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At least 595 records · Page 33Linked to original sources
PubMed2007

Spontaneous disappearance of multiple lung metastases after nephroureterectomy from sarcomatoid carcinoma of the renal pelvis: a case report.

We report a case in which lung metastases disappeared spontaneously after nephroureterectomy from sarcomatoid carcinoma of the renal pelvis. A 58-year-old man presented with gross hematuria. Computed tomography (CT) revealed a left renal tumor and multiple lung metastases. Intravenous pyelography revealed a filling defect in the upper renal calyx. Urine cytology was positive. Left renal pelvic cancer was diagnosed and nephroureterectomy performed. The resected specimen was diagnosed pathologically as sarcomatoid carcinoma of the renal pelvis. Approximately 5 months later, CT revealed that the lung metastases had disappeared. There has been no evidence of disease for 46 months postoperatively.

Carcinoma↗
PubMed1975

Bilateral pelvi-ureteric avulsion following closed trauma.

A 9-year-old girl suffered severe multiple injuries in a road traffic accident. Following a period of anuria an intravenous pyelogram was performed indicating bilateral pelvi-ureteric rupture. Continuity was eventually achieved on both sides following two attempts at ureteral anastomosis. One year after the accident the child is well and the kidneys and ureters are functionally normal. Early diagnosis and treatment is essential in order to achieve a good functional result. This is aided by an awareness of the condition and is confirmed by intravenous and retrograde pyelography. The anastomosis is performed over a polythene splint, supported by a defunctioning nephrostomy for several weeks. The aetiology remains obscure, although there have been many suggestions regarding the mechanics of pelvi-ureteric avulsion.

Accidents, Traffic↗
PubMed1988

Tumours of the renal pelvis and ureter. Observations in 170 patients.

A study was made of 170 patients with renal pelvis or ureteric tumours, 160 of whom underwent surgery between 1948 and 1981. The most important aetiological factor was chronic phenacetin abuse: 21.7% of 83 patients with renal pelvis tumours and 11.4% of those with ureteric tumours gave a history of phenacetin abuse. The latency periods ranged from 24 to 26 years. This is the first report of a relationship between abuse of analgesics and urothelial tumours from the Federal Republic of Germany.

Adolescent↗
PubMed1991

Eicosanoid synthesis in the isolated human renal pelvis, ureter and bladder.

Prostaglandin synthetase inhibitors are used for the treatment of ureteric colic. However, there is controversy regarding the mechanism of action of these drugs. In this study, differential prostaglandin synthesis in the human renal pelvis, ureter and bladder was measured using specific radioimmunoassays and gas chromatography/mass spectrometry. There was a significant quantitative predominance of the smooth muscle constrictor eicosanoids, PGF2 alpha and TXA2 over the dilatory PGE2 in tissue from all sites--renal pelvis, ureter and bladder. The results indicate that prostaglandins play a direct role in smooth muscle activity of the upper urinary tract and the inhibition of this activity with indomethacin indicates a further mode of its action in pain relief in ureteric colic.

6-Ketoprostaglandin F1 alpha↗
PubMed2006

Preoperative evaluation of the "hostile pelvis" in radical prostatectomy with computed tomographic pelvimetry.

OBJECTIVE: To determine whether preoperative pelvimetry based on computed tomography (CT) can be used to predict technical difficulties during open radical prostatectomy (RP). PATIENTS AND METHODS: An open RP database accrued prospectively between January 1997 and June 2005 was used to identify 450 patients with preoperative pelvic imaging. Of these, 165 had adequate imaging of the pelvis with CT to allow pelvimetry using software provided with the medical imaging records. Several pelvic measurements were recorded in conjunction with body mass index and transrectal ultrasonographic estimates of prostatic volume. Outcome measures used to reflect technical surgical difficulties included operative duration, blood transfusion requirements within 30 days of RP, the pathological positive surgical margin and prostatic capsular breech rate. Logistic and linear regression analyses were used to determine the relationship between variables before and after RP. RESULTS: The selected pelvimetric measurements failed to predict either operative duration or the peri-operative blood transfusion requirement. Prostatic volume was predictive of operative duration; for every increase of 20 mL in prostate volume the duration increased by 8.4 min. Although pelvimetric measures failed to predict positive surgical margins at pathology, the transverse diameter predicted the likelihood of a positive margin due to capsular breech. With every 8.6 mm (1 sd) decrease in transverse diameter, the odds of a capsular breech resulting in positive surgical margins increased 5.3 times (95% confidence interval 2.1-20.0, P = 0.002). CONCLUSIONS: Although the "hostile pelvis" influences the likelihood of prostatic capsular breech resulting in positive surgical margins, CT pelvimetric screening of patients before RP is unlikely to be cost-effective. Routine pelvic CT in the evaluation of patients before RP is not supported.

