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1.
J Coll Physicians Surg Pak ; 31(10): 1202-1206, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34601842

RESUMO

OBJECTIVE: To evaluate the results of retrograde intrarenal surgery (RIRS) with flexible ureteroscope (f-URS), using ureteral access sheath and without the sheath. STUDY DESIGN: Descriptive study. Place and Duration of the Study: Kesan State Hospital, Edirne, Turkey, between February 2019 and May 2020. METHODOLOGY: Patients treated with RIRS for renal and proximal ureteral stone were evaluated. Two groups were formed that used ureteral access sheath or not. Operation and fluoroscopy times, postoperative complications and stone-free rates were compared. RESULTS: Group 1 consisted of 51 patients were operated with, using ureteral access sheath; and Group 2 having 62 patients, were operated without using ureteral access sheath. The mean volume of the stones was 1135 mm3 (73-7491 mm3) in the group without access sheath and 1273 mm3 (251-3635 mm3) in the group with access sheath. The mean operation time was 55 minutes (20-115 min) in the group without access sheath, and 70 minutes (30-125 min) in the group with access sheath. Postoperative febrile UTI was found in 5 (8%) of the patients without access sheath, and in 4 (8%) of the patients with access sheath (p=0.733). The stone-free rate of the patients with radiological controls was 58 (93%) in the group without access sheath and 46 (90%) in the group with access sheath (p=0.306). Fluoroscopy timings were 2.7 seconds (0-8 sec) in the group without access sheath and 8.4 seconds (2-20 sec) in the group with access sheath (p=0.001). CONCLUSION: UAS usage has no marked impact on SFR, complication rate and operation time. RIRS can be performed safely and effectively without using UAS. Key Words: Flexible ureteroscope, ITO score, Ureteral access sheath, Intrarenal stones.


Assuntos
Cálculos Renais , Ureter , Cálculos Ureterais , Humanos , Rim , Cálculos Renais/cirurgia , Masculino , Estudos Retrospectivos , Cálculos Ureterais/cirurgia
2.
J Int Med Res ; 49(10): 3000605211050799, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34637357

RESUMO

Malakoplakia, a rare acquired granulomatous disease, affects many systems, including the urogenital tract. The literature describes malakoplakia of different viscera, and satisfactory results have been obtained after treatment. We reported a 48-year-old patient with diabetes who received multiple treatments in our hospital for bladder malakoplakia near the ureteral orifice. Despite aggressive treatment, the patient had recurrent bladder malakoplakia and even developed right ureteral orifice stenosis, which resulted in urinary obstruction and hydronephrosis. We believe that malakoplakia in the bladder near ureteral orifice should receive more attention. Satisfactory results may not be obtained through antibiotic treatment alone, and early antibiotic therapy combined with full surgical excision may be a better choice.


Assuntos
Cistite , Hidronefrose , Malacoplasia , Ureter , Humanos , Malacoplasia/diagnóstico , Pessoa de Meia-Idade
3.
Pan Afr Med J ; 39: 213, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34630825

RESUMO

Double-J (DJ) stents have been widely utilized in urological practice. They are commonly used to relieve ureteral obstruction. Serious complications may occur when stents are left in place for long periods of time. In the present paper, we report a patient with a neglected DJ stent that had been inserted for five years after uterus-tumor surgery and led to a bladder stone. We report a case of a female who presented a bladder stone with a right DJ stent in the pelvic cavity. The stone was evident in radiological examination in an incidental finding. The treatment was transurethral cystolithotripsy. This case reminds us of the necessity of providing enough information and appropriate knowledge pertaining to the insertion of a ureteral stent. Transurethral cystolithotripsy is one of the treatment methods and can be suggested as a definitive method in consideration that it is a clinically effective and safe intervention.


