Enfermedad , Transición Epitelial-Mesenquimal , Fibrosis , Hidronefrosis/complicaciones , Hidronefrosis/diagnóstico , Enfermedades Renales/etiología , Enfermedades Renales/metabolismo , Enfermedades Renales/patología , Ratones , Ratones Endogámicos C57BL , Índice de Severidad de la Enfermedad , Transducción de Señal , Sistema Urinario
11.
J Urol ; 201(5): 1005-1011, 2019 05.
Artículo en Inglés | MEDLINE | ID: mdl-30395839

RESUMEN

PURPOSE: Reoperative pyeloplasty is commonly used in children with recurrent obstruction after pyeloplasty. We previously reported on reoperative robot-assisted laparoscopic repair for failed pyeloplasty in 16 children and concluded that short-term and intermediate outcomes were comparable to open reoperative repair. In this updated series we describe longer term outcomes from an extended study. MATERIALS AND METHODS: We retrospectively reviewed outcomes of consecutive children with prior failed primary pyeloplasty who underwent robot-assisted laparoscopic reoperative repair at a single institution from January 2008 to June 2018. RESULTS: Overall, 36 children 0.6 to 15.2 years old (median 3.7) underwent robot-assisted laparoscopic reoperative repair (pyeloplasty in 31, ureterocalicostomy in 5) at a median of 24.3 months (range 3.9 to 136.7) after primary repair. Median reoperative time was 285.0 minutes (range 207 to 556) and median length of stay was 1 day (1 to 8). Crossing vessels were present in 8 of 30 children (26.7%) with prior open repair and in 0 of 6 with prior minimally invasive repair. Clavien-Dindo grade 1 to 2 perioperative complications occurred in 4 children (11.1%) and grade 3 to 5 complications in 2 (5.6%). Median followup was 35.3 months (range 1.4 to 108.3), with 18 children (50.0%) being followed for more than 3 years. Postoperative ultrasound in 34 children revealed improvement in 31 (91.2%), stability in 2 (5.9%) and worsening hydronephrosis in 1 (2.9%). All 11 children undergoing preoperative and postoperative diuretic renography demonstrated stable or improved differential renal function. All children were symptom-free at last followup. CONCLUSIONS: To our knowledge, this is the largest series of robot-assisted laparoscopic reoperative repair for failed pyeloplasty in children. Our results indicate the feasibility, efficacy, safety and durability of this procedure.


Asunto(s)
Hidronefrosis/cirugía , Pelvis Renal/cirugía , Laparoscopía/métodos , Procedimientos Quirúrgicos Robotizados/métodos , Procedimientos Quirúrgicos Urológicos/efectos adversos , Adolescente , Niño , Preescolar , Estudios de Cohortes , Femenino , Humanos , Hidronefrosis/diagnóstico , Lactante , Pelvis Renal/fisiopatología , Masculino , Pronóstico , Reoperación/métodos , Estudios Retrospectivos , Insuficiencia del Tratamiento , Resultado del Tratamiento , Procedimientos Quirúrgicos Urológicos/métodos
12.
Bol. pediatr ; 59(247): 19-31, 2019. ilus, graf, tab
Artículo en Español | IBECS | ID: ibc-183164

RESUMEN

La urología pediátrica comprende una extensa serie de patologías de complejidad variable, que afectan al sistema urogenital, y que suponen aproximadamente el 50% de las intervenciones quirúrgicas en cirugía pediátrica. describiremos aquellas de mayor impacto y repercusión clínica desde el punto de vista quirúrgico, destacando las denominadas CaKUt o anomalías congénitas del riñón y del tracto urinario. estas últimas tienen su origen en la alteración de alguno de los procesos que conforman el desarrollo renal: a) Malformación del parénquima renal: hipoplasia, displasia, agenesia renal y riñón multiquístico (drMQ). b) anomalías relacionadas con la migración de los riñones: ectopia renal y anomalías de fusión. c) anomalías en el desarrollo del sistema colector: estenosis pieloureteral (epU), duplicidades ureterales, megauréter primario, uréter ectópico, ureterocele y válvulas de uretra posterior (VUp). El objetivo de este artículo es determinar en qué casos es necesaria la cirugía para resolver un problema urológico en el niño y cuándo es el mejor momento para realizar la intervención


Pediatric Urology comprises an extensive series of pathologies of variable complexity, which affect the urogenital system, and account for approximately 50% of surgical interventions in pediatric surgery. We will describe those ones of greater impact and clinical repercussion from the surgical point of view, highlighting the so-called CaKUt or congenital anomalies of the kidney and urinary tract. the latter have their origin in the alteration of some of the processes during the renal development: a) Malformation of the renal parenchyma: hypoplasia, dysplasia, renal agenesis and multicystic kidney (MCdK). b) abnormalities related to the migration of the kidneys: renal ectopia and fusion anomalies. c) abnormalities in the development of the collecting system: pyelo-ureteral stenosis, ureteral duplicities, primary megaureter, ectopic ureter, ureterocele and posterior uretral valves. R The objective of this article is to inform about the cases in which surgery is necessary to solve a urological problem in the child, and the best time to perform the intervention


