Articles de revues : « Ureter MRI »

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Grbic, Dragan, Dimitrije Jeremic, Sasa Vojinov, Milan Popov et Goran Marusic. « Renal dysplasia with the ipsilateral ectopic ureter mimicking abscess of the prostate ». Vojnosanitetski pregled 71, n^o 2 (2014) : 211–13. http://dx.doi.org/10.2298/vsp1402211g.

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Introduction. In males the ectopic ureter usualy drains into the prostate (50%). During ureteric developement a thin membrane (Chawalla?s membrane) separates the lumen of the ureter and the urogenital sinus at the point where the ureter joins the urogenital sinus. This membrane ruptures allowing urin to drain from the ureter to the urogenital sinus. The authors reported a case of renal dysplasia associated with ipsilateral uretral ectopia mimicking prostatic abscess. Case report. A subfebrile (37.3?C), 23-year-old patient, otherwise healthy, presented with persistent ascending perineal pain non-responsive to antibiotics and analgetics. Digitorectal examination (DRE) showed asymmetric prostate with a soft, tender, buldging left lobe suggestive of prostatic abscess. The diagnosis was suspected using transrectal ultrasonography (TRUS), but the picture of the anechoic tubular structure in the left lobe of the prostate with a proximal undefined extraprostatic extension and a caudal intraprostatic blind end was incoclusive for the definitive diagnosis of prostatic abscess. Magnetic resonance imaging (MRI) was ordered and definitive diagnosis of renal dysplasia associated with the ipsilateral ectopic ureter filled with inflamed content mimicking prostatic abscess was made. Transurethral incision/minimal resection of the distal, blindly closed end of left ectopic ureter was done. Endoscopic surgical treatment was sufficient for relief of clinical symptoms. The patient?s recovery was uneventful. Conclusion. To the best of our knowledge, a case of renal dysplasia with the ipsilateral ectopic ureter mimicking prostate abscess has not been reported so far. Cystic pelvic malformations in males may result from too craniall sprouting of the ureteral bud, with delayed absorption and ectopic opening of the distal end of the ureter.

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Venyo, Anthony Kodzo-Grey. « Endometriosis of the Urinary Bladder and Ureter : A Review and Update of the Literature ». Journal of Clinical and Translational Urology 1, n^o 1 (29 juillet 2019) : 1–23. http://dx.doi.org/10.33702/jctu.2019.1.1.1.

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Endometriosis of the urinary bladder and / or ureter are diseases that may occur alone or in association with endometriosis elsewhere in the pelvis or other sites of the body in women between the 2nd decades of life and the fifth decades of their lives typically in women who are menstruating but endometriosis of urinary bladder may occur / present in post-menopausal women on very rare occasions or in women with a past history of treatment for endometriosis elsewhere. Endometriosis of the urinary bladder and / or endometriosis of the ureter are uncommon diseases which tend to be reported sporadically globally. Endometriosis of the urinary bladder and / or ureter may be asymptomatic in some patients but other cases of endometriosis of the urinary bladder / and or ureter tend to present with non-specific symptoms including: suprapubic pain, urinary frequency and urgency, loin pain, dyspareunia, dysmenorrhoea, cyclical dysuria, and other non-specific symptoms including loin pain and infertility. A high-index of suspicion is required in order to diagnose the disease early with utilization of (a) various radiology imaging including ultrasound scan of pelvis and urinary tract, computed tomography scan of pelvis and urinary tract, or magnetic resonance imaging (MRI scan of pelvis and renal tract, (b) laparoscopy and biopsy of the endometriosis lesion for histopathology examination including immunohistochemistry studies of the specimen, (c) cystoscopy examination for further assessment. Diagnosis of endometriosis of the urinary bladder and / or ureter tends to be confirmed by pathology examination finding of endometrial glands and stroma in the excised or biopsy specimen and immunohistochemistry staining studies tend to exhibit the following features: (a) the endometrial stromal cells of endometriosis tend to stain positively upon immunohistochemistry staining for CD 10; (b) the glandular component of endometriosis does exhibit positive nuclear staining for p63; (c) the glandular component of endometriosis also stains positively for: CK7, ER oestrogen receptor, PR progesterone receptor; (d) endometriosis specimens also usually stain positively for: CA125. Treatment for endometriosis of bladder and or ureter could be conservative with inclusion of hormonal treatment, pain relief, and medications to reduce urinary bladder symptoms and this tends to be effective in many cases but recurrences tend to be higher in most cases in comparison with surgical treatment. Some of the surgical treatment for endometriosis of urinary bladder includes partial cystectomy ensuring completed excision of the endometriosis lesion or submucosal excision of the urinary bladder endometriosis lesion but leaving an intact urinary bladder mucosa. Surgical treatment of endometriosis of the ureter tend to involve (a) complete excision of the endometriosis segment of the ureter and end-to end ureteric anastomosis, or excision of the endometriotic ureter segment with either Boari-flap ureteric anastomosis to the urinary bladder or Psoas hitch anastomosis. Complication may occur following various treatment options adopted for the disease of the ureter and urinary bladder including recurrence, urinary urgency and urge incontinence, urinary stress incontinence, ureteric stenosis / stricture, vesico-ureteric reflux and these complications need to be treated and a long-period of follow-up would be required in order to also diagnose the late complications of the disease. Surgical excision surgery in the developed countries tend to be undertaken by the laparoscopic technique but in the developing countries that do not have facilities for laparoscopic surgery the open technique would tend to be adopted for all surgical treatment options of the disease.

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Chowdhury, Md Shafiqul Alam, Md Mostafizur Rahman, Uttam Karmaker, Md Towhid Belal et Md Humayun Kabir Bhuiyun. « Retrocaval Ureter A Case Report ». Journal of Dhaka Medical College 23, n^o 2 (23 octobre 2015) : 259–61. http://dx.doi.org/10.3329/jdmc.v23i2.25401.

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Retrocaval ureter is a rare congenital urologic anomaly. It occurs due to the persistence of the right subcardinal veins during embryologic development. Its presence should be suspected with the finding of a characteristic S-shaped deformity on intravenous or retrograde pyelography. Today, a definitive diagnosis can be made noninvasively using multi-slice CT imaging or MRI. Intervention is indicated in the presence of functionally significant obstruction leading to pain or renal function deterioration.J Dhaka Medical College, Vol. 23, No.2, October, 2014, Page 259-261

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Wang, Feng, Keiko Takahashi, Hua Li, Zhongliang Zu, Ke Li, Junzhong Xu, Raymond C. Harris, Takamune Takahashi et John C. Gore. « Assessment of unilateral ureter obstruction with multi‐parametric MRI ». Magnetic Resonance in Medicine 79, n^o 4 (24 juillet 2017) : 2216–27. http://dx.doi.org/10.1002/mrm.26849.

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Liu, Hang, Liang Ren, Bohan Fan, Wei Wang, Xiaopeng Hu et Xiaodong Zhang. « Artificial Intelligence Algorithm-Based MRI in the Diagnosis of Complications after Renal Transplantation ». Contrast Media & ; Molecular Imaging 2022 (16 août 2022) : 1–7. http://dx.doi.org/10.1155/2022/8930584.

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This study was to explore the diagnostic value of magnetic resonance imaging (MRI) optimized by residual segmentation attention dual channel network (DRSA-U-Net) in the diagnosis of complications after renal transplantation and to provide a more effective examination method for clinic. 89 patients with renal transplantation were selected retrospectively, and all underwent MRI. The patients were divided into control group (conventional MRI image diagnosis) and observation group (MRI image diagnosis based on DRSA-U-Net). The accuracy of MRI images in the two groups was evaluated according to the comprehensive diagnostic results. The root mean square error (RMSE) and peak signal-to-noise ratio (PSNR) of DRSA-U-Net on T1WI and T2WI sequences were better than those of U-Net and dense U-Net P < 0.05 ; comprehensive examination showed that 39 patients had obstruction between ureter and bladder anastomosis, 13 cases had rejection, 10 cases had perirenal hematoma, 5 cases had renal infarction, and 22 cases had no complications; the diagnostic sensitivity, specificity, accuracy, and consistency of the observation group were higher than those of the control group P < 0.05 . In the control group, the sensitivity, specificity, and accuracy in the diagnosis of complications after renal transplantation were 66.5%, 84.1%, and 78.32%, respectively; in the observation group, the sensitivity, specificity, and accuracy in the diagnosis were 67.8%, 86.7%, and 80.6%, respectively. DRSA-U-Net denoising algorithm can clearly display the information of MRI images on the kidney, ureter, and surrounding tissues, improve its diagnostic accuracy in complications after renal transplantation, and has good clinical application value.

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Kotlyarov, P. M., N. I. Sergeev, S. P. Aksenova et V. A. Solodky. « Clinical and diagnostic observation of transitional cell carcinoma recurrence in the ureteral stump : a case report ». Diagnostic radiology and radiotherapy 13, n^o 3 (19 octobre 2022) : 115–23. http://dx.doi.org/10.22328/2079-5343-2022-13-3-115-123.

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Urothelial cancer of the upper urinary tract is quite rare and accounts for 5–10% of all cases of urothelial cancer. Radiation research methods, primarily computer and magnetic resonance imaging, are leading in monitoring and detecting recurrence after surgery on the organs of the urinary system. A rare clinical case of recurrence of transitional cell carcinoma of the upper urinary tract in the ureteral stump is presented. The article, with an emphasis on radiodiagnosis, outlines a step-by-step follow-up of a patient with primary cancer of the upper third of the ureter (рT2N0M0), who was hospitalized in the city clinical hospital for pain in the right lumbar region. During dynamic contrast enhancement multiparametric MRI, a recurrence of the disease was established with a lesion of the non-removed stump of the right ureter. Semiotic MR signs of recurrence of transitional cell carcinoma of the upper urinary tract are described. The recurrent tumor of the ureteral stump was characterized by a moderate hyperintense T2WI MR signal and an isointense T1WI MR signal. Our data indicate lower ADC values in the tumor when measured by a large ROI (937 mm2, versus 796 mm2 ROI with a small size). The dynamic contrast enhancement performed in our study showed intensive accumulation of the contrast by the recurrent tumor.

