Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 8 de 8
Filtrar
Mais filtros










Intervalo de ano de publicação
1.
Urol Ann ; 10(3): 287-290, 2018 Jul-Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30089987

RESUMO

Purpose: The aim is to assess the outcomes of different approaches for the management of renal stones associated with horseshoe kidneys (HSKs) in our institution over a 12-year period. Methods: A retrospective review of 144 patients with HSKs who presented from 2000 to 2012 was performed. Twenty-eight patients (19.4%) were found to have renal stones. Demographic data were collected; the method of treatment and the outcomes of stone management were reviewed. We excluded patients with non-functioning moieties and associated genitourinary anomalies, and those with incomplete data. Results: We included 25 patients, of which 16 males (64%) and 9 females (36%), with a mean age of 37 years. Mean serum creatinine level was 66 mmol/L. Eleven patients with a stone size <8 mm were treated expectantly with medical treatment, with only one patient requiring endoscopic intervention. Six patients (24%) with a stone size between 1 cm and ≤2 cm were treated with extracorporeal shock wave lithotripsy (ESWL) with the placement of double J stents, and seven patients (28%) with a stone size of >2 cm were treated with percutaneous nephrolithotomy. One patient with a 10 mm stone was treated using flexible ureteroscopy. No significant perioperative complications were encountered. Conclusions: Indications, methods of treatment, and outcomes of management of stones associated with HSKs were comparable to those for stones associated with normal kidneys. Tailored approach based on stone size is highly recommended. ESWL accompanied with ureteric stenting is a promising strategy for the management of stones associated with HSKs in selected patients requiring intervention.

2.
Int. braz. j. urol ; 44(4): 812-818, July-Aug. 2018. tab, graf
Artigo em Inglês | LILACS-Express | ID: biblio-954081

RESUMO

ABSTRACT Purpose: To assess the need for postnatal evaluation and the medium term outcome in patients with isolated unilateral low grade prenatally detected hydronephrosis. Materials and Methods: We prospectively selected 424 patients (690 kidney units) with a prenatal diagnosis of urinary tract dilatation between 2010 and 2013. We included only those patients with isolated unilateral low-grade hydronephrosis who underwent at least 2 postnatal ultrasound examinations. The Society for Fetal Urology (SFU) grading system was utilized for assessment of the hydronephrosis. We excluded patients with bilateral dilation or other urological abnormalities. The fate of hydronephrosis including resolution, stability or worsening was documented. Results: A total of 66 infants (44 boys and 22 girls) with antenatally diagnosed unilateral urinary tract dilation (23 right and 43 left) were identified. Ultrasounds showed SFU grade 1 hydronephrosis in 32 patients (48%) and SFU grade 2 hydronephrosis in 34 (52%). After a mean follow-up period of 32 months (range 12 to 60), 37 patients (56%) had complete resolution of hydronephrosis while the remaining 29 were stable (44%). None of our patients developed UTIs during follow-up and none required surgical intervention. Conclusions: Prenatally detected, isolated unilateral low-grade hydronephrosis usually have a favorable prognosis. All cases in our cohort showed either stability or resolution of hydronephrosis without any harmful consequences. Based on our findings on medium-term in this category of patients, long-term follow-up is not warranted.

3.
Int Braz J Urol ; 44(4): 812-818, 2018 Jul-Aug.
Artigo em Inglês | MEDLINE | ID: mdl-29757579

RESUMO

PURPOSE: To assess the need for postnatal evaluation and the medium term outcome in patients with isolated unilateral low grade prenatally detected hydronephrosis. MATERIALS AND METHODS: We prospectively selected 424 patients (690 kidney units) with a prenatal diagnosis of urinary tract dilatation between 2010 and 2013. We included only those patients with isolated unilateral low-grade hydronephrosis who underwent at least 2 postnatal ultrasound examinations. The Society for Fetal Urology (SFU) grading system was utilized for assessment of the hydronephrosis. We excluded patients with bilateral dilation or other urological abnormalities. The fate of hydronephrosis including resolution, stability or worsening was documented. RESULTS: A total of 66 infants (44 boys and 22 girls) with antenatally diagnosed unilateral urinary tract dilation (23 right and 43 left) were identified. Ultrasounds showed SFU grade 1 hydronephrosis in 32 patients (48%) and SFU grade 2 hydronephrosis in 34 (52%). After a mean follow-up period of 32 months (range 12 to 60), 37 patients (56%) had complete resolution of hydronephrosis while the remaining 29 were stable (44%). None of our patients developed UTIs during follow-up and none required surgical intervention. CONCLUSIONS: Prenatally detected, isolated unilateral low-grade hydronephrosis usually have a favorable prognosis. All cases in our cohort showed either stability or resolution of hydronephrosis without any harmful consequences. Based on our findings on medium-term in this category of patients, long-term follow-up is not warranted.


