Ureteral stenosis

Intrapelvic instillation of silver nitrate is sometimes stiU used in the treatment of essential hematuria. In one case ureteric stenosis developed as a consequence (38). 

Vijan SR, Keating MA, Althausen AF. Ureteral stenosis after silver nitrate instillation in the treatment of essential hematuria. J Urol 1988 139(5) 1015-16. 

Banner MP, Pollack HM (1984) Dilatation of ureteral stenosis techniques and experience in 44 patients. AJR Am J Roentgenol 143 789... 

Other rare urologic complications of WG include renal artery aneurysms (73,74), renal masses (75,76), necrotizing vasculitis involving the ureters (74), ureteral stenosis (72,77), penile necrosis (73) or ulcers (77), acute urinary retention (72), bladder pseudotumor (77), and involvement of the prostate (3,78). 

II. Findings in experimentally induced ureteric stenosis. Pediatr Radiol 30 523-532... 

Fig. 21. 5a-c. Acute rise of serum creatinine and oliguria 8 weeks after successful RTx. US with DS (a) shows a moderate distension of the renal pelvis without severe reduction of renal perfusion. Immediate percutaneous nephrostomy with antegrade filling (b) confirms distal ureteral stenosis caused by ureteral necrosis. Antegrade filling before surgical reconstruction and after stabilization of the renal function (c)... 

Some adverse reactions lead to organ fibrosis for instance in the lungs, peritoneum or of mucous membranes in Stevens-Johnson syndrome. Then other treatments of these conditions may be needed which can include even surgery, for example, to free ureteric obstruction or to correct vaginal stenosis. 

Fig. 5.5. MR imaging of bilateral infundibulo-pelvic stenosis. T2-weighted sequence. The anomaly is associated with a right megaureter and with a segmental ureteral cystic dilatation to the left ureter...

Ureteral dilatation may occur secondarily to ureteral valves, midureteral or distal stenosis, or due... 

Liu AHY, Dhillon HK, Diamond DA et al (1994) Clinical outcome and management of prenatally diagnosed primary megaureters. J Urol 152 614-617 Lucaya J, Enriquez G, Delgado R et al (1984) Infundibulopel-vic stenosis in children. AJR 142 471-474 Maizels M, Stephens FD (1980) Valves of the ureter as a cause of primary obstruction of the ureter. J Urol 123 742-746 Maizels M, Reisman ME, Flom LS et al (1992) Grading nephro-ureteral dilatation detected in the first year of life. JUrol 148 609-614... 

Urological problems can be visualized by US in most situations. If requested, isotope studies, CT, or MRI may add valuable information. Severe bleeding around the transplant may be caused by anticoagulation for hemodialysis or a leak of the vessel anastomoses. Hydronephrosis caused by urinary tract obstruction may be the consequence of ureteral kinking, stenosis of ureteral implantation, ureteral necrosis, or large lymphoceles. It is important to note that children with acute renal failure caused by severe urinary obstruction may present with just minimal or moderate renal pelvic dilatation due to a diminished urinary flow (Fig. 21.5). In addition, these situations are painless as the transplant and the ureter have no nerves. Close follow-up is mandatory, especially in patients with bladder dysfunction or an augmented bladder. 

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