- MeSH
- Kidney Diseases, Cystic MeSH
- Child MeSH
- Kidney Pelvis abnormalities MeSH
- Humans MeSH
- Kidney Diseases * MeSH
- Ureteral Diseases MeSH
- Ureteral Obstruction MeSH
- Ureter abnormalities MeSH
- Ureterocele MeSH
- Vesico-Ureteral Reflux MeSH
- Check Tag
- Child MeSH
- Humans MeSH
- Publication type
- Review MeSH
Dilatace kalichopánvičkového systému je nejčastěji zjišťovanou abnormitou při prenatálním a postnatálním ultrazvukovém screeningu ledvin a močových cest. Často je doprovázena také rozšířením močovodu (megaureter). Ve více než 60 % případů nález spontánně mizí s věkem v důsledku vyzrávání uropoetického systému. Pokud ne, podílí se na etiologii dilatace (mimo vezikoureterální reflux) zejména vrozené překážky v odtoku moči. Jejich obvyklou lokalizací je oblast pelviureterálního a vezikoureterálního přechodu, převážně se přitom jedná o faktory intraluminální. Z celkově méně často zastoupených extraluminálních příčin obstrukce se v praxi nejčastěji setkáváme s křížící aberantní cévou utlačující ureter v jeho subrenálním průběhu. V těchto případech odstupuje aberantní tepna z aorty a směřuje mimo oblast cévního hilu k dolnímu pólu ledviny, pro který je hlavním zdrojem cévního zásobení. V místě křížení ureteru pak může znesnadňovat jeho průchodnost (1). Prezentovaná kazuistika popisuje zcela výjimečnou příčinu symptomatické obstrukce močových cest cévní etiologie - atypické křížení a útlak ureteru ovarickými cévami.
Pelvicalyceal dilatation is the most common abnormity identified in ultrasound screening of the urinary tract. Often it is accompanied by dilatation of the ureter too (megaureter). In more than 60% of all cases this finding disappears with age due to maturation of the urinary tract. Otherwise, there are mainly congenital narrowings paticipating in the etiology of dilatation (except for vesicoureteral reflux). It ́s usual location is the pelviureteral and vesicoureteral junction and most of them are represented by intraluminal factors. As regards extraluminal causes of obstruction most often we can see aberant vessels crossing ureter in it ́s subrenal course. In these cases the aberant vessel is a branch of the aorta and points toward lower pole of the kidney as the main source of its blood suply. At the site of crossing the ureter there may be a difficult outflow of the urine. Our case represents an extraordinary cause of the symptomatic vascular obstruction of the urinary tract - atypical crossing and oppression of the ureter by ovaric vessels.
- MeSH
- Dilatation, Pathologic * surgery MeSH
- Child MeSH
- Kidney Pelvis abnormalities MeSH
- Kidney Calices abnormalities MeSH
- Humans MeSH
- Ureteral Obstruction * surgery diagnosis etiology MeSH
- Ovary surgery blood supply pathology MeSH
- Ureter abnormalities surgery diagnostic imaging MeSH
- Age of Onset MeSH
- Check Tag
- Child MeSH
- Humans MeSH
- Female MeSH
- Publication type
- Case Reports MeSH
- Keywords
- obstrukční uropatie, megaureter,
- MeSH
- Acute Kidney Injury diagnosis etiology MeSH
- Anti-Bacterial Agents administration & dosage MeSH
- Renal Insufficiency, Chronic classification complications therapy MeSH
- Diagnosis, Differential MeSH
- Enuresis diagnosis classification physiopathology therapy MeSH
- Glomerular Filtration Rate MeSH
- Hydronephrosis diagnostic imaging therapy MeSH
- Hypertension diagnosis etiology therapy MeSH
- Urinary Tract Infections diagnosis etiology drug therapy MeSH
- Creatinine analysis MeSH
- Blood Pressure MeSH