Aged↗
PubMed1989

Evaluation of intermittent drainage of the renal pelvis as seen in the isotope renogram.

Intermittent drainage (ID) of the renal pelvis is probably due to episodes of aperistalsis in the pelvo-calyceal system. The incidence of ID in adult patients referred for renography for various nephro-urological conditions was found to be 4.5%. Presence of ID was not related to sex or age but more common at a low urine flow. It was then usually bilateral and interpreted as a normal phenomenon. If the urine flow at the renographic examination exceeded 2 ml min-1, ID was typically unilateral and there was often a history of obstructive uropathy and dilatation of the renal pelvis. However, there were no signs of obstruction or flank pains in connection with the recording of ID and follow-up studies did not disclose any deterioration of renal function. It is concluded that ID seen at renography during diuresis should not be regarded as evidence of obstruction of pelvic outflow but merely as an indication of a dilated upper urinary tract.

Adult↗
PubMed1994

CT anatomy of the female pelvis: a second look.

Computed tomography (CT) remains a valuable technique in the assessment of the female pelvis. The CT appearance of the normal ligamentous, vascular, and visceral anatomy of the female pelvis can be confusing. Newer high-resolution CT scanners combined with mechanical intravenous contrast medium injectors and thinner sections have substantially improved the imaging of female genital tract anatomy. In addition to the cardinal, uterosacral, and round ligaments, the ovaries and their ligamentous attachments, as well as the blood supply to the female internal organs, can now be visualized. Inferior-to-superior image acquisition following bolus administration of intravenous contrast material with an angiographic injector facilitates precise identification of the uterine artery and its relationship to the pelvic ureter and the vascular plexus supplying the vagina, ovaries, and uterine body. Ideally, familiarity with variations in the CT appearance of normal female pelvic anatomy will enable more accurate evaluation of pelvic abnormalities.

Adult↗
PubMed2004

Sixteen-detector row CT of abdomen and pelvis: study for optimization of Z-axis modulation technique performed in 153 patients.

PURPOSE: To retrospectively determine the optimal noise indexes required to obtain diagnostically acceptable computed tomographic (CT) images of the abdomen and pelvis with z-axis modulation. MATERIALS AND METHODS: Ninety-five patients underwent 16-section multi-detector row CT of the abdomen and pelvis with z-axis modulation at noise indexes of 10.5, 11.0, 11.5, and 12.0 HU with 10-380 mA. Subsequently, 58 patients were scanned at noise indexes of 12.5 and 15.0 HU with 75-380 mA. The weights of all subjects were recorded, and transverse and anteroposterior diameters were measured. The CT images were evaluated for abnormalities and graded for image quality in terms of noise and diagnostic acceptability by using a five-point scale. Objective noise in the liver parenchyma was measured, and the tube current was recorded at each section in all 153 patients. Statistical analyses were performed to determine the appropriate noise index and to assess the effect of patient weight and abdominal diameters on image noise and diagnostic acceptability at different noise indexes. Tube current-time products (in milliampere seconds) at various noise indexes were compared with those at CT previously performed without z-axis modulation. RESULTS: No significant difference in subjective image noise or diagnostic acceptability was found at noise indexes of 10.5-15.0 HU (P =.14), and objective noise was significantly inferior only at a noise index of 15.0 HU (P =.009). Compared with CT scanning at a 10.5-HU noise index, CT scanning at 12.5- and 15.0-HU noise indexes yielded, respectively, 10.0% and 41.3% reductions in radiation exposure. Patient weight and abdominal diameters affected subjective image quality. CONCLUSION: Use of a 15.0-HU noise index at 75-380 mA results in acceptable subjective image noise and diagnostic acceptability but significantly greater objective image noise at routine abdominal-pelvic CT. For greater image quality demands, a noise index of 12.5 HU results in acceptable image quality and a 19.6% reduction in radiation exposure.

Abdomen↗
PubMed1989

Variable-flip-angle spin-echo MR imaging of the pelvis: more versatile T2-weighted images.

