DTI of the kidney in children: comparison between normal kidneys and those with ureteropelvic junction (UPJ) obstruction

2019 ◽  
Vol 33 (1) ◽  
pp. 63-71 ◽  
Author(s):  
Hansel J. Otero ◽  
Juan S. Calle-Toro ◽  
Carolina L. Maya ◽  
Kassa Darge ◽  
Suraj D. Serai
Keyword(s):  
Ureteropelvic Junction ◽  
Upj Obstruction

scholarly journals Reverse Tubularized Pelvis Flap Method for the Treatment of Long Segment Ureteropelvic Junction Obstruction

2019 ◽  
Vol 29 (2) ◽  
pp. 128-133 ◽  
Author(s):  
Haluk Sarihan ◽  
Hatice Sonay Yalçın Comert ◽  
Mustafa İmamoğlu ◽  
Dilek Basar
Keyword(s):  
Blood Supply ◽  
Ureteropelvic Junction Obstruction ◽  
Good Health ◽  
Distal Portion ◽  
Ureteropelvic Junction ◽  
Absorbable Suture ◽  
Distal Ureter ◽  
Upj Obstruction ◽  
Age Range

Objective: The most common cause of urinary obstruction is ureteropelvic junction (UPJ) obstruction. In short stenosis, a dismembered pyeloplasty is performed, but for long segment stenosis, the procedure is not well defined. We present the reverse flap ureteroplasty method, which we prepared from the pelvis for use in long segment UPJ obstruction. Methods: Between 2007 and 2016, we operated on 6 cases (4 males, 2 females) with an age range of 2–6 months. After reaching the UPJ region, depending on the length of the long segment obstruction, a flap measuring 25–35 mm in length was prepared from the pelvis so that its width would be 10–12 mm on the pelvis side and 10 mm in the distal portion. It was then reversed and tubularized with an absorbable suture over a 10-French nelaton catheter. The end of this ureter and the end of the distal ureter were spatulated and anastomosed. A double J and minivac drain were used in each case. Results: There were no complications in the postoperative period of all our patients. They were all discharged with good health. Follow-up with renal ultrasonography showed that the anteroposterior diameters were decreased and that parenchymal thicknesses had returned to normal. Secondary stenosis, flap necrosis, and retraction did not develop. Conclusion: Because the blood supply of the pelvis is increased in patients with UPJ obstruction, a reverse flap of adequate length with preserved blood supply can be achieved and tubularized. We suggest that this method will be appropriate for the treatment of long segment UPJ obstruction.

scholarly journals Giant fibroepithelial polyp of the ureter

2017 ◽  
pp. bcr-2016-218999 ◽  
Author(s):  
Mayank Gupta ◽  
Sanjeet Roy ◽  
Cornerstone Wann ◽  
Anu Eapen
Keyword(s):  
Urothelial Carcinoma ◽  
Rare Case ◽  
Histopathological Examination ◽  
Frozen Section ◽  
Polypoid Lesion ◽  
Ureteropelvic Junction ◽  
Fibroepithelial Polyp ◽  
Upj Obstruction

Giant fibroepithelial polyp is a rare cause of ureteric/ureteropelvic junction (UPJ) obstruction. We report a rare case of giant fibroepithelial polyp in a 32-year-old woman involving the whole length of the ureter, reaching up to the UPJ which was clinically and radiologically considered to be urothelial carcinoma. Frozen section showed a polypoid lesion lined by urothelium with no evidence of dysplasia or malignancy. Subsequently, nephroureterectomy was done as there was marked renal hydronephrosis and it was impossible to separate the polyp from the wall of the ureter. Histopathological examination and immunohistochemistry confirmed the diagnosis of giant fibroepithelial polyp, ruling out malignancy.