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Anthony Kodzo-Grey Venyo. « Leiomyoma of the Urinary Bladder : A Review and Update ». Journal of Clinical and Translational Urology 1, n^o 1 (13 novembre 2019) : 82–105. http://dx.doi.org/10.33702/jctu.2019.1.1.5.

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Leiomyoma of the urinary bladder / leiomyoma of the ureter is a very rare benign tumour of smooth muscle origin which has been reported sporadically globally. Leiomyoma of the urinary bladder/ureter may be diagnosed incidentally during investigation of various conditions including infertility and hepatitis. Leiomyoma of the urinary bladder / ureter may manifest in female as well as in a male patient with non-specific symptoms including lower urinary tract symptoms / retention of urine, haematuria, loin pain/discomfort, urinary tract infections and cystitis. The general and systematic examinations may be normal but at times there may be a palpable mass within the area of the urinary bladder on bimanual examination but not always. There may occasionally be tenderness in the loin. The results of routine haematology and biochemistry blood tests would generally tend to be normal but there may be anaemia and impairment of renal function some cases of visible haematuria and obstruction of the ureter respectively. Ultrasound scan would tend to illustrate a well-circumscribed polypoidal soft tissue mass projecting into the urinary bladder or within the intramural area of the bladder. Intravenous urography would show a filling defect in the urinary bladder. CT and MRI scans of abdomen and pelvis with contrast would show a well-defined round mass in the area of the bladder which could be iso-tense to skeletal muscles on T1 and T2 weighted images and occasionally may show cystic areas of necrosis. Cystoscopy would show the lesion projecting into the urinary bladder at the specific area of the urinary bladder involved and at times the projecting lesion would be covered by normal looking urothelial mucosa and on other occasions when the lesion is large and in the area of a ureteric orifice the specific ureteric orifice would not be visualized. Diagnosis of leiomyoma of the urinary bladder / ureter would be confirmed upon histopathology and immunohistochemistry study features of trans urethral resection biopsies of the lesion which would tend to show smooth muscle spindled-cells with no evidence of atypia, or necrosis, or haemorrhage and associated with a low Ki67 index. Trans-urethral resection of the urinary bladder lesion tends to be undertaken for small to medium sized lesions with good outcome but this tends to be associated with about 18% recurrence rate that would require further resections or surgical excision to ensure complete removal of the lesion and no further recurrences. Surgical excision of the lesion including partial cystectomy, local excision / enucleation have been very effective for the treatment of larger leiomyomas with no reported recurrence so far; nevertheless, patients who undergo augmentation cystoplasty or total cystectomy and urinary diversion would need to cope with the functional problems related to the cystoplasty or urinary diversion. Differential diagnoses of leiomyoma of the urinary bladder / ureter include leiomyosarcoma, urothelial carcinoma and other malignant lesions affecting the urinary bladder. There is need for clinicians to explore minimal invasive surgery to treat patients who have leiomyoma of the bladder / ureter especially those who have multiple co-morbidities and the alterative management options that could be undertaken in multi-centre trials include: Cryotherapy, radiofrequency ablation, irreversible electroporation, high frequency ultrasound treatment and super-selective embolization of the arterial branch supplying the leiomyoma. Patients who develop ureteric obstructions would additionally require nephrostomy insertions or insertion of ureteric stents as a temporary measure to improve their renal functions.

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Kim, Myung Joon, Joon Seok Lim, Choon Sik Yoon et Sang Won Han. « MRI for the Detection of Ureteral Opening and Ipsilateral Kidney in Children with Single Ectopic Ureter ». Journal of the Korean Radiological Society 40, n^o 6 (1999) : 1217. http://dx.doi.org/10.3348/jkrs.1999.40.6.1217.

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Fuyong, Jiao. « Analysis of 3 Cases of Refractory Urinary Tract Infection Caused by Enterococcus Faecium and Literature Review ». Global Journal of Pediatrics (GJP) 01, n^o 2 (21 août 2021) : 1–6. http://dx.doi.org/10.54026/gjp/1009.

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Objective: To explore the clinical features, drug resistance, treatment and prognosis of refractory urinary tract infection caused by Enterococcus faecium infection. Methods: A retrospective analysis of 3 cases of Enterococcus faecium infection admitted to the Children’s Hospital of Shaanxi Provincial People’s Hospital from January 2017 to December 2019, And the clinical manifestations of refractory urinary tract infections caused by it, routine laboratory examinations, mid-stage urine culture and drug sensitivity, urinary ultrasound, magnetic resonance (or CT) examination, treatment process and prognosis, and search and review relevant literature. Result: The three children in this group were all women, aged 5 years, 2 months, 9 years and 11 years old. One case had renal abscess, one case had acute pyelonephritis, and one case had bladder-ureteritis. Clinical features: 2 cases had fever with a temperature of 38-39.5°C, and children with renal abscess were accompanied by chills; 2 cases had frequent urination, dysuria, and urethral irritation; 1 case of 5-year-old child had only transient urinary retention, All 3 cases were treated with conventional antibiotics orally and intravenously outside the hospital. During the course of 2 cases, the leukocytes were more than 25×109/L, 3 cases had neutrophils above 70%, CRP was high, and 3 cases of mid-stage urine culture were Enterococcus faecium;2 cases were sensitive to vancomycin and linezolid, Others are resistant.3 cases had negative blood cultures, 1 case of urinary B-mode ultrasound had a thicker bladder wall, and a slightly thicker wall in the lower right ureter. Considering the inflammatory changes, 1 case had left hydronephrosis and 1 case had left kidney urinary salt crystals. MRI plain scan of both kidneys and ureters + MRU showed: 1 case had a thicker bladder wall, and the wall of the lower ureter was slightly thickened, considering the inflammatory changes. One case had a slight dilation of the upper left ureter and the renal pelvis and calyces. 1 case of CT enhanced scan + CTU showed: 1. Left nodular superior nodules and strip low-density shadow, considering the repeated deformity of the left renal pelvis and ureter with dilation of the ureter (upper renal pelvis is small, hypoplasia); [2]. Abnormal strengthening of the left kidney and a slight thickening of the fascia around the kidney; consider pyelonephritis with abscess formation or cystic lesions. 3. Mild water accumulation in the left kidney and upper middle ureter [4]. There are multiple lymph nodes in the retro peritoneum and the left side of the spine, and some are swollen. Treatment 3 cases were initially ineffective with three generations of cephalosporins, and 2 cases had obvious effect of intravenous infusion of vancomycin based on drug sensitivity. After 7-10 days of treatment, cefepime was changed for consolidation treatment and cured. One case of meropenem treatment improved. Three cases were followed up for 1 year without recurrence. 1 case relapsed 20 days after discharge, intravenous infusion of cefepime for 17 days, and nitrofurantoin was taken preventively for 2 weeks before relapse. Conclusion: Most of the urinary tract infections caused by Enterococcus faecium infections are refractory upper urinary tract infections, which have many complications, timely and mid-stage urine culture, and urinary tract B ultrasound. Magnetic resonance imaging and hydrography of both kidneys and ureters play an important role in the diagnosis of complications. High drug resistance, timely adjustment of treatment according to drug susceptibility, selection of effective drugs is very important, given a sufficient course of treatment, can improve the prognosis.

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Rodríguez-López, J., D. Ling, A. Keller, H. Kim, A. Mojica-Márquez, S. Glaser et S. Beriwal. « OC-0058 Does dose to the ureter predict for ureteral stenosis ? - Analysis of 3D MRI-based brachytherapy ». Radiotherapy and Oncology 158 (mai 2021) : S44. http://dx.doi.org/10.1016/s0167-8140(21)06291-5.

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Duong, David T., et Linda MD Shortliffe. « A case of ectopic dysplastic kidney and ectopic ureter diagnosed by MRI ». Nature Clinical Practice Urology 5, n^o 11 (7 octobre 2008) : 632–36. http://dx.doi.org/10.1038/ncpuro1220.

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Kaushal, Aayushi, Manjeet Kaur, Vidur Bhalla et Dilpreet Kaur. « Unusual giant central cervical leiomyoma : surgical challenge ». International Journal of Reproduction, Contraception, Obstetrics and Gynecology 7, n^o 12 (26 novembre 2018) : 5197. http://dx.doi.org/10.18203/2320-1770.ijrcog20184994.

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Leiomyomas are most common uterine and pelvic tumours. The most common anatomical location is uterus. Fibroids arising from cervix are rare tumours accounting for 2% of all fibroids. A cervical leiomyoma is commonly single and is either interstitial or subserous, rarely it becomes submucous and polypoidal. Here authors report a case of huge cervical fibroid in an unmarried lady who presented to us with complaint of heaviness in abdomen. On per abdomen examination a firm mass of 32 weeks size arising from pelvis with restricted mobility was noticed. Ultrasound showed 21*10.3*10 cm heterogenous mass in pelvis with evidence of internal vascularity. MRI was suggestive of fibroid arising from body of uterus. True cut biopsy of the lesion was taken which showed benign lesion. Decision for myomectomy or Hysterectomy (according to intraoperative findings) was taken. While doing the procedure, after accidental ligation of left ureter and injury to bladder, diagnosis of cervical fibroid was made. Hence pre-operative diagnosis of cervical fibroid is very important in order to avoid damage to bladder and ureters.

