Pyeloureteral dynamics in the intact and chronically obstructed multicalyceal kidney

1981 ◽  
Vol 241 (5) ◽  
pp. R398-R411 ◽  
Author(s):  
C. E. Constantinou ◽  
J. C. Djurhuus
Keyword(s):  
Urinary Tract ◽  
Ureteral Obstruction ◽  
Intravenous Infusion ◽  
Upper Urinary Tract ◽  
Urine Flow ◽  
Hierarchical Organization ◽  
Bolus Volume ◽  
Pelvic Contractions ◽  
The Mean ◽  
Pelvic Pressure

The transport of urine in the upper urinary tract of the multicalyceal kidney was studied in healthy and chronically obstructed pigs in terms of renal pelvic pressure, rate of and coordination of ureteral contractions, and bolus volume. The variations of these parameters to diuresis was examined by incremental elevation of urine output effected by intravenous infusion of mannitol. In 16 healthy animals the mean variation in urine flow was 0.01-3.20 ml/min, the change in peristaltic rate ranged from 0.763 to 5.125 min-1, and bolus volume from 0.003 to 2.083 ml.. In 14 chronically obstructed kidneys, for a mean variation in urine flow of 0.006-5.4 ml/min, peristaltic rate ranged from 0.237 to 6.095 min-1 and bolus volume from 0.00 to 1.80 ml. Discoordinated contractions, bursts of peristalsis, and incompletely transmitted pelvic contractions were characteristic of a chronically obstructed system. These observations are compared with the unobstructed unicalyceal and multicalyceal kidney. The disrupting impact of chronic ureteral obstruction on the hierarchical organization of the pyeloureteral pacemaker system is discussed.

Criteria for Ureteral Obstruction by Functional Imaging of the Upper Urinary Tract

2015 ◽  
pp. 225-231
Author(s):  
W. M�ller-Schauenburg ◽  
U. Hofmann ◽  
U. Feine ◽  
A. Flach ◽  
W. D. Erdmann
Keyword(s):  
Urinary Tract ◽  
Functional Imaging ◽  
Ureteral Obstruction ◽  
Upper Urinary Tract

Pelviureteric junction obstruction and megaureter in children

2015 ◽  
Author(s):  
Michiel F. Schreuder
Keyword(s):  
Urinary Tract ◽  
Upper Urinary Tract ◽  
Urine Flow ◽  
Ultrasound Screening ◽  
Antenatal Ultrasound ◽  
Antenatal Hydronephrosis ◽  
Pelviureteric Junction Obstruction ◽  
Good Marker ◽  
Urinary Tract Dilatation ◽  
Vesicoureteric Junction

Two main sites of urine flow obstruction in the upper urinary tract are located at the pelviureteric and vesicoureteric junctions, both of which result in urinary tract dilatation. With current antenatal ultrasound screening, most patients are identified before birth, and 10–30% of infants with antenatal hydronephrosis are found to have pelviureteric junction obstruction, and 5–10% vesicoureteric junction obstruction/megaureter. In addition, a megaureter can also be based on urine reflux, even in combination with obstruction, or be a non-refluxing non-obstructed megaureter. In case of obstruction, surgery may be indicated, but identifying cases that need to be operated on is challenging and no good marker to assist in this differentiation is available yet.

Fluconazole Treatment in Torulopsis Glabrata Upper Urinary Tract Infection Causing Ureteral Obstruction

1992 ◽  
Vol 147 (4) ◽  
pp. 1116-1117 ◽  
Author(s):  
Xavier Corbella ◽  
Jordi Carratala ◽  
Manuel Castells ◽  
Begona Berlanga
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Ureteral Obstruction ◽  
Upper Urinary Tract ◽  
Torulopsis Glabrata

