Ureteritis Cystica Research Articles

Thulium laser ablation for ureteritis cystica

Patients with ureteral obstruction often present a diagnostic dilemma on imaging techniques. Ureteritis cystica (UC) is one benign condition which can occasionally be a cause of ureteric obstruction and almost always eludes diagnosis unless ureteroscopic examination is performed. Although no definitive operative technique has been defined for its cure in the literature, ureteroscopic laser ablation is an effective minimally invasive option. We hereby present a short case report of thulium laser ablation in an elderly female with UC in the left upper ureter.

Inverted urothelial papilloma of the upper urinary tract: description of two cases with systematic literature review

BackgroundInverted urothelial papilloma (IUP) of the upper urinary tract is an uncommon benign tumour that occasionally presents as a polypoid mass causing urinary obstruction. Histologically, IUP is characterised by a proliferating urothelium arranged in cords and trabeculae, in continuity with overlying intact epithelium, and extending into the lamina propria in a non-invasive, endophytic manner. Cytological atypia is minimal or absent. Top differential diagnoses include urothelial carcinoma with inverted growth pattern and florid ureteritis cystica. Although urothelial carcinomas of the upper urinary tract with prominent inverted growth pattern commonly harbour microsatellite instability, the role of the mutator phenotype pathway in IUP development is still unclear. The aim of this study was to describe two additional cases of IUP of the upper urinary tract, along with an extensive literature review.Case presentationWe observed two polypoid tumours originating in the renal pelvis and the distal ureter, respectively. Both patients, a 76-year-old woman and a 56-year-old man, underwent surgery because of the increased likelihood of malignancy. Histology was consistent with IUP and patients are alive and asymptomatic after long-term follow-up (6 years for the renal pelvis lesion and 5 years for the ureter lesion). The tumours retained the expression of the mismatch-repair protein MLH1, MSH2, and PMS2 whereas loss of MSH6 was found in both cases.ConclusionsWhen completely resected, IUP does not require rigorous surveillance protocols, such as those for urothelial carcinoma and exophytic urothelial papilloma. It is therefore important for the surgical pathologist to be aware of this rare entity in order to ensure correct patient management.

A Rare Case of Extensive Unilateral Ureteritis Cystica

Ureteritis cystica is rare, benign entity that associates with chronic urothelial irritation such as recurrent urinary tract infection or nephrolithiasis. It is often diagnosed incidentally on routine imaging or ureteroscopy in asymptomatic individuals. In this case report, we present the retrograde pyelogram and ureteroscopy images of a rare case of extensive unilateral ureteritis cystica in a 78-year-old female presenting for elective stone surgery.

High-volume Concurrent Polypoid Ureteritis and Ureteritis Cystica Manifesting With Ureteral Obstruction

High-volume Concurrent Polypoid Ureteritis and Ureteritis Cystica Manifesting With Ureteral Obstruction

Ureteritis Cystica: An Unusual Presentation in an Otherwise Healthy Female

A 23-year-old, previously healthy female presented with lower abdominal pain and mildly elevated creatinine one month following a right ureter stent for non-specific ureteral thickening causing obstruction. On admission, computed tomography (CT) revealed moderate hydronephrosis of the left kidney that would require stent placement as well. During stent placement, it was noted that the gross appearance of the ureters resembled ureteritis cystica. Biopsies were taken and showed signs of chronic inflammatory changes consistent with this diagnosis. Interestingly, this patient had no obvious medical history suggesting a cause for this process. She had been otherwise healthy with no recurrent episodes of urinary tract infection, nephrolithiasis, or sexually transmitted infection. The patient was discharged symptom-free following stent placement and will follow with urology for future stent replacements and clinical monitoring.

