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At least 523 records · Page 29Linked to original sources
PubMed1987

Performance of patients with a "frozen pelvis" in an in vitro fertilization program.

It is now possible to identify and study the performance of different subgroups of patients in in vitro fertilization (IVF) programs. Patients with severe pelvic adhesions due to pelvic inflammatory disease (PID) or endometriosis were classed as having a frozen pelvis if less than or equal to 20% of total ovarian surface was visible and if the rest of the ovary was bound down with significant adhesions. IVF offers the only hope of pregnancy for these patients. Fifty-one treatment cycles in 23 such patients were matched against 51 cycles in 48 patients with adhesion-free ovaries. The study group had a significantly higher number of cancelled oocyte retrievals because of poor estradiol (E2) response. They also had a significantly lower rate of E2 rise and a lower peak value of E2 before and after the administration of human chorionic gonadotropin. These patients took longer to respond to a hyperstimulation regime, and when a response occurred they formed fewer follicles, as measured with the use of ultrasound. Lower numbers of oocytes were obtained from this group, but the fertilization rate of oocytes was the same for both groups. One pregnancy occurred in the study group and 11 in the control group. It is possible that disruption of ovarian blood supply or mechanical factors due to the pressure of significant adhesions prevent a good follicular response in patients with a frozen pelvis.

Adult↗
PubMed1997

Squamous cell carcinoma of the renal pelvis with metastasis in a dog.

The gross and microscopical features of a squamous cell carcinoma of the renal pelvis in an 18-year-old dog are described. This is a rare tumour originating from transitional cells of the pelvis. The tumour, which invaded the renal parenchyma and capsule and the small intestinal wall, metastasized to the lungs. Tumour cells expressed cytokeratin 8 and were arranged in a pattern similar to that of a squamous cell carcinoma found elsewhere, with prickle cells and horny pearls. The tumour was not diagnosed clinically but was found at necropsy. The presence of pelvic calculi in this dog is suggested as a cause of transitional cell squamous metaplasia and malignant transformation.

Animals↗
PubMed2006

Micropapillary carcinoma of the renal pelvis and ureter.

PURPOSE: MPC located in the upper urinary tract is rare with only 2 cases reported to date. We report clinical and histopathological data on 26 patients to increase the knowledge of this rare entity. MATERIALS AND METHODS: A clinical and histopathological review was performed in 943 patients with a neoplasm in the renal pelvis or ureter, diagnosed between 1971 and 1998. We identified 26 patients with MPC. No patients were alive at the end of the study. RESULTS: Of the patients 11 had greater than 50% MPC and 15 had focal MPC (at least 10%). The incidence was 2.8%. Median patient age at diagnosis was 69 years (range 54 to 88) and the male-to-female ratio was 17:9. All except 4 patients had stage T3 disease or higher. Carcinoma in situ was identified in 64% of cases and vascular invasion was present in 81%. A total of 20 patients (77%) died of disease and only 7 survived longer than 5 years. CONCLUSIONS: The prognosis is poor since most patients with MPC of the renal pelvis and ureter initially present with advanced disease. Stage for stage the prognosis is not different from that in nonMPC urothelial cell carcinoma. Surgery is curative in less advanced cases. However, radiotherapy and systemic chemotherapy appear to be ineffective.

Aged↗
PubMed1992

Non-adrenergic non-cholinergic excitatory innervation of the guinea-pig isolated renal pelvis: involvement of capsaicin-sensitive primary afferent neurons.

Circular muscle strips from the guinea-pig renal pelvis exhibit a spontaneous activity averaging about 50% of maximal contractile response at a frequency of about six contractions/min. This spontaneous activity is tetrodotoxin resistant. Acetylcholine and noradrenaline (one to 100 microM) produce a positive inotropic effect which was abolished or strongly inhibited by atropine and phentolamine, respectively. Electrical field stimulation (five to 10 Hz, 0.5 ms pulse width for 10 s, 60 V, maximal voltage) produces a transient positive inotropic response which is tetrodotoxin-sensitive but unaffected by atropine and phentolamine alone or in combination, as well as by atropine plus guanethidine. Application of capsaicin produced a large positive inotropic response which was not reproduced upon a second application of the drug (desensitization). After in vitro capsaicin desensitization, the response to electrical field stimulation was abolished, indicating its dependence on activation of peripheral endings of sensory nerves. These findings demonstrate the existence of a non-adrenergic non-cholinergic functional innervation of the guinea-pig renal pelvis which is entirely dependent on sensory nerve activation.