Regulation of renal pelvic pressure by diuresis and micturition

1990 ◽  
Vol 259 (3) ◽  
pp. R637-R644 ◽  
Author(s):  
J. C. Djurhuus ◽  
J. Frokjaer ◽  
T. Munch Jorgensen ◽  
L. Knudsen ◽  
T. Pham ◽  
...  
Keyword(s):  
Renal Pelvis ◽  
Upper Urinary Tract ◽  
Bladder Pressure ◽  
Ureterovesical Junction ◽  
Urinary Bladder Pressure ◽  
Pelvic Contractions ◽  
Left And Right ◽  
Pressure Changes ◽  
Pelvic Pressure

The influence of the voiding cycle and diuresis on the hydrodynamic pressures of the renal pelvis in the multicalyceal kidney of miniature pigs has been examined. Identification of the pressure patterns characteristic of the renal pelvis with an undisturbed pelviureteric and ureterovesical junction was emphasized. The frequency and amplitude of contractions in the renal pelvis were measured bilaterally. The patterns of renal pelvic pressure changes were interpreted during bladder filling and emptying and diuresis to evaluate the mechanisms facilitating the pressure isolation of the upper urinary tract. These studies were undertaken in the awake pig equipped with a long-term radiotelemetry implant transmitting renal pelvic and urinary bladder pressure. The results show that renal pelvic contractions are low-pressure events having an amplitude of 10.3 +/- 4.2 cmH2O and a frequency of 6.6 +/- 0.7 contractions/min. During basal hydration, the process of renal pelvic filling and emptying is active, with rhythmic pelvic contractions. The left and right renal pelvis demonstrate approximately equal frequency, 1.04:1.00, but are not synchronous. Furosemide-stimulated diuresis produces radical changes in the renal pelvis by transforming emptying from an active to passive mode and facilitating the transmission of voiding pressures and spontaneous bladder pressures to the kidney.

scholarly journals Correlation of prostate volume with severity of lower urinary tract symptoms as measured by international prostate symptoms score and maximum urine flow rate among patients with benign prostatic hyperplasia

2021 ◽  
Vol 27 (1) ◽  
Author(s):  
Mudi Awaisu ◽  
Muhammed Ahmed ◽  
Ahmad Tijjani Lawal ◽  
Abdullahi Sudi ◽  
Musliu Adetola Tolani ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Flow Rate ◽  
Lower Urinary Tract ◽  
Prostate Volume ◽  
Prostatic Hyperplasia ◽  
Urine Flow ◽  
Urine Flow Rate ◽  
Urinary Tract Symptoms ◽  
The Mean ◽  
Lower Urinary

Abstract Background The aim of the study is to find the correlation between the prostate volume and severity of lower urinary tract symptoms (LUTS) as measured by international prostate symptoms score and maximum urine flow rate among patients with benign prostatic hyperplasia (BPH). Methods The study was a prospective correlational study conducted between June 2016 and November 2017. A total of 290 patients who presented with LUTS suggestive of BPH and satisfied the inclusion criteria were consecutively recruited. Clinical evaluation including digital rectal examination of the prostate was done. Symptoms severity was assessed using the self-administered international prostate symptoms score (IPSS) questionnaire. Prostate volume was determined by transrectal ultrasound scan, and the urine flow rate was measured using uroflowmeter. Data were analyzed using SPSS version 20.0, and p value < 0.05 was taken to be statistically significant. Results The mean age of the patients was 64.22 ± 9.04 years with a range of 40 to 95 years. Most of the patients had moderate symptoms (55%) on IPSS with the mean IPSS value of 16.41 ± 7.43. The mean Qmax value was 16.55 ± 7.41 ml/s, and the median prostate volume (IQR) was 45.05 (35, 59). There was a positive significant correlation between prostate volume and IPSS (r = 0.179, p = 0.002) and a negative significant correlation between prostate volume and Qmax (r = − 0.176, p = 0.003). Conclusion This study showed a significant correlation between the prostate volume and IPSS, and also between prostate volume and maximum flow rate (Qmax).

scholarly journals Quantitative evaluation of upper urinary tract pump function in pigs with acute unilateral lower ureteral obstruction by 640-slice dynamic volume CT

