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At least 199 records · Page 11Linked to original sources
PubMed2006

Accurate scaling of digital radiographs of the pelvis. A prospective trial of two methods.

Magnification of anteroposterior radiographs of the pelvis is variable. To improve the accuracy of templating, reliable and radiographer-friendly methods of scaling are necessary. We assessed two methods of scaling digital radiographs of the pelvis: placing a coin of known diameter in the plane of interest between the patient's thighs, and using a caliper to measure the bony width of the pelvis. A total of 39 patients who had recently undergone hemiarthroplasty of the hip or total hip replacement were enrolled in the study. The accuracy of the methods was assessed by comparing the actual diameter of the head of the prosthesis with the measured on-screen value. The coin method was within a mean of 1.12% (0% to 2.38%) of the actual measurement, the caliper group within 6.99% (0% to 16.67%). The coin method was significantly more accurate (p < 0.001). It was also reliable and radiographer friendly. We recommend it as the method of choice for scaling radiographs of the pelvis before hip surgery.

Arthroplasty, Replacement, Hip↗
PubMed1983

Discrepancy between the renal pelvic fluctuations and the pacemaker discharges at the pelvi-calyceal border.

Experiments were performed in vitro to explore the influence of isoproterenol on the canine pelvi-ureteral system. The rhythmic changes of intrapelvic pressure became no longer manifest and simultaneously recorded electromyograms revealed disappearance of peristalsis at sites distal to the upper region of renal pelvis following application of isoproterenol, while the pacemaker at the pelvi-calyceal border continued to discharge with an enhanced pace. This result has demonstrated that the renal pelvic pressure recorded during treatment with isoproterenol did not reflect the pacemaker activity of the renal pelvis.

Animals↗
PubMed2001

Detailed ultrasonographic mapping of the pelvis in clinically normal horses and ponies.

OBJECTIVE: To map the equine pelvis using ultrasonography, validated by use of computed tomography (CT), magnetic resonance imaging (MRI), and measurements of frozen cadaver slices. ANIMALS: 6 ponies and 6 horses. PROCEDURE: Ultrasonographic examination of the pelvis was performed on 6 clinically normal ponies. Measurements were obtained for imaged structures. Computed tomography, MRI, and measurements of frozen sections were performed after death and used to verify measurements. Linear regression determined the degree of correlation between measurements obtained ultrasonographically and the other modalities. Six clinically normal horses were then examined by use of ultrasonography. For each structure measured mean, SD, and range were calculated. RESULTS: Data obtained from ponies revealed high correlations between ultrasonographic findings and those of CT, MRI, and frozen section measurements (r2 = 0.97, r2 = 0.99, and r2 = 0.99, respectively). Differences between structures measured on each side of the pelvis were not significant. Variation in size of structures was not associated with weight of horses. A correlation was not found between weight of horses and ponies and size of structure. CONCLUSIONS AND CLINICAL RELEVANCE: Ultrasonography can be used to accurately measure and evaluate the musculoskeletal structures of the pelvis of horses. The use of CT, MRI, and measurements of frozen sections provided a means of validating the ultrasonographic measurements. Reference range values determined in our study can be used to evaluate horses with suspected pelvic disease.

Animals↗
PubMed2003

Management of patellofemoral pain targeting hip, pelvis, and trunk muscle function: 2 case reports.

STUDY DESIGN: Case report. OBJECTIVE: To describe an alternative treatment approach for patellofemoral pain. BACKGROUND: Weakness of the hip, pelvis, and trunk musculature has been hypothesized to influence lower-limb alignment and contribute to patellofemoral pain. Two patients who had a chief complaint of patellofemoral pain and demonstrated lack of control of the hip in the frontal and transverse planes during functional movements were treated with an exercise program targeting the hip, pelvis, and trunk musculature. METHODS AND MEASURES: The patients presented in these 2 case reports did not exhibit obvious patellar malalignment or tracking problems; however, on qualitative assessment, both demonstrated excessive hip adduction, internal rotation, and knee valgus during gait and while performing a step-down maneuver. In addition, both patients exhibited weakness of the hip abductors, extensors, and external rotators, as demonstrated by hand-held dynamometry testing. Treatment in both cases occurred over a 14-week period and focused on recruitment and endurance training of the hip, pelvis, and trunk musculature. Functional status, pain, muscle force production, as well as subjective and objective assessment of lower-extremity kinematics during gait and a step-down maneuver were assessed preintervention and postintervention. RESULTS: Both patients experienced a significant reduction in patellofemoral pain, improved lower-extremity kinematics during dynamic testing, and were able to return to their original levels of function. Gluteus medius force production improved by 50% in patient A and 90% in patient B, while gluteus maximus force production improved 55% in patient A and 110% in patient B. Objective kinematic improvements in the step-down task also were demonstrated in patient A. CONCLUSION: Assessment and treatment of the hip, pelvis, and trunk musculature should be considered in the rehabilitation of patients who present with patellofemoral pain and demonstrate abnormal lower-extremity kinematics.