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Wang, Zhen J., Heike Daldrup-Link, Fergus V. Coakley et Benjamin M. Yeh. « Ectopic ureter associated with uterine didelphys and obstructed hemivagina : preoperative diagnosis by MRI ». Pediatric Radiology 40, n^o 3 (19 novembre 2009) : 358–60. http://dx.doi.org/10.1007/s00247-009-1454-8.

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Akteruzzaman, M., Z. Islam, S. Afroza, ARML Kabir, SK Paul et M. Rahman. « Nephrogenic Diabetes Insipidus (NDI) : a Rare Presentation in Early Infancy- A Case Report ». Bangladesh Medical Journal 41, n^o 1 (4 mai 2014) : 62–63. http://dx.doi.org/10.3329/bmj.v41i1.18788.

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A 30 months old boy presented with polyuria and polydipsia since 6 months of age. There was no family history of similar illness. Investigations revealed serum hyperosmolarity and normal renal function. Diagnostic findings correlated with nephrogenic diabetis insipidus (NDI) as the patient was non-responsive to vasopressin in water deprivation test. MRI of brain was normal and ultrasonogram of kidney, ureter, and urinary bladder was normal and other investigations showed no abnormality. DOI: http://dx.doi.org/10.3329/bmj.v41i1.18788 Bangladesh Medical Journal 2012 Vol. 41 No. 1; 62-63

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Soumeya, Dr Ettahiri, Dr Ezzaki Houda, Dr Souiki Tarik, Dr Ibn Majdoub Karim, Dr Toughrai Imane et Dr Mazaz Khalid. « Accidental Bladder Injury during Elective Repair of a Strangulated Inguinal Hernia : A Preventable Complication with High Morbidity ». SAS Journal of Surgery 8, n^o 1 (23 janvier 2022) : 31–33. http://dx.doi.org/10.36347/sasjs.2022.v08i01.009.

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Urinary bladder injury is usually rare and asymptomatic, and can occur during herniorrhaphy for misdiagnosed sliding hernia. It’s necessary to recognize a iatrogenic injury intra operatively, and institute treatment in the same operative session, Preoperative diagnosis can prevent possible to the bladder and ureter surgery and lead to quick recovery. The radiological examination is needed before any surgery, especially when the patient has concomitant urinary symptoms. If bladder hernia is suspected, we should imperatively perform preoperative radiology including ultrasound cystography, CT scan or MRI. Keeping a bladder catheter in situ can alert the surgeon in the event of bladder surgery.

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Thiagarajan, Senthil Kumar. « Vesico-Salpingo Fistula Masquerading as Hydrosalpinx with Neurogenic Bladder - An Interesting Case Report ». Journal of Evolution of Medical and Dental Sciences 10, n^o 34 (23 août 2021) : 2942–44. http://dx.doi.org/10.14260/jemds/2021/600.

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A fistula is an abnormal connection between two luminal structures of different epithelium. The majority of urological fistulas in developed countries are consequences of iatrogenic injury most commonly laparoscopic hysterectomies, or from radiotherapy in the treatment of pelvic cancers.1 Contrary to this, most obstetric fistulas in developing countries result from obstructed labour during childbirth.2 Common factors that contribute to obstructed labour in developing countries are delayed presentation after trial labour at home, cephalopelvic disproportion and poor nutrition. Due to prolonged compression by head on the pelvic tissues there happens ischemic necrosis of vagina, bladder neck, and urethra3 called obstructed labour complex. Necrosis and fibrotic healing lead to fistula formation with adjacent structures. The vesicovaginal fistula was the most frequent one (78 %) and the common site involved was trigone (51 %) and based on the level it could be a high or low fistula. Others are vesicouterine fistula, vesicourethral fistula, vesicoureteral fistula and rarely vesico-salpingo fistula. During the acute phase of fistula, tissue oedema, hypovascularity, infection, and nonviable tissue hinder proper tissue healing and hence delayed repair is done after 3 months. Recent literature advises early repair for simple fistulas to reduce patient morbidity and delayed repair of complex fistula, multiple fistulas, infected fistulas, post-radiotherapy, fistula due to foreign bodies, immunocompromised patients, hypoproteinaemia patients, urosepsis patients. 4 Fistula repair is preceded by contrast evaluation of ureter and bladder by CT –IVU and cystogram or MRI followed by cystoscopy or retrograde pyelography. Apart from fistula closure, bilateral ureteric implantation may be needed if ureters are close to the fistula. 5 Abdominal hysterectomy is done in uterovesical fistulas. Huge fistulas close to the bladder neck cannot be repaired without compromising continence hence bladder neck closure is done with the Mitrofanoff procedure. 6 A vesico-salpingo fistula is an abnormal epithelial-lined communication between the urinary bladder and the fallopian tube. This rare type of urogenital fistula has only 7 previously published cases in the literature.

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Hamid, Agus Rizal Ardy Hariandy, Fakhri Zuhdian Nasher, Meilania Saraswati, Sahat Matondang et Chaidir Arif Mochtar. « Case Report : Metachronous bilateral upper tract and bladder urothelial carcinoma : a long-term follow-up ». F1000Research 10 (9 août 2021) : 778. http://dx.doi.org/10.12688/f1000research.55516.1.

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Background: Upper tract urothelial carcinoma (UTUC) is a malignant disease of the urothelial cell lining the upper urinary tract from renal calyces, pelvises, and ureter down to the ureteral orifice. Urothelial carcinoma is a multifocal malignant tumor which tends to reoccur after treatment. Radical cystectomy shows that upper tract recurrence occurs in 0.75% to 6.4% of patients. The occurrence of contralateral UTUC after nephroureterectomy is rarer with a prevalence of 0.5%. Case presentation: The case of a 43-year-old male with metachronous bilateral UTUC was reported. The patient had undergone gemcitabine-cysplatine neoadjuvant chemotherapy followed by radical cystectomy and orthotopic neobladder for urothelial carcinoma of the bladder cT2N0M0. Left hydronephrosis was discovered three months after the procedure. The patient was diagnosed with left UTUC cT4N0M0 of renal pyelum after a series of examinations. A left open radical nephroureterectomy was conducted to remove the mass followed by adjuvant chemotherapy. This was followed up with routine ultrasound and magnetic resonance imaging (MRI) every three months with a “tumor-free” period of 26 months. Meanwhile, the patient was re-admitted with fever and an increase in creatinine value of 4.3. After further workups, the patient was diagnosed with UTUC cT2N0M0 of the right renal pyelum. A kidney sparring approach with laser evaporation of the tumor was conducted followed by eight cycles of Gemcitabine intracavity antegrade per nephrostomy. After the regimen was finished, an MRI evaluation was conducted to assess treatment results, and the mass had decreased. Conclusions: This report showed a rare case of urothelial cell carcinoma recurrences. From bladder urothelial carcinoma to left UTUC and then to contralateral UTUC. It is important to evaluate the upper tract to reduce the risk of recurrence.

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Kaushal, Lovely, Swati Goyal et Vetrivel K. S. « Comparison of USG KUB Findings with MR Urography (fluid static) in Patients with Obstructive Uropathy- A Cross Sectional Study ». International Journal of Medical and Allied Health Sciences 2, n^o 02 (22 juillet 2022) : 29–37. http://dx.doi.org/10.54618/ijmahs.2022223.

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Introduction– Obstructive uropathy is one of the most urgent clinical entities that has to be diagnosed and treated on time. Ultrasonography [USG] is cheap and easily accessible for determining the cause of obstructive uropathy. Magnetic Resonance Urography [MRU] has the potential to provide an excellent noninvasive examination of a wide range of urinary tract disorders, congenital anomalies and neoplasms without contrast administration. Aims- To assess the role of USG in obstructive uropathy patients and compare its finding with MRU static fluid. Design- Cross sectional study Materials and methods- This study was conducted on all patients referred to the Radio-Diagnosis department with any clinically suspicious obstructive uropathy symptoms. They underwent USG KUB and those with confirmed obstructive uropathy, underwent static fluid MR urography. Results- The study was conducted in 74 patients; 59.4% patients were males. Hydroureteronephrosis was the most common finding. MRU was superior to USG for diagnosis of stricture ureter and calculus in patients with obstructive uropathy. USG and MRI for diagnosis of VUJ, vesical, renal and pelvis calculus showed perfect agreement (κ=1; p=0.01); moderate for ureteric calculus (0.60-0.79; p less than 0.05) and minimal for ureteric stricture (0.21-0.39; p less than 0.05). MRU was superior in detailing PUJ obstruction as partial and complete. Conclusions- Ultrasound as an initial investigation helped in finding the level and severity of urinary obstruction. However, MRU performed better, in whom ultrasound showed inadequate results. In case of malignant obstruction, it gave precise soft tissue details. MRU appears as a better tool in diagnosing both extrinsic and intrinsic causes of obstructive uropathy.

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Metzemaekers, J., M. D. Blikkendaal, K. E. v. Nieuwenhuizen, K. Bronsgeest, J. P. T. Rhemrev, M. J. G. H. Smeets, J. English, F. W. Jansen, S. Both et A. R. H. Twijnstra. « Preoperative pain measurements in correlation to deep endometriosis classification with Enzian. Deep endometriosis classification in relation to pain ». Facts, Views and Vision in ObGyn 14, n^o 3 (septembre 2022) : 245–53. http://dx.doi.org/10.52054/fvvo.14.3.034.

