Showing 11 results for Ureter
A Tajeddini , F Nily ,
Volume 57, Issue 3 (6-1999)
Abstract
A 43-day old infant with myelomeningocele was evaluated for feeding problems and ill appearance. The presence of metabolic acidosis, hyponatermia and hypercalemia suggested renal tubular acidosis type IV. Later examination showed urinary tract infection together with bilateral vesicoureteral reflux. After treatment of the infection, metabolic acidosis and electrolyte imbalances were resolved and the diagnosis of pseudohypoaldosteronism was confirmed.
Ataei N, Compani F, Madani A, Rezaei N ,
Volume 60, Issue 3 (6-2002)
Abstract
Background: Urinary tract infection is a common bacterial infection in children and may lead to irreversible renal damage. TC 99-m Dimercaptosuccinic acid renal scintigraphy is the most sensitive method for diagnosing acute pyelonephritis. We designed a study to evaluate the ability of DMSA scan and ultrasonography to detect renal paranchymal lesion.
Materials and Methods: 62 children 1 month to 12 years of age with the first episode of acute pyelonephritis were prospectively studied with DMSA scan and ultrasonography during acute phase of infection. A Voiding Cystourethrogram was performed in 60 children when urine culture became negative. Children with renal paranchymal changes were older at the time of acute pyelonephritis (P=0.04) but no difference was found between the groups with regard to levels of CRP, ESR (P>0.05).
Results: Changes on the DMSA scan were found in 106 (85.5 percent) kidneys of 62 children but ultrasonography showed renal changes in 19.4 percent (sensitivity=20 percent, specificity=83 percent) (Kappa=0.06). Vesicoureteric reflux was found in 14 children (23.3 percent) but 83 percent of the affected kidneys were drained by non-refluxing ureters.
Conclusion: It is concluded that DMSA scan is more sensitive than ultrasonography in detecting renal paranchymal changes in acute pyelonephritis and we found out that renal paranchymal changes after acute pyelonephritis is common, even in those without VUR.
Nikoobakht,
Volume 63, Issue 2 (5-2005)
Abstract
Background: This study was conducted to evaluate results of urethroscopic management of iatrogenic urethral injuries due to gynecological operations.
Materials and Methods: From November 2001 till November 2003, 12 iatrogenic urethral injuries which were managed with mean time 12 hours (Range= 6-72) after gynecological operations were included in this study. 3 months after urethroscopy and distending, patients were evaluated with IVP. Mean time of clinical follow up was 12 months (range= 4-29).
Results: 7 patients with urethral stricture were found and considering fluoroscopy guided urethral dilatation with balloon in 2 of them, urethroscopy and distending was successful in 6 patients (85/7%). In 5 patients with complete dissection of urethra, urethroscopy and distending was successful only in 1 of them (20%). All patients were discharged after 24 hours and in follow up IVP after 3 months. Results were satisfactory in 6 of 7 patients. One of patients needed re-distending due to stricture.
Conclusion: Urethroscopic approach as first step in management of iatrogenic urethral injuries seems reasonable and cost benefit, specially in ligating lesions.
Madani A, Pournasiri Z, Kajbafzadeh A.m, Attaee N, Mohseni P, Esfehani T,
Volume 65, Issue 6 (9-2007)
Abstract
Background: Impairment in the function of the lower urinary tract can be the cause of recurrent urinary tract infections (UTI) and vesico-ureteral reflux (VUR) in children. The purpose of our research was to evaluate the frequency of occurrence of bladder instability in children with UTI.
Methods: The research involved 133 children (11 boys, 122 girls), ranging in age from seven months to 14 years. Group A consisted of 78 children with a history of recurrent UTI, while Group B included 55 children with recurrent UTI and VUR. Urodynamic tests (cystometry) were performed on all the children.
Results: Abnormal functioning of the lower urinary tract was found in 98 children (73.1%) from Group A and 41 children (78.8%) from Group B. The most common dysfunction was detrusor-sphincter dyssynergia (DSD), which was found in 54% of all subjects, 46.2% of patients in Group A and 60% of patients in Group B (p<0.05). Unstable bladder was found in 42 (33%) children with no significant difference between the two groups. In 17 children (12.6%) DSD was accompanied by bladder instability. In both groups about 20% of the children did not present with symptoms indicative of urination dysfunction, where as 80% reported various symptoms, of which the most common were constipation and urinary urgency. In half of the children from Group A and one-fourth of the children from Group B there were several co-occurring symptoms: frequency, urgency, intermittent voiding, incontinence, dribbling and retention, and constipation.