URETERITIS CYSTICA: A RARE CASE OF BILATERAL OBSTRUCTION OF THE UPPER URINARY TRACTS

Cystic Ureteritis (ureteritis cystica) is an uncommon pathology characterized by the formation of cysts beneath the mucosa of the upper urinary tract, usually with a diameter of a few millimeters up to a centimeter. They belong to benign conditions and are associated with chronic irritation of the ureter as a result of recurrent infection or urolithiasis. As a rule, this pathology is seldom accompanied by any specific clinical manifestations. They are usually found incidentally during routine radiological investigations of the upper urinary tract. Management involves the treatment of the underlying disease and eradicating any infection. In this article we present a clinical case of a patient with bilateral obstruction of the ureters by intralumenal cystic lesions.

64 MS-CTU: Review of techniques and spectrum of the ureteric diseases

ObjectiveThe study aims to clarify the sensitivity of the CTU, and if is it coast effective and time effective to be used as first and the one-stop shop imaging modality for the diagnosis of the different ureteric diseases. Patients and methods400 patients with different urinary tract complaints (hematuria and/or renal colic) did triphasic CTU examinations, for diagnosis of suspected obstructive or traumatic ureteric uropathy from January 2014 to October 2016. These patients were filtered from a larger number of patients – who were presented with urinary tract complaints by plain KUB X ray and US, which showed no explaining kidneys or urinary bladder pathology. ResultsUreteric duplication was detected in 5 (1.25%) patients, ectopic ureter in one patient (0.25%), UPJ stricture in 4 patients (1%), PUJ vascular impression in 2 patients (0.5%), ureteric calculus in 103 patients (25.75%), pyogenic ureteritis in 8 patients (2%), ureteritis cystica in one patient (0.25%) TCC in 3 patients (0.75%), PRPF in one patient (0.025%) and Trauma in one patient (0.025%). ConclusionCTU is very sensitive tool of imaging and could be confidently considered the one-stop shop imaging tool for accurate diagnosis of the different ureteric lesions.

Ureteritis cystica associated with xanthogranulom atouspyelonephritis

Ureteritis cystica (UC) and xanthogranulomatous pyelonephritis (XP) are rare, benign conditions that uncommonly appear together. The first one has not well established etiology yet and can affect ureter, renal pelvis and bladder. The second one is a chronic renal infection resulting in severe kidney deterioration and destruction. Both of these entities are usually unilateral. They both cause wide spectrum of symtoms so the diagnose can be difficult to establish. We report the case of a 68 year old male with a history of intermittent macroscopic hematuria, left flank pain, recurrent urinary tract infection and calculosis of left kidney. We describe the imaging and endoscopic investigations leading to the diagnosis of ureteritis cystica as well as the treatment options.

Ureteral Replacement and Onlay Repair with Reconfigured Intestinal Segments

Ureteral loss represents a surgical challenge to provide low pressure drainage while avoiding urinary stasis and reflux. The ideal replacement should optimize drainage while minimizing absorption, allowing for ureteral repair of varied lengths and locations with maximal preservation of the urinary tract. We reviewed our experience with ureteral repair, focusing on the use of reconfigured intestine. We report what is to our knowledge the novel use of reconfigured intestine as an onlay flap on the preserved ureteral segment and as a circumferential interpositioned segment. A total of 16 ureters were repaired in 4 men and 9 women using reconfigured ileum, colon or appendix. Mean patient age was 45 years (range 26 to 66). The etiology of the ureteral defect was iatrogenic in 8 patients, retroperitoneal fibrosis in 3, trauma in 3 and ureteritis cystica in 1. Mean defect length was 10 cm (range 5 to 20) in the 10 right and 6 left ureters, and the defect was proximal in 3, mid in 4, distal in 7 and panureteral in 2. Ureteral replacement was performed using a segment of ileum in 13 cases or colon in 1. The segment was detubularized and reconfigured according to the Yang-Monti principle and used as a complete retubularized interposed segment in 7 cases or as an onlay flap on the opened ureter without resection in 7. Also, 2 ureters were reconstructed with an incised appendiceal flap onlayed over the preserved ureteral plate. At a mean followup of 44 months (range 12 to 78) all patients underwent antegrade nephrostogram, followed by renal scan and upper tract imaging. All patients tolerated the procedure without initial bowel or urinary tract complications. In 1 patient who had received radiation a ureteral fistula developed to a blind Hartmann pouch at 9 months, requiring repair. Ultimately, cystectomy was done for irradiation cystitis (onlay group). Another patient with bilateral obstruction at presentation lost unilateral renal function during 5 years. Urinary drainage was achieved in all 14 remaining renal units with preservation of function, as shown on renal scan. Patients reported minor mucous production without renal colic or stone formation. Long ureteral defects require tissue replacement when bladder flaps do not suffice. Ureteral replacement can be achieved by reconfigured intestinal segments, which are readily mobilized and secured as interposed segments or as an onlay flap on the preserved ureter. A relatively short segment can be used to repair a lengthy defect along any segment of ureter, also allowing for nonrefluxing reimplantation.