Asunto(s)
Humanos , Niño , Enfermedades Renales/clasificación , Enfermedades Urológicas/clasificación , Enfermedades Renales/congénito , Enfermedades Urológicas/congénito , Índice de Severidad de la Enfermedad , Estrechez Uretral/diagnóstico , Estrechez Uretral/cirugía , Reflujo Vesicoureteral/diagnóstico , Reflujo Vesicoureteral/cirugía , Enfermedades Renales/diagnóstico , Enfermedades Renales/cirugía , Enfermedades Urológicas/diagnóstico , Enfermedades Urológicas/cirugía , Hidronefrosis/diagnóstico , Hidronefrosis/cirugía , Uréter/anomalías , Quistes/diagnóstico , Quistes/cirugía
13.
J Coll Physicians Surg Pak ; 28(12): 974-975, 2018 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-30501840

RESUMEN

The success rate of percutaneous nephrolithotomy (PNL) is about 90%, but overall complications of this surgery have been reported in up to 83% cases. The complications are graded using Clavien classification system from grade 1 to 5. Grade 1 needs simple treatments without surgical, endoscopic, and radiologic interventions like antiemetics, antipyretics, and analgesics. Grade 5 denotes death of the patient. Calyx neck stricture is grade 3b complication with an incidence of 0.1%. In this study, a case of hydrocalyx, which is very rare complication after PNL, is presented. To the best of the authors' knowledge, there is no hydrocalyx case reported after PNL in the literature.


Asunto(s)
Hidronefrosis/diagnóstico , Hidronefrosis/etiología , Cálculos Renales/diagnóstico , Cálculos Renales/etiología , Nefrolitotomía Percutánea/efectos adversos , Humanos , Hidronefrosis/cirugía , Cálculos Renales/cirugía , Masculino , Persona de Mediana Edad
14.
J Urol ; 200(6): 1346-1353, 2018 12.
Artículo en Inglés | MEDLINE | ID: mdl-30563653

RESUMEN

PURPOSE: We assessed the diagnostic value of anteroposterior diameter of the fetal renal pelvis in predicting postnatal surgery. MATERIALS AND METHODS: PubMed®, Embase® and Cochrane Library databases were searched for articles comparing patients who underwent surgery or conservative therapy with 15 mm anteroposterior diameter as a cutoff value. Data on sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic OR and area under the summary ROC curve were used to evaluate the diagnostic value of anteroposterior diameter of the fetal renal pelvis in predicting postnatal surgery. RESULTS: Five studies involving a total of 1,159 patients met the inclusion criteria. The summary sensitivity and specificity were 0.81 (95% CI 0.60 to 0.92) and 0.78 (95% CI 0.68 to 0.86), respectively. Positive and negative likelihood ratios of anteroposterior diameter were 3.73 (95% CI 2.75 to 5.06) and 0.24 (95% CI 0.11 to 0.52), respectively. Diagnostic OR of anteroposterior diameter for predicting postnatal surgery was 13.33 (95% CI 6.61 to 26.89) and area under the summary ROC curve was 0.85 (95% CI 0.82 to 0.88). Subgroup analysis suggested postnatal anteroposterior diameter was associated with higher diagnostic OR compared to prenatal anteroposterior diameter for predicting postnatal surgery (ratio between prenatal and postnatal anteroposterior diameter 0.27, 95% CI 0.09 to 0.86, p = 0.026). CONCLUSIONS: Using 15 mm anteroposterior diameter of the fetal renal pelvis as a cutoff showed moderate diagnostic value for predicting postnatal surgery.


Asunto(s)
Feto/patología , Hidronefrosis/diagnóstico , Pelvis Renal/patología , Femenino , Feto/diagnóstico por imagen , Humanos , Hidronefrosis/patología , Hidronefrosis/cirugía , Pelvis Renal/diagnóstico por imagen , Tamaño de los Órganos , Valor Predictivo de las Pruebas , Embarazo , Pronóstico , Curva ROC , Ultrasonografía Prenatal
15.
J Pak Med Assoc ; 68(11): 1699-1704, 2018 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-30410153

RESUMEN

Causes and outcomes of children diagnosed with hydronephrosis in resource-limited countries with a low utilization of antenatal ultrasonography remain unexplored. We performed a retrospective, crosssectional study of all paediatric patients diagnosed with hydronephrosis and managed at a tertiary care center in Karachi, Pakistan between 2005 and 2010. Data relating to demographics, clinical features, etiologies and treatment modalities were systematically collected. Of a total of 234 cases (74.4% male), 83 (35.5%) and 42 (17.9%) were neonates and infants respectively. Congenital urinary tract pathologies were noted in 192(72.2%) patients, of which only 96(50%) had undergone foetal ultrasonography and 77(40.1%) first presented after the age of 1 year. At a median follow-up of 4 years, 24(12.5%) of these patients had evidence of renal dysfunction. Worse urologic outcomes in this study were most likely attributable to delayed diagnosis of congenital urinary tract abnormalities.