Assuntos
Litotripsia/métodos , Stents/efeitos adversos , Cálculos da Bexiga Urinária/etiologia , Feminino , Humanos , Pessoa de Meia-Idade , Ureter/patologia , Obstrução Ureteral/cirurgia , Cálculos da Bexiga Urinária/terapia
4.
Harefuah ; 160(9): 556-558, 2021 Sep.
Artigo em Hebraico | MEDLINE | ID: mdl-34482665

RESUMO

INTRODUCTION: In this special issue dedicated to surgical urology we discuss several aspects of our profession with 8 original articles and 4 reviews. Calculi in the urinary tract are a major topic in day-to-day practice. A comparison between stone fragmentation and dusting using laser technology is discussed. Robotic surgery is increasingly used in urology, mainly for radical prostatectomies and renal pathologies. In this issue, factors that may predict urinary continence following robot-assisted radical prostatectomy are discussed, as well as clinical outcomes following robot-assisted partial nephrectomy for renal tumors ≤ 7 cm in diameter and robot-assisted repair of ureteral-pelvic junction stenosis in adults. Transitional cell carcinoma (TCC) is mainly diagnosed in the urinary bladder and less frequently in the kidney or the ureter. Can we select the best candidate for neo-adjuvant chemotherapy before cystectomy for invasive bladder TCC? What might be the best way for diagnosis and treatment for patients of different risk groups with upper-tract TCC? Those issues are discussed in detail. The place and timing for multiparametric-magnetic resonance imaging (mp-MRI) of the prostate for diagnosis of malignancy is debated and focal therapy for such a malignancy of the gland is reviewed. Vesicovaginal fistulas following obstetric surgery are a known complication and repair requires surgical skill; one Israeli centre's experience is presented. The possibility of predicting painful bladder outcome is discussed and the usage of botulinum toxin in urology is reviewed. Finally, issues regarding gender and urology are discussed.


Assuntos
Carcinoma de Células de Transição , Procedimentos Cirúrgicos Robóticos , Ureter , Neoplasias da Bexiga Urinária , Feminino , Humanos , Masculino , Nefrectomia , Procedimentos Cirúrgicos Robóticos/efeitos adversos , Neoplasias da Bexiga Urinária/cirurgia
5.
Hinyokika Kiyo ; 67(8): 381-384, 2021 Aug.
Artigo em Japonês | MEDLINE | ID: mdl-34472320

RESUMO

Ectopic ureteroceles is sometimes noted in children as an incidental finding in antenatal ultrasonography results or because of symptoms related to a urinary tract infection. In contrast, it is rarely noted in adults, with only 18 cases in Japan presented in literature. We report here a 30-year-old adult male with an ectopic ureterocele discovered due to urination difficulty. The patient noted a poor urine stream and macroscopic hematuria after exercise, and over time needed manual compression on the lower abdomen for urination. Computed tomography results revealed a 35 mm right ureterocele containing a 7.0 mm stone. Cystoscopy showed the ureterocele protruding into the prostatic urethra, which was thought to be the cause of urination difficulty. Transurethral resection of the ureterocele and lithotripsy for the stone were performed. The right ureteral orifice was not visualized during the operation. Resection was performed from the bladder neck side so that the ureterocele wall did not interfere with urination and the calculus was crushed with a pneumatic lithotripter (LithoClast®). Urination difficulty was improved following the procedures. Urinary cystourethrography performed two weeks postoperatively confirmed no vesicoureteral reflux. No symptoms of dysuria or fever were noted at a follow-up visit two months after the operation.


Assuntos
Ureter , Ureterocele , Refluxo Vesicoureteral , Adulto , Criança , Disuria/etiologia , Feminino , Humanos , Masculino , Gravidez , Ureterocele/complicações , Ureterocele/diagnóstico por imagem , Ureterocele/cirurgia , Micção
6.
Arch Esp Urol ; 74(7): 676-680, 2021 Sep.
Artigo em Espanhol | MEDLINE | ID: mdl-34472436