Acetylcholine↗
PubMed1987

Squamous cell carcinoma of the renal pelvis.

From 1970 to 1985 we treated 144 cases of malignant tumors of the kidney. Of these patients only 11 (8 per cent) had squamous cell carcinoma of the renal pelvis compared to transitional cell carcinoma of the renal pelvis in 53 per cent, renal cell carcinoma in 37 per cent and other types in 2 per cent. In all patients the squamous cell carcinoma was associated with chronically infected staghorn renal calculi of long duration. The patients usually presented late with extensive local infiltration, making surgical resection difficult. In addition, poor response to surgery, radiotherapy and chemotherapy resulted in a poor prognosis and short survival. A summary of our cases and a review of the literature are presented.

Adult↗
PubMed1987

Fibroepithelial polyp of the renal pelvis.

Benign tumors of the renal pelvis are rare, with less than 10 cases reported in the literature. The fibroepithelial polyp, a benign mesodermal tumor, seems to be the most common type. We report a case of a fibroepithelial polyp of the renal pelvis, and discuss its clinical features and diagnostic pitfalls.

Adult↗
PubMed1986

125I-hippuran absorption from the human renal pelvis.

The absorption of 125I-hippuran from human renal pelvis was studied peroperatively in 18 patients with obstruction at the pelviureteric junction. Three types of experiment were included: absorption during induced diuresis, absorption at a constant intrapelvic pressure of 30 cm. H2O, and excretion of the indicator by the contralateral kidney. Total and separate glomerular filtration rate were measured using 51Cr-EDTA clearance technique and isotope renography. Distal tubular function was evaluated as maximum concentration ability. During induced diuresis the intrapelvic pressure increased to an average maximum value of 31.6 cm. H2O. The excretion of isotope from the contralateral kidney varied from one to 44% of the given dose. A significant correlation (r = 0.87) between the maximum intrapelvic pressure obtained and the amount of isotope excreted from the contralateral kidney was demonstrated. At a constant intrapelvic pressure of 30 cm. H2O the excretion of isotope from the contralateral kidney varied from two to 26% of the dosage given. The low value probably depended on the impaired function of the obstructed kidney. Our results show the existence of a significant reflux from the renal pelvis of small molecules, which was affected by renal function, intrapelvic pressure and volume.

Adult↗
PubMed1984

Subepithelial hematoma of the renal pelvis (Antopol-Goldman lesion): a case report and review of the literature.

A 45-year-old woman presented with gross hematuria and pain in the right flank. Blood was found in the right renal pelvis with bleeding from the lower pole of the kidney. Partial nephrectomy revealed hematomas in and about the pelvis and calices, confirming the diagnosis of Antopol-Goldman lesion. The cause of the lesion remains uncertain, although renal trauma superimposed on a hyperplastic pelvic capillary network, secondary to analgesic abuse, is suspected.

Analgesics↗
PubMed1980

Lavage of cytology of the renal pelvis and ureter with special reference to tumors.

Lavage cytology was done in 101 patients with radiological filling defects in the ureter and renal pelvis. This simple and inexpensive technique is valuable in the preoperative diagnosis of tumors of the ureter and renal pelvis. In our series it was possible to recognize clearly 29 of 36 such tumors (80.5 per cent) through preoperative lavage cytology. No falsely positive diagnoses were made. Lavage cytology failed in 6 patients with hypernephroma. The diagnostic reliability of lavage cytology with urothelial tumors is far greater than that of exfoliative urine cytology and reaches almost equally good results as brush biopsy.

Diagnosis, Differential↗
PubMed1980

Mucinous adenocarcinoma probably arising in the renal pelvis and ureter: a case report.