Asunto(s)
Manejo de la Enfermedad , Hidronefrosis/diagnóstico , Centros de Atención Terciaria/estadística & datos numéricos , Urodinámica/fisiología , Anomalías Urogenitales/diagnóstico , Preescolar , Estudios Transversales , Femenino , Humanos , Hidronefrosis/epidemiología , Hidronefrosis/etiología , Incidencia , Lactante , Recién Nacido , Masculino , Pakistán/epidemiología , Estudios Retrospectivos , Ultrasonografía , Anomalías Urogenitales/complicaciones , Anomalías Urogenitales/epidemiología
18.
Urol Clin North Am ; 45(4): 641-657, 2018 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-30316318

RESUMEN

Urinary tract dilatation (UTD) is the most common congenital anomaly detected on prenatal ultrasonography (US), affecting 1% to 3% of all pregnancies. This article focuses on the prenatal detection of UTD and the postnatal evaluation and management based on the UTD grading system risk assessment. Prophylactic antibiotics and postnatal imaging are discussed. The recent management trend is for a more conservative approach to minimize unnecessary testing and exposures to the fetus and neonate while detecting those who may have clinically significant disorder. The renal bladder US remains a critical part of the evaluation and helps guide further investigations.


Asunto(s)
Hidronefrosis/diagnóstico , Ultrasonografía Prenatal , Sistema Urinario/diagnóstico por imagen , Femenino , Humanos , Hidronefrosis/embriología , Riñón/diagnóstico por imagen , Riñón/embriología , Embarazo , Vejiga Urinaria/diagnóstico por imagen , Vejiga Urinaria/embriología , Sistema Urinario/embriología
19.
BMJ Case Rep ; 20182018 Oct 21.
Artículo en Inglés | MEDLINE | ID: mdl-30344154

RESUMEN

Giant hydronephrosis (GH) is a rare clinical entity with about 600 cases and defined as the adult renal pelvis containing greater than 1 L of fluid, or at least 1.6% of the body weight or kidney occupying the hemiabdomen. The pelvic-ureteric junction (PUJ) obstruction is the most frequent cause of GH. We thus report a case of massive abdominal distension due to GH secondary to PUJ obstruction who presented with acute duodenal obstruction due to extrinsic compression and was managed with percutaneous nephrostomy followed by open nephrectomy.


Asunto(s)
Obstrucción Duodenal/diagnóstico , Hidronefrosis/diagnóstico , Abdomen Agudo/etiología , Adolescente , Obstrucción Duodenal/complicaciones , Obstrucción Duodenal/diagnóstico por imagen , Obstrucción Duodenal/cirugía , Humanos , Hidronefrosis/complicaciones , Hidronefrosis/diagnóstico por imagen , Hidronefrosis/cirugía , Masculino , Nefrectomía , Nefrostomía Percutánea , Tomografía Computarizada por Rayos X
20.
J Pak Med Assoc ; 68(9): 1400-1402, 2018 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-30317275

RESUMEN

Lipomas are benign, usually asymptomatic, tumours and pelvic lipomas are extremely rare. We describe the case of a giant pelvic lipoma causing obstructive uropathy to a 66-year-old morbidly obese female treated in the 4th Surgical Department of the Medical School of Aristotle University of Thessaloniki in General Hospital "G. Papanikolaou" in March 2016. The patient presented with a history of nocturia and frequent daytime urination for 1 year. Her medical history included diffuse lipomatosis. Computer tomography revealed a giant pelvic mass which lead to left side hydronephrosis, hydrouterer and a pear-shaped bladder, with the differential diagnosis including pelvic lipoma or liposarcoma. An ultrasound guided biopsy excluded the diagnosis of liposarcoma. The patient was submitted to laparoscopic resection of the pelvic lipoma, with complete remission of urinary symptoms. The key-point is to consider the possibility that the pelvic mass is a well-differentiated liposarcoma and to manage it adequately and thus, we recommend intact excision of the mass through a wound protector, and extreme caution to avoid any rupture of the capsule.


Asunto(s)
Disección/métodos , Hidronefrosis , Lipoma , Obesidad Mórbida , Anciano , Diagnóstico Diferencial , Femenino , Humanos , Hidronefrosis/diagnóstico , Hidronefrosis/etiología , Hidronefrosis/fisiopatología , Biopsia Guiada por Imagen/métodos , Lipoma/complicaciones , Lipoma/diagnóstico , Lipoma/fisiopatología , Lipoma/cirugía , Liposarcoma/diagnóstico , Obesidad Mórbida/complicaciones , Obesidad Mórbida/diagnóstico , Neoplasias Pélvicas/diagnóstico , Pelvis/diagnóstico por imagen , Resultado del Tratamiento , Ultrasonografía Intervencional/métodos
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