RESUMO

INTRODUCTION AND OBJECTIVES:  The ureteral catheter is used to provide adequate drainage of the upper urinary tract. They have been used to prevent or relieve ureteral obstruction due to multiple causes. The literature mentions the standard placement of double J catheter guided by fluoroscopy, reporting the use of ultrasound exclusively in cases of pregnant patients in order to avoid ionizing radiation. Based on the aforementioned, the primary objective was to evaluate the placement of double J catheter guided by ultrasound, as an alter native technique to the use of the fluoroscope in ureteral obstructions, as secondary objectives the intensity of the pain and the complications of the procedure. MATERIALS AND METHODS: An observational, descriptive and prospective study was carried out with 41patients who attended the lithiasis consultation. RESULTS: A total of 41 patients who under went double J catheter guided by ultrasound were evaluated, achieving it successfully in 35 of the cases, resulting in bad position in 2 patients and being impossible to insert it in 4. Averageage was 41 years, size of the lithium 10.41mm. The complications presented were 17% with the use of the scale of Clavien modified these complications were represented as follows: 4.9% grade I back pain, 7.2% grade II lower urinary tract symptoms, lower tract infections, and 4.9% grade IIIa malposition. CONCLUSIONS: The placement of ureteral catheters guided by ultrasound, represent a useful tool, safe, with manageable complications, taking place in times adjusted to the procedure.


Assuntos
Ureter , Obstrução Ureteral , Cateteres , Humanos , Estudos Prospectivos , Stents , Ultrassonografia , Ultrassonografia de Intervenção , Obstrução Ureteral/diagnóstico por imagem
7.
Urologiia ; (4): 93-96, 2021 Sep.
Artigo em Russo | MEDLINE | ID: mdl-34486281

RESUMO

INTRODUCTION: Late diagnosis of renal tuberculosis leads to complications that cannot be eliminated by treatment. CLINICAL CASE: A clinical observation of patient Ch., born in 1976, who was admitted to TB Research Institute of Ministry of Health of Russia on 17.02.2020. A diagnosis was cavernous renal tuberculosis. Tuberculosis of the ureter. MBT (-). Right ureteral stricture (obliteration), complicated by ipsilateral hydronephrosis. Right nephrostomy tube (2018). Clinical cure of disseminated pulmonary tuberculosis. He underwent planned laparoscopic bowel substitution of the right ureter on 10.03.2020. In the postoperative period, pyelonephritis developed, which was resolved by drug therapy. CONCLUSION: 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.


Assuntos
Hidronefrose , Tuberculose Renal , Tuberculose , Ureter , Obstrução Ureteral , Humanos , Hidronefrose/etiologia , Hidronefrose/cirurgia , Masculino , Pessoa de Meia-Idade , Tuberculose Renal/complicações , Tuberculose Renal/diagnóstico , Tuberculose Renal/tratamento farmacológico , Obstrução Ureteral/cirurgia
8.
J Med Case Rep ; 15(1): 475, 2021 Sep 26.
Artigo em Inglês | MEDLINE | ID: mdl-34563239

RESUMO

BACKGROUND: Fibroepithelial polyps located in the ureter constitute 2-6% of all benign tumors in the urinary system. Distinguishing these lesions from transitional cell carcinoma is essential to avoid unnecessary nephroureterectomy. CASE PRESENTATION: A 59-year-old asymptomatic caucasian male patient was enrolled in follow-up for Ta low-grade transitional cell bladder cancer 4 years ago in our clinic. A suspicious, solid, contrast-enhancing mass 15 × 9 mm in diameter in the anteromedial mid-section of the left kidney, which was causing minimal washout and largely located in the parenchyma, was reported as renal cell carcinoma on computed tomography during routine controls. In the excretory phase, soft-tissue densities of approximately 30 mm in length, which were located in the distal part of the left ureter at a distance of 40 mm from the ureterovesical junction, extending towards the lumen suggested a urethral carcinoma. Urothelial lesion was reported as fibroepithelial polyp after histopathological examination. Partial nephrectomy for the mass, which was reported as renal cell carcinoma in the left kidney, was performed in the first postoperative month. Histopathological examination revealed Fuhrman grade 1 papillary type renal cell carcinoma. No recurrence was observed in the first year after treatment. CONCLUSIONS: Although our patient had a bladder transitional cell carcinoma and a suspicious renal cell carcinoma mass of 15 mm in the ipsilateral kidney, the patient was safeguarded from unnecessary nephroureterectomy early on by cross-sectional and endoscopic imaging of the ureter.