Adult↗
PubMed1993

[Computed tomography in the diagnosis of transitional cell carcinoma of the renal pelvis].

CT scans were carried out on 25 patients with transitional cell carcinoma of the renal pelvis. Of the 25 patients, tumors were identified in 24 patients (96%) and not in one patient on CT scan. Of the 24 patients the tumor was delineated as a solid mass in the renal pelvis and/or calyx in 15 and as an infiltrating mass in the renal parenchyma in 8 on CT scan. The depth of invasion was correctly estimated by CT in 18 of the 25 patients (72%). Whereas the tunica muscularis of the renal pelvis or the renal parenchyma was found involved in 3 of 10 patients (30%) in whom the diagnosis was made that the tumor was limited to the renal pelvic mucosa, the correct diagnosis was possible in 22 of 25 patients (88%) in whom the tumor was confined to the renal pelvic wall (pTa-pT2) or more invasive (pT3-pT4). In 6 of 7 patients with lymph nodes matastases enlarged lymph nodes were seen on the CT scan. In all 7 cases the primary tumor was classified as a pT3 or pT4 invasive disease. Based on the results presented above, it may be concluded that CT scan is valuable in making the diagnosis of transitional cell carcinoma of the renal pelvis and also in determining whether the tumor has invaded beyond the renal pelvic wall, thereby providing guidelines for the adequate treatment.

Adult↗
PubMed1997

[Continent urinary reservoir using dilated renal pelvis of non-functioning pelvic kidney in a girl with cloacal exstrophy].

We performed construction of continent urinary reservoir in an 8-year-old girl with cloacal exstrophy who had double stoma of ileostomy and colon conduit. Preoperative evaluation revealed non-functioning right kidney with severely dilated renal pelvis and calyxes in her pelvis. Urinary reservoir was constructed using detubularized colon segment which had been used as the urinary conduit and dilated renal pelvis of non-functioning pelvic kidney. Using Mitrofanoff's principle, continent catheterizable channel was also made of the anterior wall of the renal pelvis. Postoperative course was uneventful. Reservoir capacity increased to 350 ml one and half year postoperatively and she is almost dry with clean intermittent catheterization 5 times a day. Dilated upper urinary tract is one of the ideal material for bladder enlargement that avoids the complication associated with the use of gastrointestinal tract.

Child↗
PubMed1998

[Fibroepithelial polyp of the renal pelvis. A case report].

Benign tumors of the renal pelvis are relatively rare, and only a few reports have been published so far. Recently we experienced a case of a 50-year-old woman with a fibroepithelial polyp in the left pelvis. Drip infusion pyelography and abdominal CT revealed a filling defect and tiny renal stones in the left pelvis under the study of her urinary blood occult. A transitional cell carcinoma of the renal pelvis was suspected, so a left total nephroureterectomy was done. The pathological diagnosis of this tumor was fibroepithelial polyp. As it is said that preoperative diagnosis of such a polyp is difficult, preoperative ureteroscopy or perioperative pathological diagnosis by frozen sections should be attempted. But it is difficult to avoid a nephroureterectomy because low incidence of the disease.

Female↗
PubMed2002

Hypoechoic normal renal sinus and renal pelvis tumors: sonographic differentiation.

OBJECTIVE: To evaluate the sonographic findings of an unusually hypoechoic renal sinus that mimics a tumor in the renal pelvis or renal sinus. METHODS: Sonographic scans of 7 patients with an unusually hypoechoic portion in the renal sinus were reviewed retrospectively. Computed tomography, excretory urography, or both confirmed all sinuses as normal. Five consecutive cases of renal pelvis tumors, which were detected on sonography initially in same period, were also reviewed to determine the differences between the 2 conditions. All cases were transitional cell carcinomas of the renal calyces. The images were analyzed for location, shape, margin, presence of posterior sonic attenuation, and associated findings such as caliectasis. RESULTS: Sonographic findings noted in patients with hypoechoic normal renal sinuses were irregular and poorly defined margins (n = 7), a central and symmetric location in the renal sinus (n = 6), the presence of posterior sonic attenuation with nonvisualization of the posterior border of the lesion (n = 7), an unaffected peripheral hyperechoic renal sinus (n = 7), and traversing hilar vessels in the lesion on color Doppler sonography (n = 7). In contrast, renal pelvis tumors had a relatively well-defined margin (n = 4), an eccentric location in the renal sinus (n = 2), a partially or completely obliterated hyperechoic renal sinus (n = 2), a visible posterior margin (n = 5), no posterior shadowing (n = 5), vessel displacement by the mass on color Doppler sonography (n = 5), and associated caliectasis (n = 1). CONCLUSIONS: By being familiar with the sonographic characteristics of a hypoechoic renal sinus, it can be differentiated from renal pelvis tumors, and unnecessary diagnostic workups can be avoided.

