Nondilated obstructive uropathy

Spital, Aaron; Valvo, John R.; Segal, Arthur J.

doi:10.1016/0090-4295(88)90211-7

Cited by 41 publications

(10 citation statements)

References 12 publications

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“…Gray scale ultra sonography is the most effective way to exclude sub acute or chronic obstruction. However, regular gray scale US is not accurate in minimally dilated obstruction, such as with partially obstructing ureteric stone; in one series, 4–5% of patients with obstruction showed minimal or no upper tract dilatation [7]. Duplex Doppler is less effective in acute and incomplete obstruction since obstruction for longer than six hours is necessary to show a consistently elevated resistive index (RI) [8].…”

Section: Discussionmentioning

confidence: 99%

Diagnostic accuracy of ultrasonography compared to unenhanced CT for stone and obstruction in patients with renal failure

2004

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BackgroundTo determine accuracy of ultrasound (US) kidney, ureter and bladder (KUB) compared to un-enhanced helical CT (UHCT) in patients with renal failure in the diagnosis of stone and obstruction.MethodsThis is a case controlled study conducted in the period from June 2000 to July 2003 at a university hospital. All patients had both US and UHCT scan. Patients with serum creatinine ≥ 1.8 mg/dl were included in the study. Only direct visualization of stone was considered as confirmatory. In both the studies, UHCT and US, presence of stone and obstruction were noted. The relevant biochemicals, radiological and clinical records of all the patients were analyzed. Data was analyzed using commercially available software.ResultsDuring the period of study 864 patients had UHCT for evaluation of the urinary tract in patients presenting with flank pain. Out of these 34 patients had both UHCT and US done within a span of one day and had serum creatinine of ≥1.8 mg/dl. Mean age was 48 ±15.8 years and 59% of patients were males. UHCT identified renal stones in 21 (62%), whereas 17 of these were identified on US, with a sensitivity of 81%. Of the four patients with renal stones missed on US, three were identified on plain x-ray; the mean size of stones missed was 6.3 mm. Of the 22 (65%) patients with ureteric stone on UHCT, US could only identify 10; a further 7 were identified on x-ray KUB, giving a sensitivity of 45% (US alone) and 77% (US with x-ray KUB).ConclusionsUS is sensitive and specific for renal stones, 81% and 100% and for hydronephrosis, 93% and 100%, respectively. Its sensitivity to pick ureteric stone (46%) and to identify hydroureter (50%) is low. Addition of x-ray KUB abdomen increases the sensitivity for ureteric stones to 77%.

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Section: Discussionmentioning

confidence: 99%

Diagnostic accuracy of ultrasonography compared to unenhanced CT for stone and obstruction in patients with renal failure

2004

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“…1 Bilateral ureteric obstruction because of external compression caused by retroperitoneal fibrosis or malignant disease account for 60% of these cases. [1][2][3][4][5][6] We report an unusual case of acute renal failure secondary to non-dilated bilateral ureteric obstruction from stone disease.…”

Section: Introductionmentioning

confidence: 99%

Anuric, obstructive uropathy in the absence of obvious radiological evidence of obstruction

Leong¹,

Sells²,

Moretti³

2004

ANZ Journal of Surgery

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“…A significant number of patients with prostate cancer present with advanced disease but, unlike those with other malignancies, they fare better because initially the tumour is sensitive to androgen withdrawal or suppression (Sandhu et al, 1990). The importance of diagnosing obstructive uropathy lies in the potential reversibility of renal failure (Spital et al, 1988) and improvement in survival (Ganem, 1957). The advent of endourology with percutaneous nephrostomy and ureteric stenting has significantly altered the management of obstructive Based on a Poster Demonstration at the 47th Annual Meeting of the British Association of Urological Surgeons in Glasgow, June 1991 uropathy in these patients (Singh et al, 1979;Suryva and Provet, 1989).…”

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confidence: 99%

Outcome and Prognostic Factors in Patients with Advanced Prostate Cancer and Obstructive Uropathy

Sandhu

Mayor

Sambrook

et al. 1992

British Journal of Urology

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In a series of 51 patients with prostate cancer and obstructive uropathy, unilateral or bilateral obstruction was identified in 22 (43%) and 29 (57%) respectively. This included a non-functioning kidney in 12 patients. In 86% of patients the T category was advanced. Bone metastases were present in 36 cases (71%); 19 patients (37%) had chronic retention. All patients with metastatic disease underwent hormonal manipulation and 43 underwent transurethral resection of the prostate. External beam radiotherapy, percutaneous nephrostomy and ureteric reimplantation were performed in 4, 5 and 1 patient respectively. Actuarial survival of all 51 patients was 57 and 25% at 2 and 5 years. Presentation with bilateral or non-function did not predict a worse prognosis in comparison with patients with unilateral hydroureteronephrosis. Raised alkaline phosphatase and prostatic acid phosphatase were of no prognostic value, while creatinine reached marginal significance. A positive bone scan and raised urea were strongly predictive of a poor outlook. It was concluded that prostate cancer and obstructive uropathy should not uniformly imply a terminal event, and interventional therapy is justified with a 25% 5-year survival rate.

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Nondilated obstructive uropathy

Cited by 41 publications

References 12 publications

Diagnostic accuracy of ultrasonography compared to unenhanced CT for stone and obstruction in patients with renal failure

Diagnostic accuracy of ultrasonography compared to unenhanced CT for stone and obstruction in patients with renal failure

Anuric, obstructive uropathy in the absence of obvious radiological evidence of obstruction

Outcome and Prognostic Factors in Patients with Advanced Prostate Cancer and Obstructive Uropathy

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