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Background: Deep Endometriosis (DE) classification studies with Enzian never compared solitary (A, B, C, F), and combinations of anatomical locations (A&B, A&C, B&C, A&B&C), in correlation to pain. Therefore, the results of these studies are challenging to translate to the clinical situation. Objectives: We studied pain symptoms and their correlation with the solitary and combinations of anatomical locations of deep endometriosis lesion(s) classified by the Enzian score. Materials and Methods: A prospective multi-centre study was conducted with data from university and non-university hospitals. A total of 419 surgical DE cases were collected with the web-based application called EQUSUM (www.equsum.org). Main outcome measures: Preoperative reported numeric rating scale (NRS) were collected along with the Enzian classification. Baseline characteristics, pain scores, surgical procedure and extent of the disease were also collected. Results: In general, more extensive involvement of DE does not lead to an increase in the numerical rating scale for pain measures. However, dysuria and bladder involvement do show a clear correlation AUC 0.62 (SE 0.04, CI 0.54-0.71, p< 0.01). Regarding the predictive value of dyschezia, we found a weak, but significant correlation with ureteric involvement; AUC 0.60 (SE 0.04, CI 0.53-0.67, p< 0.01). Conclusions:TPain symptoms poorly correlate with anatomical locations of deep endometriosis in almost all pain scores, with the exception of bladder involvement and dysuria which did show a correlation. Also, dyschezia seems to have predictive value for DE ureteric involvement and therefore MRI or ultrasound imaging (ureter and kidney) could be recommended in the preoperative workup of these patients. What’s new? Dyschezia might have a predictive value in detecting ureteric involvement.

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Hsieh, Chin-Chiang, Rong-Sen Yang, Yih-Jyh Lin et Kuo-Yuan Huang. « MULTICENTRIC RETROPERITONEAL LEIOMYOSARCOMA WITH SATELLITE LESIONS NOT FOUND ON PET-CT : A CASE REPORT AND LITERATURE REVIEW ». Journal of Musculoskeletal Research 17, n^o 03 (septembre 2014) : 1472004. http://dx.doi.org/10.1142/s021895771472004x.

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Most retroperitoneal leiomyosarcomas are clinically silent and are usually detected late, so a large size main tumor accompanied by satellite lesions might be presented. We report a case of a large multicentric retroperitoneal leiomyosarcoma with satellite lesions in the left iliac region, mimicking an abscess, was found on pre-operative pelvic computed tomography (CT). Positron emission tomography (PET-CT) was performed, but revealed only focal bony destruction of the left ilium and no discernable lesions in the abdomen. After resection of the iliacus satellite lesion, CT and magnetic resonance imaging (MRI) of the abdomen revealed another huge retroperitoneal leiomyosarcoma with invasion of the left kidney and ureter, descending colon and left iliac arteries. The patient was then treated with a multidisciplinary extensive excision operation. The clinical presentation, operative findings and imaging findings were reported and related articles were reviewed.

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Prachi, Gaurav Sharma et Vikas Jain. « Primary squamous cell carcinoma of renal pelvis and kidney- Sole diagnosis by histopathology ». IP Journal of Diagnostic Pathology and Oncology 6, n^o 3 (15 septembre 2021) : 242–44. http://dx.doi.org/10.18231/j.jdpo.2021.052.

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Primary Squamous cell carcinoma of the renal pelvis is rare and accounts to only 0.5- 0.8 % of malignant renal tumours having poor prognosis. Chronic irritation, inflammation and infection induce the pathogenesis of this malignancy. A 53 year old male patient, presented with left flank pain since one month. On radiological investigation, his CT revealed atrophic shrunken left kidney measuring 7.9x5.2cms showing significant parenchymal thinning and complete loss of corticomedullary differentiation. A left upper ureteric calculus is seen measuring 7.5 mm with significant left renal hydronephrosis.Clinically, it was diagnosed as Xanthogranulomatous Pyelonephritis. Grossly the radical nephrectomy specimen measures 10.5x5.5x3.5cm. External surface is irregular & bosselated. On Cut surface renal architecture is effaced by necrotic mass measuring 9.5x5.0x3.0 cm involving pelvic ureter and most of renal parenchyma.Hematoxylin and eosin stained tissue revealed characteristic feature such as keratin pearls and intracellular bridges seen, rendering the diagnosis of well-differentiated keratinising squmaous cell carcinoma seen with 40% tumour necrosis associated with Keratinizing Squamous Dysplasia. In the present case, obstructive uropathy has triggered the event of malignancy. The radiologic differential diagnosis includes primary and secondary renal neoplasms and xanthogranulomatous pyelonephritis associated with renal calculi. XGP is commonly associated with lithiasis however, rarely causes keratinizing squamous metaplasia and its manifestations closely mimic renal neoplasm, leading to misdiagnosis of malignancy.The prognosis is dismal with a 5-year survival rate of <10%. CT and MRI play a crucial role in diagnosis and staging of these tumors, though histology always remains confirmatory and diagnostic.

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Parvin, A., BS Khan, J. Alam, FA Ruby et TJ Iqbal. « Uterine Didelphys Associated With Obstructed Hemivagina and Ipsilateral Renal Anomaly (OHVIRA) Syndrome : a Case Report ». Pulse 6, n^o 1-2 (7 septembre 2014) : 66–69. http://dx.doi.org/10.3329/pulse.v6i1-2.20358.

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A 30 year old nulligravida female reported to the fertility centre of AHD with the complaints of primary infertility for three and half years and spasmodic dysmenorrhoea. There is also history of progressively increasing right lower abdominal pain as well as discomfort which was cyclically associated with the onset of menses. Transabdominal sonography showed-Endometrial splitting into two at the fundussuggesting bicornuate uterus. Echogenic soft tissue in the cervical canal due to blood clots. Non visualized right kidney. Mildly enlarged left kidney. HSG done outside AHD suggestive of unicornuate uterus with single fallopian tube. IVU showed non visualized right kidney. Normally excreting left kidney. TVS showed normal sized septated nulliparus uterus with homogeneous myometrium and thick endometrium with proliferative phase echo. Mildly enlarged right ovary with mildly distended right tube. Mild collection adjacent to the vagina. Then the patient came to the gynaecology dept of AHD from where she was sent to our Radiology department to undergo MRI of pelvis. The MRI showed uterine didelphys. Obstructed hemivagina (right) with hematocolpos extended upto pelvic brim along right and posterior aspect of uterus through anomalous dilated remnant of right lower ureter with ipsilateral renal agenesis. Patient was diagnosed as OHVIRA syndrome radiologically. DOI: http://dx.doi.org/10.3329/pulse.v6i1-2.20358 Pulse Vol.6 January-December 2013 p.66-69

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Dalpiaz, Amanda, Jason Gandhi, Noel L. Smith, Gautam Dagur, Richard Schwamb, Steven J. Weissbart et Sardar Ali Khan. « Mimicry of Appendicitis Symptomatology in Congenital Anomalies and Diseases of the Genitourinary System and Pregnancy ». Current Urology 9, n^o 4 (2015) : 169–78. http://dx.doi.org/10.1159/000447136.

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Introduction: Appendicitis is a prevailing cause of acute abdomen, but is often difficult to diagnose due to its wide range of symptoms, anatomical variations, and developmental abnormalities. Urological disorders of the genitourinary tract may be closely related to appendicitis due to the close proximity of the appendix to the genitourinary tract. This review provides a summary of the urological complications and simulations of appendicitis. Both typical and urological symptoms of appendicitis are discussed, as well as recommended diagnostic and treatment methods. Methods: Medline searches were conducted via PubMed in order to incorporate data from the recent and early literature. Results: Urological manifestations of appendicitis affect the adrenal glands, kidney, retroperitoneum, ureter, bladder, prostate, scrotum, and penis. Appendicitis in pregnancy is difficult to diagnose due to variations in appendiceal position and trimester-specific symptoms. Ultrasound, CT, and MRI are used in diagnosis of appendicitis and its complications. Treatment of appendicitis may be done via open appendectomy or laparoscopic appendectomy. In some cases, other surgeries are required to treat urological complications, though surgery may be avoided completely in other cases. Conclusion: Clinical presentation and complications of appendicitis vary among patients, especially when the genitourinary tract is involved. Appendicitis may mimic urological disorders and vice versa. Awareness of differential diagnosis and proper diagnostic techniques is important in preventing delayed diagnosis and possible complications. MRI is recommended for diagnosis of pregnant patients. Ultrasound is preferred in patients exhibiting typical symptoms.

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Agah, Jila, Sedighe Karimzadeh et Fateme Moharrer Ahmadi. « Misdiagnosis of a Giant Uterine Leiomyosarcoma : Clinic and Image Challenges ». Case Reports in Oncological Medicine 2017 (2017) : 1–4. http://dx.doi.org/10.1155/2017/3568328.

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A 41-year-old woman (G3P2L2Ab1) was referred to gynecology clinic with chief complaints of abdominal distension and localized abdominal wall pruritus for three months. She was misdiagnosed with gastrointestinal disorder and ultimately had undergone imaging. Ultrasonography and computed tomography (CT) scan disclosed a huge solid-cystic mass originating from the ovary. On clinical examination the patient had no pain or tenderness and no gynecologic complaints. Laboratory tests showed normal tumor markers and hemoglobin at 8 g/dl. Laparotomy was carried out as diagnosis of ovarian serous cyst adenoma, but a huge tumor with attachment to uterus and ovaries and extension to pelvic floor, peripheral tissues of ureter, and upper abdomen was found. Hysterectomy with bilateral salpingooophorectomy was done. Pathology report demonstrated uterine leiomyosarcoma measuring 40 centimeters and weighing 10 kilograms. In conclusion, as pelvic masses even in a large size may present unspecific symptoms misdiagnosis may occur which lead to overgrowth, local invasion, or other complications. So, it is rather to suggest ultrasonography in patients with persistent abdominal or pelvic symptoms and if needed, more exact diagnostic modalities like magnetic resonance imaging (MRI) could be offered to avoid misdiagnosis and mismanagement.

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Sun, Mengya, Lili Chen, Ke Wang, Guanglei Tang et Jian Guan. « An ectopic ureter inserting into epididymis combined with ipsilateral duplex kidney in a boy diagnosed by MRI : report of a rare case ». Surgical and Radiologic Anatomy 44, n^o 3 (5 janvier 2022) : 475–78. http://dx.doi.org/10.1007/s00276-021-02878-4.