- Kidney abnormalities diagnostic imaging pathology growth & development MeSH
- Humans MeSH
- Urinary Tract abnormalities MeSH
- Nephrocalcinosis etiology therapy MeSH
- Infant, Premature, Diseases * diagnosis etiology classification therapy MeSH
- Infant, Premature growth & development MeSH
- Infant, Newborn MeSH
- Prognosis MeSH
- Risk Factors MeSH
- Tourniquets MeSH
- Ureter abnormalities MeSH
- Urethra abnormalities MeSH
- Urogenital Abnormalities * diagnosis etiology classification therapy MeSH
- Vesico-Ureteral Reflux diagnosis classification pathology MeSH
- Check Tag
- Humans MeSH
- Infant, Newborn MeSH
- Publication type
- Review MeSH
- MeSH
- Urinalysis MeSH
- Child MeSH
- Urinary Tract Infections etiology MeSH
- Infant MeSH
- Humans MeSH
- Kidney Diseases congenital MeSH
- Pyelonephritis * diagnosis urine therapy congenital MeSH
- Ureter abnormalities diagnostic imaging MeSH
- Treatment Outcome MeSH
- Check Tag
- Child MeSH
- Infant MeSH
- Humans MeSH
- Female MeSH
- Publication type
- Case Reports MeSH
Kontinuálny únik moču pri súčasne normálnej mikcii môže byť príznakom ektopického vyústenia močovodu u dievčat. Prezentujem kazuistiku 6 roč- ného dievčatka, ktoré trpelo nepretržitým denným aj nočným únikom moču. Diagnostika a terapia u die- ťaťa bola uskutočnená na Klinike pediatrickej urológie. V diagnostike sme použili sonografiu, vylučovaciu urografiu, cystoskopiu, vaginoskopiu a retrográdnu ureteropyelografiu. Vyšetreniami sme zistili raritne sa vyskytujúci triplexný močovod (II. typu podľa Smithovej klasifikácie) vľavo s ureter fissus dolného segmentu a naviac so sub-sfinkterickým ektopickým vyústením močovodu horného segmentu do uretry. Podozrenie na prítomnosť tretieho močovodu vzniklo potom, keď sme upresnili anatómiu ureteru dolného segmentu v zmysle ureter fissus pri klinicky jasnej ureterickej inkontinencii, aj prítomnej funkcii horného segmentu pri vylučovacej urografii. Ako terapeutický postup sme zvolili hemiureteronefrektómiu. Po výkone u dievčaťa prestal únik moču.
Continuous leakage of urine despite simultaneous normal micturition can be a sign of an ectopic ureter in girls. The case of 6 year old girl who suffered from continuous daylight and night time urine leakage is reported. Diagnosis and treatment of the child was done at the Clinic of paediatric urology. In diagnostics, we used sonography, excretory urography, cystoscopy, vaginoscopy and retrograde ureteropyelography. We found a rarely occurring triplex ureter on the left side and a sub-sphincteric ectopic ureter – with outlet into urethra. It was a case of ureteric incontinence. As a therapeutic approach, we chose hemiureteronephrectomy. In girl stopped urine leakage after surgery
- Keywords
- ektopický močovod, triplexní močovod, ureterická inkontinence,
- MeSH
- Child MeSH
- Urinary Incontinence etiology surgery MeSH
- Humans MeSH
- Ureteral Diseases * diagnosis surgery MeSH
- Ureter abnormalities surgery MeSH
- Urologic Surgical Procedures methods MeSH
- Treatment Outcome MeSH
- Check Tag
- Child MeSH
- Humans MeSH
- Female MeSH
- Publication type
- Case Reports MeSH
The ureter is a derivate of the Wolffian mesonephric duct and undergoes complex changes during development. The most common developmental anomaly is complete duplication of the ureter. Duplication of the ureter may be complete or incomplete. Incomplete duplication of ureter is well known as bifid ureter. Presence of various anomalies of the ureter is associated with increased risk of urinary tract infections and many other clinical complications.