BMC Urology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Chongwen Mao ◽  
Cong Peng ◽  
Song Li ◽  
Liling Chen ◽  
Mengjing You ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Renal Pelvis ◽  
Ureteral Obstruction ◽  
Upper Urinary Tract ◽  
Acute Obstruction ◽  
Left Ureter ◽  
Pump Function ◽  
Continuous Dynamic ◽  
Volume Ct ◽  
Dynamic Volume Ct

Abstract Background It is a challenging problem to differentiate obstructive hydronephrosis from noninvasive evaluation of renal pelvis and ureteral motility in patients. The purpose of this study was to explore the value of 640-slice dynamic volume CT (DVCT) in the quantitative measurement of upper urinary tract (UUT) pump function after acute unilateral lower ureteral obstruction in pigs. Methods In this study, a perfusion pig model was constructed by constant pressure perfusion testing of the renal pelvis and left nephrostomy. The perfusion and pressure measuring devices were connected to create a state of no obstruction and acute obstruction of the lower part of the left ureter. After successful modelling, continuous dynamic volume scanning of the bilateral renal excretion phase was performed with 640-slice DVCT, and pump functions of the renal pelvis and part of the upper ureter were calculated and analysed. No obstruction or acute obstruction of the lower part of the left ureter was observed. Pump functions of the renal pelvis and part of the upper ureter were determined. Results The results showed that after LUUT fistulostomy, the time difference between the average UUT volume and positive volume value increased gradually, and the calculated flow velocity decreased, which was significantly different from that of the RUUT. The volume difference of the LUUT increased significantly in mild obstruction. In the bilateral control, the volume change rate of the LUUT increased with mild obstruction and decreased with severe obstruction, and there was a significant difference between the left and right sides. Conclusion The continuous dynamic volume scan and measurement of 640-slice DVCT can obtain five pump function datasets of UUT in pigs with acute lower ureteral obstruction.

scholarly journals Initial Results of Laser Ureteroscopy Treatment for Lithiasis of the Upper Urinary Tract at Aristide Le Dantec Hospital in Dakar (Senegal)

2021 ◽  
Vol 4 (2) ◽  
pp. 13-19
Author(s):  
Oumar Gaye ◽  
Ngor Mack Thiam ◽  
Youssef Bellamine ◽  
Modou Ndiaye ◽  
Boubacar Fall ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Minimally Invasive ◽  
Laser Treatment ◽  
Dietary Habits ◽  
Statistical Significance ◽  
Upper Urinary Tract ◽  
Ureteral Stones ◽  
Residual Fragment ◽  
Postoperative Control ◽  
The Mean

Background: In Africa, lithogenesis was initially considered rare and it was mostly caused by infections. Recent studies suggest that obesity, change in dietary habits (milk, dairy products) and hot climate can contribute to an increase of the condition in the region. Over the past decades, the management of upper urinary tract urolithiasis has evolved significantly with minimally invasive techniques. The challenge for sub-Saharan countries is related with the acquisition and the training for minimally invasive treatment. In fact, open surgery has less indications in the management of urolithiasis. The aim of this study is to evaluate the preliminary results of ureteroscopic laser treatment for upper urinary tract lithiasis in our hospital. Methods: This was a prospective, descriptive study realized between June 2016 and December 2018. The patients included were those who had ureteroscopic laser treatment for upper urinary tract lithiasis. The treatment was performed under general anesthesia by two surgeons. The studied parameters were: age, sex, patient medical history, comorbidities, renal function, cytobacteriological examination of urine, characteristics of lithiasis, intra and postoperative complications (using the Clavien–Dindo classification), ureteroscopic laser failures (frequency and causes). Success of treatment was defined by: the absence of a residual fragment at the renal and ureteral level or of a residual fragment <4 mm at the renal level on the control imaging. Data analysis was done with IBM SPSS Statistic 23 software. Statistical significance was considered when P < 0.05. Results: This study involved 43 patients. The mean age was 40.84 years ± 15.33 years. The age group between 30 and 39 years was predominant. The sex ratio was 1.26. Nephritic colic was the circumstance of discovery in 93.02%. The Uro-CT scan performed in all our patients, revealed kidney stones in 16.3% and ureteral stones in 83.7%. The right side was the most involved in 55.8%. The mean size of the stones was 12.2 mm ± 4.89 at the renal level and 12.05 mm ± 5.54 at the ureteral level. The semi-rigid ureteroscope was used in 88.37% and the flexible ureteroscope in 11.63%. The lithiasis was visualized in 74.4% of cases. Laser fragmentation was performed in 69.77% of cases. A J stent was placed after 72.1% of cases. Pelvic ureteral stripping and pelvic ureteral aspiration were realized in one case each. Acute pyelonephritis (ANP) was observed in 25.6% of patients. There were 75% fragment free at postoperative control. Any factors associated with treatment failure were not found.