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Dunphy, Louise, et Gemma Sheridan. « Uterine leiomyosarcoma : a rare clinical entity ». BMJ Case Reports 14, n^o 8 (août 2021) : e244233. http://dx.doi.org/10.1136/bcr-2021-244233.

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Leiomyosarcoma is a rare aggressive malignant mesenchymal tumour, accounting for 1% of all uterine malignancies. It spreads rapidly through the intraperitoneal and haematogenous pathways. It is often diagnosed postoperatively following myomectomy, hysterectomy or supracervical hysterectomy for presumed benign disease. It has a predilection for perimenopausal women with a median age of 50 years. Individuals may describe symptoms of vaginal or abdominal pressure. Physical examination may reveal a large palpable pelvic mass, which may haemorrhage. Surgery remains the mainstay of treatment. Hysterectomy and a bilateral salpingo-oophorectomy may be considered, depending on the individual’s menopausal status. Ovarian preservation can be considered in young patients. Adjuvant systemic treatment and radiotherapy are of no benefit. Gemcitabine/docetaxel and doxorubicin have shown benefit in the treatment of advanced or recurrent disease. The authors present the case of a 44-year-old woman with lower abdominal pain, vaginal bleeding and a uterine fibroid. Laboratory investigations confirmed a leucocytosis, neutrophilia and a thrombocythaemia. Further investigation with an MRI pelvis showed a very large, heterogeneous, malignant appearing pelvic mass compressing the right ureter and it appeared uterine in nature. Her staging CT showed multiple lung metastases. The diagnosis of uterine leiomyosarcoma was subsequently established. Due to the aggressive behaviour of this sarcoma subtype, novel early detection strategies and targeted therapies are required.

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Ben Salem, Amina, Ines Mazhoud, Rachida Laamiri, Randa Salem, Hayet Laajili et Chiraz Hafsa. « Anterior Urethral Valve : Uncommon Association with Renal Duplicity ». Journal of Neonatal Surgery 6, n^o 2 (15 avril 2017) : 41. http://dx.doi.org/10.21699/jns.v6i2.544.

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Anterior urethral valves (AUVs) is an unusual cause of congenital obstruction of the male urethra, being 15–30 times less common than posterior urethral valves. We present a case of AUV diagnosed at 24th gestational week. Ultrasonography and fetal MRI revealed hydronephrotic kidneys with ureteral duplicity, a distended bladder and perineal cystic mass which confirmed dilated anterior urethra in a male fetus. Diagnosis was confirmed postnatally by voiding cystourethrogram and surgery.

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Cosciani-Cunico, S., C. Simeone et T. Zanotelli. « MRI of the female urethra and pelvic floor ». Urologia Journal 59, n^o 5 (octobre 1992) : 13–15. http://dx.doi.org/10.1177/039156039205900503.

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— MRI is the most powerful imaging procedure to visualize the structures of the pelvic floor. We have been interested in the use of MRI towards a better understanding of the pathophysiology of genuine stress incontinence due either to anatomical malposition of the pelvic viscera or to an intrinsically damaged urethra. Axial continuous images were obtained with T2 weighted spin-echo sequence in a total of 47 patients. In stress incontinent patients the urethra was usually more distant from the pubic bone than in normal controls. The urethro-pelvic ligaments were seen to extend downward in an oblique course. The levator sling was frequently deficient, usually thin or partially replaced by fat and connective tissue. In our experience, MRI provides information about the quality of the urethral wall and the pelvic floor. It is clearly superior to other radiological methods and will likely assume an even greater role in evaluating the urethra with paraurethral area and the female pelvis.

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P. Naga Jyothi, G. Sreemahalaksmi, G. Sai Prathyusha et M. Swapna. « Carcinoma of bladder : A rare case report ». World Journal of Biology Pharmacy and Health Sciences 13, n^o 1 (30 janvier 2023) : 272–76. http://dx.doi.org/10.30574/wjbphs.2023.13.1.0017.

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Bladder cancer begins after the healthy cells in the bladder wall, the most commonly urothelial cells change and grow out of control, forming a mass called tumor urothelial cells, the urothelial cells that also line the renal pelvis and ureter cancer that develops in the type of urothelial cancer, and it is often called upper tract urothelial cancer. A tumor can be benign or malignant, a cancerous tumor is malignant it can grow and spread to other parts of the body, a benign tumor means the tumor can grow but will not spread, these are very rare. Bladder tumors can be divided into 3 types based on microscopic structure of the tumor cells: Urothelial carcinoma, squamous cell carcinoma, adenocarcinoma and others include sarcoma. These cancers may be of two types based on cell type bladder cancer that can be categorized as NMIBC (Non-muscle invasive bladder cancer) and MIBC (Muscle invasive bladder cancer). Risk factors include tobacco use, age, gender, race, chemicals, chronic bladder problems, cyclophosphamide use and pioglitazone use, personal history, schistosomiasis, arsenic exposure, genetic syndromes. Clinical symptoms are blood clots in the urine, pain or burning micturition, frequent urination, lower back ache on one side of the body in the abdomen region, hematuria. Diagnostic tests include urine test, cystoscopy, biopsy, TURBT, MRI, CT (KUB), and USG. Treatment includes surgical removal by TURBT, BCG vaccination, radiotherapy, chemotherapy, and immunotherapy in addition palliative or supportive care.

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Matteo, Mastrorosato, Bertelli Elena, Bonini Maria Cristina, Danti Ginevra, Vannini Costanza, Agostini Simone et Miele Vittorio. « Rare case of an upper urinary tract carcinoma (UTUC) in renal pelvis and ureter associated to renal vein thrombosis : diagnostic imaging with CECT, MRI and CEUS ». Journal of Ultrasound 22, n^o 3 (26 juin 2019) : 373–79. http://dx.doi.org/10.1007/s40477-019-00396-z.

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Woo, Sungmin, Jeong Yeon Cho, Sang Youn Kim et Seung Hyup Kim. « Intravoxel incoherent motion MRI-derived parameters and T2* relaxation time for noninvasive assessment of renal fibrosis : An experimental study in a rabbit model of unilateral ureter obstruction ». Magnetic Resonance Imaging 51 (septembre 2018) : 104–12. http://dx.doi.org/10.1016/j.mri.2018.04.018.

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Mastrorosato, Matteo, Elena Bertelli, Maria Cristina Bonini, Ginevra Danti, Costanza Vannini, Simone Agostini et Vittorio Miele. « Correction to : Rare case of an upper urinary tract carcinoma (UTUC) in renal pelvis and ureter associated to renal vein thrombosis : diagnostic imaging with CECT, MRI and CEUS ». Journal of Ultrasound 22, n^o 3 (18 juillet 2019) : 371. http://dx.doi.org/10.1007/s40477-019-00397-y.

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Ivan, R., L. C. Nistor, C. G. Lipan, R. M. Mezei et C. A. Sirbu. « P11.31.B Pseudotumor Cerebri - a rare paraneoplastic manifestation ». Neuro-Oncology 24, Supplement_2 (1 septembre 2022) : ii63—ii64. http://dx.doi.org/10.1093/neuonc/noac174.220.

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Abstract Background Pseudotumor Cerebri (PC) is defined by an elevated intracranial pressure of unidentified cause, associated with normal cerebrospinal fluid (CSF) composition and no cause for hypertension on the neuroimaging evaluations. The symptoms described in association are headache, papilledema, changes in vision, and sometimes tinnitus. Its pathophysiology is far from being elucidated and the mechanisms proposed are multiple. There are some cases described in the literature in which PC is the first manifestation of a systemic neoplasm, most probably due to an abnormal response of the immune system to cancerous growth. We aim to emphasize a possible connection between adenocarcinoma of the lung and PC as the first paraneoplastic manifestation. Material and Methods We present the case of a 59-year-old patient, female, non-obese, who presented to the hospital for severe headache, blurred vision, tinnitus, and paresthesia on both her upper limbs. On the first evaluation, the usual blood tests showed an increased creatinine level, and the subsequent abdominal echography and CT scan revealed bilateral ureter hydronephrosis, without an obvious obstacle, for which nephrostomies were implanted. On the ophthalmological evaluation bilateral papillary edema was described, although the cerebral CT with angiography and MRI showed no pathological modifications. A lumbar puncture with manometry was performed, that showed a CSF pressure of approximately 500 mmH2O. Results Following the clinical, imagistic, and biological manifestations, the diagnosis of PC was established. The decision to start the corticotherapy was made, followed by the addition of acetazolamide. Although the treatment tented was not efficient, the neurosurgery team decided that she is not a suitable candidate for a CSF shunting procedure and the ophthalmologist advised against an optic nerve sheath fenestration. The evolution was unfavorable, with the persistence of the symptoms. She underwent extensive investigations, the second cerebral MRI showing a slight dilation of the ventricles. On the thoracic-abdominal-pelvic CT, a pulmonary nodule with a malignant aspect was described, the histopathological results pleading for adenocarcinoma. The decision to excise the lesion was made, but after the surgery, the patient developed a cardiorespiratory arrest, without response to resuscitation. Conclusion Although there is scarce evidence of PC as a paraneoplastic syndrome, the evolution and investigations results support the possibility of a causal relationship. This is, to our knowledge, the second case of adenocarcinoma of the lung that primarily presents with PC. Further studies must be conducted to understand the underlying pathophysiology of this condition and to develop new treatment possibilities.

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Magomedova, Zavazhat M., Elena A. Egorova, Dmitry A. Lezhnev et Margarita V. Smislenova. « Magnetic Resonance Imaging in Diagnosis of Complications of Renal and Ureteral Injuries in Different Periods of Traumatic Disease ». International Journal of Biomedicine 11, n^o 3 (9 septembre 2021) : 342–45. http://dx.doi.org/10.21103/article11(3)_oa10.