V1819: From Davis to da Vinci: The Evolution in the Treatment of Ureteropelvic Junction (UPJ) Obstruction

2007 ◽  
Vol 177 (4S) ◽  
pp. 605-605
Author(s):  
Mark Chang ◽  
Mauricio Davalos ◽  
Israel Franco ◽  
Majid Eshghi
Keyword(s):  
Da Vinci ◽  
Ureteropelvic Junction ◽  
Upj Obstruction

scholarly journals Postnatal evaluation of intrauterine hydronephrosis due to ureteropelvic junction obstruction

2013 ◽  
Vol 28 (suppl 1) ◽  
pp. 33-36 ◽  
Author(s):  
Carlos Augusto Fernandes Molina ◽  
Inalda Facincani ◽  
Valdair Francisco Muglia ◽  
Whemberton Martins de Araujo ◽  
Marcelo Ferreira Cassini ◽  
...  
Keyword(s):  
Renal Function ◽  
Surgical Treatment ◽  
Surgical Approach ◽  
Urinary Tract Obstruction ◽  
Ureteropelvic Junction ◽  
Fetal Hydronephrosis ◽  
Antenatal Hydronephrosis ◽  
Upj Obstruction ◽  
Definition Of

PURPOSE: Fetal hydronephrosis is a frequent finding due to advances in prenatal ultrasonography. The definition of fetal and neonatal urinary tract obstruction is a very difficult task requiring confirmation of reduced renal function and hydronephrosis. In this study we followed a series of consecutive patients with intrauterine hydronephrosis that persisted during post-natal life. METHODS: 116 newborns with antenatal hydronephrosis diagnosed by ultrasound and submitted to a specific post-natal evaluative protocol with a follow-up period of 6 years. RESULTS: In 45 (38.8%) of 116 patients, ureteropelvic junction (UPJ) obstruction was confirmed and surgical correction of the UPJ obstruction was done in 19 patients. From 26 children who were initially submitted to non-surgical treatment, only 6 (23%) needed a surgical approach during follow up. Overall analysis showed that surgery was performed in 25 patients with UPJ obstruction, and the others 20 patients were kept under clinical observation, since normal renal function was confirmed by scintigraphy scans. CONCLUSION: Fetal hydronephrosis due to UPJ obstruction deserves careful postnatal evaluation. UPJ obstruction is the most frequent anomaly and its surgical treatment has very precise indications. The evaluative protocol was useful in identify patients that could be followed-up with a non-surgical approach.

Comparative Proteome Analyses of Ureteropelvic Junction Obstruction and Surrounding Ureteral Tissue

2020 ◽  
Vol 209 (1) ◽  
pp. 2-12
Author(s):  
Uzay Görmüş ◽  
Murat Kasap ◽  
Gürler Akpınar ◽  
Halil Tuğtepe ◽  
Aylin Kanlı ◽  
...  
Keyword(s):  
Atp Synthase ◽  
Proximal Part ◽  
Apolipoprotein A1 ◽  
Ureteropelvic Junction ◽  
Two Dimensional Gel Electrophoresis ◽  
Tissue Samples ◽  
Upj Obstruction ◽  
Mitochondrial Atp Synthase ◽  
Lipase Inhibition ◽  
Carbonic Anhydrase 1

Ureteropelvic junction (UPJ) obstruction is a common problem in children, but its etiology remains unclear. In this study, the proteome profiles of the obstructed segment and its surrounding distal and proximal parts were comparatively evaluated. Twelve children younger than 2 years of age with unilateral intrinsic UPJ obstruction were included. The excised operational tissue was divided into three parts immediately after resection: the obstructed part (Obst), the distal normal ureteral part (Dist), and the proximal part of the obstructed segment (Prox). Proteins extracted from the tissue samples were subjected to two-dimensional gel electrophoresis analysis to identify differentially regulated proteins. Spot analysis revealed that four proteins, namely tropomyosin beta and alpha-1 chains, actin and desmin, were upregulated in Obst in comparison to Dist. A similar analysis between Obst and Prox showed that heat shock protein beta-1 and carbonic anhydrase-1 were upregulated in Obst, while tropomyosin alpha 3 chain and ATP synthase beta were upregulated in Prox. The last comparative analysis between Dist and Prox revealed upregulation of annexin-A5 and annexin-A1 in Dist and vimentin, mitochondrial ATP synthase subunit-beta, peroxiredoxin-2, and apolipoprotein-A1 in Prox. Bioinformatics analysis using the STRING server indicated that the differentially regulated proteins, altogether, point to the changes occurring in muscle filament sliding pathway. When regulations occurring in each group were mutually compared, a change in lipase inhibition activity was detected by STRING. This is the first study scrutinizing changes occurring in protein profiles in UPJ.