Initial outcomes of robotic assisted laparoscopic upper urinary tract reconstruction – report of the first 7 cases

2018 ◽  
Vol 8 (2) ◽  
Author(s):  
Anh Toàn Đỗ ◽  
◽  
Keyword(s):  
Urinary Tract ◽  
Operation Time ◽  
Upper Urinary Tract ◽  
Stone Extraction ◽  
Short Term ◽  
Robotic Assisted ◽  
Urinary Tract Reconstruction ◽  
The Mean ◽  
Radiographic Improvement ◽  
Robotic Assisted Laparoscopy

Tóm tắt Đặt vấn đề: Đánh giá kết quả ban đầu phẫu thuật nội soi ổ bụng với Rô bốt hỗ trợ tạo hình đường tiết niệu trên tại Bệnh viện Bình Dân.Phương pháp nghiên cứu: Số liệu thu thập từ 07 trường hợp (TH) được phẫu thuật nội soi ổ bụng với Rô bốt hỗ trợ tạo hình đường niệu trên, gồm các trường hợp tạo hình khúc nối bể thận – niệu quản có hoặc không lấy sỏi bể thận, phẫu thuật cắt nối niệu quản tận- tận và cắm lại niệu quản vào bàng quang. Các TH này được tiến hành tại Bệnh viện Bình Dân, từ 11/ 2016 đến 3/2017. Kết quả chính bao gồm khả năng cải thiện triệu chứng lâm sàng cũng như trên hình ảnh học và ghi nhận tỷ lệ tai biến - biến chứng xảy ra. Kết quả: Tất cả 07 TH đều phẫu thuật thành công, dù thời gian mổ tương đối dài, trung bình là 222,8 phút (150 – 330 phút), không có trường hợp nào xảy ra tai biến - biến chứng. Sau rút thông JJ niệu quản 01 tháng, chưa ghi nhận trường hợp nào bị tái phát. Kết luận: Qua 07 TH đầu tiên được phẫu thuật nội soi ổ bụng tạo hình đường tiết niệu trên với hỗ trợ Rô bốt cho thấy tuy thời gian mổ khá dài nhưng khả thi và an toàn, có thể thay thế mổ mở trong một số trường hợp phức tạp. Tuy nhiên, cần thực hiện với số lượng lớn hơn và theo dõi thêm để có thể đánh giá kết quả lâu dài của phương pháp này trong điều kiện thực tế hiện nay. Abstract Introduction: To evaluate the initial outcomes of robotic assisted laparoscopic (RAL) upper urinary tract (UUT) reconstruction at Binh Dan hospital. Material and Methods: 07 patients underwent RAL UUT reconstruction including pyeloplasty with or without stone extraction, uretero-ureterostomy and ureteric reconstruction at Binh Dan hospital from November 2016 to March 2017. Primary outcomes were symptomatic and radiographic improvement of obstruction and complication rate. Results: All 07 cases of RAL UUT reconstruction had good clinical and radiographic improvement without any significant complication (over grade I of Clavien Dindo classification). The mean operation time was 222,8 minutes (150 – 330 minutes). Conclusion: Robotic-assisted laparoscopic UUT could be performed safely with good short-term results and be considered a reasonable alternative to the open procedure for robotic experienced surgeons in some complicated cases. Keyword: Upper urinary tract reconstruction, robotic assisted laparoscopy.

Sign in / Sign up

Export Citation Format

Share Document