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The aim of this study was to evaluate the effectiveness of MRI in diagnosing combined renal and ureteral injuries at different periods of traumatic disease (TD). Methods and Results: We analyzed the results of diagnostics and treatment of 139 patients (80 women and 59 men) with renal and ureteral injuries aged between 18 and 72 years. There were 67(48.2%) patients in the period of acute reaction to trauma, 40(28.8%) patients with early manifestations, and 32(23%) patients in the period of late manifestations. In 127(91.4%) patients, an urgent plain abdominal X-ray was performed without any preliminary preparation. USI of the abdominal and retroperitoneal space was performed in 108(77.7%) patients in the stage of the primary assessment of renal injury as it was a rapid non-invasive investigation. A whole-body MSCT was performed in 131(94.2%) patients, using the nonionic contrast agents Ultravist (350mg I/ml) and Omnipaque (350mg I/ml). MRI was performed in 125(89.9%) patients, including cases of pregnancy and a medical history of allergies. Contrast-enhanced MSCT had a high diagnostic efficiency in assessing complications in kidney and ureteral injuries at different periods of TD (accuracy of 89.2% for acute reaction, 88.8% for early manifestations, and 89.5% for late manifestations). MRI of the kidneys and ureters was indicated in periods of early and late manifestations of TB to detect renal complications in cases with a discrepancy between clinical manifestations and the results obtained by ultrasound and MSCT (accuracy of 87.5% for early manifestations and 89.9% for late manifestations).

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Sardeshpande, Nagendra, et Jainesh Doctor. « An unusual case of bilateral hydroureter : solved by a gynaecologist ». International Journal of Reproduction, Contraception, Obstetrics and Gynecology 7, n^o 3 (27 février 2018) : 1273. http://dx.doi.org/10.18203/2320-1770.ijrcog20180937.

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A 26-year unmarried girl presented with severe dysmenorrhoea and hesitancy of micturition during menses since, 2 years. She had history of regular menstruation. On IVP and ultrasound there was presence bilateral hydroureter and hydronephrosis. She had previous history of cystoscopy with bilateral ureteroscopy done for the same. Bilateral ureteric stenting for a period of 3 months was done 1 year earlier, however it failed to resolve the hydroureter. A MRI was done, which showed hydroureter with surrounding endometriotic nodule. Laparoscopy was done, and ureteral shaving was performed. Postoperative IVP showed normal ureteral and renal pelvic anatomy. Patient is presently on Dienogest and is asymptomatic.

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Delshad, Salahaddin, Hadith Rastad et Parham Mardi. « Congenital Bladder and Urethral Agenesis : Two Case Reports and Management ». Advances in Urology 2020 (24 septembre 2020) : 1–5. http://dx.doi.org/10.1155/2020/2782783.

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Background. Agenesis of the bladder and urethra is a rare congenital anomaly, with a very few living cases reported in the literature so far. Case Presentation. We are reporting two female patients (3 and 6 years old) with bladder and urethral agenesis who presented with urinary incontinence. In both patients, magnetic resonant imaging (MRI) revealed a case of bladder and urethral agenesis with normal ureters draining into the vagina. Patients underwent a neobladder and conduit creation surgery. The neobladder was constructed from the whole cecum and a part of the ascending colon, followed by an anastomose of the ureters into the neobladder in a nonrefluxing fashion; the appendix was used simultaneously as a continent catheterizable conduit. The two patients attained urinary continence postoperatively. Conclusion. We reported two cases of bladder agenesis, and for the first time, we have performed neobladder creation surgery using the cecum and ascending colon. One-year follow-up did not reveal any complications.

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Coroleucă, C. B., C. Berceanu, L. Brindușe, D. Marcu et Elvira Brătilă. « Diagnosis and management of cases with deep infiltrating endometriosis affecting the urinary tract ». Romanian Journal of Military Medicine 121, n^o 3 (1 décembre 2018) : 31–37. http://dx.doi.org/10.55453/rjmm.2018.121.3.4.

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Objective: The goal of this paper is to present the management of cases of deep endometriosis that affects the bladder, the ureters and the kidney. Materials and method: In this review we analyzed the sensitivity and specificity of imaging techniques for diagnosing deep infiltrating endometriosis, the optimal surgical technique and the surgical approach. Results: In patients with pelvic endometriosis in advanced stages the urinary tract is frequently involved. Preoperative work-up of patients with deep infiltrating endometriosis is aimed at evaluating the extension of the lesions in order to assess the complexity of the intervention and to choose the optimal approach. Conclusions: Laparoscopic and robotic management of these cases are good therapeutic alternatives. Ultrasound, sonovaginography with gel and MRI are useful imaging techniques for evaluating patients with deep infiltrating endometriois. The surgical management of patients with deep infiltrating endometriosis that involves the urinary tract consists of partial bladder resections, ureterolysis, ureteral resection and anastomosis and ureteral reimplantation.

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Tellambura, Mahima, Isaac Thangasamy, Kwang Chin et Declan Murphy. « Effect of Metallic Ureteric Stents on Magnetic Resonance Imaging : Implications for Malignant Ureteral Obstruction ». Société Internationale d’Urologie Journal 2, n^o 4 (16 juillet 2021) : 256–58. http://dx.doi.org/10.48083/wlvr1509.

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Metallic ureteric stents are increasingly used for the management of malignant ureteric obstruction, a commonly encountered complication in urological and other malignancies. However, there has been limited evaluation of complications associated with these stents, including those that might arise from the use of magnetic resonance imaging (MRI). While most devices are deemed nominally “MRI-safe,” their implication on the quality of imaging produced has not been evaluated in clinical trials, and in our practice, significant artefact has been encountered with some ureteric stents—specifically, the Teleflex Rüsch DD tumour stent—compromising image quality and diagnostic certainty.

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Kodzo-Grey Venyo, Anthony. « Cystitis Cystica and Cystitis Glandularis of the Urinary Bladder : A Review and Update ». Journal of Clinical Research and Reports 11, n^o 1 (21 avril 2022) : 01–22. http://dx.doi.org/10.31579/2690-1919/240.

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Cystitis glandularis is a proliferative disorder of the urinary bladder which has tended to be associated with glandular metaplasia of the transitional cells that line the urinary bladder. Cystitis glandularis tends to be closely related to cystitis cystica with which it commonly does exist. Cystitis cystica represents a proliferative or reactive changes which tend to occur within von Brunn nests which do acquire luminal spaces and become cystically dilated, and cystitis may undergo glandular metaplasia which does represent cystitis glandularis or the cystitis may undergo intestinal type of metaplasia which is referred to as intestinal type of cystitis. Cystitis cystica and cystitis glandularis is a very common incidental finding. Cystitis cystica and glandularis tend to develop I the setting of chronic irritation or inflammation of the urinary bladder mucosa. Cystitis cystica and glandularis tend to be frequently found in co-existence with interrelated lesions and they represent benign simulators of invasive carcinoma of the urinary bladder. With regard to mode of manifestation and diagnosis, cystitis cystica and cystitis glandularis tend to be diagnosed incidentally based upon: findings of urinary bladder lesions at cystoscopy undertaken for some other reason or upon incidental finding of a urinary bladder lesion following the undertaking of radiology imaging (ultra-sound scan, or computed tomography (CT) scan or magnetic resonance imaging (MRI) scan undertaken for something else. The patient may also manifest with lower urinary tract symptoms of urinary frequency, urgency, urge incontinence or poor flow of urine or difficulty in initiating urine. On rare occasions when the ureteric orifices are involved the patient may manifest with one sided loin pain or bilateral loin pain if both ureteric orifices are obstructed by the urinary bladder lesion. In severe cases of bilateral ureteric obstruction there may be evidence of impairment of renal function. Haematuria could also be a mode of presentation. Ultrasound scan of renal tract could demonstrate a polypoidal thickening of the wall of the urinary bladder usually in the trigone of the bladder but in extensive cases the thickening could be all over the urinary bladder and in cases where the ureteric orifices are obstructed there may be evidence of hydroureter and hydronephrosis. CT scan may show hyper-vascular polypoid mass within the urinary bladder, and MRI scan could demonstrate a hyperintense vascular core with encompassing low-intensity signal. These radiology imaging features are non-specific and would differentiate the urinary bladder lesion from invasive urothelial carcinoma. Diagnosis of the cystitis tends to be made based upon histopathology examination and immunohistochemistry staining studies of biopsy specimens or the trans-urethral resection specimens of the urinary bladder lesions. Microscopy pathology examination of the specimens tend to demonstrate: (a) abundant urothelial von Brunn nests which often tend to exhibit a vaguely lobular distribution of invaginations as well evidence of non-infiltrative growth as well as growth and variable connection to surface, (b) Gland-like lumina with columnar or cuboidal cells with regard to cases of cystitis glandularis, (c) Cystically dilated lumina or cystic cavities which are filled with eosinophilic fluid in the scenario of cystitis cystica, (d) Majority of cases of cystitis tend to demonstrate coexistence of both patterns, (e) Cells lack significant atypia, mitotic activity, stromal reaction and muscular invasion and degenerative atypia tends to be occasionally present. Immunofluorescence studies in cases of cystitis glandularis tend to demonstrate uniform membranous expression of beta catenin without cytoplasmic or nuclear localization. Cases of cystitis cystica and cystitis glandularis tend to exhibit positive immunohistochemistry staining for various markers as follows: GATA3, CK7, (full thickness), CK20 (umbrella cells), p63 (basal cell layer), uroplakin II/III, thrombomodulin, beta catenin, (membranous), and E-cadherin. Cases of cystitis cystica and cystitis glandularis tend to exhibit negative immunohistochemistry staining for the following immunohistochemistry staining agents: CDX2, Villin, MUC2, MUC5AC, and beta catenin, (nuclear). Some of the differential diagnoses of cystitis cystica and cystitis glandularis include: von Brunn nest hyperplasia, Urothelial carcinoma in situ, Inverted Urothelial papilloma, Nested variant of invasive urothelial carcinoma, and Microcystic variant of urothelial carcinoma. On rare occasions cystitis cystica and cystitis glandularis could be found contemporaneously in association with a urothelial carcinoma and hence every pathologist who examines specimens of cystitis cystica and cystitis glandularis needs to undertake a thorough examination of various areas of the bladder lesion to be absolutely sure there is no synchronous malignancy in the urinary bladder lesion. The treatment of cystitis cystica does entail removal of the source of irritation or source of the bladder inflammation including foreign bodies, long-term urinary catheter, vesical calculus and others as well as trans-urethral resection of the urinary bladder lesion or lesions. On very rare occasions cystectomy had been undertaken. Individuals who have vesical-ureteric obstruction may require insertion of nephrostomy on the side of the obstruction followed by insertion of antegrade or retrograde ureteric stents due to scarring at the site of obstruction or when the scar is too dense then excision of the lesion and re-implantation of the ureter may be required. In cases of severe impairment of renal function, on very rare occasions dialysis may be required as supportive care. But for majority of patients, trans-urethral resection of the bladder lesion would tend to be enough.