Conclusions: The most common disturbance of lower urinary tract function in these children with recurrent UTI was DSD, which occurred more often in children with VUR.
Ashtiyani Sc, Moosavi Smsh, Hosseinkhani S, Shirazi M,
Volume 65, Issue 7 (10-2007)
Abstract
Background: Ureteral obstruction, leading to urinary stasis and elevated pressure in the proximal part of urinary tract, causes progressive renal dysfunction. This study was designed to evaluate the status of oxidative stress and metabolic defect in acute unilateral ureteral obstruction (UUO).
Methods: Experiments were performed on three groups of male Sprague-Dawley rats (n=10 in each group). In the UUO group, rats were lightly anesthetized by ether and the left ureter was occluded by means of a sterile surgical procedure. Twenty-four hours after UUO-induction, both kidneys were removed and stored at -70 °C. In the sham group, anesthesia and surgery were performed without ureteral occlusion, and the control group received no surgical procedure. The kidney samples were assessed to measure the levels of ATP and ADP by the luciferin-luciferase method for determining metabolic status. In addition, the levels of malondialdehyde (MDA) and ferric reducing/antioxidant power (FRAP) of the kidneys were measured to evaluate the redox state. Data are expressed as means ±SEM per gram of kidney weight (gKW). The comparisons were performed using paired t-test for intra-group analysis, and ANOVA followed by Duncan's post-hoc test and then LSD test for inter-group analysis. Significance was taken at p<0.05.
Results: The comparisons between the UUO and sham groups indicated that 24 hours of UUO increased levels of MDA (51.42±1.86 vs. 38.64±1.02 nmol/gKW, respectively p<0.001) and ADP (0.67±0.04 vs. 0.47±0.045 µmol/gKW, respectively p<0.01), but decreased levels of FRAP (2.44±0.18 vs. 4.28±0.27 µmol/gKW, respectively), ATP (1.09±0.10 vs. 2.26±0.19 µmol/gKW, respectively) and ATP/ADP ratio (1.64±0.14 vs. 5.11±0.56, respectively) in the obstructed kidneys, all p<0.001. In the non-obstructed kidneys, the levels of ATP and ADP were higher (p<0.01 and p<0.001, respectively), while the levels of MDA and ATP/ADP ratio were equal to those of the sham group.
Conclusion: Twenty-four hours of acute UUO induces oxidative stress and reduces the aerobic metabolism in obstructed kidneys, whereas non-obstructed kidneys with a normal redox state show the higher levels of metabolism.
Hashemian H, Tabatabaee P, Siadati A, Ataee N,
Volume 66, Issue 9 (12-2008)
Abstract
Background: Urinary Tract Infection (UTI) is one of the major etiological factors of permanent kidney impairment, resulting in renal scarring and severe and pernicious side effects, such as arterial hypertension and renal failure. The purpose of this study was to clarify the impression of renal parenchyma involvement by first UTI (on the basis of acute DMSA scan) and vesicoureteral reflux (VUR-on the basis of VCUG/ RNC) on the renal scar formation (on the basis of late DMSA scan).
Methods: Children diagnosed with their first UTI at the Children's Hospital Medical Center, Tehran, Iran, were evaluated. For each patient, we recorded age, sex, results of VCUG/RNCs and acute DMSA scan, as well as those of a late DMSA scan performed 4-6 months later. The results of acute and late DMSA scans were compared along with the results of VCUG/RNCs.
Results: This study included a total of 103 children, of whom 16 (15.5%) were boys and 87 (84.5%) were girls. The mean age was 27.2±27.7 months. The frequency of renal scars in kidneys with mild (28.6%, 8.7%) and moderate (33.3%, 18.2%) pyelonephritis with or without VUR was not significantly different, while the frequency of renal scars in kidneys with severe pyelonephritis (84.6%, 23.1%) in the presence of VUR was significantly higher than non-refluxing kidneys with severe pyelonephritis (p=0.005). Furthermore, the frequency of renal scars in refluxing kidneys increased significantly with the severity of pyelonephritis (normal 8.3%, mild 28.6%, moderate 33.3%, and severe 84.6% p=0.001). This pattern was not significant in non-refluxing kidneys (0%, 10.3%, 18.2%, and 23.1%, respectively p=0.062).
Conclusion: The present study indicates that the incidence of renal scarring increases with pyelonephritis severity in patients with VUR. Furthermore, we can estimate the risk of renal scar formation from the results of acute DMSA scan and VCUG/RNC.