Adult↗
PubMed2006

The type and frequency of fetal renal disorders and management of renal pelvis dilatation.

OBJECTIVE: This study describes the frequency of sonographically detected fetal renal disorders, the correlation of fetal renal pelvis dilatation (RPD) with the need for postnatal surgery, and proposed management of RPD. METHODS: The study population consisted of 342 fetuses with prospectively identified isolated renal abnormalities and known follow-up. Fetuses with RPD were considered separately with respect to underlying renal disease, postnatal testing, and the need for surgical correction. Obstructive RPD was defined as the need for surgical treatment. Nonobstructive RPD included those cases that required no therapy. The correlation between prenatal RPD and the need for postnatal evaluation was examined. RESULTS: Renal pelvis dilatation was the primary postnatal sonographic finding in 66.4% of cases. The remainder were distributed between multicystic dysplastic kidney, duplication malformations, and reflux, with a smaller number of other diagnoses. Renal pelvis dilatation in the obstructive group was significantly greater than in the nonobstructive group. However, 10% of fetuses with maximum RPD of 10 mm or less had an obstructive process, whereas 58% of fetuses with RPD of greater than 10 mm did not have obstruction. There were no cases in which preterm delivery was necessitated by RPD. CONCLUSIONS: Renal pelvis dilatation is the most common fetal renal abnormality. The greater the RPD, the more likely it is due to obstruction. However, the overlap between obstruction and no obstruction dictates postnatal evaluation. In that RPD, regardless of degree, did not change the timing of delivery, a single follow-up sonographic examination either late in pregnancy or after delivery is considered adequate for follow-up of RPD detected earlier in pregnancy.

Dilatation, Pathologic↗
PubMed2001

[Rupture of renal pelvis due to urolithiasis: report of two cases].

Two cases of renal pelvis rupture caused by urolithiasis are reported. The first case was in a 62-year-old male who had left flank pain. Urological examination including drip infusion pyelography (DIP) and abdominal computed tomography (CT) revealed a spontaneous rupture of the left renal pelvis. The rupture was assumed to have been caused by a small ureteral stone. The stone passed spontaneously, and the extravasation disappeared with conservative therapy. The second case was in a 84-year-old male who was admitted with high fever. Urological examination including DIP and abdominal CT showed a suspected rupture of the left renal pelvis due to a renal stone at the ureteropelvic junction. Percutaneous nephrostomy was performed and antegrade pyelography showed extravasation from the left renal pelvis. Extravasation disappeared on the 12th postoperative day. Extracorporeal shock wave lithotripsy was performed three times. The renal stone was completely discharged and the nephrostomy tube was removed successfully.

Aged↗
PubMed2001

Iatrogenic injuries of renal pelvis and ureter following open surgery for urolithiasis.

OBJECTIVE: To study the types of injuries of renal pelvis and ureter following open surgical procedures for urolithiasis and predisposing factors leading to such injuries and discuss various options for the management of iatrogenic injuries of the renal pelvis and ureter. PATIENTS AND METHOD: Case files and available radiographs of the patients who were managed for ureteral and renal pelvic injuries were reviewed. Initial procedure, mode of injury and clinical course were noted. RESULTS: The study consisted of 13 patients (9 males and 4 females). Age of the patients ranged from 18 to 65 years. Eight patients had injuries of renal pelvis or ureteropelvic junction and 5 patients got ureteral injuries. Primary management of ureteral and renal pelvic injuries was successful in 9 patients. Four patients required further surgery. Three out of 4 patients underwent nephrectomy and in 1 patient renal function deteriorated despite secondary pyeloplasty. Among 3 patients who had nephrectomy, one died postoperatively due to sepsis and haemorrhage. CONCLUSION: Injuries of the renal pelvis and ureter have significant morbidity and even mortality. Peroperative recognition of these injuries and appropriate management can prevent the late sequele of these injuries such as stricture formation leading to progressive renal damage.

