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At least 325 records · Page 18Linked to original sources
PubMed1979

Extracorporeal surgery and autotransplantation for carcinoma of the pelvis and ureter.

Multiple transitional cell tumours of the renal pelvis and proximal ureter of a solitary kidney were successfully managed by total ureterectomy, extracorporeal subtotal resection of the renal pelvis, autotransplantation, and calicovesicostomy. The method permits resection of a maximum of the uroepithelium of the upper urinary tract at the same time as it preserves available renal parenchyma. It also implies a new and exciting approach to the renal pelvis for endoscopic postoperative control and local treatment of the malignancy.

Carcinoma, Transitional Cell↗
PubMed1984

Renal pelvis pressure flow relationship in pigs after transsections of the ureter.

The relationship between pressure and flow of the multicalyceal renal pelvis of the pig was investigated in 10 units. The relationship was studied in the intact system and after three consecutive transsections of the ureter 3 cm proximal to the ureterovesical junction, at the lower pole of the kidney and as proximal on the renal pelvis as possible. The mean resting renal pelvic pressure changed from 7.3 to 8.8 cm H2O when a distal transsection was performed. The resting pressure after proximal transsection and pelvic transsection was 8.0 and 6.5 cm H2O respectively. During perfusion the intact system as well as the distal transsection showed a three-phased relationship. In the latter the phases showed a shift to the right and the renal pelvic pressure was significantly decreased at flow rates from 4-10 ml/ureter/min. Perfusion after proximal transsection and pelvic transsection caused only minor increases in the renal pelvic pressure approximating a linear relationship. The study confirms a three-phased relationship between pressure and flow in renal pelvis and a resistance to high flow rates depending on the length of the ureter.

Animals↗
PubMed2005

[Subepithelial hematoma of the renal pelvis producing a filling defect in the upper urinary tract radiological study].

OBJECTIVES: After taking care of a patient with suspicion of upper urinary tract neoplasia which was finally diagnosed of renal pelvis subepithelial hematoma (Antopol-Goldman lesion), we decided to review such unfrequent pathology with the aim to summarize its main characteristics. METHODS: The patient presented clinically and radiologically as an upper urinary tract tumor and underwent nephroureterectomy. Past history was significant for oral anticoagulative treatment after deep vein thrombosis. RESULTS: Pathologic study of the nephrectomy specimen reported absence of urothelial tumor and presence of a subepithelial hematoma of the renal pelvis, which explained both clinical manifestations and radiological findings. Our case is very similar to the other 27 published in the bibliography. CONCLUSIONS: Subepithelial hematoma of the renal pelvis is a benign lesion, more frequent in females, which appears between the fourth and sixth decades of life. Not much is known about its etiopathogenesis, it probably is a multifactorial process. It simulates an upper urinary tract urothelial tumor, both clinically and radiologically, and so is treated in most published cases. It is necessary to know this entity as possible differential diagnosis of upper urinary tract radiological study filling defects to avoid non necessary nephrectomies.

Aged↗
PubMed1999

Benign fibroepithelial polyps of the renal pelvis.

Benign fibroepithelial polyps of the renal pelvis are rare. Although many ureteral fibroepithelial polyps have been reported, there are, to our knowledge, only 20+ reported cases in the renal pelvis. We report herein the clinical and pathologic features of fibroepithelial polyp of the renal pelvis and provide a detailed review of the literature.

Female↗
PubMed1990

[Carcinoma of the renal pelvis and ureter. An investigation of 384 registered cases in the Tokai Urological Cancer Registry].

