scholarly journals Exacerbation of Congenital Hydronephrosis as the First Presentation of COVID-19 Infection in Children: A Case Series

2021 ◽  
Author(s):  
Masoumeh Mohkam ◽  
Mahnaz Jamee ◽  
Farshid Kompani ◽  
Mitra Khalili ◽  
Atena Seifi ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Case Series ◽  
Upper Urinary Tract ◽  
Abrupt Increase ◽  
Antenatal Hydronephrosis ◽  
Congenital Hydronephrosis ◽  
Abdominal Masses ◽  
The Common ◽  
Case Presentations

Abstract Background:Congenital hydronephrosis is one of the most common abnormalities of the upper urinary tract, which can be exacerbated by a variety of intrinsic or extrinsic triggers. The urinary tract system is one of the major organs complicated by COVID-19 infection. Case presentations:Here we report five patients with an established diagnosis of congenital hydronephrosis, who presented with acute abdominal pain and fever and an abrupt increase in the anteroposterior pelvic diameter (APD). Patients had a previous stable course and were under regular follow-up with serial ultra-sonographic studies. They underwent surgery or supportive treatment due to the later exacerbation of hydronephrosis. Based on the clinical and imaging findings, no plausible etiologies for these exacerbation episodes, including infection, nephrolithiasis or abdominal masses, could be postulated. The common aspect in all these patients was the evidence of a COVID-19 infection. Conclusions:Infection with COVID-19 in children with antenatal hydronephrosis may exacerbate the degree of hydronephrosis and renal APD in ultrasonography, which itself may be mediated by the increase in inflammatory mediators.

The role of adjuvant chemotherapy for pT2-4 upper urinary tract urothelial cancer: Exploratory analysis of large multi-institutional study (JCOG1110A).

2019 ◽  
Vol 37 (7_suppl) ◽  
pp. 374-374
Author(s):  
Junichi Inokuchi ◽  
Kentaro Kuroiwa ◽  
Hiroyuki Nishiyama ◽  
Takahiro Kojima ◽  
Yoshiyuki Kakehi ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Adjuvant Chemotherapy ◽  
Urothelial Cancer ◽  
Multivariable Analysis ◽  
Case Series ◽  
Upper Urinary Tract ◽  
Free Survival ◽  
Case Series Study ◽  
The Impact

374 Background: Recently, it was presented that adjuvant chemotherapy (AC) after radical nephroureterectomy (RNU) improved metastasis-free survival in pT2-4 upper urinary tract urothelial cancer (UTUC) with a median follow-up of 17.6 months (POUT study). However, the impact of AC on other outcomes remains unclear, especially for pT2 disease. Methods: The large case-series study, JCOG1110A, included 2,744 patients with non-metastatic UTUC who underwent RNU in 30 institutions in Japan between 1995 and 2009. In this analysis, patients with prior history or synchronous bladder cancer, patients who received neoadjuvant chemotherapy were excluded. Patients who received AC except for GC (gemcitabine, cisplatin) or MVAC (methotrexate, vinblastine, doxorubicin, cisplatin) were also excluded. We extracted pT2-4 patients as study subjects from remaining patients, and identified 950 patients. The impact of AC on overall survival (OS) and extravesical recurrence-free survival (RFS) were examined by the multivariable Cox regression model in all patient and pT2, pT3-4 subgroups. Results: Of 244 pT2 and 706 pT3-4 patients with a median follow-up of 41.1 months, AC were performed in 34 (13.9%) and 183 (25.9%). In AC (+) group, high frequency of pT3-4 disease, high grade tumor, pathological node metastasis, lymphovascular invasion, and younger age were seen compared to AC (-) group. The 5-year survival of the AC (+) and AC (-) were 66.0% and 67.4% for OS, 58.0% and 57.8% for RFS, respectively. Multivariable analysis showed the improved outcome in AC (+) group on both OS and RFS in all patients (OS: HR 0.60, 95% CI 0.41-0.89, RFS: HR 0.71, 95% CI 0.51-1.00). Although AC had a great impact on OS in pT3-4 patients (HR 0.56, 95% CI 0.36-0.87), there was no clear impact on either OS or RFS in pT2 patients (OS: HR 0.81, 95% CI 0.32-2.07, RFS: HR 0.69, 95% CI 0.29-1.62). Conclusions: AC after RNU had the significant impacts on OS and RFS in pT2-4 UTUC patients. This tendency was seen strongly in pT3-4 patients, but not in only pT2 patients. The randomized trial is necessary to determine the utility of AC in UTUC patients, especially in pT2 patients. Clinical trial information: NCT01993979.