Widespread Tuberculosis Including Renal Involvement

Renal and urogenital disease is a prevalent finding of extrapulmonary Mycobacterium tuberculosis. Patients can present with unusual complaints not immediately suspicious for tuberculosis. We describe a 38-year-old man who presented with vomiting and an acute kidney injury. Imaging studies showed nodules throughout the lungs, retroperitoneum, abdominal viscera, and kidneys. Asymmetrical hydronephrosis was found on renal imaging. A classic beaded ureteral appearance (ureteritis cystica) was found during retrograde pyelography. The patient was screened and found to have a negative purified protein derivative skin test, negative acid-fast bacilli of sputum in three samples, and an indeterminate QuantiFERON Gold test. Evaluation of the urine for acid-fast bacilli was negative in four separate samples. A fifth urine sample for acid-fast bacilli was positive. A renal biopsy showed granulomatous interstitial nephritis with multiple areas of caseous necrosis. The patient was diagnosed with active tuberculosis and started on traditional four-drug antituberculous medical therapy. Kidney function remained marginal but did mildly improve with volume expansion and urinary drainage.

Ureteritis Cystica: Important Consideration in the Differential Diagnosis of Acute Renal Colic

Ureteritis cystica is an uncommon cause of acute renal pain. The aetiology remains unclear and the diagnosis may be difficult to establish. We report the case of a 29 year old woman with a history of repeated urinary tract infections presenting with acute renal colic in the absence of lithiasis. We review the diagnostic tools available to make the diagnosis and the recent pertinent literature.

Ureteritis Cystica: A Radiologic Pathologic Correlation

Ureteritis cystica (UC) is a benign condition that commonly affects the ureter and can mimic other conditions such as transitional cell carcinoma, blood clots, air bubbles, radiolucent stones, fibroepithelial polyps, and sloughed renal papillae. Radiographically, UC is characterized by multiple small, round, lucent defects, which cause scalloping of the ureteral margins when seen in profile. The scalloping is produced by the projection of the submucosal cysts into the lumen and represents an important differential feature of this disease. We present a case of UC with a radiological pathological correlation.

A cribriform urothelial neoplasm of the renal pelvis: an adenoid cysticlike variant of inverted urothelial papilloma or florid ureteritis cystica?

Abstract Tumors with cribriform appearance, similar to that of salivary gland adenoid cystic carcinoma, have been described at various anatomic sites. We present an unusual polypoid tumor, discovered incidentally, in the renal pelvis of an elderly man. The mass displayed a prominent cribriform architecture, akin to adenoid cystic carcinoma with an immunophenotype that supported a urothelial origin. Because of its lack of significant invasive growth and other adverse morphologic features, this lesion will likely behave in a banal fashion. This cribriform urothelial neoplasm of the renal pelvis may, in fact, represent a variant of an inverted urothelial neoplasm with a prominent cystic component or florid ureteritis cystica. It is important for pathologists to recognize this growth pattern as a possible variant of urothelial tumors.

A Cribriform Urothelial Neoplasm of the Renal Pelvis: An Adenoid Cysticlike Variant of Inverted Urothelial Papilloma or Florid Ureteritis Cystica?

