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OBJECTIVE: To assess the feasibility and safety of diagnostic or therapeutic semirigid ureteroscopy without ureteral meatus dilatation. MATERIALS AND METHODS: A comparative, retrospective study was conducted of patients undergoing ureteroscopy from January 2000 to May 2008. For data analysis purposes, the population was divided into two groups based on whether ureteroscopy had been performed with (Group 1) or without (Group 2) ureteral meatus dilatation. Variables recorded included age, sex, type of procedure, surgical diagnosis, passive or active dilatation, number of stones, stone location, stone diameter, peroperative and postoperative complications, internal urinary diversion after the procedure, therapeutic success rate, operating time, and hospital stay duration. A 8-9.8 Fr Wolf semirigid ureteroscope was used. Descriptive statistics of the population and cohorts were performed, providing medians, quartiles, and limit values for non-normally distributed interval variables, and absolute and relative frequencies for categorical variables. Shapiro-Wilk's, Mann-Whitney's U, Chi-square, and Fisher's exact tests were used for statistical analysis. A value of p 2 alpha < or = 0.005 was considered statistically significant. Arcus Quickstat Biomedical 1.0 software was used. RESULTS: Among the 306 ureteroscopies studied, 286 performed in 256 patients were analyzed. Median age was 50 years (16-83), 59% of patients were male, and elective ureteroscopy was performed in 183 patients (64%). Group 1: 191 ureteroscopies, Group 2: 95 ureteroscopies. Stone location: 149 in distal ureter, 60 in middle ureter, and 35 in proximal ureter. Sixty-nine percent of stones had sizes ranging from 5 and 10 mm. The overall success rate was 86.5%. There were 5 peroperative and 22 postoperative complications, with no statistically significant differences between the groups. CONCLUSIONS: In selected cases, ureteroscopy may be performed without ureteral meatus dilatation with success and morbidity rates similar to when the procedure is performed with meatal dilatation.

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With the widespread use of obstetric echography the incidence of fetal hydronephrosis has been reported more frequently. Consequently, many uropathies have been detected in asymptomatic neonates. The authors report their experience with prenatally detected primary non-refluxing megaureter. Newborns with fetal hydronephrosis were investigated by ultrasonography and micturating cystourethrogram after the beginning of chemoprophylaxis. If primary megaureter was identified, after 1 month the children underwent 99tm-DMSA, diuretic 99tm-DTPA, and intravenous urography. Eight infants with primary megaureter (bilateral in 3 cases) were identified, for a total of 11 renal units for study. All children were submitted to non-operative management. We performed ultrasonography and diuretic 99tm-DTPA during follow-up, which lasted on average 75 months. The mean cross-sectional diameter of the dilated ureter was 13.6 mm during neonatal period, and reached 8.4 mm at the end of follow-up. The renal function and the diuretic renogram remained stable throughout follow-up. Two neonates presented transitory hypertension. Our results support the notion that conservative management is safe for primary megaureter detected in asymptomatic neonates, with most cases showing spontaneous regression during a prolonged follow-up.

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Los pólipos fibroepiteliales son tumores benignos que se pueden manifestar a lo largo de todo el tracto urinario. Se presenta un caso de pólipo fibroepitelial en uréter. Revisamos la literatura y discutimos las características clínicas, diagnósticas y terapéuticas de esta rara entidad

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Los pólipos fibroepiteliales son tumores benignos que se pueden manifestar a lo largo de todo el tracto urinario. Se presenta un caso de pólipo fibroepitelial en uréter. Revisamos la literatura y discutimos las características clínicas, diagnósticas y terapéuticas de esta rara entidad(AU)

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Se realizó un estudio descriptivo de un grupo de 9 pacientes con diagnóstico de endometriosis urogenital, atendidos en el Servcio de Urología del Hospital Universitario "General Calixto García" en los años 1990-1995. Éste incluyó: edades, síntomas y signos, hallazgos imagenológicos, tratamiento y evolución. Se observó que la endometriosis se presenta en edades fértiles de la vida, y sus síntomas predominantes son secundarios a la afección de la porción intramural del uréter. El tratamiento quirúrgico se realizó en caso de complicaciones. Es poco frecuente la transformación maligna

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Se presenta un caso de ruptura espontánea del uréter que clínicamente se manifestó con dolor abdominal intenso y en el que se encontró infección urinaria por Klebsiella. Se revisan los posibles factores causales, el diagónstico clínico y el tratamiento

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Os autores apresentam um caso de duplicaçåo pieloureteral completa com ureter ectópico vulvar em mulher de 37 anos de idade. A principal queixa era o corrimento vaginal com evoluçåo de 20 anos. A clínica, diagnóstico e tratamento såo discutidos

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Dez pacientes com estenose ureteroiintestinal foram tratados por tecnica endourologica endoscopoco compreendeu dilataçao endoscopica com balao (5 casos), incisao com faca fria (2 casos) e dilataçao precedida por incisao com eletrodo (2 casos). Os autores discutem a indicaçao, evoluçao e as tecnicas endoscopicas para tratamento da afecçao.

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Se presentan 100 casos (87 pacientes) de estenosis uretopiélitica tratados quirúrgicamente en el Instituto Nacional de Pediatría entre los años de 1973-1986; un total de 87 casos fueron corregidos con éxito en la primera cirugía; 4 más en la segunda y otros dos en una tercera intervención con procedimientos más especializados y siete pacientes fueron nefrectomizados de primera intención por atrofia renal. Se comentan los puntos más importantes del diagnóstico clínico, de laboratorio y gabinete, así como un análisis de los resultados y tratamiento quirúrgico.

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