scholarly journals A study on postnatal evaluation and follow-up of infants with antenatally detected hydronephrosis

2017 ◽  
Vol 4 (5) ◽  
pp. 1677
Author(s):  
Soundaiyan Balasankar ◽  
Jeyaraman Balasubramanian
Keyword(s):  
Urinary Tract ◽  
Surgical Intervention ◽  
P Value ◽  
Postnatal Life ◽  
Antenatal Hydronephrosis ◽  
Urinary Tract Anomaly ◽  
Antenatal Ultrasonography ◽  
Significant Pathology ◽  
Anteroposterior Renal Pelvic Diameter

Background: Antenatal hydronephrosis(ANH) has now become a frequent diagnosis with the increasing use of antenatal ultrasonography. Objective of present study was to evaluate and follow up infants with antenatally detected hydronephrosis and to determine whether there is significant correlation between anteroposterior renal pelvic diameter detected in antenatal USG and urinary tract anomalies detected postnatally.Methods: After obtaining an informed consent, all neonates with antenatal ultrasound showing hydronephrosis (n=80) were enrolled in the study. Postnatal ultrasound was done at 3 days ,1 month and 6 months of postnatal life. Atleast 6 months followup was done to look for spontaneous resolution or other significant pathology. Micturating cystourethrography/radionuclide scan done in selected cases.Results: Out of 80 cases ,43 had mild,24 had moderate and 13 had severe degrees of hydronephrosis.31 of them (9 mild,10 moderate and 12 with severe hydronephrosis) had postnatal anomaly detected.14 of them (1 mild, 4 moderate and 9 with severe hydronephrosis) underwent surgery. As the grade of antenatal hydronephrosis increases from mild, moderate to severe, the relative risk of postnatal anomaly and requirement of surgical intervention also increased (p value<0.0001).Conclusions: Antenatal hydronephrosis may be associated with significant postnatal urinary tract anomaly with risk quantified by the measurement of anteroposterior renal pelvic diameter(APPD). 

Is baseline routine renal ultrasound indicated for all MS patients?

2019 ◽  
Vol 96 (1134) ◽  
pp. 194-196
Author(s):  
Igor B Títoff ◽  
Victoria Titoff ◽  
Thomas F Scott
Keyword(s):  
Urinary Tract ◽  
Upper Urinary Tract ◽  
Renal Ultrasound ◽  
Red Flags ◽  
Inclusion Criteria ◽  
Detrusor Sphincter Dyssynergia ◽  
History Of ◽  
Bladder Symptoms ◽  
Tract Infections

BackgroundMost patients with multiple sclerosis (MS) develop multiple urological complaints due to hyperactive or hypoactive bladder, and may have detrusor-sphincter dyssynergia. Routine renal ultrasound (RUS) screening has been recommended for both symptomatic and asymptomatic MS patients; however, there is little data to support this practice.MethodsProspectively screened consecutive MS clinic patients in 2016–2017 with functional systems scores (FSS) indicating moderate to severe neurogenic bladder symptoms (FSS bladder ≥2) were sent for RUS. We also screened for history of urinary tract infections.Results872 patients were screened between 3 September 2016 and 13 April 2017. 58 patients met inclusion criteria for RUS. 6 were excluded due to non-compliance with testing or unavailability of results; 52 patients were imaged. Only 3/52 patients were found to have renal pathology requiring follow-up. Of those three, one had known symptomatic nephrolithiasis, and one had subsequently normal findings, leaving one patient newly found to have valid abnormal upper urinary tract (UUT) findings. Multiple incidental findings were also discovered.ConclusionThe minimal yield for significant UUT pathology found in this enriched group of symptomatic MS patients indicates that RUS screening for asymptomatic MS patients without clear risk factors is not indicated. Red flags for high risk of UUT complications should be used as triggers for baseline RUS screening in MS patients.

