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Kidane MY, Mideksa AG, Adem MB, Gebrehiwot FG, Adem RY, Ahmed MM, Aderu AK, Berta MT. Case Report; Concomitant Left Nutcracker Syndrome and Right Ureteropelvic Junction Obstruction. Res Rep Urol 2024; 16:131-135. [PMID: 38883265 PMCID: PMC11178079 DOI: 10.2147/rru.s446710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 06/02/2024] [Indexed: 06/18/2024] Open
Abstract
We report rare case of concomitant left nutcracker syndrome and right ureteropelvic junction obstruction (UPJO) on adult female patient diagnosed by CT urogram after she presented with intermittent bilateral flank pain. For this we did Anderson-Hynes pyeloplasty for right ureteropelvic obstruction, it was laparoscopic initially but due to difficulty of stenting it is changed to open. She had smooth post-op course then discharged on 3rd post-op day. Symptoms of nutcracker syndrome are not that much bothersome for the patient so we planned to follow her conservatively.
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Affiliation(s)
- Mintesnot Yitagesu Kidane
- Department of Surgery, Urology Division at St. Paul Hospital and Millennium Medical College, Addis Ababa, Ethiopia
| | - Adugna Getachew Mideksa
- Department of Surgery, Urology Division at St. Paul Hospital and Millennium Medical College, Addis Ababa, Ethiopia
| | - Mubarek Bargicho Adem
- Department of Surgery, Urology Division at St. Paul Hospital and Millennium Medical College, Addis Ababa, Ethiopia
| | | | - Ramzi Yessuf Adem
- Department of Surgery, Urology Division at St. Paul Hospital and Millennium Medical College, Addis Ababa, Ethiopia
| | - Mensur Mohammed Ahmed
- Department of Surgery, Urology Division at St. Paul Hospital and Millennium Medical College, Addis Ababa, Ethiopia
| | - Abebe Ketema Aderu
- Department of Surgery, Urology Division at St. Paul Hospital and Millennium Medical College, Addis Ababa, Ethiopia
| | - Mintesnot Tadesse Berta
- Department of Surgery, Urology Division at St. Paul Hospital and Millennium Medical College, Addis Ababa, Ethiopia
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Ullah R, Ali W, Adil Mehmood M, Ali W, Hameed MB, Ullah M, Khan Zada A, Naveed Khan K. Efficacy of Endopyelotomy for Secondary Pelvi-Ureteric Junction (PUJ) Obstruction in Terms of Improvement in Renal Function. Cureus 2024; 16:e54728. [PMID: 38523976 PMCID: PMC10960931 DOI: 10.7759/cureus.54728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/22/2024] [Indexed: 03/26/2024] Open
Abstract
Objective The objective of this study is to measure renal function improvement after endopyelotomy for secondary pelvi-ureteric junction (PUJ) obstruction using technetium-99m diethylene-triamine-pentaacetate (DTPA) renal scintigraphy. Material and methods This descriptive study was carried out at the Department of Urology, Institute of Kidney Diseases, Peshawar, Pakistan from June 1, 2021, to May 31, 2023. The study included 118 secondary PUJ blockage patients who underwent endopyelotomy. Patient demographics, clinical history, and preoperative imaging findings were obtained. DTPA renal scintigraphy assessed renal function improvement postoperatively at intervals to determine the efficacy of endopyelotomy. Results The majority of the patients included in the study were male (n=65, 55.1%). The average age of the patients was 45.2 years, with the majority falling within the age range of 46-60 years (n=42, 35.6%). All patients had ultrasonography and computed tomography imaging done, and preoperative renal functions were obtained. Comorbidities included hypertension in 32 (27.12%) and diabetes in 18 (15.25%). DTPA renal scintigraphy showed improved renal function in 81.35% of patients at three months, 88.13% at six months, and 83.05% at 12 months; 15.3% of patients needed further treatments, and 5.1% had PUJ blockage recurrence. Conclusion This study offers significant insights into the results and complexities of endopyelotomy in patients suffering from PUJ blockage. The findings indicate that the technique efficiently enhances kidney function and alleviates symptoms in most patients. However, the study also emphasizes the need to monitor patients undergoing this procedure.