Registration of renal pelvic and ureteral tumor was done from 1980 through 1986, in the Tokai Urological Tumor Registry. Among the 404 cases of the carcinoma, 384 cases (210 renal pelvis, 174 ureter) were subjected to the present study. A total of 319 cases (83.1%) showed a complete cure, while 20 cases (5.2%) were considered as partial cure, and 45 cases (11.7%) were classified to progressive disease group. Chemotherapy was performed on 151 patients including systemic administration to 141 patients (33.9%) and 11 patients received combined intravesical instillation therapy. Irradiation was performed on 49 patients (12.8%). Degree of histological and morphological differentiation of renal pelvis and ureter tumor were studied in 341 cases of transitional cell carcinoma (88.8%); G0, 0.3%, G1, 12.9%, G2, 49.3%, Gx, 5.2%. Stage of the tumor were T1, 33.6%; T2, 12.5%; T3, 14.6%; T4, 13.3%; Tis, 0.3%; Tx, 24.7%. Five-year relative survival for carcinoma of the renal pelvis was 46.6%, and for the ureter it was 53.1%. Five-year survival according to histological differentiation of transitional cell carcinoma and according to the stage of the tumor were as follows; G1, 91.6%; G2, 58.5%; G3, 27.2%; Ta, 84.6%; T1. 74.2%; T2, 48.5%; T3, 24.1%, T4, 7.3%. The rate of survival was correlated with histological differentiation of the tumor cells. The survival was poor in cases who had the components of squamous cell carcinoma and/or adenocarcinoma. Overall survived case were 177, 122 patients died of cancer, 20 patients died of other causes than cancer, and 1 patient died from immediate surgical effect.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

[Statistical study of tumors of the renal pelvis and ureter].

We reviewed data from 62 patients with epithelial tumors of the renal pelvis and ureter who were hospitalized and treated at Nagoya University Hospital between July, 1970 and June, 1988. Of the 62 patients, 50 were males and 12 were females, the ratio being 4.2:1. The mean age was 62.1 years, the ages ranging from 41 to 87 years. The peak incidence of tumors was marked in the sixth decade for the males and in the seventh decade for the females. Eighty-two percent of the patients were 50 years of age or older. Smoking habits were noted in 76.0 percent of the males and in 16.7 percent of the females. Asymptomatic macrohematuria, found in 43 patients, was the most frequent symptom. Ninety percent of the 62 tumors were transitional cell carcinoma. Twenty-five patients (40.3%) had concomitant bladder cancer, which was previously diagnosed in 3, simultaneously found in 9, and subsequently developed in 16. Twenty-nine patients had tumors localized in the renal pelvis and eighteen in the ureter; the remaining fifteen had tumors localized in two or three organs, including the renal pelvis, ureter and bladder. Histological grades of ureteral tumors were significantly higher than those of renal pelvic tumors. The sensitivity of urinary cytology was 57.8 percent. High-grade tumors had higher sensitivity than low-grade tumors. Larger tumors (greater than 3 cm in diameter) were significantly associated with high-stage tumors, whereas no apparent correlation was found between tumor size and histological grade. Nonpapillary growth of tumor and vascular invasion were significantly related with high-stage and high-grade tumors; diffuse pattern of tumor infiltration was associated with high-stage tumors.

Adult↗
PubMed1999

[Rupture of kidney pelvis in retroperitoneal fibrosis].

OBJECTIVE: To present a case of rupture of the renal pelvis in a patient with idiopathic retroperitoneal fibrosis and no previous dilatation of the left excretory system. METHODS/RESULTS: A patient with retroperitoneal fibrosis underwent surgery for ureterolysis and intraperitonealization of the right ureter. The control IVP was unremarkable. One week later, however, rupture of the left renal pelvis was observed, which was resolved by placement of a ureteral catheter. CONCLUSIONS: In the case described, rupture of the renal pelvis without previous obstruction could be due to ureteral akinesia associated with the retroperitoneal fibrosis.

Humans↗
PubMed1999

[Inverted papilloma of the renal pelvis: report of a case].

Inverted papilloma of the upper urinary tract is a rare lesion. To our knowledge, we report here the 32nd case of inverted papilloma of the renal pelvis. A 50-year-old man presented with asymptomatic gross hematria. Excretory urography showed a filling defect in the left upper calyx. Computerized tomography showed a poorly enhanced low-density area within the renal pelvis. Since radiographic findings suggested a renal pelvic tumor, the patient underwent total nephroureterectomy. Unexpectedly, a 3 x 2.5 cm polypoid tumor of the renal pelvis was consistent with inverted papilloma. Since this benign lesion is extremely rare within the upper tract and its radiographic characteristics closely resemble those of urothelial carcinoma, the preoperative diagnosis of inverted papilloma of the upper tract cannot be conclusively established even by modern imaging techniques. Therefore treatment consistent with that for urothelial carcinoma should be applied in this disease entity.