C132 OUR EXPERIENCE WITH 13-YEARS FOLLOW-UP OF PATIENTS WITH UPPER URINARY TRACT TUMORS

2010 ◽  
Vol 9 (6) ◽  
pp. 651-652
Author(s):  
P. Macek ◽  
Z. Valova ◽  
V. Soukup ◽  
T. Hanus ◽  
I. Pavlik ◽  
...  
Keyword(s):  
Urinary Tract ◽  
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.

Laparoscopic ureterocalicostomy for complicated upper urinary tract obstruction: mid-term follow-up

2013 ◽  
Vol 46 (5) ◽  
pp. 865-869 ◽  
Author(s):  
Marco Antonio Arap ◽  
Hiury Andrade ◽  
Fabio Cesar Miranda Torricelli ◽  
Francisco Tibor Denes ◽  
Anuar Ibrahim Mitre ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Obstruction ◽  
Upper Urinary Tract ◽  
Upper Urinary Tract Obstruction

scholarly journals Accuracy of photodynamic diagnosis in the detection and follow-up of patients with upper urinary tract lesions: Initial 3-year experience

2012 ◽  
Vol 10 (2) ◽  
pp. 138-142 ◽  
Author(s):  
Omar M. Aboumarzouk ◽  
Sarfraz Ahmad ◽  
Harry Moseley ◽  
Slawomir G. Kata
Keyword(s):  
Urinary Tract ◽  
Upper Urinary Tract ◽  
Photodynamic Diagnosis

scholarly journals Impact of Initial Computed Tomography Findings on Management of Atypical Urinary Cytology of the Upper Urinary Tract

2021 ◽  
pp. 1-5
Author(s):  
Kotaro Takemura ◽  
Taketo Kawai ◽  
Yusuke Sato ◽  
Jimpei Miyakawa ◽  
Satoru Taguchi ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Urinary Tract ◽  
Upper Urinary Tract ◽  
Wall Thickening ◽  
Urinary Cytology ◽  
Class Iii ◽  
Ct Findings ◽  
Retrograde Ureteropyelography ◽  
Tumor Like Lesions

<b><i>Introduction:</i></b> Management of patients with atypical urinary cytology (class III) of the upper urinary tract is often complicated because some patients develop upper urinary tract urothelial carcinoma (UTUC). Here, we aimed to help define the optimal management of these patients. <b><i>Methods:</i></b> We investigated 31 patients who underwent retrograde ureteropyelography (RP) and were diagnosed with atypical findings of upper urinary tract cytology. <b><i>Results:</i></b> UTUC was revealed in 17 of 31 patients during the follow-up period of 1 year or longer. Tumor-like lesions and wall thickening in the upper urinary tract on initial computed tomography (CT) were significant predictors of UTUC (<i>p</i> = 0.0002 and <i>p</i> = 0.012, respectively). All 11 patients with tumor-like lesions and 3 of 8 patients with wall thickening on initial CT underwent nephroureterectomy, and UTUC was confirmed histologically. Moreover, 3 of 12 patients with hydronephrosis only or with normal findings later went on to develop UTUC. Repeated RP performed within 6 months from the initial RP was able to distinguish patients with UTUC from those without, even in individuals with normal CT findings. <b><i>Discussion/Conclusion:</i></b> Repeated RP based on initial CT findings is recommended in patients with atypical urinary cytology of the upper urinary tract. Nephroureterectomy without repeated RP may be warranted in patients with tumor-like lesions on initial CT findings.

Sign in / Sign up

Export Citation Format

Share Document