Assuntos
Assistência ao Convalescente/normas , Doenças Fetais/diagnóstico por imagem , Hidronefrose/diagnóstico por imagem , Hidronefrose/embriologia , Ultrassonografia Pré-Natal/normas , Feminino , Doenças Fetais/patologia , Idade Gestacional , Humanos , Hidronefrose/patologia , Estimativa de Kaplan-Meier , Masculino , Estudos Prospectivos , Medição de Risco , Índice de Gravidade de Doença , Fatores Sexuais , Fatores de Tempo
4.
Can Urol Assoc J ; 12(3): E137-E141, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29283090

RESUMO

INTRODUCTION: Fetal hydronephrosis (HN) occurs in approximately 5% of pregnancies and its prognosis depends mainly on the grade of the dilation. We attempted to determine the fate of isolated, unilateral, high-grade HN in children with antenatal diagnosis, emphasizing the risk factors for progression. METHODS: We retrospectively evaluated 424 children (690 kidney units) with antenatal HN in the period between 2010 and 2014. We included only those patients with isolated high-grade HN (Society for Fetal Urology [SFU] Grade 3 or 4). Patients with bilateral HN or unilateral HN associated with dilated ureter or reflux and patients with missed followup were excluded. The prognosis of HN (whether improved, stabilized, or progressed) and the need for surgical intervention in this subset of patients was evaluated. RESULTS: A total of 44 children (34 boys and 10 girls) were identified. Ultrasounds showed SFU Grade 3 HN in 24 (54%) and SFU Grade 4 HN in 20 (46%). After a mean followup of three years (range 1-5), 10 children (23%) needed surgical intervention; four Grade 3 HN (16%) and six Grade 4 HN (30%). The majority of children with differential renal function (DRF) ≥40% (69.5%) were stable or improved. Five girls (50%) and five boys (17%) progressed and required surgical intervention. No patient with a renal pelvis anteroposterior diameter (APD) <1.5 cm needed surgical intervention. CONCLUSIONS: Infants with isolated, unilateral, high-grade HN might be managed conservatively. Male gender, DRF ≥40%, SFU Grade 3 HN, and APD <1.5 cm were favourable prognostic factors.

5.
Urology ; 98: 144-148, 2016 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-27421781

RESUMO

OBJECTIVE: To assess the need for postnatal evaluation and the long-term consequences in patients with prenatal diagnosis of unilateral renal agenesis (URA). MATERIALS AND METHODS: A retrospective review of the records of all patients with prenatal diagnosis of URA between 2004 and 2013 was done. We included all patients who underwent postnatal evaluation with renal bladder ultrasound (RBUS), dimercaptosuccinic acid scan, and a voiding cystourethrogram. Long-term follow-up included physical examination and assessment of contralateral renal growth. RESULTS: A total of 46 children (24 boys and 22 girls) with URA were identified. Ultrasounds showed associated hydronephrosis in 9 patients (19%). Dimercaptosuccinic acid scans confirmed the diagnosis of URA in all patients and showed renal scars in 2 solitary kidneys (4%). Vesicoureteral reflux was diagnosed in 4 patients (12%); all were of low grade and managed conservatively. After a mean follow up of 4 years, RBUS showed compensatory hypertrophy in 31 patients (67%), 3 patients (6%) developed chronic kidney disease, and 2 patients (4%) developed hypertension. CONCLUSION: Prenatally detected cases of URA should be promptly evaluated. RBUS is found to be sufficient for diagnosis. However, additional imaging may be indicated for confirming the diagnosis and detection of other associated urinary anomalies. Serial assessment of the contralateral solitary kidney growth and serum creatinine measurement will be helpful to assess kidney function on the long term.


Assuntos
Rim/diagnóstico por imagem , Cuidado Pós-Natal , Diagnóstico Pré-Natal/métodos , Rim Único/diagnóstico , Feminino , Seguimentos , Humanos , Recém-Nascido , Rim/anormalidades , Masculino , Gravidez , Estudos Retrospectivos , Fatores de Tempo
6.
Int J Biochem Cell Biol ; 74: 12-7, 2016 May.
Artigo em Inglês | MEDLINE | ID: mdl-26905436

