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Bladder outlet obstruction is included in the spectrum of congenital anomalies of the kidney and urinary tract (CAKUT). CAKUT is the most common cause of birth defects, occurring in 1 out of 1000 live births, and accounts for approximately half of all cases of chronic kidney disease and end-stage renal disease in children. [1] [2]
Pyeloplasty is a type of surgical procedure performed to treat an uretero-pelvic junction obstruction if residual renal function is adequate. [1]This revision of the renal pelvis treats the obstruction by excising the stenotic area of the renal pelvis or uretero-pelvic junction and creating a more capacious conduit using the tissue of the remaining ureter and renal pelvis.
A partial nephrectomy should be attempted when there is a kidney tumor in a solitary kidney, when there are kidney tumors in both kidneys, or when removing the entire kidney could result in kidney failure and the need for dialysis. Partial nephrectomy is also the standard of care for nearly all patients with small renal masses (<4 cm in size). [22]
Blockage of urine flow in an area below the kidneys results in postrenal azotemia. It can be caused by congenital abnormalities such as vesicoureteral reflux, blockage of the ureters by kidney stones, pregnancy, compression of the ureters by cancer, prostatic hyperplasia, or blockage of the urethra by kidney or bladder stones. [1]
Risks during surgery include heart problems, pulmonary (lung) complications, development of blood clots , blocking of arteries , and injury to adjacent structures, such as bowel or vascular entities. Inadequate ureteral length may also be encountered, leading to ureteral kinking and subsequent obstruction.
Ureteral stent Ureteral stent (detail) A ureteral stent (pronounced you-REE-ter-ul), or ureteric stent, is a thin tube inserted into the ureter to prevent or treat obstruction of the urine flow from the kidney. The length of the stents used in adult patients varies between 24 and 30 cm. Additionally, stents come in differing diameters or gauges ...
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Urology is one of the early match programs, with results given to applicants by early February (6 weeks before NRMP match). Applications are accepted starting Sep 1, with some programs accepting applications until early Jan. [7] It is a relatively competitive specialty to match into, with only 65.6% of US seniors matching in the 2022 match ...