Tumors with cribriform appearance, similar to that of salivary gland adenoid cystic carcinoma, have been described at various anatomic sites. We present an unusual polypoid tumor, discovered incidentally, in the renal pelvis of an elderly man. The mass displayed a prominent cribriform architecture, akin to adenoid cystic carcinoma with an immunophenotype that supported a urothelial origin. Because of its lack of significant invasive growth and other adverse morphologic features, this lesion will likely behave in a banal fashion. This cribriform urothelial neoplasm of the renal pelvis may, in fact, represent a variant of an inverted urothelial neoplasm with a prominent cystic component or florid ureteritis cystica. It is important for pathologists to recognize this growth pattern as a possible variant of urothelial tumors.

Ureteritis Cystica: A Rare Cause of Ureteral Obstruction

Ureteritis cystica is a rare, but recognized cause of ureteral obstruction. To our knowledge, we present the first case where obstruction secondary to the cystic component is confirmed with a functional study. Additionally, we present high-quality radiologic and endoscopic images of two cases of ureteritis cystica.

Ureteritis Cystica Presenting with Atrophic Kidney: Report of a Case

Ureteritis cystica is a rare proliferative condition that is found predominantly in the bladder, renal pelvis, and upper ureter. It may occlude the ureteral lumen and should be considered in the reasons for an atrophic kidney. A 65-year-old-female with a 2-year history of right flank pain that increased in the last 2 months was presented. Abdominal ultrasonography revealed right-sided atrophic kidney. Nephroureterectomy was performed. On the gross examination, along the ureter wall, there were numerous polyps, 0.5 cm in maximum diameter, protruding into the lumen. On the histopathological evaluation, ureteritis cystica and chronic pyelonephritis was detected. In conclusion, ureteritis cystica is a benign and indolent lesion that needs to be kept in mind among the causes of renal atrophy.

Ureteritis cystica: a report of two cases, illustrated by ureterograms.

Ureteritis cystica: a report of two cases, illustrated by ureterograms.

Ureteritis Cystica Presenting as a Retractile Ureteral Polyp

An 82-year-old woman presented with asymptomatic microhematuria and mild stress incontinence. Physical examination revealed an atrophic vagina and a small cystocele. Ultrasound showed bilateral small echogenic foci in each kidney, consistent with nephrolithiasis. Urinalysis demonstrated 3 red blood cells per high power field. Cystoscopy revealed a 5 ml. retractile polyp protruding from the left ureteral orifice (fig. 1). Cystoscopy and biopsy with the patient under anesthesia showed the polyp to have a long stalk extending from the left ureteral orifice. The tumor was resected and the stalk was electrocauterized. Retrograde pyelograms following resection demonstrated no ureteropelvic filling defect. Histological analysis revealed ureteritis cystica with focal squamous metaplasia (fig. 2). The submucosa contained focal nonspecific inflammatory infiltrate, edematous changes and focal collections of macrophages.

Ureteritis Cystica Presenting as a Retractile Ureteral Polyp

Ureteritis Cystica Presenting as a Retractile Ureteral Polyp

Urinary schistosomiasis: urographic features and significance of drooping kidney appearance.

The purpose of the study was to analyse the urographic features of schistosomiasis and to see the theurapeutic implications of "drooping kidney" appearance for the urologists. Over a period of one year, 1636 patients undergoing intravenous urography (IVU) were analysed to look for urographic features of schistosomiasis. A total of 136 patients revealed the classical urographic feature such as ureteric strictures, vesical and ureteric calcification and calculi etc. 131 of these patients were of Egyptian origin. In addition to above mentioned classical features, 8 patients (6%) with urinary schistosomiasis revealed "drooping kidney" appearance. In the remaining patients with no evidence of clinical or urographic features of urinary schistosomiasis, only one patient (0.07%) showed similar bilateral appearance. Renogram in 6 to 8 patients with "drooping kidney" revealed poorer renal function on the affected side. Ureteroscopy (URS) revealed more florid ureteritis cystica on the side with "drooping kidney" in 6 out of 8 patients compared with the normal side. URS also confirmed the presence of a kink and more difficulty with insertion of J stents. "Drooping kidney" a new urographic feature of urinary schistosomiasis may have theurapeutic implications for the urologists and should be looked for on the I.V.U. of patients with urinary schistosomiasis.