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Pal, Sumanta K., Neeraj Agarwal, Yohann Loriot, Cristina Suarez Rodriguez, Parminder Singh, Ulka N. Vaishampayan, Elizabeth Mcilvaine, Dominic Curran, Daniel Castellano et Andrea Necchi. « Cabozantinib in combination with atezolizumab in urothelial carcinoma previously treated with platinum-containing chemotherapy : Results from cohort 2 of the COSMIC-021 study. » Journal of Clinical Oncology 38, n^o 15_suppl (20 mai 2020) : 5013. http://dx.doi.org/10.1200/jco.2020.38.15_suppl.5013.

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5013 Background: Cabozantinib (C), an inhibitor of MET, AXL, and VEGFR, has been shown to promote an immune-permissive environment and has shown promising clinical activity in combination with immune checkpoint inhibitors (ICIs) in solid tumors including renal cell carcinoma and urothelial carcinoma (UC). ICI monotherapy is approved for patients (pts) with locally advanced or metastatic UC with disease progression after platinum-containing chemotherapy. COSMIC-021, a multi-center phase 1b study, is evaluating the combination of C with atezolizumab (A) in various solid tumors (NCT03170960). We report results from Cohort 2 in UC pts with prior platinum-containing chemotherapy. Methods: Eligible pts had ECOG PS 0-1 and had progressed on or after a platinum-containing chemotherapy (including pts with disease recurrences < 12 months after the end of perioperative chemotherapy). Pts received C 40 mg PO QD and A 1200 mg IV Q3W. CT/MRI scans were performed Q6W for first year and Q12W thereafter. The primary endpoint is objective response rate (ORR) per RECIST v1.1 by investigator. Other endpoints include safety, duration of response (DOR), PFS, and OS. Results: As of Dec 20, 2019, 30 pts with advanced UC were enrolled with a median follow-up of 16.5 mo (range 12, 21). Median age was 66 yrs (range 44, 84), 73% were male, and 60% had ECOG PS 1. Primary tumor sites were bladder (80%), renal pelvis (10%), and ureter (10%); the most frequent metastatic sites included lung (40%) and liver (27%). Fourteen pts (47%) had received ≥2 prior systemic anticancer therapies. The most common treatment-related AEs (TRAEs) of any grade were asthenia (37%), diarrhea (27%), decreased appetite (23%), increased transaminases (23%), and mucosal inflammation (20%). Grade 3/4 TRAEs occurred in 57% of pts, with no grade 5 TRAEs. Confirmed ORR per RECIST v1.1 was 27% (8 of 30 pts), including 2 pts with CR. DCR (CR+PR+SD) was 64%. Median DOR was not reached, with the longest DOR ongoing at 14.3+ mos. Median PFS was 5.4 mo (range 0.0+, 17.3+). Conclusions: C in combination with A demonstrated encouraging clinical activity in pts with advanced UC with an acceptable safety profile. Additional cohorts of pts with advanced UC are being explored in the study. Clinical trial information: NCT03170960 .

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Pham, Jonathan, Ricky R. Savjani, Yu Gao, Minsong Cao, Peng Hu, Ke Sheng, Daniel A. Low, Michael Steinberg, Amar U. Kishan et Yingli Yang. « Evaluation of T2-Weighted MRI for Visualization and Sparing of Urethra with MR-Guided Radiation Therapy (MRgRT) On-Board MRI ». Cancers 13, n^o 14 (16 juillet 2021) : 3564. http://dx.doi.org/10.3390/cancers13143564.

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Purpose: To evaluate urethral contours from two optimized urethral MRI sequences with an MR-guided radiotherapy system (MRgRT). Methods: Eleven prostate cancer patients were scanned on a MRgRT system using optimized urethral 3D HASTE and 3D TSE. A resident radiation oncologist contoured the prostatic urethra on the patients’ planning CT, diagnostic 3T T2w MRI, and both urethral MRIs. An attending radiation oncologist reviewed/edited the resident’s contours and additionally contoured the prostatic urethra on the clinical planning MRgRT MRI (bSSFP). For each image, the resident radiation oncologist, attending radiation oncologist, and a senior medical physicist qualitatively scored the prostatic urethra visibility. Using MRgRT 3D HASTE-based contouring workflow as baseline, prostatic urethra contours drawn on CT, diagnostic MRI, clinical bSSFP and 3D TSE were evaluated relative to the contour on 3D HASTE using 95th percentile Hausdorff distance (HD95), mean-distance-to-agreement (MDA), and DICE coefficient. Additionally, prostatic urethra contrast-to-noise-ratios (CNR) were calculated for all images. Results: For two out of three observers, the urethra visibility score for 3D HASTE was significantly higher than CT, and clinical bSSFP, but was not significantly different from diagnostic MRI. The mean HD95/MDA/DICE values were 11.35 ± 3.55 mm/5.77 ± 2.69 mm/0.07 ± 0.08 for CT, 7.62 ± 2.75 mm/3.83 ± 1.47 mm/0.12 ± 0.10 for CT + diagnostic MRI, 5.49 ± 2.32 mm/2.18 ± 1.19 mm/0.35 ± 0.19 for 3D TSE, and 6.34 ± 2.89 mm/2.65 ± 1.31 mm/0.21 ± 0.12 for clinical bSSFP. The CNR for 3D HASTE was significantly higher than CT, diagnostic MRI, and clinical bSSFP, but was not significantly different from 3D TSE. Conclusion: The urethra’s visibility scores showed optimized urethral MRgRT 3D HASTE was superior to the other tested methodologies. The prostatic urethra contours demonstrated significant variability from different imaging and workflows. Urethra contouring uncertainty introduced by cross-modality registration and sub-optimal imaging contrast may lead to significant treatment degradation when urethral sparing is implemented to minimize genitourinary toxicity.

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Lebowitz, J. A., N. M. Rofsky, J. C. Weinreb et P. Friedmann. « Ureteral lymphoma : MRI demonstration ». Abdominal Imaging 20, n^o 2 (mars 1995) : 173–75. http://dx.doi.org/10.1007/bf00201532.

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Nechiporenko, A. S. « DIAGNOSTIC POSSIBILITIES OF STATIC MRI IN THE EVALUATION OF THE SHAPE OF THE PARAURETHRAL LIGAMENTOUS APPARATUS IN WOMEN BEFORE THE PLANNED SURGERY FOR CYSTOCELE AND STRESS URINARY INCONTINENC ». Journal of the Grodno State Medical University 18, n^o 5 (2020) : 584–89. http://dx.doi.org/10.25298/2221-8785-2020-18-5-584-589.

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Background. Damages to the ligamentous apparatus of the urethra are the most significant causes of the development of urinary disorders in women with cystocele.Aim. To determine the diagnostic capabilities of static MRI in assessing the state of the paraurethral ligamentous apparatus in women.Material and methods. The condition of the ligaments forming the supporting urethral system was assessed according to the results of static MRI performed in 73 patients.Results. Assessment of the condition of the ligamentous apparatus of the urethra according to the results of MRI shows that any type of failure of the paraurethral and periurethral ligaments of the urethra, ensuring its physiological position, is accompanied by stress urinary incontinence. There is no significant difference in the frequency of differentiation disorders of the paraurethral, periurethral and pubic-urethral ligaments in all patients with difficulty urinating, which indicates more severe anatomical disorders.Conclusions. The ligamentous apparatus of the urethra must be considered as a single complex system due to the complex damage to the ligaments of the urethra. MRI data on the condition of the urethral ligaments are documentary evidence and justification for the need for surgical treatment.

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Lildal, Søren Kissow, Esben Søvsø Szocska Hansen, Christoffer Laustsen, Rikke Nørregaard, Lotte Bonde Bertelsen, Kirsten Madsen, Camilla W. Rasmussen, Palle Jörn Sloth Osther et Helene Jung. « Gadolinium-enhanced MRI visualizing backflow at increasing intra-renal pressure in a porcine model ». PLOS ONE 18, n^o 2 (16 février 2023) : e0281676. http://dx.doi.org/10.1371/journal.pone.0281676.

