New PDF release: Pediatric Urology

By George W. Kaplan, Irene M. McAleer (auth.), Dix P. Poppas MD, Alan B. Retik MD (eds.)

ISBN-10: 146131089X

ISBN-13: 9781461310891

ISBN-10: 1475708068

ISBN-13: 9781475708066

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Philadelphia: WB Saunders Co; 1992: 1563-1589. 25. : Surgery versus observation for managing obstructive grade 3 to 4 unilateral hydronephrosis: a report from the Society for Fetal Urology. j Uro/1998, 159:222-228. 12. King LR: Hydronephrosis: when is obstruction not obstruction? Ural Clin North Am 1995,22:31-42. 26. : Primary dilated megaureter: long-term followup. j Uro/1994, 152(2 Pt 2):618-621. 13. : Routine fetal genitourinary tract screening. Radiology 1985, 156:485-489. 27. : Clinical outcome and man agement of prenatally diagnosed primary mega ureters.

In females, the ureters ending in the bladder neck or urethra arc usually dilated and may reflux. UTI is common in this case. Conversely, ureters that drain distal to the bladder neck or urethra, at the vaginal introitus, or along the path of Gartner's duct usually are found during an evaluation for continuous urinary incontinence. ~ FIGURE 4-9. Ectopic ureteral orifice to the introitus. Sometimes ectopic ureters end inferiorly on the anterior vaginal wall or in the septum between the urethra and vagina.

If the upper pole function is poor, the lower pole pelvis and ureter will not opacify initially. With delayed imaging, the upper pole pelvis will be visible about 50% of the time. Rarely, an ipsilateral lower pole ureter and (less frequently) a controlateral ureter may be obstructed by the ureterocele. The controlateral kidney must be imaged carefully to identifY an occult duplication or lower pole reflux. Bilateral ureteroceles arc ti:mnd in about 10°;(, of cases. Ureteral Duplications and Ureteroceles o~--------------------------------~----------~--------------------------~0 43 t FIGURE 4-17.

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Pediatric Urology by George W. Kaplan, Irene M. McAleer (auth.), Dix P. Poppas MD, Alan B. Retik MD (eds.)


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