- MeSH
- Dissection methods MeSH
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Urinary Tract anatomy & histology pathology MeSH
- Cadaver MeSH
- Aged MeSH
- Ureter abnormalities pathology MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
AIM: To assess of the role of renal ultrasonography (US) and DMSA renal scintigraphy in the prediction of irreversible histological lesions of the upper pole in duplex system. METHODS: A prospective cohort study based on data collected between 2005 and 2012 at our institution. The cohort consisted of 23 patients with ureteroceles and 28 patients with ectopic ureters who underwent upper pole nephrectomy. Preoperative recordings from ultrasound and nuclear renal scans were compared with the histological findings. Histological irreversible lesions were defined as the presence of dysplasia and/or severe chronic interstitial nephritis (CIN) in ≥ 90% of the specimen. ROC (Receiver Operating Characteristic) curves were used to investigate thresholds in order to identify irreversible lesions using various differential functions. The histology was correlated with the results of imaging. RESULTS: Pathological findings were found in all histological samples. Histological lesions were irreversible in 20/23 patients (87.0%) with ureteroceles and in 14/28 patients (50.0%) with ectopic ureters. The model is able to predict irreversible lesions if an upper pole differential function is ≤ 3% in patients with ureteroceles, and ≤ 2% in the presence of ectopic ureters. Weak association between parenchymal thinning on ultrasonography and irreversible lesions was found in patients with ectopic ureters. CONCLUSION: DMSA renal scintigraphy provides a useful tool for the prediction of irreversible lesions in the upper pole. Low differential function (≤ 3% and ≤ 2%, respectively) indicates irreversible lesions, favoring heminephrectomy. Higher differential function indicates greater remaining biological potential of the parenchyma, favoring reconstruction of the upper pole.
- MeSH
- Child MeSH
- Infant MeSH
- Succimer MeSH
- Kidney abnormalities MeSH
- Humans MeSH
- Child, Preschool MeSH
- Prospective Studies MeSH
- Radionuclide Imaging MeSH
- ROC Curve MeSH
- Ultrasonography MeSH
- Ureter abnormalities MeSH
- Ureterocele diagnostic imaging MeSH
- Check Tag
- Child MeSH
- Infant MeSH
- Humans MeSH
- Male MeSH
- Child, Preschool MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Evaluation Study MeSH
- Comparative Study MeSH
- Keywords
- OHVIRA syndrom,
- MeSH
- Abdominal Pain etiology therapy MeSH
- Kidney abnormalities MeSH
- Humans MeSH
- Magnetic Resonance Imaging MeSH
- Menstruation Disturbances etiology therapy MeSH
- Adolescent MeSH
- Abnormalities, Multiple * diagnosis surgery MeSH
- Ureter abnormalities MeSH
- Uterus abnormalities MeSH
- Vagina abnormalities MeSH
- Vaginal Diseases * diagnosis surgery complications MeSH
- Check Tag
- Humans MeSH
- Adolescent MeSH
- Female MeSH
- Publication type
- Case Reports MeSH
V našem článku prezentujeme případ podkovovité ledviny s jedním sběrným systémem a jediným zkříženým močovodem a pyelolitiázou. V anglickém jazyce byly dosud celosvětově uveřejněny pouze čtyři publikace popisující případ podkovovité ledviny s jediným zkříženým močovodem. Prezentujeme náš postup při léčbě třicetiletého pacienta s touto vzácně se vyskytující vrozenou malformací a objemnou nefrolitiázou, uvádíme přehled dostupné literatury a nabízíme možná vysvětlení.
The present study reports a horseshoe kidney with a single collecting system and a crossed single ureter associated with pyelolythiasis. An association of a crossed single ureter and a horseshoe kidney has only been mentioned in four previous reports in the available English literature worldwide. We present our management of a 30‑year‑old patient with this rare congenital malformation and a large stone burden together with a review of the current available literature and suggest explanation.
- MeSH
- Adult MeSH
- Kidney * abnormalities MeSH
- Humans MeSH
- Lithotripsy methods MeSH
- Abnormalities, Multiple etiology MeSH
- Urinary Calculi MeSH
- Nephrolithiasis * etiology surgery physiopathology MeSH
- Tomography, X-Ray Computed MeSH
- Prevalence MeSH
- Ureter * abnormalities MeSH
- Urolithiasis * etiology surgery physiopathology MeSH
- Check Tag
- Adult MeSH
- Humans MeSH
- Male MeSH
- Publication type
- Case Reports MeSH
