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Objectives: To evaluate our experiences with ureteroscopic treatment of ureteral calculi in pregnancy. Patients and methods: Between April 2006 and October 2013, 41 pregnant women with persistent renal colics and/or hematuria refractory to conservative measures were treated with ureteroscopy. The patients’ mean age was 23 (range 19–37) years. Most of the patients (56.1%) presented in the 2nd trimester. Loin pain and colic were the most common presenting symptoms (90.2%). Twenty-seven patients (65.9%) had an obstruction on the right side. All patients underwent ureteroscopy under epidural anesthesia. Results: Ureteroscopy revealed the presence of ureteric stones in 36 of the 41 cases. The stone size ranged from 5 to 16 (mean 8.9) mm. Distal ureteric stones were found in 29 patients. The pneumatic lithoclast was used for stone fragmentation in 22 of them (75.9%), while the stone was directly extracted in 4 patients. In 3 patients the stone migrated proximally and was not accessible any more. Proximal ureteric stones were detected in 7 of the remaining 12 cases. When attempting to manipulate these stones, they migrated more proximally and became unreachable. In the last 5 patients the entire ureter was free of stones; they only had edema at the ureteric orifice. A long lasting JJ stent was left until the end of the pregnancy in all cases with migrated inaccessible stones. In all patients successfully treated, a JJ stent with dangle extraction strings was left for two weeks. Minor urologic complications were encountered in the form of mild dysuria in 12 cases (29.2%) and mild hematuria in 5 cases (12.2%). All patients completed their pregnancy until full term without any serious obstetric complications requiring intervention. Conclusion: Ureteroscopy is a safe and effective therapeutic option for the treatment of obstructing ureteral stones in pregnancy with stone-free and complication rates comparable to the non-pregnant population. Keywords: Stones; Ureteroscopy; Pregnancy

A case of antenatally diagnosed hydronephrosis (later known to be PUJO complicated with urinoma and associated with hypoplasia of entire ureter) was treated using vermiform appendix as replacement.

The role of retrograde ureterography in the management of pelviureteric junction (PUJ) obstruction remains controversial and it has recently been reiterated that visualisation of the entire ureter on the affected side is mandatory owing to the high incidence of other ureteric abnormalities. In a review of 119 consecutive adult pyeloplasties carried out over a 9-year period, only 2 ureteric abnormalities were found in association with PUJ obstruction (duplex ureter/3-cm proximal stricture). Other anatomical abnormalities included aberrant vessels, fascial bands and renal anomalies. Most secondary abnormalities were undiagnosed prior to surgery and all were easily dealt with per-operatively.

Summary— A technique is described for removing the entire ureter in children by intussuscepting the ureter into the bladder. The technique has been successfully used in the orthotopic refluxing ureter and in the ectopic ureter.

Four cases of primary ureteral tumour are presented. The significance of cytologic examination of the urine and complete visualization of the entire ureter by either intravenous or retrograde urography is stressed.

Since the introduction thirty-four years ago of intravenous urography as a means of visualizing the urinary tract, the limitations imposed by the usual form of the examination have become evident and better methods have been sought (5, 8, 11–13). Until recently the 20 ml dose of contrast medium administered to a dehydrated patient has remained the accepted routine for all pyelographic examinations. In an effort to improve the quality of the examination, prolong the nephrogram, and consistently visualize the entire ureter by increasing the radiographic density of the opacified urine, Schencker in 1964 introduced drip infusion urography. This led to a re-evaluation of the low-dosage dehydration method (3,4, 7, 9). Although higher doses of contrast medium do not seem to increase the hazard to the patient, because of the risk and expense smaller doses would be desirable if comparable results could be achieved. Also, the routine use of drip infusion pyelography is precluded by the cost of a disposable infusion...