Objective To review the prenatal assessment of associated renal pathology, non-renal pathology and renal biometry, fetal outcome and postnatal urological management in the presence of unilateral fetal multicystic dysplastic kidney.Methods A total of 38 singleton pregnancies with fetal unilateral multicystic dysplastic kidney was studied over a 13-year period. Prenatally, fetal biometry, including head and abdominal circumferences and largest longitudinal diameter of the affected and contralateral kidneys, was performed. The amount of amniotic fluid was assessed. Fetal karyotyping was offered in cases of contralateral renal or non-renal pathology. A MAG 3 scan and voiding cystogram was performed approximately 4 weeks after delivery to establish renal function and to exclude urinary reflux.Results Unilateral fetal multicystic dysplastic kidney, was left-sided in 53% and right-sided in 47% of cases. The fetus was male in 63% and female in 37% of cases. Associated renal and non-renal pathology existed in 21% and 5% of cases, respectively. The fetal karyotype in these subsets was always normal. The longitudinal diameter of the multicystic dysplastic kidney was above the 95th centile in 87%. There was polyhydramnios in three cases and oligohydramnios in two cases. The prematurity rate was 16%. Postnatal examination revealed a non-functional multicystic kidney in 87% (33138) of cases. Following surgical removal of the affected kidney, these infants progressed normally. Of the remaining five infants, four died because of associated anomalies and one infant developed normally, without surgery.Conclusions Fetal outcome is determined by associated renal and/or non-renal structural pathology, and not by the size/location of the unilateral multicystic dysplastic kidney or amniotic fluid volume.

Purpose: We explored the applicability of Raman spectroscopy to in situ investigation of bladder wall tissue.Materials and Methods: Bladder wall tissue was obtained from a guinea pig model and frozen sections were used for Raman spectroscopic investigations. From each section 500 to 700 spectra were obtained in a 2-dimensional grid spanning the urothelium, lamina propria and muscle layer. The data set of spectra was subdivided into groups of similar spectra by a cluster analysis algorithm. With each group assigned a different color Raman maps of frozen sections were constructed based on group membership of measured spectra. These maps were then compared with histological and histochemical data obtained from hematoxylin and eosin and immunohistochemical staining for collagen I and III and for smooth muscle actin to correlate Raman spectral features with bladder wall structure and molecular composition.Results: Urothelium, lamina propria and muscle layers could be clearly distinguished based on Raman spectra. Lamina propria spectra were dominated by signal contributions of collagen and the smooth muscle layer showed strong signal contributions of actin. The urothelium had a relatively strong lipid signal contribution.Conclusions: These results and the fact that Raman spectroscopy is rapidly evolving into a technology that can be applied in vivo by thin, flexible fiberoptic catheters indicate that prospects are good for in vivo analysis of the molecular composition of the normal and pathological bladder without biopsies.

It is unknown whether changes in bladder function due to urethral obstruction follow a specific sequence. To answer this, we adapted a small animal model to allow repeated complete pressure‐flow studies, enabling individual follow‐up of changes in bladder function on urethral obstruction. Obstruction was induced in guinea pigs by placing a silver ring around the urethra. Urodynamic studies were repeated under anesthesia with ketamine/xylazine. Bladders were filled and bladder pressure measured through a single suprapubic catheter. Urine flow rate was measured using an ultrasound probe around the penis. Accurate measurements of bladder pressure and urine flow rates were obtained at 1‐week intervals for 11 weeks in individual guinea pigs. In the control animals, the urodynamic parameters did not show significant changes. In the obstructed group, urethral resistance (Plow,ave) increased from 20 to 35 cm H2O after 4 weeks and remained at that level. The maximum flow rate (Qmax) increased from 0.17 to 0.24 mL/s after 2 to 3 weeks. After this peak, it gradually decreased to lower than the starting value after 10 to 11 weeks. The pressure at maximum flow rate (pQmax) increased from 24 to 47 cm H2O after 6 to 7 weeks and thereafter declined. During weeks 1 through 4 of obstruction, unstable contractions were seen. All animals followed a similar sequence of patterns but at variable rates. Our animal model allows complete urodynamic follow‐up of individual animals with urethral obstruction. We observed a specific sequence of changes in urodynamic patterns and parameters of bladder function. Neurourol. Urodynam. 20:699–713, 2001. © 2001 Wiley‐Liss, Inc.