Humans↗
PubMed2000

[Radiologic investigation of external rectal prolapse. Assessment in 48 patients with defecography, seven of them also with dynamic CT of the pelvis].

PURPOSE: To report our personal experience in 48 patients with external rectal prolapse examined with defecography, evaluating radiological signs and the indications for surgical treatment. We also report the results of 7 patients with severe prolapse submitted to dynamic CT of pelvis. MATERIAL AND METHODS: The findings relative to 48 patients suffering from external prolapse, 27 women and 21 men, (mean age 58 years), were retrospectively reviewed. In our study protocol the patient is made to sit on a defecographic commode with the pelvis in lateral projection and radiographic images are acquired at rest, on contraction and on evacuation. Dynamic CT of pelvis with axial and coronal scans of the pelvic floor was carried out in 7 patients with severe prolapses. Twenty-six of 48 patients underwent rectopexy. RESULTS: The main symptoms were anorectal and perineal weight sensation (93%), perineal disturbance in the sitting position (91%) and anorectal pain extended to sacral area (83%). Manometry, which was performed in 36 cases, showed a rectoanal inhibitory reflex evokable at high volumes of air, especially in incontinent subjects. Defecography demonstrated external rectal prolapse in all cases; rectal intussusception in 32, mucosal prolapse in 30, abnormal widening of the anorectal angle in 24 (16 of them were incontinent), rectocele in 22 and perineal descent syndrome in 16 cases. DISCUSSION AND CONCLUSIONS: External rectal prolapse is sometimes a dynamic progression of a rectal intussusception. In anorectal intussusceptions, the invaginatum involves the anal canal, thus causing the external prolapse. Defecography clearly shows the continuation of invagination out of the anus, with the formation of prolapse. Dynamic CT proved accurate in detecting the rectum morphology, but added no further information to defecography, except for the diastasis of anosphincterial muscles. Therefore, we conclude that defecography is the method of choice, though complementary to other instrumental techniques such as manometry, electromyography and endoscopy, in the diagnostic workup of these patients. Moreover, it can recognize other alterations, such as incontinence and rectocele, which can be submitted to surgical correction with rectopexy.

Adult↗
PubMed2001

Lamina muscularis propria thickness of renal pelvis predicts radiological outcome of surgical correction of ureteropelvic junction obstruction.

PURPOSE: We examine if there is a relationship between the histopathology of the renal pelvis and postoperative radiological findings in children with ureteropelvic junction obstruction. MATERIALS AND METHODS: The records of 220 patients who underwent pyeloplasty for isolated ureteropelvic junction obstruction between 1988 and 1996 were retrospectively reviewed, and 41 (42 kidneys) were identified who had adequate histological specimens and postoperative radiographic studies (ultrasonography and/or well tempered renogram) for examination. Histological features of the lamina muscularis propria from the renal pelvis were correlated with the radiographic outcome after pyeloplasty. RESULTS: Lamina muscularis propria thickness of the renal pelvis correlated significantly with radiological improvement. All kidneys with renal pelvic lamina muscularis propria thickness less than 250 microm. showed radiological improvement at 3 to 6 months postoperatively, those with thickness between 250 and 350 microm. had improvement at 9 months and those with lamina thickness greater than 350 microm. had a significantly worse outcome at all observation points. At 3 and 6 months postoperatively 16 of 30 (53%) and 23 of 34 (68%) children with radiological improvement had a mean lamina muscularis propria thickness of 252 +/- 131.5 microm. and 263 +/- 122.8 microm., respectively, while the remaining unimproved 14 and 12 patients had a mean thickness of 374 +/- 64.3 microm. (p <0.01) 372 +/- 66.1 microm. (p <0.05), respectively. CONCLUSIONS: The lamina muscularis propria thickness of the renal pelvic wall can provide insight to the expected time of postoperative improvement on radiological studies in children with ureteropelvic junction obstruction.

Child↗
PubMedDate not supplied

[Magnetic resonance of the male pelvis].