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Introduction Intrarenal backflow (IRB) is known to occur at increased intrarenal pressure (IRP). Irrigation during ureteroscopy increases IRP. Complications such as sepsis is more frequent after prolonged high-pressure ureteroscopy. We evaluated a new method to document and visualize intrarenal backflow as a function of IRP and time in a pig model. Methods Studies were performed on five female pigs. A ureteral catheter was placed in the renal pelvis and connected to a Gadolinium/ saline solution 3 ml/L for irrigation. An occlusion balloon-catheter was left inflated at the uretero-pelvic junction and connected to a pressure monitor. Irrigation was successively regulated to maintain steady IRP levels at 10, 20, 30, 40 and 50 mmHg. MRI of the kidneys was performed at 5-minute intervals. PCR and immunoassay analyses were executed on the harvested kidneys to detect potential changes in inflammatory markers. Results MRI showed backflow of Gadolinium into the kidney cortex in all cases. The mean time to first visual damage was 15 minutes and the mean registered pressure at first visual damage was 21 mmHg. On the final MRI the mean percentage of IRB affected kidney was 66% after irrigation with a mean maximum pressure of 43 mmHg for a mean duration of 70 minutes. Immunoassay analyses showed increased MCP-1 mRNA expression in the treated kidneys compared to contralateral control kidneys. Conclusions Gadolinium enhanced MRI provided detailed information about IRB that has not previously been documented. IRB occurs at even very low pressures, and these findings are in conflict with the general consensus that keeping IRP below 30–35 mmHg eliminates the risk of post-operative infection and sepsis. Moreover, the level of IRB was documented to be a function of both IRP and time. The results of this study emphasize the importance of keeping IRP and OR time low during ureteroscopy.

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Flammia, Rocco Simone, Antonio Tufano, Luca Antonelli, Arianna Bernardotto, Alberto A. Castro Castro Bigalli, Zhen Tian, Marc C. Smaldone, Pierre I. Karakiewicz, Valeria Panebianco et Costantino Leonardo. « Diagnostic Performance of Magnetic Resonance Imaging for Preoperative Local Staging of Penile Cancer : A Systematic Review and Meta-Analysis ». Applied Sciences 11, n^o 15 (31 juillet 2021) : 7090. http://dx.doi.org/10.3390/app11157090.

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Invasion of the tunica albuginea (TA) and/or urethra are key factors in determining the feasibility of organ-preserving surgery in penile cancer (PC). Magnetic resonance imaging (MRI) appeared to be a promising technique for preoperative local staging. We performed a systematic review (SR) and pooled meta-analysis to investigate the diagnostic performance of MRI in preoperative local staging of primary PC. An SR up to May 2021 was performed according to the PRISMA statement. The diagnostic performance of MRI was evaluated according to TA invasion, urethra invasion, and pT-stage ≥ 2. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) from eligible studies were pooled and summary receiver operating characteristic (SROC) curves were constructed. Overall, seven qualified studies were deemed suitable. Diagnostic performance of MRI showed an accuracy of 0.89 for TA invasion (sensitivity 0.78, PPV 0.79, specificity 0.91, and NPV 0.90); an accuracy of 0.88 for urethra invasion (sensitivity 0.65, PPV 0.46, specificity 0.86, and NPV 0.93); an accuracy of 0.90 for pT ≥ 2 (sensitivity 0.86, PPV 0.84, specificity 0.70, and NPV 0.73).Currently available evidence indicates that MRI might be a one-stop shop for local staging of primary PC and play a central role with regard to conservative surgical management.

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Parashari, UmeshC, Ragini Singh, Neera Kohli et S. Bhadury. « MRI in congenital duplication of urethra ». Indian Journal of Radiology and Imaging 19, n^o 3 (2009) : 232. http://dx.doi.org/10.4103/0971-3026.54884.

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Protoshchak, V. V., A. A. Sivakov, V. K. Karandashov, L. M. Sinelnikov, S. M. Gozalishvili, V. S. Chirsky et A. A. Erokhina. « Recurrence of bladder cancer in the urethra ». Experimental and Сlinical Urology 14, n^o 2 (29 juin 2021) : 40–45. http://dx.doi.org/10.29188/2222-8543-2021-14-2-40-45.

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Introduction. Bladder cancer (ВС) is one of the most common malignant tumors of the urinary tract. In recent decades, recurrent BC in the urethra has become increasingly common. Given the rarity of this pathology, it is of clinical interest for oncologists and urologists. Materials and methods. A clinical case of recurrent bladder cancer in the urethra in a 63-year-old patient is presented. The results of magnetic resonance imaging (MRI) of the pelvic organs and external genital organs, as well as the results of computed tomography of the abdominal organs and observation by a hematologist are presented. Results. For early diagnosis of tumor changes in the urethra in patients with risk factors for the recurrence of BC after cystectomy, careful observation in the form of a cytological study of flushing water from it, performing urethroscopy with ascending urethrography and MRI of the external genital organs is advisable. Conclusions. This clinical observation demonstrates the importance of assessing the state of the urethra when follow up patients after radical cystectomy for BC.

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Khan Rind, Jubran Afzal, et Zeb Ijaz Saeed. « Cushing’s Syndrome Associated With an Adrenal Cavernous Hemangioma ». Journal of the Endocrine Society 5, Supplement_1 (1 mai 2021) : A126. http://dx.doi.org/10.1210/jendso/bvab048.253.

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Abstract Introduction: Adrenal cavernous hemangiomas are rare benign tumors that arise from vascular endothelium and are often discovered incidentally on abdominal imaging. The majority are nonfunctioning; however, we present a case of adrenal Cushing’s syndrome in a patient with a cavernous adrenal hemangioma. Case: A 72-year-old woman was referred for an incidental right adrenal mass. On questioning, she endorsed abdominal pain, sixty-pound unintentional weight gain over five years, truncal obesity, and easy bruising. Past medical history was relevant for hypertension. Her surgical history was extremely complicated, having had a perforated peptic ulcer, open cholecystectomy complicated by injury to the right ureter, incisional hernia repair, appendectomy, and hysterectomy with bilateral salpingo-oophorectomy. She was first noted to have a right adrenal mass on a CT done eight years ago, measuring 3.8 x 3.2 cm. A repeat CT abdomen and pelvis now showed this mass to be 6.5 x 6.3 x 8.1 cm with unenhanced Hounsfield units of 29.6. Radiographically, this was a heterogeneous, solid, and cystic appearing mass with peripheral brisk arterial enhancement areas, which appeared to fill in on delayed imaging. The enhancement pattern of the lesion was consistent with an adrenal cavernous hemangioma. An MRI of the abdomen also demonstrated similar peripheral nodular enhancement favoring an adrenal cavernous hemangioma. Functional testing for the adrenal mass was undertaken. Morning cortisol was 23.4 mcg/dl with ACTH low at 5.3 pg/ml, and DHEA-S 3 mcg/dl. She failed to suppress with overnight 1 mg dexamethasone with AM cortisol of 3.6 mcg/dl. Midnight salivary cortisol levels were high at 0.237 mcg/dl and 0.419 mcg/dl while a 24-hour urine free cortisol was normal at 15.2 mcg/d. She tested negative for pheochromocytoma and primary aldosteronism. The patient was deemed a poor surgical candidate due to her history of multiple prior abdominal surgeries and a BMI of 46. Therefore, she underwent an IR angioembolization of the right adrenal mass instead. On follow-up CT, there was no significant change in the size of the lesion; however the degree of rim enhancement was slightly decreased. Post procedurally, her a.m. cortisol remained high-normal at 18.3 mcg/dL.. She is currently enrolled in a study for medical treatment of Cushing’s syndrome. Discussion: Adrenal cavernous hemangiomas usually present incidentally in the 6th-7th decade of life with a female predominance. These lesions are often asymptomatic; however, abdominal pain is the most common presenting symptom. The majority of adrenal cavernous hemangiomas are hormonally quiescent and mineralocorticoid excess and/or subclinical Cushing’s syndrome is exceedingly rare. Our patient is unique in her presentation of adrenal Cushing’s with this lesion and the novel use of angioembolization to decrease the size of this vascular tumor.

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Itani, Malak, Ania Kielar, Christine O. Menias, Manjiri K. Dighe, Venkat Surabhi, Srinivasa R. Prasad, Ryan O’Malley, Kiran Gangadhar et Neeraj Lalwani. « MRI of female urethra and periurethral pathologies ». International Urogynecology Journal 27, n^o 2 (26 juillet 2015) : 195–204. http://dx.doi.org/10.1007/s00192-015-2790-x.

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Amit Kumar Singh, Mishra S.S. et Arun Kumar Dwivedi. « Observational Study to evaluate the role of Ultrasonography and X-Ray in Urinary Disease ». International Journal of Research in Pharmaceutical Sciences 11, n^o 1 (8 février 2020) : 1206–9. http://dx.doi.org/10.26452/ijrps.v11i1.1959.

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Urinary diseases are very common in our society which system constitutes kidneys ureters urinary bladder and urethra various abnormalities occur in these organs due to many reasons like infection inflammation metabolic abnormalities neoplastic changes trauma etc. these abnormalities lead to various physical problems ending into death many times the abnormalities of urinary system can be diagnosed by hematological examination urine analysis radiological examination and histopathological examination especially radiological examination provide wide range of diagnosis of disease of urinary system of almost all origin although various radiological technique like X-ray (plain and contrast) Ultrasonography CT scan MRI and many others are available but in present study X-ray (plain and contrast ) and ultrasonography were used for diagnosis of disease of urinary system because of its easy availability and affordability the diseases of urinary system has been described under the name of Mutrakrichha and Mutraghata in ayurveda these two conditions are in fact group of clinical entities in which urination is difficult and retention is present respectively further they are divided into various subtypes these conditions resembles clinically with various types of urinary diseases early diagnosis has been the always advocated by ayurveda by virtue of this prevention and management becomes easy in the present study written informed consent has been taken from all the patients early detection of these conditions facilitates the management otherwise renal failure may complicate the condition

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