A patient with widely disseminated mucinous adenocarcinoma had polypoid tumors in the left renal pelvis and ureter. While no certain primary site was determined, either clinically or at postmortem examination, microscopic examination of the left renal pelvis and ureter revealed atypical glandular metaplasia adjacent to the tumors and made the upper urinary tract a likely site of origin for the adenocarcinoma.

Adenocarcinoma, Mucinous↗
PubMed1977

Yo-yo renal pelvis: an unusual cause of flank pain.

Herein we describe 2 patients in whom a bifid renal pelvis was associated with peristaltic dysfunction and pyelopelvic reflux, causing pyelocaliectasis and flank pain. The patients were improved with pyelopyelostomy. Previous explanations for the yo-yo phenomenon have indicated that there is functional obstruction because of a higher resting pressure in the common stem. The asynchronous peristaltic waves a coincident with a relatively low pressure in the oal fold that acted as a baffle to direct the flow of urine from the lower segment of the bifid pelvis down the ureter. This baffle favored reflux into the upper segment.

Adult↗
PubMed1975

Bilateral transitional cell carcinoma of the renal pelvis with unilateral non-functioning kidney.

A case is presented of bilateral transitional cell carcinoma of the renal pelvis with extension of the tumor to involve the renal parenchyma bilaterally. Unilateral complete absence of function was demonstrated and pathological study correlated the absence of function with complete replacement and destruction of the renal parenchyma by transitional cell tumor. Segmental absence of function of the contralateral kidney is also correlated pathologically with complete replacement of the involved renal segment with tumor. Total replacement of renal parenchyma by transitional cell carcinoma of the renal pelvis should be considered in the evaluation of renal non-function.

Acute Kidney Injury↗
PubMed1982

Simultaneous histochemical demonstration of noradrenergic nerves and tissue components in guinea-pig renal pelvis after treatment with daunomycin.

A standard histochemical technique for detecting catecholamines has been applied to tissues from the renal pelvis of untreated and daunomycin-pretreated guinea-pigs. Under the fluorescence microscope, muscular, mucosal, and endothelial cells exhibited the drug-specific orange-red fluorescence, in contrast to the dark background of control tissues. The presence of daunomycin in the cells also greatly improved the visibility of numerous noradrenergic fibres which appeared to originate from perivascular plexuses and distribute to the smooth cells. A dense noradrenergic innervation was detected in the submucosa, but the epithelium did not contain any yellow-green fluorescent fibres. A typical arrangement was observed consisting of muscular, nervous and vascular components, enveloped by connective tissue: this formation appeared to be related to the system modulating the pacemaker activity of the renal pelvis.

Animals↗
PubMed2003

Retroperitoneoscopic nephroureterectomy for transitional cell carcinoma of the renal pelvis and ureter: Nagoya experience.

OBJECTIVES: To evaluate the efficacy of our new retroperitoneoscopic nephroureterectomy for patients with transitional cell carcinoma of the renal pelvis and ureter, we present the operative procedure and analysis of the clinical outcome of retroperitoneoscopy in 23 patients. METHODS: Twenty-three patients with transitional cell carcinoma of the upper urinary tract underwent retroperitoneal laparoscopic nephroureterectomy between February 2000 and February 2002. Patient age ranged from 44 to 83 years (mean 66.7). Each kidney was retroperitoneoscopically dissected en bloc, together with the perirenal fatty tissue, lymph nodes, and/or adrenal gland, without transecting the ureter. The lower ureter was resected with the bladder cuff transected using an ultrasonic scalpel and an endoscopic gastrointestinal automatic stapler. The dissected specimen was removed intact through a 6-cm-long original incision. RESULTS: The mean operating time was 4.8 hours, including 0.7 hours for complete removal of the ureteral end with the bladder cuff. The mean estimated blood loss was 304 mL. The mean time to recovery to normal activity was 18 days. In the mean follow-up period of 15 months, 2 patients died of cancer progression in the sixth postoperative month, 2 died of other causes, and 4 had recurrent transitional cell carcinoma of the bladder after surgery. CONCLUSIONS: Our retroperitoneal laparoscopic nephroureterectomy using an endoscopic gastrointestinal automatic stapler is a fast, low-risk, and minimally invasive procedure and might be an alternative to other laparoscopic techniques and open nephroureterectomy. However, long-term follow-up is necessary to confirm the efficacy for patients with transitional cell carcinoma of the renal pelvis and ureter.