Dependence on T1 contrast can be reduced by changing the excitation flip angle. The authors compared T2-weighted spin-echo images (with 30 degrees and 90 degrees flip angles) of the male and female pelvis in 22 individuals. In six women imaged with a 1,000/80 sequence (repetition time msec/echo time msec), signal difference-to-noise ratios (SD/Ns) were higher with a 30 degree flip angle than with a 90 degree angle for urine/fat (mean, 15.2 vs -6.2; P less than .05) and endometrium/myometrium (13.8 vs 9.0, P less than .05). In eight additional examinations, a 1,000/80 sequence with a 30 degree flip angle and two signal averages had less motion artifact (1.2 vs 2.7, P less than .01) than a 2,000/80 sequence with a 90 degree angle and one signal average (4.5 minutes each); SD/Ns were similar. In a third series of experiments, contiguous sections without cross talk, obtained by interleaving two 1,000/100, 30 degrees-flip-angle acquisitions, had better contrast than contiguous sections obtained at 2,400/100 with a 90 degree flip angle (10 minutes each), with SD/Ns of urine/fat of 28.5 versus 16.1 (P less than .01) and SD/Ns of endometrium/myometrium of 15.5 versus 7.8 (P less than .05). Reducing the flip angle can improve examination time, contrast, or motion artifact suppression or eliminate cross talk in T2-weighted spin-echo MR imaging of the pelvis.

Female↗
PubMed1996

Transitional cell carcinoma of the renal pelvis: a retrospective look at CT staging with pathologic correlation.

PURPOSE: To identify the reasons for the discrepancies between computed tomographic (CT) and pathologic staging of transitional cell carcinoma of the renal pelvis and to develop new criteria to increase the accuracy of CT in staging. MATERIALS AND METHODS: CT scans of 31 consecutive patients with renal pelvic transitional cell carcinoma were evaluated. CT and pathologic staging were compared. RESULTS: Pathologic staging revealed four stage 0 tumors, three stage I, five stage II, 10 stage III, and nine stage IV. The initial overall CT staging accuracy was 52% (16 of 31 patients). The sensitivity for minimal invasion was 17% (two of 12 patients). Two-thirds (10 of 15 patients) of the misinterpreted cases were overstaged as stage III. Proximal hydronephrosis was present in 80% of overstaged cases (eight of 10 patients). Reevaluation of the CT studies by using proximal hydronephrosis as a criterion for minimal invasion improved overall CT staging accuracy (77%). The revised staging yielded a sensitivity of 83% and specificity of 95% for minimal invasion and improved the specificity for deep invasion (17% to 92%). CONCLUSION: In a patient with transitional cell carcinoma of the renal pelvis, hydronephrosis proximal to the tumor may cause overstaging of stage 0-II disease and may not indicate more advanced disease.

Carcinoma in Situ↗
PubMed1997

Critical soft tissues of the female pelvis: serial MR imaging before, during, and after radiation therapy.

PURPOSE: To evaluate the findings in the irradiated critical soft-tissue organs of the female pelvis at magnetic resonance (MR) imaging within 30 months after radiation therapy. MATERIALS AND METHODS: Twenty-three patients (13 premenopausal and 10 postmenopausal women) with advanced cervical carcinoma underwent 276 MR examinations (T1- and T2-weighted imaging) scheduled before, three times during, and 7 weeks and 3, 6, 9, 12, 18, 24, and 30 months after the end of radiation therapy. A visual evaluation of the ureters, bladder, rectum, parametrium, and perivesical and perirectal soft tissues was performed by two radiologists. RESULTS: Fifteen abnormally wide ureters (diameter range, 7-23 mm; mean diameter, 14 mm) were seen in 10 (seven premenopausal and three postmenopausal women) (43%) of 23 patients at a median time of 18 months after the end of radiation therapy (range, 9-30 months). An abnormally wide ureter was a transient finding in eight (53%) of 15 abnormal ureters. Two premenopausal women (9%) of 23 patients had rectovaginal fistulas. One of these two patients also had a vesicovaginal fistula. CONCLUSION: Ureteral dilatation was seen in nearly half of the patients and occurred more frequently in premenopausal women than in postmenopausal women. Knowledge about the appearances of radiation-induced abnormalities of the critical soft tissues may be of help in the interpretation of MR images of the pelvis.

Aged↗
PubMed1999

Tissue characterization in the female pelvis by means of MR imaging.

Pelvic imaging techniques such as computed tomography and ultrasonography provide a limited capability for tissue characterization. Fat, fluid, and calcification, for example, can be identified on the basis of parameters such as x-ray attenuation, echogenicity, and sound attenuation. Because of the many tissue parameters, such as T1, T2, magnetic susceptibility, and chemical shift, that contribute to signal intensity, magnetic resonance (MR) imaging may afford an ability to identify a wider array of specific tissues. The purpose of this article is to review the ability of MR imaging to help identify various types of soft tissue and to provide an approach to interpretation of MR images of the female pelvis through tissue characterization. Lipid, fluid, hemorrhage, smooth muscle, fibrosis, solid malignant tissue, and hydrated soft tissue (including edema, mucin, and myxomatous tissue) have typical MR imaging properties, and their presence in a mass can often be established on MR images. Consideration of the tissue composition of various pathologic processes in the pelvis can result in more systematic approaches to image interpretation and thus narrow the differential diagnosis.