OBJECTIVE: To review the usage of magnetic resonance imaging (MRI) in the assessment of the male pelvis. METHODS: The applications of MRI in male pelvis pathology are reviewed. RESULTS/CONCLUSION: MRI has been demonstrated to be a useful diagnostic imaging technique in male pelvis pathology. It has been used mainly to evaluate the prostate, particularly for preoperative staging. MRI can depict tumor invasion of the capsule, periprostatic plexus, seminal vesicles, bladder, rectum and pelvic lymph nodes. Its main objective is to differentiate stages T1 and T2 of advanced disease. The endorectal coil enhances image resolution and diagnosis of extracapsular disease is more precise. MRI can also distinguish scar tissue from regional recurrence in patients submitted to radical prostatectomy. This imaging technique has also been used to assess benign lesions of the prostate and seminal vesicles; e.g., prostatic cysts, focal nodular hyperplasia, and amyloidosis of the bladder. Although ultrasound continues to be the primary noninvasive diagnostic method in the evaluation of scrotal pathology, MRI provides valuable diagnostic information in certain conditions; e.g., testicular tumors, inflammatory processes, testicular torsion and trauma.

Genital Diseases, Male↗
PubMedDate not supplied

[Magnetic resonance of the female pelvis].

OBJECTIVE: To analyze the utility of magnetic resonance imaging (MRI) in the assessment of the female pelvis, with special reference to the technical aspects. METHODS: Our experience and the literature on MRI in the evaluation of the female pelvis are reviewed. RESULTS/CONCLUSIONS: Conventional MRI assessment, which includes T1- and T2-weighted images in the axial, sagittal and coronal planes and T2 acquisitions along the major axis of the uterus in the sagittal plane, has proved effective in evaluating different pathologies of the female pelvis. MRI is particularly effective in staging endometrial carcinoma and in determining myometrial or cervical invasion. It is also useful in determining parametrial invasion in cervical carcinoma. In ovarian disease, MRI has been used in detecting peritoneal involvement, adenopathies and to characterize the lesion. It is particularly useful for planning the surgical approach in congenital disease. The high resolution of MRI with the use of the new coils has enhanced its efficiency and effectiveness in the diagnosis of congenital anomalies and tumors of the female urethra, and in the evaluation of prolapse of the urinary bladder and urinary incontinence.

Female↗
PubMedDate not supplied

[Plasma-cell granuloma of the kidney pelvis].

OBJECTIVE: To report a rare case of plasma cell granuloma of the renal pelvis. To our knowledge, only five cases have been reported in the literature. METHODS: Clinicopathological description of a case of plasma cell granuloma of the renal pelvis with light chain immunohistochemical study. RESULTS: A young male patient with a radiologically benign mass in the right renal pelvis extending into the upper calices that caused hematuria is described. The diagnosis was suggested during the intraoperative study of the mass that was suggested by pyelotomy (conservative surgery). Immunohistochemical study confirmed the initial diagnosis. CONCLUSIONS: Although this condition is rare, plasma cell granuloma, an inflammatory pseudotumor, can occur in the urinary tract and should be considered in the differential diagnosis of mass lesions. Histopathological diagnosis requires a complete study of the entire tumor and the use of immunohistochemical techniques to discard plasmacytic non-Hodgkin lymphoma or neoplastic plasma cell proliferation.

Adult↗
PubMed2003

Botryoid-type of embryonal rhabdomyosarcoma of renal pelvis in an adult. A case report and review of the literature.

A case of botryoid-type embryonal rhabdomyosarcoma of the renal pelvis in a 49-year-old woman is reported. The tumor led to hydronephrosis. The surgical resection specimen disclosed a translucent, polypoid mass attached to the wall of the renal pelvis by thin stalk. Light-microscopic examination revealed a large exophytic polypoid tumor with intact surface epithelium, which was negative for dysplasia or carcinoma in situ. There was a condensation of epithelioid to spindle cells underneath the basement membrane, forming a cambium layer. The core of the lesion contained interspersed epithelioid to spindle cells with myxoid change and edema. Cells of the cambium layer as well as interspersed cells in the core exhibited marked cytologic atypia with mitotic figures. Immunohistochemical stains for cytokeratin, S-100 and myoglobin were negative, stains for desmin and actin were positive. Although botryoid-type embryonal rhabdomyosarcomas have been reported to occur at various sites in the genital tract and lower urinary tract, to our knowledge, this is the first reported case of the tumor within the renal pelvis. Also, the occurrence of these tumors in adults is quite rare.