Assuntos
Carcinoma de Células Renais , Carcinoma de Células de Transição , Neoplasias Renais , Pólipos , Ureter , Neoplasias da Bexiga Urinária , Carcinoma de Células Renais/diagnóstico por imagem , Carcinoma de Células Renais/patologia , Carcinoma de Células Renais/cirurgia , Carcinoma de Células de Transição/diagnóstico por imagem , Carcinoma de Células de Transição/patologia , Carcinoma de Células de Transição/cirurgia , Estudos Transversais , Humanos , Neoplasias Renais/diagnóstico por imagem , Neoplasias Renais/patologia , Neoplasias Renais/cirurgia , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/patologia , Pólipos/diagnóstico por imagem , Pólipos/cirurgia , Ureter/diagnóstico por imagem , Ureter/patologia , Ureter/cirurgia , Neoplasias da Bexiga Urinária/diagnóstico por imagem , Neoplasias da Bexiga Urinária/patologia , Neoplasias da Bexiga Urinária/cirurgia
9.
Medicina (Kaunas) ; 57(9)2021 Sep 06.
Artigo em Inglês | MEDLINE | ID: mdl-34577862

RESUMO

The complications of percutaneous nephrolithotomy (PNL) include hemorrhage, damage to adjuvant organs, and other medical issues, although intracardiac migration of ureteral double-J stent has never been found during PNL and delaying the diagnosis might cause mortality. We report the case of a 60-year-old male who was admitted to receive one-stage PNL for right renal stones. During operation, an unexpected atrial fibrillation with a drop in blood pressure was suddenly encountered and the chest X-ray subsequently showed that the ureteral double-J had penetrated deep into the heart. Emergent endovascular intervention was performed to remove the stent and the patient was uneventfully discharged 2 days later.


Assuntos
Cálculos Renais , Nefrolitotomia Percutânea , Nefrostomia Percutânea , Ureter , Humanos , Cálculos Renais/diagnóstico por imagem , Cálculos Renais/cirurgia , Masculino , Pessoa de Meia-Idade , Nefrolitotomia Percutânea/efeitos adversos , Stents/efeitos adversos , Ureter/diagnóstico por imagem , Ureter/cirurgia
10.
Am J Case Rep ; 22: e930911, 2021 Sep 07.
Artigo em Inglês | MEDLINE | ID: mdl-34489391

RESUMO

BACKGROUND Ureteroinguinal hernias are exceptionally rare and are seldom diagnosed in the preoperative setting. There are 2 classifications of this type of hernia: paraperitoneal and extraperitoneal. CASE REPORT We report a case of a 67-year-old man who presented with urinary symptoms and a reducible right inguinal hernia. A computed tomography (CT) scan of the abdomen and pelvis suggested an ureteroinguinal hernia. Further diagnostics and treatment via cystoscopy, retrograde pyelogram, and right ureteral stent placement were performed, confirming the diagnosis and providing relief of the obstructive uropathy. The patient underwent an attempted elective transabdominal preperitoneal repair that was converted to an open Lichtenstein repair. Intraoperatively, an extraperitoneal ureteroinguinal hernia was identified. The patient did well postoperatively, and the stent was removed 1 month later. CONCLUSIONS Only 20% of the ureteroinguinal hernias described in the literature are extraperitoneal. In our case presentation, we demonstrated successful identification and treatment of an extraperitoneal ureteroinguinal hernia. The diagnosis was made using a combination of the clinical presentation, CT of the abdomen and pelvis, and cystoscopy with retrograde pyelogram. The extraperitoneal classification was an intraoperative diagnosis. The treatment consisted of a temporizing ureter stent and definitive management with an open Lichtenstein repair. We recommend obtaining a CT scan when a patient presents with a combination of urinary symptoms and an inguinal hernia because this process was invaluable in our preoperative diagnosis. Stent placement at the time of diagnosis permitted an elective repair and aided in the identification of the ureter during the hernia repair.