Female↗
PubMed1990

Electrical properties of smooth muscle cell membrane in renal pelvis of rabbits.

Intracellular recordings were made to study the electrical properties of smooth muscle cells in the rabbit renal pelvis. The muscle cells exhibited spontaneous oscillation in the membrane potential (slow wave). The slow waves were regular and were resistant to tetrodotoxin and sympathomimetic or parasympathomimetic antagonists, findings indicative of myogenic activity. The membrane was depolarized by an increase in extracellular concentration of K+ ([K+]o), decrease in [Na+]o, inhibition of the electrogenic Na(+)-K+ pump by ouabain or K(+)-free solution, and the application of norepinephrine (NE, greater than 10(-6) M). The maximum slope of the membrane depolarization produced by a 10-fold increase in [K+]o was approximately 48 mV. Reductions in [Ca2+]o inhibited the generation of slow waves with no marked change in the membrane potential. Depolarizations produced by any given method increased the frequency and decreased the amplitude of the slow wave, and NE had the most potent accelerating action on the frequency. Hyperpolarization of the membrane by 1-5 mV with extracellularly applied current stimuli reduced the frequency, and a strong hyperpolarization (greater than 5 mV) blocked the generation of slow waves. Electrophysiological properties of the slow waves obtained with tissues of the renal pelvis and intestinal smooth muscles were compared.

Animals↗
PubMed1998

Lymph node metastasis in patients with carcinomas of the renal pelvis and ureter.

OBJECTIVES: We evaluated the clinical significance of lymph node metastasis in patients with carcinomas of the renal pelvis and ureter. METHODS: 68 patients without distant metastasis were included in this study. Multivariate analysis by Cox's proportional hazards model was applied to detect the prognostic factor(s). RESULTS: 12 patients (17.6%) had nodal involvement. More than 10% of the patients with pT1-2 showed nodal metastasis. Preoperatively determined clinical factors were not a predictive factor for nodal involvement. Nodal metastasis was the only significant negative prognostic factor for patient survival by multivariate analysis. CONCLUSIONS: Lymph node dissection is valuable to predict the clinical outcome of the patients with carcinoma of the renal pelvis and ureter. Attention should be paid to nodal status to select patients for conservative surgery.

Adolescent↗
PubMed1998

Prognostic significance of p53 protein overexpression in transitional cell carcinoma of the renal pelvis and ureter.

Fifty-three patients with invasive transitional cell carcinoma of the renal pelvis and ureter were studied for p53 protein overexpression by immunohistochemistry. Overexpression of p53 protein was observed in 19 patients (35.8%). There was a significant correlation between overexpression of p53 protein and histologic grade (p < 0.01). However, there was no correlation found between p53 immunoreactivity and pathologic stage. By univariate survival analysis, a significant difference in cumulative survival was observed between stage pT2 and stage pT3 or pT4 tumors (p < 0.05). The difference in survival between patients with p53-positive and negative tumors did not reach statistical significance (0.05 < p < 0.01). Multivariate analysis revealed that pathologic stage had an independent prognostic value (p < 0.05). The independent prognostic value of p53 protein overexpression did not quite reach statistical significance (p = 0.07). p53 protein nuclear overexpression appears to be a relatively weak prognostic indicator for patients with invasive transitional cell carcinoma of the renal pelvis and ureter.

Adult↗
PubMedDate not supplied

Mucinous adenocarcinoma arising in the renal pelvis of an ectopic pyelic kidney.

A case of mucinous adenocarcinoma probably originating in the renal pelvis of an ectopic pyelic kidney with infiltration of the adjacent urinary bladder is reported. Review of the literature shows that this is the 42nd case of such a tumor, the second one reported in the pelvis of an ectopic pyelic kidney, and the first infiltrating the urinary bladder.

Adenofibroma↗
PubMed1977

Duplication of the renal pelvis and blind-ending bifid ureter in twins.

Blind-ending bifid ureter in a woman with urinary tract infection and a duplicated renal pelvis in her twin sister are reported. The blind-ending bifid ureter terminated as a fibrous cord with a terminal mass of immature renal tissue. This type of ureter may be a transitional form between histologically blind-ending bifid ureter and duplication of the renal pelvis and/or kidneys. Findings in twins support this opinion.

Adult↗
PubMed1980

Carcinoma in situ of the renal pelvis after cystectomy. A case report including comments concerning diagnostic procedures and surgical treatment.

Carcinoma in situ of the renal pelvis in a patient with an ileal conduit is reported. By fiberendoscopy, using gastrointestinal instruments, both ureters were catheterized. Cytological investigation of urine from each kidney revealed that malignant cells were exfoliated from the left side exclusively. The correct diagnosis of a carcinoma in situ of the left renal pelvis was confirmed by a histological examination of the operative specimen.

Aged↗