hydronephrosis
Dotaz
Zobrazit nápovědu
OBJECTIVE: We present two case reports of asymptomatic ureteral endometriosis leading to hydronephrosis. We demonstrate the significance of routine ultrasound scanning of the upper urinary tract in patients with dia gnosed deep infiltrating endometriosis. CASE REPORTS: The first case report describes a symptomatic patient after a surgery for deep endometriosis. After the surgery, she was completely without symptoms, but during regular check-ups she developed progressive hydronephrosis on the right side and it did not respond to conservative treatment. Surgery deliberation of the ureter was indicated. The second case report describes a patient with already developed severe hydronephrosis on the left side. The functional kidney examination proved complete renal loss of the left kidney. Because of recurrent pyelonephritis in the nonfunctional kidney, nephrectomy was indicated. CONCLUSION: Ureteral endometriosis presents a rare, but insidious form of endometriosis, which is very often asymptomatic and diagnosed at a later stage. It can cause a complete silent loss of renal function. Routine ultrasound scanning examination of the upper urinary tract in all patients with diagnosed endometriosis could prevent this severe complication.
- Klíčová slova
- hydronephrosis, routine US scanning, ureteral endometriosis,
- MeSH
- endometrióza * diagnóza diagnostické zobrazování MeSH
- hydronefróza * diagnostické zobrazování etiologie MeSH
- lidé MeSH
- nemoci močovodu * diagnóza diagnostické zobrazování MeSH
- ultrasonografie MeSH
- ureter * diagnostické zobrazování chirurgie MeSH
- Check Tag
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
- Klíčová slova
- HYDRONEPHROSIS/surgery *,
- MeSH
- hydronefróza chirurgie MeSH
- lidé MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
Evaluation has been made of a total of 272 patients who underwent surgery for hydronephrosis at the Department of Urology, Faculty Hospital in Olomouc, from 1979 to 1983. On the whole 221 (81%) pyeloplasties and 51 (19%) nephrectomies were performed. Five grades of hydronephrotic nephropathy were distinguished according to their significance. The clinical evaluation was based mainly on the results of excretory urography. The five grades of hydronephrosis were also characterized on the basis of the histological and electron-microscopical patterns and perioperational bioptic findings. Besides the dystrophic changes, seen on the tubular system of the kidney were morphological signs of regeneration, viz. the incidence of differentiated, pale "regeneration cells". However, in advanced stages of hydronephrosis, also these cells are subject to dystrophy making the hydronephrotic changes in the kidney irreversible. On the basis of the histological and clinical findings in correlation with the results of pyeloplasty the authors recommend to operate upon patients with Grades I-II hydronephrosis.
Resistence index (RI) measurement by the Doppler sonography is a noninvasive diagnostic method which was introduced in the diagnosis of hydronephrosis in children in 1989. In 1991 Palmer modified this method by administering furosemide (Diuretic Doppler ultrasonography) in order to distinguish an obstructional and nonobstructional dilatation of the upper urinary tract. The method is based on the fact that an obstruction of the upper urinary tract results in increasing of the intrarenal arterial resistence and therefore in decreasing of vascular flow. RI value shows the importance of obstruction. The authors performed this method on 37 children aged 2 to 16, 12 children with a significant ureteropelvic obstruction, 15 children with a nonsignificant obstruction (hydronephrosis of grades I-II and persisting dilatation of the ureteropelvic system after pyeloplasty); the control group consisted of 10 children with normal sonography and scintigraphy findings in the kidneys. The results were compared to the results of dynamic scintigraphy -99m Tc DTPA with furosemide. Elevation of RI values in clinically significant hydronephrosis was proved. The authors see the utility of Doppler ultrasonography as being in the diagnosis of nonsignificant obstructions, in the screening of children with ureteropelvic system dilatation, and in follow-up examinations of children after pyeloplasty.
- MeSH
- dítě MeSH
- hemodynamika MeSH
- hydronefróza diagnostické zobrazování MeSH
- ledviny krevní zásobení MeSH
- lidé MeSH
- mladiství MeSH
- předškolní dítě MeSH
- ultrasonografie dopplerovská MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- mladiství MeSH
- mužské pohlaví MeSH
- předškolní dítě MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Klíčová slova
- HYDRONEPHROSIS *,
- MeSH
- hydronefróza * MeSH
- intersticiální nefritida * MeSH
- ledvinná pánvička * MeSH
- lidé MeSH
- obstrukce močovodu * MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
Clinical findings, management, and possible linkage of congenital hydronephrosis caused by ureteropelvic junction stenosis to the HLA complex were studied in four families. These families provide evidence of possible autosomal dominant inheritance. HLA class I antigen studies in all four and class II (HLA-DR) in three families were performed. These studies failed to show close linkage to the chromosome 6 markers in two families but there was consistent inheritance in the other two. Although formal linkage calculations are not presented, it is apparent that in some families HLA haplotyping is not useful in predicting prevence of renal obstruction.
