• Childhood Kidney Diseases
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• 제15권1호
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• pp.86-89
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• 2011

처녀막 폐쇄증은 0.1%의 빈도를 가지는 드문 여성질환으로 초경이 시작된 후 처녀막 폐쇄로 생리혈이 저류되면서 하복부 통증, 변비, 1차성 무월경, 드물게 배뇨곤란, 무뇨증의 증상을 보인다. 일반적으로 요 체류(urinary retention) 증상은 대개 정신적 원인, 약물에 의한 원인, 감염이나 선천성 기형 등에 의한 급성 요 폐색이 주된 원인이며 본 증례와 같이 처녀막 폐쇄로 요 폐색이 생기는 경우는 드물다. 저자들은 급성 요 체류 증상으로 내원하여 당시 급성 요폐색이 의심되었으나 처녀막 폐쇄증으로 진단되었던 증례를 경험하였다. 자세한 병력 청취 및 외부 성기의 진찰이 오진과 치료의 지연을 막을 수 있다는 것을 다시 확인할 수 있었다.

• 한국임상수의학회지
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• 제38권2호
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• pp.63-68
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• 2021

Urethral obstruction is a life-threatening feline lower urinary tract disease (FLUTD). The rate of recurring urethral obstruction was 14.8-58.1% after the first occurrence. Ultrasonographic findings associated with reobstruction had been rarely reported although ultrasonography was a valuable technique for diagnosing urinary bladder calculi and distinguishing different FLUTD causes. This retrospective study aims to describe the ultrasonographic findings, urinalysis, and serum chemistry profile in cats with FLUTD and determine the associations of reobstruction with ultrasonographic findings, urinalysis, and serum chemistry profile. The present study included 141 cats that were followed up for more than 1 year. The ultrasonographic criteria included the presence of cystolithiasis, urine echogenicity, sediment, suspended linear strand, pericystic effusion, hyperechoic pericystic fat, ureteral dilation, pyelectasia, and perirenal effusion. The urinalysis criteria included hematuria, urine-specific gravity, pH, sediment, and proteinuria. The most common ultrasonographic findings in cats with FLUTD were echogenic urine and sediment. However, this study did not find an association between reobstruction and ultrasonographic findings, urinalysis, and serum chemistry profiles. Thus, an ultrasonographic examination may be insufficient to predict the risk of reobstruction although it is a useful modality for diagnosing FLUTD and making treatment direction.

• Childhood Kidney Diseases
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• 제23권2호
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• pp.116-120
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• 2019

Bilateral renal obstruction is a rare critical condition, requiring a prompt diagnostic approach and treatment to restore the renal function. The most commonly observed obstructive uropathy in children is congenital malformation, such as posterior urethral valves and bilateral ureteropelvic junction obstruction. Malignant pelvic masses obstructing the ureter are widely reported in adults but are rarely observed in children. The treatment of ureteral obstruction related to pelvic malignancy is a therapeutic challenge with a median survival duration of 3-7 months in adults; however, pediatric patients with pelvic malignancy leading to ureteral obstruction had better outcomes, with a reported 5-year mortality rate of 20%, than the adult patients. Here, we report a rare case of bilateral ureteral obstruction associated with pelvic rhabdomyosarcoma presenting with acute kidney injury treated by ureteral diversion with double J stent, and concommittent emergency hemodialysis, leading to restoration of good renal function. We suggest that bilateral ureteral obstruction should be released as soon as possible using surgical or interventional approach to minimize the obstruction period, and subsequential chemotherapy may contribute to improvement of survival and recovery of renal function.

• Childhood Kidney Diseases
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• 제28권2호
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• pp.59-65
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• 2024

Hydronephrosis, characterized by dilation of the renal pelvis and calyces due to urine flow obstruction, poses a significant clinical challenge. Although often asymptomatic and capable of spontaneous resolution, surgical intervention is necessary for specific scenarios such as febrile urinary tract infections, deteriorating hydronephrosis, or declining renal function. The efficacy of continuous antibiotic prophylaxis in preventing urinary tract infections remains controversial. Yet, it may benefit high-risk patients, emphasizing the importance of individualized patient selection, as surgical treatment methods for patients with hydronephrosis have become less invasive than in previous decades. However, long-term follow-up outcomes are lacking, necessitating further clarification. This review presents an overview of the etiology, natural progression, and modern management of hydronephrosis, encompassing advancements in minimally invasive procedures.

• 대한핵의학회지
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• 제36권5호
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• pp.306-313
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• 2002