Assuntos
Hérnia Inguinal , Ureter , Idoso , Hérnia Inguinal/diagnóstico por imagem , Hérnia Inguinal/cirurgia , Herniorrafia , Humanos , Masculino , Cintilografia , Tomografia Computadorizada por Raios X , Ureter/diagnóstico por imagem , Ureter/cirurgia
11.
Comput Methods Programs Biomed ; 210: 106378, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34507083

RESUMO

BACKGROUND AND OBJECTIVE: The bladder receives the urine from the kidney and ureter. The series of peristaltic waves facilitate urine transport to the bladder. The peristaltic flow in the ureter is associated with fluid trapping and material reflux, which may cause an increase in bladder pressure. It is difficult to visualize the complex peristalsis phenomenon, in the ureter using image and radiography experiments. A numerical simulation will help in the understanding of urine bolus formation and its effect on the ureter wall. METHODS: A three-dimensional computational fluid dynamic analysis is carried out to understand the flow physics associated with bolus formation and the effect of reflux on the ureter. ANSYS-CFX, a commercially available computational dynamics package is used to simulate the peristalsis. A single sinusoidal peristaltic wave traveling along a circular tube will yield the velocity, pressure, wall shear stress distributions inside the ureter. RESULTS: The propagation of the peristaltic wave results in the backflow of urine near the inlet at the beginning of the flow. As the wave propagates towards the outlet, the flow rate decreases. It is observed that pressure distribution along the ureter axis will deteriorate towards the outlet. The contraction produces a very high-pressure gradient which causes the urine backflow. The trapping and the bolus formation cause a significant rise in bolus pressure, simultaneously developing negative pressure at the contraction neck. CONCLUSIONS: The effect of peristalsis on the ureter biofluid dynamic behavior of the ureter is visualized in this study. It is established that the peristaltic contraction results in high-pressure formation at the bolus and negative pressure at the neck. It was found to be a maximum of 1.1 Pa at the bolus center and -1.13 Pa at the neck region. At the ureter pelvis junction, a higher wall shear of 0.095 Pa is observed as the wave starts to propagate. The velocity vectors show that the trapping of urine causes reflux and results in an adverse pressure gradient near the wall. A maximum pressure gradient of 485 Pa/meter was observed at the contraction of the ureter wall.


Assuntos
Peristaltismo , Ureter , Simulação por Computador , Pressão , Estresse Mecânico , Ureter/diagnóstico por imagem
12.
Urologe A ; 60(9): 1211-1219, 2021 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-34398255

RESUMO

A fundamental understanding of the physical properties is necessary for the application of lasers in medicine in order to be able to understand and appreciate the biological effect. The most important parameters are emission mode, wavelength of the laser and power output measured in watts. Pulsed lasers can be used for the treatment of stones and soft tissues, whereby in urology this essentially applies to the prostate gland and to a lesser extent also for the ureter, urethra, bladder and kidneys.


Assuntos
Lasers de Estado Sólido , Ureter , Urologia , Humanos , Masculino , Próstata , Túlio
13.
J Med Case Rep ; 15(1): 423, 2021 Aug 03.
Artigo em Inglês | MEDLINE | ID: mdl-34344471

RESUMO

BACKGROUND: Only 14 cases of leiomyoma with ureteral origin have been reported previously. Such primary leiomyomas often present as hydronephrosis, making the diagnosis difficult. Radical nephroureterectomy is often performed because of the possible diagnosis of a malignant tumor. We report the 15th case of primary leiomyoma with a ureteral origin. CASE PRESENTATION: A 51-year-old Japanese man presented with a chief complaint of asymptomatic gross hematuria with a history of hypertension. Enhanced computed tomography showed a tumor at the upper part of the right ureter that appeared to be the cause of hydronephrosis and contracted kidney; no retroperitoneal lymphadenopathy and distal metastasis were observed. A well-defined 20-mm (diameter) defect was identified at the upper of the right ureter on retrograde pyelogram with no bladder cancer on cystoscopy. Urine cytology and right divided renal urine cytology findings were negative. Laparoscopic nephroureterectomy was performed, and the extracted tumor measured 20 × 13 mm. Histopathological examination revealed primary leiomyoma with no recurrence 16 months after the operation. CONCLUSIONS: Preoperative examination with the latest available ureteroscopic technology can help preserve renal function in the case of benign tumors by enabling preoperative ureteroscopic biopsy or intraoperative rapid resection. Moreover, nephroureterectomy is recommended in the case of preoperative suspicion of ureteral malignant tumors.