Mohammad Mehdi Sepehri , Parisa Rahnama , Pejman Shadpour , Babak Teimourpour ,
Volume 67, Issue 6 (9-2009)
Abstract
Background: Data mining as a multidisciplinary field is rooted in the fields such as statistics, mathematics, computer science and artificial intelligence and has been gaining momentum in scientific, managerial, and executive applications in health care. Data mining can be defined as the automated extraction of valuable, practical and hidden knowledge and information from large data. Applying data mining in medical records and data is of utmost importance for health care givers and providers and brings vital and valuable outcomes. Data mining can help doctors come up with better recommendations and plans for treatment which actually in many respects have significant impact on patients’ life and satisfaction In this paper we have proposed and utilized data mining methods to extract hidden information in medical records of pelvis stone patients with ureteral stone. We have tried to design a decision support system model to be applicable for selecting type of treatment for these groups of patients.
Methods: We gathered needed information from Shahid Hashemi Nejad hospital. In this research we have used decision tree as a data mining tool, for selecting suitable treatment for patients with ureteral stone. This model can predict probability of success of each treatment.
Results: In this research we extracted effective attributes in selecting type of treatment for patients with ureteral stone.
Conclusions: By using this model we can have eight percent improvement in number of patients who have stone free output after treating. In fact, this model has a better functionality than expert system of hospitals.
Saeid Ashtiyani , Mostafa Moosavi , Saman Hosseinkhani , Mehdi Shirazi ,
Volume 67, Issue 10 (1-2010)
Abstract
Background: Ureteral obstruction has been shown to induce renal oxidative stress, suppressed energy metabolism and defected acid excretion. This study was aimed to examine the improving effects of L-carnitine, a facilitating cofactor for mitochondrial oxidation of fatty-acids as well as a scavenger of free-radicals, and -tocopherol as the most potent antioxidant on these renal disorders at early hours following release of unilateral ureteral obstruction.
Methods: The left ureter was ligated in 60 anaesthetised rats, L-carnitine, -tocopherol, or their vehicles (normal saline and olive oil, respectively) were injected (i.p.) in four groups. Each rat was re-anesthetized and cannulated, and ureteral legation was released at exactly 24h after UUO-induction. A 30-min clearance period performed to separately collect urine from both kidneys. The collected urine and arterial blood samples were given to pH-gas analyzer and autoanalyzer, and malondialdehyde (MDA), ATP and ADP levels were assessed in preserved kidneys. There were also sham and control groups (n=8-10 in each).
Results: In the post-obstructed kidney of vehicle-treated groups with respect to the equivalent kidney of sham group, there were increases in MDA (p<0.001), ADP (p<0.01), urinary pH (p<0.001), absolute (p<0.05) and fractional bicarbonate excretions (p<0.01), but decreases in ATP, ATP/ADP (both p<0.001), and urinary PCO2 (p<0.01). -tocopherol could normalize MDA level but did not affect the altered amounts of energy metabolic indices and acid-base excretions, while L-carnitine improved all of them except of decreased urinary PCO2.
Conclusions: Increased bicarbonate-excretion in post-obstructed kidney is due to defected acid-secretion at collecting duct, which is not related to ureteral obstruction-induced renal oxidative stress and suppressed energy metabolism.
Mohammadreza Bazrafshani , Saeideh Parvaresh , Ali Sadeghi Lotfabadi , Fatemesadat Hosseini ,
Volume 72, Issue 9 (12-2014)
Abstract
Background: Vesicoureteral reflux (VUR) is the retrograde flow of urine from the bladder into the ureter and toward the kidney. Vesicoureteral reflux is the most com-mon inherited disease in urogenital system. Primary VUR is the most common urologi-cal anomaly in children and it has been reported in 30-50% of those who present with urinary tract infection (UTI). The association of vesicoureteral reflux, urinary tract in-fection and renal damage is well known. Current methods for vesicoureteral reflux di-agnosis are unpleasant. Therefore, human leukocyte antigen system not only might help to detect causative gene but also would assists to establish better prognoses tests of this disease. In this study, the relationship between vesicoureteral reflux and HLA-DRB1 and HLA-DQB1 genes were investigated.
Methods: This study applied on forty vesicoureteral reflux confirmed children from Kerman province, Iran. These children have been admitted to the Afzalipour Hospital for UTI and primary VUR for them was proved by voiding cystourethrogram (VCUG). Also, forty children without any VUR sign as control group. DNA was extracted from the whole blood sample and was amplified using sequence-specific priming polymerase chain reaction (PCR-SSP) method. Finally PCR products were evaluated by electropho-resis in 1.5% agarose gel and frequency of alleles and haplotypes were compared by Chi-square test. Significance level was assumed at P< 0.05.