Female↗
PubMed2003

Experimental cadaveric study of lateral impact of the pelvis in children.

OBJECTIVE: To study the mechanic response of children's pelvis to lateral impact. METHODS: Twelve 2-to 12 year-old children's cadavers were donated by their relatives for this impact test, dividing into younger group (2 to 4 years old, n=6) and elder group (5 to 12 years old, n=6). CT scan and X-ray examination were performed before the impact test, and after the test, X-ray examination and autopsy were conducted. All the pelvises were impacted at a speed of 7.5+/-0.5 m/s but for one at 9.1m/s. RESULTS: All tests showed similar behavior of the pelvis with similar timing and peak viscous criterion (V*C) values. Statistical significance was noted in the maximum V*C and degree of stiffness of the pelvis between the 2 groups (P<0.05). No injuries occurred in the 2 groups after the impact. CONCLUSION: The pelvic test yields very repeatable pelvic response among each group tested.

Cadaver↗
PubMedDate not supplied

Increased radiation dose by automatic exposure control system during fluoroscopy and angiography of pelvis due to contrast material in the bladder: experimental study.

PURPOSE: To evaluate the increase of radiation dose caused by contrast material excreted in the bladder during vascular interventional procedures of the pelvis. MATERIALS AND METHODS: A latex balloon filled with diluted contrast material, simulating the bladder, was placed in a water phantom. Entrance dose rates were measured under various conditions with and without the balloon. In animal experiments, skin doses during fluoroscopy and angiographic image acquisitions were measured at the pelvis of a swine before and after the contrast was excreted in the bladder. RESULTS: In phantom experiments, fluoroscopic dose rates increased 1.3- to 3.9-fold when the contrast-filled balloon was placed at the periphery of the phantom. The dose rates increased 3.0- to 4.0-fold when the balloon was placed at the center. In the animal experiment, dose rates increased 1.4- to 2.0-fold when the bladder was filled with contrast material. Skin doses during 10-second angiographic image acquisition also increased 1.1- to 2.3-fold when the bladder was filled with contrast. CONCLUSION: When the bladder is filled with excreted contrast material, skin doses delivered by fluoroscopy and angiography will increase. Removal of urine is recommended during vascular interventional procedures of the pelvis.

Angiography↗
PubMed2004

[The mechanisms of the natural history of small pelvis varicosis].

An analysis was made of the results of an all-round clinical, ultrasound, phlebotonometric and phlebographic examination of 89 patients with the clinical evidence of chronic venous insufficiency (CVI) of the pelvis. It is established that small pelvis varicosis develops because of hemodynamic disorders in the system of the inferior vena cava, iliac and left renal veins. In men, blood reflux from the iliac vein to the parietal tributaries leads to the development of the atypical forms of varicosis. In women, the left- sided regional renal venous hypertension induces valvular insufficiency of the left ovarian vein with the extent of the renoovarian blood reflux to the pampiniform, uterovaginal, presacral, vesical and rectal venous plexus. The concomitant action of the caval and renoovarian blood refluxes causes the origination of the syndrome of the blood overfilling of the pelvic organs and varicosis of the pubis, perineum, vulva, and buttocks. The clinical, ultrasound and phlebographic appearance of small pelvis varicosis is described in detail.

Adolescent↗
PubMed2004

[Cystic hamartoma of the renal pelvis: unfrequent finding].

OBJECTIVES: This cystic hamartoma of the renal pelvis is a very unfrequent benign tumor. We report one case emphasizing its histology and performed a bibliographic review. METHODS: Mid age female patient with the incidental diagnosis of a renal mass taking up the pelvis. RESULTS: A radical nephrectomy was performed with the pathologic report of cystic hamartoma of the renal pelvis. CONCLUSIONS: It is a cystic renal tumor with well-defined histologic and immunohistochemical criteria, and it probably does not involve any danger for the patient's live.

Female↗