MATERIALS AND METHODS: This study was carried out on 50 human cadavers including dissected specimens (25 males and 25 females) the kidneys, renal pelvis, and ureters along with their arteries were exposed and the anomalous abnormalities of the renal pelvis and ureters existing with accessory renal arteries were observed. Photographs of the anomalous and developmental variations were taken for proper documentation.
RESULTS: Among the 50 cadavers studied, unilateral double ureters were found in 5 cadavers (10%), rare bilateral "S-"shaped loop of ureter with quadruple uretic constrictors in the abdominal segment of the ureter was observed in one female cadaver (2%), accessory or aberrant renal arteries were found in 15 cadavers (30%), hydronephrosis involving the renal pelvis and ureters was observed in 9 cadavers (18%). Interestingly, this prevalence was higher among males (28%) compared to females (8%). Moreover, the occurrence of bilateral hydronephrosis of the kidneys, renal pelvis, and ureters was identified in a single male cadaver, representing 2% of the sample. Notably, the prevalence of double ureter, hydronephrosis accompanied by congenital double and triple accessory renal arteries was documented in nine cadavers, accounting for 18% of the cohort.
CONCLUSION: Anatomical and developmental variations of the ureters, renal pelvis, and renal vasculature, as well as their relationships to surrounding structures, hold clinical significance due to their impact on various surgical procedures, including kidney transplantation, abdominal aorta reconstruction, interventional radiology, and urologic operations. Therefore, identifying these potential developmental variations is essential for effective surgical management to preserve renal function and ensure optimal patient outcomes.
METHODS: We enrolled all patients referred for SCI rehabilitation from 2012 to 2015 that fulfilled our study criteria. Data that were retrospectively reviewed included demographic and clinical characteristic data; and US KUB surveillance studies.
RESULTS: Out of 136 electronic medical records reviewed, 110 fulfilled the study criteria. The prevalence of NB in our study population was 80.9%. We found 22(20%) of the patients showed evidence of US diagnosed NB complications with the mean detection of 9.61±7.91 months following initial SCI. The reported NB complications were specific morphological changes in the bladder wall 8(36.4%); followed by unilateral/bilateral hydronephrosis 7(31.8%); bladder and/or renal calculi 5(22.7%); and mixed complication 2(9.1%) respectively. Half of the patients with NB complications had urodynamic diagnosis of neurogenic detrusor overactivity with/without evidence of detrusor sphincter dyssynergia. We found co-existing neurogenic bowel, presence of spasticity and mode of bladder management were significantly associated factors with US diagnosed NB complications (p<0.05), while spasticity was its predictor with adjusted Odds Ratio value of 3.93 (1.14, 13.56).
CONCLUSION: NB is a common secondary medical impairment in our SCI population. A proportion of them had US diagnosed NB complications. Co-existing neurogenic bowel, presence of spasticity and mode of bladder management were its associated factors; while spasticity was its predictor.