Assuntos
Leiomioma , Ureter , Neoplasias Ureterais , Humanos , Leiomioma/diagnóstico , Leiomioma/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Nefroureterectomia , Ureter/diagnóstico por imagem , Ureter/cirurgia , Neoplasias Ureterais/diagnóstico por imagem , Neoplasias Ureterais/cirurgia
15.
Pan Afr Med J ; 38: 345, 2021.
Artigo em Francês | MEDLINE | ID: mdl-34367424

RESUMO

Ureterocele is a pseudo-cyst dilation of the terminal submucosal ureter. It is a rare malformative uropathy, in particular associated with simplex ureter. We conducted a retrospective study over a period of 10 years. Twelve medical records of patients whose data were collected at the Department of Paediatric Surgery of Monastir between 2006 and 2016 were examined. The average age of patients was 2.7 years (ranging from 7 days to 11 years) with a sex ratio of 1. Patients´ clinical status was dominated by fever due to upper urinary tract infection. Diagnosis was mainly based on renal bladder ultrasound, intravenous urography (IVU) and retrograde urethrography and cystography. Ureterocele was unilateral in 10 cases and bilateral in 2 cases (on a total of 14 cases). It was associated with simplex ureter in all cases and all patients underwent endoscopic surgery. No perioperative adverse event was reported. The postoperative course was uneventful. Clinical and radiological improvements were reported in all cases. Ureterocele associated with simplex ureter is a very rare urinary abnormality. Early diagnosis is essential to avoid upper urinary tract involvement. Endoscopic treatment is a good alternative leading to satisfactory results.


Assuntos
Ureter/cirurgia , Ureterocele/cirurgia , Infecções Urinárias/diagnóstico , Criança , Pré-Escolar , Cistografia , Endoscopia , Feminino , Febre/etiologia , Humanos , Lactente , Recém-Nascido , Masculino , Estudos Retrospectivos , Ureter/anormalidades , Ureterocele/diagnóstico por imagem , Bexiga Urinária/diagnóstico por imagem , Infecções Urinárias/etiologia , Urografia
16.
Hinyokika Kiyo ; 67(7): 317-321, 2021 Jul.
Artigo em Japonês | MEDLINE | ID: mdl-34353013

RESUMO

A 22-year-old woman who was referred to our hospital presented with a complaint of urinary incontinence since childhood. Abdominal contrast-enhanced computed tomography revealed complete duplication of the left ureter. In addition, the upper half of the left kidney showed poor contrast, accompanied by signs of hydronephrosis. Magnetic resonance urography failed to show an opening between the upper half of the left kidney and the ectopic ureter. Cystoscopy revealed two normally positioned ureteral orifices. After intravenous injection of indigo carmine, however, the dye became evident in the vagina. Thus, she was diagnosed to have urinary incontinence due to complete duplication of the left ureter and an ectopic ureteral opening into the vagina. Transcatheter arterial embolization of the upper half of the kidney, the origin of the ectopic ureter, immediately relieved the patient of urinary incontinence. At the 6-month follow-up, the patient had experienced no recurrence or complications.


Assuntos
Embolização Terapêutica , Ureter , Incontinência Urinária , Adulto , Criança , Feminino , Humanos , Rim , Recidiva Local de Neoplasia , Ureter/diagnóstico por imagem , Ureter/cirurgia , Incontinência Urinária/etiologia , Incontinência Urinária/terapia , Adulto Jovem
17.
BMJ Case Rep ; 14(8)2021 Aug 17.
Artigo em Inglês | MEDLINE | ID: mdl-34404642

RESUMO

Neuroendocrine tumours (NETs) of the urinary tract are rare, and the urinary bladder is the the most common primary site. Primary ureteric NET is rarer with under 80 cases reported in the literature thus far. Most of these tumours are of the high-grade small cell neuroendocrine carcinoma subtype, which has a worse prognosis. Neoadjuvant chemotherapy has a proven role in the management of NET of the bladder as it downstages the tumour, which may add to significant recurrence-free survival and overall survival. We report the successful management of a patient with locally advanced small cell neuroendocrine carcinoma of the ureter, who had a pathological complete response after neoadjuvant chemotherapy with etoposide and cisplatin. He subsequently received adjuvant chemotherapy followed by radiation and is recurrence-free at a follow-up of 1 year.