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Affiliation(s)
- Rizwan Ullah
- Urology, Institute of Kidney Diseases, Peshawar, PAK
| | - Wasim Ali
- Internal Medicine, Swat Medical Complex, Saidu Sharif, PAK
| | | | - Wajid Ali
- Surgery, Hayatabad Medical Complex Peshawar, Peshawar, PAK
| | | | - Mohib Ullah
- Urology, Pakistan Institute of Medical Sciences, Islamabad, PAK
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Han C, Ma L, Li P, Wang J, Zhou X, Tao T, Cao H, Tao Y, Yang Y, Zhao Y, Zhu W, Guo T, Lyu X, Zhuo R, Zhou H. Modified robotic-assisted laparoscopic pyeloplasty in children for ureteropelvic junction obstruction with long proximal ureteral stricture: The "double-flap" technique. Front Pediatr 2022; 10:964147. [PMID: 36313892 PMCID: PMC9614221 DOI: 10.3389/fped.2022.964147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 08/29/2022] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE The objective of this study is to introduce a novel technique of robotic-assisted laparoscopic pyeloplasty (RALP) for ureteropelvic junction obstruction (UPJO) with long proximal ureteral stricture in children. MATERIALS AND METHODS Clinical information on patients who underwent a modified RALP between July 2018 and May 2019 in our center was collected retrospectively. Our surgical modifications mainly include "double-flap" tailoring of the renal pelvis and anastomosis of spatulate ureter with the double-flap. Demographic, perioperative, postoperative, and follow-up information was recorded in detail. RESULTS A total of 13 patients were included in the study. All the patients underwent a modified RALP without conversion to open surgery. They were followed up with a median time of 36 months. The anteroposterior diameter of the renal pelvis was 1.19 ± 0.21 at 6 months after the surgery, which was significantly lower than that on admission (3.93 ± 0.79). The split renal function of the children was also significantly improved from 0.37 ± 0.05) to 0.46 ± 0.02 at 6 months after surgery (p < 0.05). The diuretic renography revealed that all the patients have a T1/2 time less than 20 min postoperatively. The children were in good condition during the follow-up period. CONCLUSIONS Modified RALP is an effective surgical treatment for children with UPJO with long proximal ureteral stricture. The success rate of this modification has been preliminarily confirmed.
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Affiliation(s)
- Ce Han
- Department of Pediatric Urology, Department of Senior Pediatrics, Chinese PLA General Hospital, Beijing, China.,Department of Pediatric Urology, Bayi Children's Hospital Affiliated to the Seventh Medical Center of PLA General Hospital, Beijing, China.,Medical School of Chinese PLA, Beijing, China
| | - Lifei Ma
- Department of Pediatric Urology, Department of Senior Pediatrics, Chinese PLA General Hospital, Beijing, China.,Department of Pediatric Urology, Bayi Children's Hospital Affiliated to the Seventh Medical Center of PLA General Hospital, Beijing, China
| | - Pin Li
- Department of Pediatric Urology, Department of Senior Pediatrics, Chinese PLA General Hospital, Beijing, China.,Department of Pediatric Urology, Bayi Children's Hospital Affiliated to the Seventh Medical Center of PLA General Hospital, Beijing, China
| | - Jia'nan Wang
- Surgical Intensive Care Unit, The Second Medical Center of PLA General Hospital, Beijing, China
| | - Xiaoguang Zhou
- Department of Pediatric Urology, Department of Senior Pediatrics, Chinese PLA General Hospital, Beijing, China.,Department of Pediatric Urology, Bayi Children's Hospital Affiliated to the Seventh Medical Center of PLA General Hospital, Beijing, China
| | - Tian Tao
- Department of Pediatric Urology, Department of Senior Pediatrics, Chinese PLA General Hospital, Beijing, China.,Department of Pediatric Urology, Bayi Children's Hospital Affiliated to the Seventh Medical Center of PLA General Hospital, Beijing, China
| | - Hualin Cao
- Department of Urology, Nanxi Shan Hospital of Guangxi Zhuang Autonomous Region, Guilin, China
| | - Yuandong Tao
- Department of Pediatric Urology, Department of Senior Pediatrics, Chinese PLA General Hospital, Beijing, China.,Department of Pediatric Urology, Bayi Children's Hospital Affiliated to the Seventh Medical Center of PLA General Hospital, Beijing, China
| | - Yunjie Yang
- Department of Urology, Southern Medical University Affiliated Nanhai Hospital, Foshan, China
| | - Yang Zhao
- Department of Pediatric Urology, Department of Senior Pediatrics, Chinese PLA General Hospital, Beijing, China.,Department of Pediatric Urology, Bayi Children's Hospital Affiliated to the Seventh Medical Center of PLA General Hospital, Beijing, China
| | - Weiwei Zhu
- Department of Pediatric Urology, Department of Senior Pediatrics, Chinese PLA General Hospital, Beijing, China.,Department of Pediatric Urology, Bayi Children's Hospital Affiliated to the Seventh Medical Center of PLA General Hospital, Beijing, China.,Medical School of Chinese PLA, Beijing, China
| | - Tao Guo
- Department of Pediatric Urology, Department of Senior Pediatrics, Chinese PLA General Hospital, Beijing, China.,Department of Pediatric Urology, Bayi Children's Hospital Affiliated to the Seventh Medical Center of PLA General Hospital, Beijing, China.,Medical School of Chinese PLA, Beijing, China
| | - Xuexue Lyu
- Department of Pediatric Urology, Department of Senior Pediatrics, Chinese PLA General Hospital, Beijing, China.,Department of Pediatric Urology, Bayi Children's Hospital Affiliated to the Seventh Medical Center of PLA General Hospital, Beijing, China.,Medical School of Chinese PLA, Beijing, China
| | - Ran Zhuo
- Department of Pediatric Urology, Department of Senior Pediatrics, Chinese PLA General Hospital, Beijing, China.,Department of Pediatric Urology, Bayi Children's Hospital Affiliated to the Seventh Medical Center of PLA General Hospital, Beijing, China
| | - Huixia Zhou
- Department of Pediatric Urology, Department of Senior Pediatrics, Chinese PLA General Hospital, Beijing, China.,Department of Pediatric Urology, Bayi Children's Hospital Affiliated to the Seventh Medical Center of PLA General Hospital, Beijing, China
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