목적: 신우 확장이 심하지 않은 상부 요로 폐쇄 환자는 신우의 순응도가 낮아 이뇨신장스캔에서 위음성으로 나올 수 있다. 실질통과지연이 이뇨신장스캔 위음성을 감별해 내는 유용한 소견이 될 가능성이 있다. 저자들은 일측성 요로폐쇄가 의심되는 성인 환자들을 대상으로 Tc-99m MAG3 신장스캔을 실시하였을 때 이뇨신장스캔과 실질통과지연의 폐쇄진단 능력을 비교해 보았다. 대상 및 방법: 일측성 요로폐쇄가 의심되어 Tc-99m MAG3 이뇨신장스캔을 실시한 54명(남:여=30:24, 나이 $40.7{\pm}15.5$세)이 대상 환자군이었다. 이뇨신장스캔의 폐쇄 양성에 대한 진단기준은 $T_{1/2}>15$분 이었고, 반대측 정상신장에 비해 신우에 방사능이 늦게 나타나고 실질에 방사능 저류가 현저할 때 실질통과지연이 있다고 하였다. 수신증의 정도는 $1{\sim}2$분 배설기 영상에서 수신증이 있는 신장대 반대편 신장의 면적 비로 구하였다. 폐쇄의 최종 진단은 중재시술 후에 수신증이 호전된 때 혹은 중재시술을 하지 않은 경우는 수신증이 악화될 때였다. 폐쇄 없음으로 정의한 경우는 6개월이상 추적하였을 때 수신증이 변화 없을 때였다. 결과: 26예는 폐쇄가 있었고 28예는 폐쇄가 없었다. 이뇨신장스캔과 실질통과지연의 민감도는 각각 69% (18/26) 와 50% (13/26)이었고 이뇨신장스캔으로 위음성을 보였던 2예의 폐쇄를 실질통과지연으로 더 찾을 수 있었으며 이들은 신장 면적 비가 1.1미만이었다. 이뇨신장스캔 혹은 실질통과지연으로 폐쇄를 진단할 수 있었던 20예 중 실질통과지연이 있었던 13예는 실질통과지연이 없었던 7예보다 신장 면적 비가 유의하게 작았으나($0.97{\pm}0.20\;vs\;1.30{\pm}0.41,\;p<0.05$) 상대신기능은 차이가 없었다. 특이도는 실질통과지연이 100% (28/28)이고 이뇨신장스캔은 89% (25/28)이었다. 결론: Tc-99m MAG3 스캔에서 실질통과지연은 신우 확장 정도가 심하지 않은 요로폐쇄에서 이뇨신장스캔이 위음성인 경우의 요로폐쇄 진단에 도움이 될 수 있다.

• 대한핵의학회지
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• 제37권3호
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• pp.202-205
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• 2003

A 10 days old male infant with congenital megacalyces and megaureter, diagnosed by prenatal ultrasonographic screening, underwent Tc-99m DTPA renal scan for evaluation of urinary tract patency, Tc-99m DMSA scan for evaluation of renal cortical damage. He also underwent intravenous urography(IVU) and renal ultrasonography. Tc-99m DTPA renal scan demonstrates intense tracer accumulation in enlarged both renal pelvocalyses and ureters, which rapidly washout without diuretics administration. Tc-99m DMSA renal cortical scan shows no remarkable photon defect in both renal cortices and visible tracer uptake in both megaureter areas. Ultasonographic and IVU studios show enlarged both renal calyses and bullously dilated ureters, but no dilatation in renal pelvis. Follow up Tc-99m DTPA renal scan, peformed at one year later, also reveals intense tracer accumulation in enlarged both urinary tracts which rapidly washout without diuretics, and shows no significant change compare to the previous Tc-99m DTPA renal scan. Urinary tract obstruction and renal cortical damage can be easily evaluated with Tc-99m DTPA and Tc-99m DMSA scans in patiens with megacalyces and megaureter.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제16권3호
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• pp.200-205
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• 2013

We present a case of a 47-month-old female suffering from acute urinary bladder neck obstruction and bilateral hydronephrosis secondary to a fecaloma. Fecaloma is defined as an accumulation of inspissated feces in the colon or rectum giving the appearance of an abdominal mass. A fecaloma can be developed by diverse causes and the causes of the fecaloma in this case were septum reformation after the Duhamel procedure and long-term constipation. Chronic constipation is very common at outpatient clinic. However, acute urinary retention and voiding difficulty caused by fecaloma in the giant Duhamel pouch has never been reported in Korea. We would like to present our case with acute urinary retention due to a fecaloma and suggest that fecaloma might be considered as one of the causes for acute urinary retention, especially in cases with previous Duhamel operation for repair of Hischsprung disease.

• Journal of Yeungnam Medical Science
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• 제16권2호
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• pp.376-379
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• 1999

저자들은 전자궁적축술과 요실금 수술후 요도폐색이 발생한 43세의 여자 환자에서 장기간의 간헐적 자가도뇨법과 약물요법으로 치료되지 않아, 외요도구 상방을 통한 요도 박리술을 시행하여 좋은 결과를 볼 수 있었다. 저자들의 견해로는 과거에 부인과 수술과 동반해서 시행하거나 혹은 복측으로 치골후방으로 접근하여 시행한 요실금수술이나 요도하부 슬링수술등의 방법으로 인해 요도 폐색이 발생시 외요도구 상방을 통한 요도박리술이 바람직할 것으로 사료된다.

• 한국임상수의학회:학술대회논문집
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• 한국임상수의학회 2009년도 춘계학술대회
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• pp.266-266
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• 2009

• 센서학회지
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• 제16권3호
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• pp.202-210
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• 2007

The aim of this study is to acquire useful information of lower urinary tract symptom (LUTS) diagnosis through urophonography signal as a noninvasive method. The hardware and software which could evaluate the function of compensatory hypertrophy with noninvasive and comfortable method was implemented to measure uroflow and urophonography signal during urination. The PSD (power spectrum density) and the log-log plot gradient analysis were accomplished in frequency domain. For evaluation of the system and analysis method, a model system for the lower urinary system of men was used. From the evaluation of the model system, the PDS and the log-log plot gradient were dependent on the occlusion degree significantly. In a pilot study on normal and abnormal male subjects, the PSD and the log-log plot gradient were highly correlated with the artificial urethral obstruction.