Ureteral damage

Essential oils and their components are incorporated into enterically coated capsules to prevent damage and used for treating irritable bowel syndrome (peppermint in Colpermin), a mixture of monoterpenes for treating gallstones (Rowachol) and ureteric stones (Rowatinex) these are under product licenses as medicines (Somerville et al., 1984,1985 Engelstein et al., 1992). 

VUR may occur in both moieties of a duplex kidney, but it is much more frequent into the lower pole (Fig. 11.24). This is associated with the more lateral opening of the corresponding ureteral orifice. This type of VUR may be associated with renal damage at the corresponding lower pole (reflux nephropathy see below). Severe VUR into the lower pole may be associated with significant ureterohydronephrosis, which may obscure the presence of a duplex system. VUR into a lower pole still has a potential of spontaneous resolution just as VUR can spontaneously resolve into a single collecting system (Ben-Ami et al. 1989 Bisset and Strife 1987 Claudon et al. 1999). 

Jakobsson B, Jacobson SG, Hjdlmas K (1999) VUR and other risk factors for renal damage identification of high- and low-risk children. Acta Paediatr 431 Suppl] 31-39 Jacobsson SH, Hansson S, Jakobsson B (1999) Vesico-ureteric reflux occurrence and long-term risks. Acta Pediatr 431 [Suppl] 22-30... 

ESWL is now possible even in small children. Ureteral stones may also be treated by ESWL if they are not located very distally or are incrusted in the ureteral wall. Extracorporeal shock waves may damage the renal parenchyma when medullary NC is evident (Boddy et al. 1988). So-called stone streets in the ureters are very often found after successful ESWL and need specific attention (Dyer et al. 1998). 

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