Assuntos
Carcinoma Neuroendócrino , Ureter , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Carcinoma Neuroendócrino/tratamento farmacológico , Carcinoma Neuroendócrino/radioterapia , Quimioterapia Adjuvante , Cisplatino , Humanos , Masculino , Terapia Neoadjuvante , Recidiva Local de Neoplasia
19.
J Pediatr Urol ; 17(4): 581-582, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34332834

RESUMO

INTRODUCTION: In this video we aim to describe step-by-step a simplified surgical technique for the treatment of primary and secondary obstructed megaureters in children by laparoscopic extravesical ureteral reimplantation (LEUR). MATERIAL AND METHODS: A transperitoneal approach is used in all cases. The distal ureter is dissected and transected at the level of the stenosis. Detrusor fibers are divided to expose bladder mucosa and the distal ureter is introduced into the bladder to create a valve-like mechanism (modified-Shanfield technique). RESULTS: Between 2016 and 2020, 9 patients underwent LEUR (5 female, 4 male). Mean age at surgery was 31.6 months (SD:22.74) and indications were infection (2), obstruction (3), increase hydronephrosis (2) and decrease in renal differential function (2). The procedure was completed laparoscopically in all cases with a median operative time of 144 min (r: 120-160). The postoperative MAG-3 renogram revealed a non-obstructive pattern in 8/9 patients and MCUG demonstrated absence of VUR in all 8/9. With a mean follow-up of 2.4 years (SD:1.4) all are asymptomatic. CONCLUSIONS: LEUR by this new simplified technique is a feasible treatment of megaureters associated with good short and long-term results.


Assuntos
Laparoscopia , Ureter , Obstrução Ureteral , Refluxo Vesicoureteral , Criança , Feminino , Humanos , Masculino , Reimplante , Estudos Retrospectivos , Resultado do Tratamento , Ureter/cirurgia , Obstrução Ureteral/cirurgia , Procedimentos Cirúrgicos Urológicos , Refluxo Vesicoureteral/cirurgia
20.
World J Surg Oncol ; 19(1): 195, 2021 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-34215279

RESUMO

BACKGROUND: To describe the techniques and outcomes of complete transperitoneal laparoscopic nephroureterectomy (CTLNU) for upper urinary tract urothelial carcinoma (UTUC) in a single position. MATERIALS AND METHODS: Those patients with localized UTUC were included, among which 50 cases had CTLNU while 48 cases had laparoscopic nephroureterectomy with open bladder cuff excision (LNOBE). The clinical data were collected and analyzed retrospectively. RESULTS: All 98 patients underwent successful procedures of radical nephroureterectomy without transferring into open surgery. No significant difference was found among baseline clinical characteristics. Compared with the LNOBE group, the CTLNU group had a shorter operative time (98.5±40.3 min vs. 132.4±60.2 min), less blood loss (60.4±20.3 ml vs. 150.6±50.2 ml), shorter length of hospital stay (5.3±2.2 days vs. 8.1±2.3 days), and shorter incision (6.3±1.2 cm vs. 11.5±3.2 cm). The disease-related outcomes such as pathological stage, tumor grade, and recurrence rate were similar between the two groups. CONCLUSIONS: The CTLNU in a single position had advantages of shorter operation time, less blood loss, and shorter incision length. This surgical technique is a more minimally invasive, simplified, and effective way to perform the radical nephroureterectomy.


Assuntos
Carcinoma de Células de Transição , Laparoscopia , Ureter , Neoplasias Ureterais , Neoplasias da Bexiga Urinária , Carcinoma de Células de Transição/cirurgia , Humanos , Recidiva Local de Neoplasia , Nefrectomia , Nefroureterectomia , Prognóstico , Estudos Retrospectivos , Neoplasias Ureterais/cirurgia
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