RESUMO

Hemorrhagic cystitis is one of the devastating complications seen after receiving cyclophosphamide chemotherapy. Oleuropein is the most important phenolic compound of olive leaves that mediates most of its beneficial pharmacological properties. Herein, we investigated the possible uroprotective effect of oleuropein against cyclophosphamide induced hemorrhagic cystitis in a rat model. For this purpose, we measured bladder nitric oxide, reduced glutathione, catalase, tumor necrosis factor-alpha and vascular endothelial growth factor levels in addition to the bladder gene expression of intercellular adhesion molecule-1 after induction of hemorrhagic cystitis in the presence or absence of oleuropein. Histopathological examination of bladder tissues was also performed. After cyclophosphamide injection, we demonstrated a significant decrease in bladder reduced glutathione (39%) and catalase (55.4%) levels and a significant increase of nitric oxide (5.6 folds), tumor necrosis factor-alpha (3.3 folds), vascular endothelial growth factor (2 folds) and intercellular adhesion molecule-1 (8 folds) bladder contents when compared to those in normal control rats. Administration of oleuropein induced a marked elevation in bladder reduced glutathione (37.8%), catalase (100.4%) with a prominent reduction of bladder nitric oxide (40%), tumor necrosis factor-alpha (35.9%) and vascular endothelial growth factor (56.2%) levels along with downregulation of intercellular adhesion molecule-1 bladder expression (73.1%) in comparison to cyclophosphamide treated rats levels. Our data demonstrated that oleuropein counteracts the harmful effects of cyclophosphamide on the bladder through its antioxidant and anti-inflammatory activities. Oleuropein exerts a definite uroprotective effect against cyclophosphamide induced hemorrhagic cystitis in rats.


Assuntos
Ciclofosfamida , Cistite/induzido quimicamente , Cistite/tratamento farmacológico , Hemorragia/complicações , Iridoides/uso terapêutico , Animais , Anti-Inflamatórios/farmacologia , Anti-Inflamatórios/uso terapêutico , Antioxidantes/farmacologia , Antioxidantes/uso terapêutico , Modelos Animais de Doenças , Regulação da Expressão Gênica/efeitos dos fármacos , Hemorragia/induzido quimicamente , Humanos , Molécula 1 de Adesão Intercelular/genética , Molécula 1 de Adesão Intercelular/metabolismo , Iridoides/farmacologia , Masculino , Ratos , Ratos Sprague-Dawley , Reação em Cadeia da Polimerase em Tempo Real , Bexiga Urinária/patologia
7.
Urol Ann ; 5(4): 296-8, 2013 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-24311916

RESUMO

Association between Prune belly syndrome (PBS) and urethral hypoplasia is an unusual condition. It is usually fatal unless there is a communication between the fetal bladder and the amniotic sac. We report a case of PBS with urethral hypoplasia and congenital vesico-cutaneous fistula in a male neonate. Patient underwent cutaneous vesicostomy and was discharged for close follow up of his renal function and for future reconstruction.

8.
Urology ; 82(6): 1405-9, 2013 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-24139350

RESUMO

OBJECTIVE: To evaluate the prognostic role of antenatal diagnosis of posterior urethral valves (PUVs) on ultimate renal function. METHODS: Between 1990 and 2010, 315 patients with PUVs were diagnosed and treated at 2 separate tertiary centers. Primary valve ablation was performed in all patients except 18, who underwent initial vesicostomy. Patients were divided into two groups: group 1 included 144 patients who were diagnosed antenatally, and group 2 included 171 patients with a postnatal diagnosis. Long-term functional and radiologic outcomes were assessed. RESULTS: Follow-up was a median 5.5 years (range, 2-15 years). Mean age at ablation was 2.5 years (range, 1 day-15 years). Chronic kidney disease developed at the end of follow-up in 96 patients (30%): 27 (19%) in group 1 and 69 (40%) in group 2 (P <.05). The mean nadir serum creatinine was 0.6 and 0.8 mg/dL in groups 1 and 2, respectively, and the mean final serum creatinine was 0.9 and 1.7 mg/dL, respectively (P <.05). Persistent upper tract dilatation was noted in 43% of group 1 patients and in 69% of group 2 patients (P <.05). CONCLUSION: The potential for recovering renal function is believed to be significant in patients in whom early detection of PUVs and, hence, early intervention was performed. Antenatal screening and detection of these patients might play a significant role in protecting the upper tract and reducing the incidence of chronic kidney disease.


Assuntos
Insuficiência Renal Crônica/diagnóstico , Uretra/anormalidades , Adolescente , Anti-Infecciosos/uso terapêutico , Criança , Pré-Escolar , Creatinina/sangue , Feminino , Humanos , Incidência , Lactente , Masculino , Gravidez , Diagnóstico Pré-Natal , Prognóstico , Insuficiência Renal Crônica/epidemiologia , Combinação Trimetoprima e Sulfametoxazol/uso terapêutico , Refluxo Vesicoureteral/tratamento farmacológico
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA