Ectopic ureter associated with uterine didelphys and obstructed hemivagina: preoperative diagnosis by MRI

Uterine didelphys with obstructed hemivagina and ipsilateral renal anomalies is a rare congenital malformation of the female urogenital tract. While the urinary anomalies almost always involve renal agenesis, we report a rare case of a 17-year-old girl with the malformation associated with ectopic ureteral insertion into the obstructed hemivagina, which was diagnosed preoperatively by MR imaging. To the best of our knowledge, preoperative MR imaging diagnosis of the ectopic ureter associated with this syndrome has not been previously reported. Accurate preoperative diagnosis of ectopic ureteral insertion associated with this syndrome is important for surgical planning

Capacity and Autonomy : An Exploration of Fukuyama’s Governance Hypothesis

Peer reviewe

Surgical management of vesicoureteral reflux in children

Vesicoureteral reflux (VUR) is the most common uropathy affecting children. Compared to children without VUR, those with VUR have a higher rate of pyelonephritis and renal scarring following urinary tract infection (UTI). Options for treatment include observation with or without antibiotic prophylaxis and surgical repair. Surgical intervention may be necessary in patients with persistent reflux, renal scarring, and recurrent or breakthrough febrile UTI. Both open and endoscopic approaches to reflux correction are successful and reduce the occurrence of febrile UTI. Estimated success rates of open and endoscopic reflux correction are 98.1% (95% CI 95.1, 99.1) and 83.0% (95% CI 69.1, 91.4), respectively. Factors that affect the success of endoscopic injection include pre-operative reflux grade and presence of functional or anatomic bladder abnormalities including voiding dysfunction and duplicated collecting systems. Few studies have evaluated the long-term outcomes of endoscopic injection, and with variable results. In patients treated endoscopically, recurrent febrile UTI occurred in 0–21%, new renal damage in 9–12%, and recurrent reflux in 17–47.6% of treated ureters with at least 1 year follow-up. These studies highlight the need for standardized outcome reporting and longer follow-up after endoscopic treatment

Congenital Ureteropelvic Junction Obstruction

Primitive or congenital hydronephrosis is a dila- tion of renal pelvis and intrarenal calyces mostly due to an abnormality of the ureteropelvic junc- tion (UPJ), which results in an inadequate drain- age of urine from the pelvis into the ureter. Increased intrapelvic pressure and urinary stasis in the collecting ducts cause progressive damage to the kidney

Genitourinary disorders:Q 140

Clinical history and physical examination represent an important aspect in the management of infants and children with urological diseases. However, the role of instrumental and in particular of radiological examinations is fundamental for making a certain and correct diagnosis in all clinical cases