PURPOSE:We established the longitudinal changes in bladder contractility and compliance as a result of urethral obstruction using a guinea pig model.MATERIALS AND METHODS:Obstruction was induced in guinea pigs by a silver ring around the urethra. Urodynamic studies were performed longitudinally in individual animals. Bladder contractility and compliance were calculated from the measured bladder pressure and urine flow rate.RESULTS:Bladder contractility developed in distinct phases. It reached a maximum 200% increase after an average of 3.25 weeks concomitant with an almost 2-fold increase in urethral resistance, remained 150% to 200% increased during weeks 4 to 7 and then decreased to starting levels again, while urethral resistance remained almost 2-fold increased. Bladder compliance decreased by 80% during the first 3 weeks and continued to decrease to 5% of its original value after 10 to 11 weeks.CONCLUSIONS:Our data indicate that as a result of obstruction bladder function passes through a specific sequence of stages, including first a compensatory increase in contractility, then a stabilization phase and finally a decompensation state. In contrast bladder compliance shows a continuous decrease. The data suggest that for assessing how far a bladder has deteriorated due to obstruction a combination of functional and structural data may be warranted.

No AccessJournal of UrologyPEDIATRIC UROLOGY1 Mar 2000VANISHED TESTIS: BE AWARE OF AN ABDOMINAL TESTIS K.P. WOLFFENBUTTEL, D.J. KOK, J.C. DEN HOLLANDER, and J.M. NIJMAN K.P. WOLFFENBUTTELK.P. WOLFFENBUTTEL More articles by this author , D.J. KOKD.J. KOK More articles by this author , J.C. DEN HOLLANDERJ.C. DEN HOLLANDER More articles by this author , and J.M. NIJMANJ.M. NIJMAN More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(05)67862-7AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail "VANISHED TESTIS: BE AWARE OF AN ABDOMINAL TESTIS." The Journal of Urology, 163(3), pp. 957–958 References 1 : Historical review of theories on testicular descent. J Urol1995; 153: 754. Link, Google Scholar 2 : Pathogenesis and treatment of undescended testes. Eur J Pediatr1982; 139: 255. Google Scholar 3 : Laparoscopy for undescended testes: embryological considerations. Br J Urol1995; 76: 806. Google Scholar Departments of Pediatric Urology and Pathology, University Hospital Rotterdam, Rotterdam, The Netherlands© 2000 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byShepard C and Kraft K (2018) The Nonpalpable Testis: A Narrative ReviewJournal of Urology, VOL. 198, NO. 6, (1410-1417), Online publication date: 1-Dec-2017.Snodgrass W, Yucel S and Ziada A (2007) Scrotal Exploration for Unilateral Nonpalpable TestisJournal of Urology, VOL. 178, NO. 4S, (1718-1721), Online publication date: 1-Oct-2007.DE LUNA A, ORTENBERG J and CRAVER R (2018) Exploration for Testicular Remnants: Implications of Residual Seminiferous Tubules and Crossed Testicular EctopiaJournal of Urology, VOL. 169, NO. 4, (1486-1489), Online publication date: 1-Apr-2003. Volume 163Issue 3March 2000Page: 957-958 Advertisement Copyright & Permissions© 2000 by American Urological Association, Inc.Keywordsspermatic cord torsiontestiscryptorchidismlaparoscopyMetricsAuthor Information K.P. WOLFFENBUTTEL More articles by this author D.J. KOK More articles by this author J.C. DEN HOLLANDER More articles by this author J.M. NIJMAN More articles by this author Expand All Advertisement PDF downloadLoading ...

We have developed a method of diuretic renography for the assessment of upper urinary tract obstruction in children. A maximal diuresis under standardised conditions is obtained by forced intravenous hydration over a 2-h period prior to renography.We evaluated the predictive value of this method for the clinical and functional outcome in 73 children with apparent unilateral pelviureteric junction obstruction. The predictive value of a non-obstructive pattern was 94%, while the predictive value of an obstructive pattern could not be assessed accurately because the patients concerned subsequently underwent operation. The method is safe and reliable and offers advantages over conventional diuretic renography.