- MeSH
- dítě MeSH
- genetická vazba MeSH
- hydronefróza vrozené genetika MeSH
- kojenec MeSH
- ledviny abnormality MeSH
- lidé MeSH
- MHC antigeny I. třídy genetika MeSH
- MHC antigeny II. třídy genetika MeSH
- obstrukce močovodu vrozené genetika MeSH
- předškolní dítě MeSH
- rodokmen MeSH
- Check Tag
- dítě MeSH
- kojenec MeSH
- lidé MeSH
- předškolní dítě MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
- Názvy látek
- MHC antigeny I. třídy MeSH
- MHC antigeny II. třídy MeSH
BACKGROUND: The benefits and harms of continuous antibiotic prophylaxis (CAP) versus observation in patients with antenatal hydronephrosis (ANH) are controversial. OBJECTIVE: The aim was to determine the effectiveness of CAP for ANH, and if beneficial to determine the best type and regimen of antibiotic and the most harmful to provide guidance for clinical practice. METHODS: A systematic literature search was performed in databases including Medline, Embase, and Cochrane in June 2015. The protocol was prospectively registered to PROSPERO (CRD42015024775). The search started from 1980, when maternal ultrasound was first introduced into clinical practice. Eligible studies were critically evaluated for risk of bias using Revman software. The outcomes included reduction in urinary tract infections (UTI), drug-related adverse events and kidney functions. RESULTS: Of 797 articles identified, 57 full text articles and six abstracts were eligible for inclusion (2 randomized controlled trials, 11 non-randomized comparative studies, and 50 case series). It remains unclear whether CAP is superior to observation in decreasing UTIs. No conclusion could be drawn for drug-related adverse events and kidney function because of lack of data. Children who were not circumcised, with ureteral dilatation, and high-grade hydronephrosis may be more likely to develop UTI, and CAP may be warranted for these subgroups of patients. A majority of the studies had low-to-moderate quality of evidence and with high risk of bias. CONCLUSIONS: The benefits of CAP in a heterogeneous group of children with ANH involving different etiologies remains unproven. However, the evidence in the form of prospective and retrospective observational studies has shown that it reduces febrile UTI in particular subgroups.
- Klíčová slova
- Antenatal hydronephrosis, Antibiotic prophylaxis, Children, Urinary tract infection,
- MeSH
- antibiotická profylaxe * MeSH
- hydronefróza komplikace MeSH
- infekce močového ústrojí etiologie prevence a kontrola MeSH
- lidé MeSH
- novorozenec MeSH
- Check Tag
- lidé MeSH
- novorozenec MeSH
- Publikační typ
- časopisecké články MeSH
- systematický přehled MeSH
OBJECTIVE: Hydronephrosis leads to deterioration of renal function. As urinary N-acetyl-beta-D-glucosaminidase (U-NAG) activity is considered a sensitive marker of renal tubular impairment, our aim was to measure U-NAG in children with hydronephrosis and to look for a relationship among selected clinical parameters. MATERIALS AND METHODS: We studied 31 children (22 boys and 9 girls, mean age 2.3 +/- 2.5 years) with hydronephrosis grade 1-4 that had U-NAG/creatinine ratio (U-NAG/Cr) measured. RESULTS: The U-NAG/Cr was significantly higher in patients with hydronephrosis compared to reference data (p = 0.002). There was no difference in U-NAG/Cr between children with unilateral and bilateral hydronephrosis (p = 0.51). There was no significant difference in U-NAG/Cr between children with grades 1-3 (pooled data) and grade 4, respectively (p = 0.89). There was no correlation between U-NAG/Cr and the grade of hydronephrosis (r = 0.01). CONCLUSIONS: U-NAG/Cr is increased in children with hydronephrosis grade 1-4, and there is no relationship with the grade of hydronephrosis. U-NAG is a useful marker of renal tubular dysfunction, however its relationship with the degree of kidney damage in patients with hydronephrosis should be considered as doubtful.
- MeSH
- acetylglukosaminidasa moč MeSH
- biologické markery moč MeSH
- hydronefróza enzymologie patofyziologie moč MeSH
- ledvinové kanálky patofyziologie MeSH
- lidé MeSH
- předškolní dítě MeSH
- stupeň závažnosti nemoci MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- předškolní dítě MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Názvy látek
- acetylglukosaminidasa MeSH
- biologické markery MeSH
Renal colic symptoms may be caused by an aberrant vascular bundle that intermittently incarcerates the pyeloureteral junction. The authors describe 6 patients who were complaint free except for the period of fits and routine urological examinations showed normal findings. The patients had no subjective complaints after open surgery.
- MeSH
- arteriovenózní malformace komplikace MeSH
- dospělí MeSH
- hydronefróza etiologie MeSH
- kolika etiologie MeSH
- lidé MeSH
- nemoci ledvin etiologie MeSH
- obstrukce močovodu vrozené MeSH
- stenóza vrozené MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
OBJECTIVES: To assess the efficacy of neoadjuvant chemotherapy (NAC) before radical cystectomy (RC) in a retrospective multicentre cohort of patients with cT2N0M0 bladder cancer (BCa) without preoperative hydronephrosis. PATIENTS AND METHODS: This was a propensity-based analysis of 619 patients. Of these, 316 were treated with NAC followed by RC and 303 with upfront RC. After multiple imputations, inverse probability of treatment weighting (IPTW) was used to account for potential selection bias. Multivariable logistic regression analysis was performed to evaluate the impact of NAC on pathological complete response and downstaging at RC, while IPTW-adjusted Kaplan-Meier curves and Cox regression models were built to evaluate the impact of NAC on overall survival (OS). RESULTS: After IPTW-adjusted analysis, standardised differences between groups were <15%. A complete response (pT0N0) at final pathology was achieved in 94 (30%) patients receiving NAC and nine (3%) undergoing upfront RC. Downstaging to non-muscle-invasive disease (
- Klíčová slova
- #BladderCancer, #blcsm, #uroonc, #utuc, bladder cancer, clinical T2, downstaging, hydronephrosis, neoadjuvant chemotherapy,
- MeSH
- cystektomie * metody MeSH
- hydronefróza MeSH
- kohortové studie MeSH
- kombinovaná terapie MeSH
- lidé středního věku MeSH
- lidé MeSH
- nádory močového měchýře farmakoterapie patologie chirurgie MeSH
- neoadjuvantní terapie * MeSH
- retrospektivní studie MeSH
- senioři MeSH
- staging nádorů MeSH
- tendenční skóre MeSH
- výsledek terapie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- srovnávací studie MeSH