Adolescent↗
PubMed2003

[Management of isolated fetal dilatations of the kidney pelvis].

The most common sonographic abnormality found in the fetal urinary tract is collecting system dilatation, accounting for 4.5% of examinations. Numerous renal pelvis measurements and various gestational age cut-off points have been recommended in the assessment of obstructive fetal uropathy. As a result, renal pelvic measurements are not well standardized. The first measurements of the renal pelvis diameter in the 80's suggested that a threshold value of 10 mm was significant in order to distinguish between physiologic and pathologic dilatations. The routine use of prenatal ultrasound and the improving resolution of ultrasound equipment allow the detection of smaller dilatations. The third-trimester threshold value for the antero-posterior renal pelvis diameter of 7 mm is the best ultrasound criterion to predict postnatal renal abnormalities with a positive predictive value of 69%. A renal pelvis dilatation during the second trimester of pregnancy can be used as a warning sign for urinary tract malformation, and should not be ignored even if there is no further progression in the third trimester, because this finding may reveal a significant urologic abnormality in 12% of cases. Isolated pyelectasis can signal the presence of vesico-ureteral reflux. Normal appearing urinary tract on 2 successive neonatal ultrasound rarely coexist with significant abnormal findings on voiding cysto-urethrography. Therefore, in such cases, invasive investigations are not justified.

Decision Trees↗
PubMed1992

The single compartment model applied to the large renal pelvis: a preliminary study.

Diuresis renography should exclude or confirm pelvi-ureteric junction obstruction. Numerous equivocal cases seen here had large renal pelves with slow emptying on frusemide diuresis. An attempt was made to relate the rate of emptying to the volume of the renal pelvis. The fully distended renal pelvis during frusemide diuresis appears to satisfy the criteria of the single compartmental model which predicts a linear relationship between volume and flow rate, i.e. F = [0.693 V0]/t1/2 where F is the flow rate, V0 is the volume and t1/2 the time at which half the tracer has disappeared. Clearance half-time was measured from the diuresis renogram curve. Volume was estimated from a longitudinal ultrasound image at the end of the procedure, using a volumetric version of Simpson's rule as a sequential slice technique, given a roughly circular transverse image. Of 18 kidneys in 14 adult patients, three had large volume pelves and short emptying times. The remaining 15 showed a roughly linear relationship between volume as estimated and clearance half-time. This appears to validate both the theory and the method and permits calculation of the pelvic outflow rate. An hypothesis to explain the large unobstructed renal pelvis is advanced.

Adult↗
PubMedDate not supplied

[Prognostic implication of morphometric stromal parameters of renal pelvis and ureteral transitional cell carcinomas].

To evaluate prognostic value of morphometric studies of the stroma of transitional cell carcinomas of the renal pelvis and ureter, we studied retrospectively the data of primary examination and follow-up of 75 patients (49 males, 65% and 26 females, 35%; mean age 61.9 +/- 1.2 years) given radical surgical treatment for cancer of the renal pelvis and ureter. Five-year survival in the absence of tumor progression was 23%. Morphological examination diagnosed transitional cell carcinoma with invasion pT1, pT2, pT3 and pT4 in 3(4%), 15(20%), 47(63%) and 10(13%) cases and differentiation degree G1, G2, G3 in 31(41%), 15(20%) and 29(39%) cases, respectively. In addition to the standard morphological examination of the tumor, we made morphometry of stromal and tumor area, analysed composition and count of stromal effector cells (lymphocytes, eosinophilic and neutrophilic leukocytes, macrophages, mast and plasmic cells), the degree of stromal vascularization. Prognostic value of the above parameters was estimated according to significance of their correlation with postoperative survival of the patients. The survival correlated with the depth of cancer invasion (p = 0.005) and differentiation of tumor tissue (p = 0.006), high cell infiltration of tumor stroma is prognostically unfavourable (R2 = 0.03; F = 3.41; p = 0.069) as well as weak presentation of stromal component of the tumor (p = 0.056). The lowest survival was observed in patients with cancer of the renal pelvis and ureter with a great number of mast cells (p = 0.056), macrophages (p = 0.037) and neutrophils (p = 0.029) in the tumor stroma. According to the results of multiple regression analysis (R2 = 0.08; F = 5.42; p = 0.024), five-year postoperative survival most closely correlated with cancer invasion depth (p < 0.001), degree of tumor cells differentiation (p < 0.001) and number of macrophages infiltrating tumor stroma (p < 0.001). Significance of survival prognosis for patients with cancer of renal pelvis and ureter can be raised by estimation of mean number of free stromal cells and expression of stromal component.