Results: Low-resolution HLA typing showed the frequency of the HLA-DR17 antigen was significantly increased in vesicoureteral reflux children compared to control group (P= 0.039). On the other hand HLA-DR16 was significantly decreased in vesicoureteral reflux group. Also, frequency of HLA-DQ2 was significantly higher in patients com-pared to control group (P= 0.002). DRB1 (11, 17) and DQ (2, 7) haplotypes were also higher in vesicoureteral reflux patients (P= 0.027, P= 0.01).
Conclusion: The HLA cluster might affect on susceptibility to vesicoureteral reflux es-pecially by locus which located close to HLA-DRB1 and HLA-DQB1 genes. This study demonstrates for the first time in Iran. However, further extensive researches with a large number of samples from different populations and ethnicities are required to val-idate the results obtained in this study.
Saeedeh Parvaresh, Ahmad Enhesari , Seyed Ali Moafi, Maedeh Jafari , Fatemeh Karami Robati,
Volume 79, Issue 11 (2-2022)
Abstract
Background: Vesicoureteral reflux (urinary reflux) is one of the most common congenital anomalies in children. This study aimed to compare the ureteral opening distance from the midline in children with vesicoureteral reflux (VUR) and healthy children
Methods: This cross-sectional study was performed on the children with pyelonephritis who were referred to Afzalipour Hospital in Kerman, Iran from August 2019 to August 2020. Twenty children with vesicoureteral reflux (urinary reflux) and twenty healthy children were randomly selected. Then children with vesicoureteral reflux (urinary reflux) and healthy children were divided into two groups. The distance from the ureter to the midline in these children was then measured by a radiologist with a Philips affinity 70 ultrasound machine.
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Results: In both groups (healthy children and ones with vesicoureteral reflux), ninety-five percent of the children were girls. The mean age of the children in the second group (the children with urinary reflux) was 5.8±2.58 years and the mean age of the children in the first group (the healthy children) was 4.75±1.54 years. The mean age difference between the children with urinary reflux and healthy children was not statistically significant (P=0.127). The mean distance of the ureter from the midline in children with vesicoureteral reflux was 11.44±2.60 mm and the mean distance of the ureter from the midline in healthy children was 9.32±2.74 mm. The mean difference distance of the ureter from the midline in children with vesicoureteral reflux (VUR) and healthy children was statistically significant (P=0.002).
Conclusion: Considering that the distance between the ureter and the midline in patients with urinary reflux is significantly longer than non-reflux ureters, it can be used as a non-invasive method for the diagnosis of vesicoureteral reflux (urinary reflux) in children.
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Mohammad Bakhtiar Hesam Shariati , Fahimeh Rajabi , Ehsan Motavasel ,
Volume 80, Issue 9 (12-2022)
Abstract
Background: Congenital malformations of the kidney and urinary tracts happen in 3-6 per 1000 live births and these abnormalities are the reason, for (ESRD) in children and also the reason for subsequent kidney problems such as kidney stones, infections and hypertension in adulthood. One of the most common anomalies of the renal system is the double collecting system. Knowledge of anatomical variations and disorders before surgery can make the surgical procedure smoother for the surgeon and prevent unwanted mistakes. Imaging through radiology, computed tomography, and MRI is the best way to diagnose early, follow-up, and planning for surgery, diagnosis of complications and extra kidney abnormalities.
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Case Presentation: Our report in this article is about four years old girl who went to the MRA center of Baath Hospital in Sanandaj due to flank pain in December 2019. After abdominal imaging, signs of an abnormality of the double collecting system were revealed. Abdominal and pelvic ultrasound revealed abnormalities of the UVJ, and the distal part of the right urethral duct was approximately 2 mm in size. Also, the anterior-posterior diameter of the right renal pelvis was reported to be 2 mm and the upper calyx of the right kidney was quite dilated. This incomplete integration leads to complete or incomplete forms of the renal collecting system. The prevalence of this anomaly is also mostly unilateral, but our report, in this case, is about bilateral ureters.
Conclusion: We reported a rare case of bilateral Y-shaped bifid ureter, that's in this kind of anomaly 2, pyelocaliceal systems connect at the junction of the ureter to pelvic (bifid pelvis), and this abnormality was accidentally detected on ultrasound and MRI examinations. However, since duplex kidneys are often asymptomatic and therefore mainly diagnosed incidentally in patients, the actual number of patients with symptoms is probably lower.
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