scholarly journals Minimally Invasive Approach of a Retrocaval Ureter

2016 ◽  
Vol 2016 ◽  
pp. 1-5
Author(s):  
Nuno Fidalgo ◽  
Hugo Pinheiro ◽  
Frederico Ferronha ◽  
Jorge Morales ◽  
Luís Campos Pinheiro
Keyword(s):  
Minimally Invasive ◽  
Clinical Case ◽  
Laparoscopic Approach ◽  
Ureteropelvic Junction ◽  
Minimally Invasive Approach ◽  
Invasive Approach ◽  
Retrocaval Ureter ◽  
Upj Obstruction ◽  
Open Pyeloplasty

The retrocaval ureter is a rare congenital entity, classically managed with open pyeloplasty techniques. The experience obtained with the laparoscopic approach of other more frequent causes of ureteropelvic junction (UPJ) obstruction has opened the method for the minimally invasive approach of the retrocaval ureter. In our paper, we describe a clinical case of a right retrocaval ureter managed successfully with laparoscopic dismembered pyeloplasty. The main standpoints of the procedure are described. Our results were similar to others published by other urologic centers, which demonstrates the safety and feasibility of the procedure for this condition.

scholarly journals Immunohistochemical and electron microscopic examination of Cajal cells in ureteropelvic junction obstruction

2013 ◽  
Vol 7 (5-6) ◽  
pp. 311 ◽  
Author(s):  
Alper Eken ◽  
Seyda Erdogan ◽  
Yurdun Kuyucu ◽  
Gulsah Seydaoglu ◽  
Sait Polat ◽  
...  
Keyword(s):  
Microscopic Examination ◽  
Circular Muscle ◽  
Electron Microscopic Examination ◽  
Muscle Layer ◽  
Ureteropelvic Junction ◽  
Electron Microscopic ◽  
Upj Obstruction ◽  
Cajal Cells ◽  
Group A ◽  
Ureteral Peristalsis

Objective: We examine the ultrastructural configurations of Cajalcells by electron microscopy, as well as the quantitative changesoccurring in Cajal cells by light microscopy.Methods: In total, 35 patients with ureteropelvic junction (UPJ)obstruction and 7 patients without obstruction were comparedimmunohistochemically with c-kit (CD117) to quantify the numberof cells. On electron microscopic examination, 7 patients with UPJobstruction and 3 patients without obstruction were compared toevaluate the changes which occurred in the ultrastructural configurationof the Cajal cells.Results: On light microscopic examination, it was determined thatthe Cajal cells, which demonstrate c-kit (CD117) immunoreactivecharacter, were located near the circular muscle layer and parallelto the muscle cells. The number of Cajal cells in the control groupwas significantly increased compared to the number of cells inpatients with UPJ obstruction (p < 0.001). On electron microscopicexamination, the number of interstitial cells was also higher in thecontrol group. A decrease in the number of the caveolae in thesecells was seen in the group with UPJ obstruction compared to thecontrol group.Conclusion: In UPJ obstruction, a decrease in the number of Cajalcells, as well as the changes in the morphologic structure of theCajal cells, indicates that these cells have a role in the pacemakersystem and are associated with ureteral peristalsis.

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