Carcinoma, Transitional Cell↗
PubMed2005

[Port site metastasis of primary adenocarcinoma of the renal pelvis after a laparoscopic nephrectomy: a case report].

We report a case of port site metastasis of primary adenocarcinoma of the renal pelvis after a laparoscopic nephrectomy. A 76-year-old woman was admitted to our hospital with a complaint of anorexia, general malaise and left abdominal distension. Computed tomography revealed severe hydronephrosis in the left kidney. Laboratory examination revealed a high serum level of CA19-9 (155 U/ml). However, antegrade and retrograde pyelography revealed no filling defects and urine cytopathology for renal pelvis showed no malignancy. Thus, on the suspicion of a ureteropelvic junction stenosis, a laparoscopic nephrectomy was performed. There were some papillary tumors in the renal pelvis and a histopathological examination of the tumor revealed a papillary adenocarcinoma. Twelve months after nephrectomy, left iliopsoas muscle metastasis was found. Thus irradiation therapy with a total of 30 Gy was performed. However, 3 months later, the patient developed metastasis at the trocar site and the serum level of CA19-9 elevated to 6,720 U/ml. She died of multiple metastases from adenocarcinoma of the renal pelvis 4 months after port site metastasis.

Abdominal Muscles↗
PubMed1991

[Tumors of the renal pelvis and ureter in Denmark in the period 1943-1986. Cancer statistics no. 28].

A review based on data from the Cancer Register reveals that the age-standardized incidence rate of tumours of the renal pelvis and ureter in Denmark has increased more than ten-fold where both men and women are concerned during the 40 year period from 1943 to 1982. A random control sample suggest underreporting of pelvic tumours of 8% and it is known from previous investigations that 95-98% of all known cases of tumour are registered in the Cancer Register. These circumstances suggest a greater increase in the incidence than that registered in the present article. Where tumours of the renal pelvis in men are concerned, however, the development was reversed in the middle of the nineteen seventies with a decrease in the incidence continuing to the conclusion of the period of this review in 1986. The decrease in tumours of the renal pelvis in men is observed particularly in the capital and in rural districts. A possible cause of this decrease is reduction of tobacco consumption in men. The incidence of tumours of the ureter in men is still increasing but the account is based on few observations. Possible reasons for the uninterrupted increase in incidence of tumours of the renal pelvis and ureter in women continuing until the conclusion of the period of registration is the increasing tobacco consumption which has been observed in women and consumption of phenacetin before this preparation was deleted from the drug register in Denmark.

Adult↗
PubMed1989

[Cytologic diagnostic value of voided urine in 60 cases of primary transitional cell carcinoma of the renal pelvis and ureter].

Exfoliative urinary cytology was performed on 60 cases of histologically proven TCC (Transitional cells carcinoma) of the renal pelvis and ureter. There were 39 cases of TCC of the renal pelvis. Urine cytology was positive in 27 cases (69.2%); suspicious in 5 cases (12.8%) and negative in 7 cases (17.9%). Significant correlation was found in the frequency of diagnosis and the histological grade of carcinoma. The cytological positive rate in G1 carcinoma was 40%; 71% in G2; 100% in G3. It is considered that the location of tumor in the renal pelvis predominates the urinary cytological positive rate. Urine cytology was positive in 3 cases (33.3%) out of 9 cases of the carcinoma seated in the inferior renal calix, whereas 19 cases (86.4%) from 22 cases in other sites of the renal pelvis (P less than 0.05). The positive rate of urine cytology for 21 cases of TCC of the ureter was 42.9%. The results showed that the secondary ureteric obstruction was an influence on the cytological positive rate.

Adult↗
PubMed1989

[Five cases of the double renal pelvis and ureter].

Five cases of the double renal pelvis and ureter were encountered among 340 cadavers for dissection practice. Number of minor calices and their surface area in these kidneys were calculated, and causal relationship to abnormal organogenesis was discussed. These 5 cases were formal exclusively in consist of males; 4 right sides and 1 left side, 2 complete duplications and 3 partial duplications. The 5 cases were divided into 2 groups by the number and surface area of minor calices in upper and lower pelvises as follows: 1) The number and surface area of minor calices in the upper pelvis and the lower pelvis were respectively equivalent to the mean value of those in one normal kidney (case 1). 2) The sum of the number and surface area of minor calices in the upper and those in the lower pelvises were equivalent to the mean value of those in one normal kidney (case 2-5). These cases give useful criteria for classification of the double renal pelvis and ureter.

Adult↗