Evaluating Bilharzial Ureteropathy for Surgery

Husain, I.; Ali, I. H. Al.; Kinare, Arun S.

doi:10.1111/j.1464-410x.1980.tb03087.x

Cited by 15 publications

(7 citation statements)

References 3 publications

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“…Stricture of the ureter is the most important lesion because it produces severe symptoms that necessitate reimplantation [9]. Surgical attempts for ureteroneocystostomy with an antireflux procedure are not recommended [10] and reimplantation in such pathological tissue with an antireflux procedure carries a high risk of restenosis [11,12].…”

Section: Discussionmentioning

confidence: 99%

Extravesical Antireflux Peritoneal Tunnel Technique for the Treatment of Dilated High-Grade Refluxing Ureters

Ibrahim¹,

Ezzat²,

Ezzat³

2011

UIJ

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INTRODUCTION:The purpose of the study was to assess the effectiveness of a new antireflux technique that uses a peritoneal flap as a tunnel for the treatment of high-grade refluxing ureters. METHODS:This was a prospective, nonrandomized trial involving15 patients with grade 4 or grade 5 vesicoureteral reflux, seen between 1998 and 2004. Their mean age was 41 years (range, 27-58 years). Of the 15 patients, 13 had a past history of ureteroneocystostomy without an antireflux procedure for the treatment of bilharzial ureteral stricture; 2 patients had reflux secondary to neurogenic bladder. A peritoneal flap was used to create an extravesical ureteral tunnel as an antireflux procedure that does not interrupt the ureterovesical junction. The effective tension of the tunnel and its ability to prevent reflux were tested using intraoperative fluoroscopy. Patients were followed at 6 and 12 months with urine cultures, creatinine measurement, voiding cystourethrogram, and renal ultrasound. RESULTS:Voiding cystourethrogram showed that 10 of 12 patients without reflux during the procedure remained free of reflux during follow-up; the remaining 2 patients developed grade 1 and grade 2 reflux. For 3 patients with low-grade reflux during surgery, 2 remained at the same grade and 1 progressed to high grade. There were no major changes in serum creatinine from baseline to follow-up. After surgery, the frequency and severity of urinary tract infections and pyuria were appreciably diminished. There was no evidence of ureteral obstruction. CONCLUSIONS:The new technique was effective in preventing or downgrading reflux in this small number of patients. By creating an extravesical tunnel from a peritoneal flap, the technique avoids interrupting the ureterovesical junction in the dilated unhealthy ureter and fibrosed bladder wall. It could be applied to cases with a severely fibrosed ureter and bladder when other surgical techniques cannot be safely used.UroToday International Journal ® UI J

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Section: Discussionmentioning

confidence: 99%

Extravesical Antireflux Peritoneal Tunnel Technique for the Treatment of Dilated High-Grade Refluxing Ureters

Ibrahim¹,

Ezzat²,

Ezzat³

2011

UIJ

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“…I. Husain, et al identified true strictures in less than ten percent of their patients. 13 They have proposed a classification of bilharzial ureteropathy that they believe is helpful in the choice of therapy and determination of prognosis. Type A ureteropathy has minimal changes localized to the lower ureteric segment.…”

Section: Uretersmentioning

confidence: 99%

Genitourinary Schistosomiasis (Bilharziasis). Part 2: Clinical, Parasitologic, Immunologic, and Radiologic Diagnosis

et al. 1981

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Clinical PictureAs described in Genitourinary Schistosomiasis (Bilharziasis) Part 1, the life of the Schistosoma haematobium begins in stagnant waters where the parasite lays its eggs. During the warm hours of the day the egg swells, ruptures, and releases a miracidium which then penetrates a specific species of snail, the Bulinus. Having penetrated the snail, it becomes a sporocyst and, by repeated budding, gives rise to a second generation of daughter sporocysts. Cercariae by the thousands are produced by the sporocysts and liberated from the snails. Unless these free-swimming cercariae can penetrate the skin or mucous membrane of a human host within seven days, they will die.Irritative dermatitis may result around the area of the cercariae's penetration.

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“…In general, the selection of patients with dilated urinary tracts for surgery is a difficult task. This is especially true in schistosomal patients (Hussain et a/., 1980;Kazim, 1987).…”

mentioning

confidence: 99%

“…Urinary schistosomiasis produces various abnormalities in the urinary tract. The most frequent lesion is bilateral pelvicaliceal and ureteric dilatation (Umerah, 1977(Umerah, , 1981Hussain et a/., 1980;Young et al, 1984). The dilated ureter may become obstructed at the lower end by a stricture, a stone or bilharzial papilloma (Kazim, 1987).…”

mentioning

confidence: 99%

99m Tc DTP A Diuretic Renography in the Evaluation of Surgery in Chronic Schistosomal and Non‐schistosomal Obstructive Uropathy

Bahar

Sabha²,

Kouris³

et al. 1990

British Journal of Urology

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The selection of patients with chronic obstructive uropathy for surgery is difficult because of problems in identifying true obstruction in a grossly dilated urinary tract. This is especially so in schistosomal (bilharzial) obstructive uropathy. A prospective study of 90 patients (68 with chronic schistosomal and 22 with non-bilharzial obstructive uropathy) was carried out. All patients underwent pre-operative and post-operative radionuclide 99mTc DTPA diuretic renography (RDR). The aims were to assess the value of RDR in the pre- and post-operative management of these patients and whether it could predict the outcome of surgery. Distinctive renogram patterns were identified in patients who required surgical management. These were found useful in monitoring the results and in predicting the outcome of surgery.

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Evaluating Bilharzial Ureteropathy for Surgery

Cited by 15 publications

References 3 publications

Extravesical Antireflux Peritoneal Tunnel Technique for the Treatment of Dilated High-Grade Refluxing Ureters

Extravesical Antireflux Peritoneal Tunnel Technique for the Treatment of Dilated High-Grade Refluxing Ureters

Genitourinary Schistosomiasis (Bilharziasis). Part 2: Clinical, Parasitologic, Immunologic, and Radiologic Diagnosis

99m Tc DTP A Diuretic Renography in the Evaluation of Surgery in Chronic Schistosomal and Non‐schistosomal Obstructive Uropathy

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