Ureteral obstruction by the vas deferens after urostomy. 2010

Subramanian Vaidyanathan, and Peter L Hughes, and Bakul M Soni, and Gurpreet Singh
Regional Spinal Injuries Centre, District General Hospital, Southport, Merseyside, UK. Subramnaian.Vaidyanathan@nhs.net

A male patient with spina bifida and paraplegia, born in 1968, underwent urostomy in 1973. In 1999, he developed urine infections. Intravenous urography showed bilateral hydronephrosis and hydroureter. This patient continued to get recurrent urine infections. In 2009, computed tomography of the abdomen revealed dilatation of the ureters, but the ureters reverted to normal calibre as they passed forward through the anterior abdominal wall. The vas deferens on either side was crossing and kinking the ureter. Magnetic resonance imaging of the abdomen confirmed that the level of obstruction in both ureters was at the site where the vas deferens crossed the ureter and kinked it. While performing urostomy, the ureters below the crossover by the vas deferens were detached from the bladder and attached to the skin for urinary diversion, thus causing the vas deferens to hook the lower end of the ureters. As the patient gained height and weight, thereby increasing abdominal girth, kinking of the ureters by the vas deferens was accentuated. In hindsight, bilateral midline cutaneous urostomy using the ureters below the crossover by the vas deferens represents a poor surgical technique for urinary diversion.

UI MeSH Term Description Entries
D008297 Male Males
D003937 Diagnosis, Differential Determination of which one of two or more diseases or conditions a patient is suffering from by systematically comparing and contrasting results of diagnostic measures. Diagnoses, Differential,Differential Diagnoses,Differential Diagnosis
D004108 Dilatation, Pathologic The condition of an anatomical structure's being dilated beyond normal dimensions. Ectasia,Dilatation, Pathological,Dilatations, Pathologic,Dilatations, Pathological,Pathologic Dilatation,Pathologic Dilatations,Pathological Dilatation,Pathological Dilatations
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D013521 Urologic Surgical Procedures, Male Surgery performed on the male genitalia. Male Urologic Surgery,Male Urologic Surgical Procedure,Male Urologic Surgical Procedures,Male Urological Surgical Procedure,Male Urological Surgical Procedures,Procedure, Urologic Surgical, Male,Procedure, Urological Surgical, Male,Procedures, Urologic Surgical, Male,Procedures, Urological Surgical, Male,Surgery, Male Urologic,Surgical Procedure, Urologic, Male,Surgical Procedure, Urological, Male,Surgical Procedures, Urologic, Male,Surgical Procedures, Urological, Male,Urologic Surgery, Male,Urologic Surgical Procedure, Male,Urological Surgery, Male,Urological Surgical Procedure, Male,Urological Surgical Procedures, Male,Male Urological Surgery,Surgery, Male Urological
D014513 Ureter One of a pair of thick-walled tubes that transports urine from the KIDNEY PELVIS to the URINARY BLADDER. Ureters
D014517 Ureteral Obstruction Blockage in any part of the URETER causing obstruction of urine flow from the kidney to the URINARY BLADDER. The obstruction may be congenital, acquired, unilateral, bilateral, complete, partial, acute, or chronic. Depending on the degree and duration of the obstruction, clinical features vary greatly such as HYDRONEPHROSIS and obstructive nephropathy. Obstruction, Ureteral,Obstructions, Ureteral,Ureteral Obstructions
D014547 Urinary Diversion Temporary or permanent diversion of the flow of urine through the ureter away from the URINARY BLADDER in the presence of a bladder disease or after cystectomy. There is a variety of techniques: direct anastomosis of ureter and bowel, cutaneous ureterostomy, ileal, jejunal or colon conduit, ureterosigmoidostomy, etc. (From Campbell's Urology, 6th ed, p2654) Ileal Conduit,Conduit, Ileal,Conduits, Ileal,Diversion, Urinary,Diversions, Urinary,Ileal Conduits,Urinary Diversions
D014649 Vas Deferens The excretory duct of the testes that carries SPERMATOZOA. It rises from the SCROTUM and joins the SEMINAL VESICLES to form the ejaculatory duct. Ductus Deferens,Deferens, Ductus,Deferens, Vas

Related Publications

Subramanian Vaidyanathan, and Peter L Hughes, and Bakul M Soni, and Gurpreet Singh
January 1993, The Journal of urology,
Subramanian Vaidyanathan, and Peter L Hughes, and Bakul M Soni, and Gurpreet Singh
February 1978, Journal of pediatric surgery,
Subramanian Vaidyanathan, and Peter L Hughes, and Bakul M Soni, and Gurpreet Singh
November 1960, The Journal of urology,
Subramanian Vaidyanathan, and Peter L Hughes, and Bakul M Soni, and Gurpreet Singh
February 2006, The American surgeon,
Subramanian Vaidyanathan, and Peter L Hughes, and Bakul M Soni, and Gurpreet Singh
January 1958, Obstetricia y ginecologia latino-americanas,
Subramanian Vaidyanathan, and Peter L Hughes, and Bakul M Soni, and Gurpreet Singh
June 1999, Techniques in urology,
Subramanian Vaidyanathan, and Peter L Hughes, and Bakul M Soni, and Gurpreet Singh
February 2018, Urology,
Subramanian Vaidyanathan, and Peter L Hughes, and Bakul M Soni, and Gurpreet Singh
June 2018, BMJ case reports,
Subramanian Vaidyanathan, and Peter L Hughes, and Bakul M Soni, and Gurpreet Singh
May 2000, International journal of urology : official journal of the Japanese Urological Association,
Subramanian Vaidyanathan, and Peter L Hughes, and Bakul M Soni, and Gurpreet Singh
March 2020, IJU case reports,
Copied contents to your clipboard!