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Related Concept Videos

Urinary Tract Calculi VI: Surgical Management01:25

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Procedures for Kidney StonesMedical intervention is necessary when kidney stones or renal calculi are too large to pass spontaneously (typically greater than 5 millimeters) when stones are accompanied by symptomatic infection (such as fever or pyelonephritis), when they impair kidney function, or when they cause persistent symptoms like severe pain, nausea, or urinary retention. Additionally, patients with only one kidney or those who cannot be treated with medical management also require...
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AssessmentSubjective Data: Obtain a detailed health history, including any recent or chronic urinary tract infections, periods of immobilization, previous episodes of renal calculi, and medical conditions such as gout, benign prostatic hyperplasia, or hyperparathyroidism. Review the medication history for drugs that may influence stone formation, including allopurinol, analgesics, loop diuretics, or thiazide diuretics. Document the use of long-term indwelling catheters and any past surgical...
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Imaging Studies V: Intravenous Urography and Retrograde Pyelography01:22

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IntroductionIntravenous Urography (IVU) and Retrograde Pyelography (RP) are important diagnostic imaging techniques used to evaluate the urinary system. These methods help identify structural abnormalities, obstructions, and functional issues in the kidneys, ureters, and bladder. Both procedures use iodine-based contrast media to enhance the visibility of urinary tract structures on X-ray images, though they differ in their methods and indications.1. Intravenous Urography (IVU)Intravenous...
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The diagnosis of renal calculi involves several imaging techniques, including non-contrast CT scans and ultrasound. These methods help visualize kidney stones, assess their size and location, and detect possible obstructions. Additionally, Measuring urine pH is useful for diagnosing specific stone types, such as struvite (alkaline pH) and uric acid stones (acidic pH). Cystine stones are primarily linked to cystinuria, a genetic condition. A urinalysis helps detect blood in the urine (hematuria)...
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Preoperative ManagementThe primary goals of preoperative management in kidney transplantation are to optimize the patient’s metabolic state and prepare them for surgery through diet adjustments, necessary dialysis, and tailored medical treatment. This phase also involves comprehensive infection screening and patient education about the surgical procedure and postoperative care to improve outcomes and adherence.Medical ManagementA comprehensive evaluation is required for both the living...
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Ureterosciatic hernia causing obstructive uropathy successfully managed with minimally invasive procedures.

Yeong Uk Kim1, Jae Ho Cho2, Phil Hyun Song3

  • 1Department of Urology, Yeungnam University Hospital, Daegu, Korea.

Yeungnam University Journal of Medicine
|July 30, 2020
PubMed
Summary

Ureterosciatic hernia, a rare condition where the ureter prolapses through the sciatic foramen, can be successfully managed. Minimally invasive procedures offer a long-term, asymptomatic outcome for patients.

Keywords:
HerniaMinimally invasive surgical proceduresTreatment outcomeUreter

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Area of Science:

  • Urology
  • Anatomy
  • Radiology

Background:

  • Ureterosciatic hernia is an exceptionally rare condition involving ureteral prolapse through the greater or lesser sciatic foramen.
  • Predisposing factors include piriformis muscle atrophy, hip joint diseases, and pelvic fascia defects.
  • Surgical intervention is standard for symptomatic cases, with conservative management for asymptomatic individuals.

Observation:

  • A 68-year-old woman presented with colicky left abdominal pain, indicative of obstructive uropathy.
  • Computed tomography (CT) scan and anterograde pyelography confirmed a ureterosciatic hernia.
  • The patient underwent minimally invasive treatment involving ureteral balloon dilatation and double-J ureteral stent placement.

Findings:

  • Post-procedure CT scans revealed the left ureter had returned to its normal anatomical position, resolving the herniation.
  • The patient remained asymptomatic with no adverse events observed during a 7-year follow-up period.
  • This case highlights the efficacy of minimally invasive management for ureterosciatic hernia.

Implications:

  • Minimally invasive techniques provide a viable and effective long-term treatment option for ureterosciatic hernia.
  • This approach may reduce the need for more invasive surgical procedures.
  • Further research into long-term outcomes of minimally invasive management for this rare condition is warranted.