Adult↗
PubMed2003

Endoscopic treatment of fibroepithelial polyps of the renal pelvis and ureter.

OBJECTIVES: To report our experience on the endoscopic treatment of large fibroepithelial polyps of the renal pelvis and ureter. Fibroepithelial polyps of the upper urinary tract are rare benign tumors that have traditionally been treated by open exploration and resection. METHODS: Five patients underwent either percutaneous or ureteroscopic treatment of a renal pelvic or ureteral fibroepithelial polyp by electroresection or holmium:yttrium-aluminum-garnet laser resection. RESULTS: All 5 patients were without recurrence after endoscopic resection. The mean follow-up was 19.6 months (range 6 to 41). The average length of stay was 3 days (range 2 to 5) and 0.5 day (range 0 to 1) for those undergoing percutaneous and ureteroscopic treatment, respectively. No major complications resulted from either approach, and no ureteral strictures have developed. All patients treated remain recurrence free. CONCLUSIONS: Endoscopic management of large fibroepithelial polyps of the renal pelvis and ureter is an acceptable treatment modality with minimal morbidity and durable treatment results. The percutaneous approach offers the advantage of identifying the base of the polyp under direct visualization, allowing safe destruction of the stalk and efficient removal of the entire polyp. To our knowledge, this is the first reported series of percutaneous, antegrade excision of fibroepithelial polyps.

Electrosurgery↗
PubMed1997

Fibroepithelial polyp of the renal pelvis: nephron-sparing surgery after false-positive biopsy for transitional cell carcinoma.

Benign fibroepithelial polyps of the renal pelvis are extremely rare, with only 23 cases previously reported. The diagnosis is usually made following nephrectomy or nephroureterectomy for an assumed malignancy. This case involves a 66-year-old woman referred with presumed biopsy-proven transitional cell carcinoma of the renal pelvis. Radiographic findings were suggestive of a benign lesion. Pyelotomy and frozen section confirmed these suspicions. The polyp was excised and the kidney spared. The diagnosis and management of fibroepithelial polyps are discussed and the literature reviewed.

Aged↗
PubMed2002

[Pelvis obliquity, hip excentration and scoliosis in a population of 120 polyhandicaped adults. Descriptive study].

UNLABELLED: The objective of this study is to give objective data about neuro-orthopaedic status of the population of polyhandicapped patients for improving both our medical and surgical practices. MATERIAL AND METHOD: It was a multicentre, cross-sectional study to describe the population of polyhandicapped patients over 15 years of age. Each person was provided with clinical examination and X rays to detect scoliosis, pelvis obliquity and hip excentration (subluxation or dislocation) and other factors associated with polyhandicap. Polyhandicap was defined as a severe handicap linking physical and mental disability and responsible for extreme restriction of autonomy. RESULTS: One hundred and twelve persons were studied. Mean age was 27.2 years. Etiology of the handicap was neonatal asphyxia (38.3% of patients). 69.0% of patients had no possibility to turn over in lying position. Orthopaedic status was serious : 75.9% scoliosis, 65.2% pelvis obliquity (75% left and 25% right), 19.1% hip dislocation. General condition was precarious : one patient in two had a weight judged lower than normal weight, 32.5% had bedsores, 45.2% suffered from hip pain and only 13.6% received treatment against pain. DISCUSSION AND CONCLUSION: The description of general and neuro-orthopaedic status of these 120 people with polyhandicap cannot leave us indifferent. Although life expectancy in this population was lower than in normal populations, we are faced with life process and no with accompanying the terminally ill. We urgently need to review preventive care in terms of quality and quantity as well as surgical proposals for treating spasticity in children and adults.

Adolescent↗