Submited on: 12 Nov 2010 01:48:58 PM GMT
Published on: 13 Nov 2010 05:44:10 PM GMT
 

1 Is the subject of the article within the scope of the subject category? Partly
2 Are the interpretations / conclusions sound and justified by the data? Partly
3 Is this a new and original contribution? No
4 Does this paper exemplify an awareness of other research on the topic? No
5 Are structure and length satisfactory? Yes
6 Can you suggest brief additions or amendments or an introductory statement that will increase the value of this paper for an international audience? Yes
7 Can you suggest any reductions in the paper, or deletions of parts? Yes
8 Is the quality of the diction satisfactory? Yes
9 Are the illustrations and tables necessary and acceptable? No
10 Are the references adequate and are they all necessary? Yes
11 Are the keywords and abstract or summary informative? No
  • Other Comments:

    The article introduce a case of vaginal ectopic ureter with duplicated pyeloureter which cause urinary incontinence in a girl. The article is valuable for warnning the clinicians to notice this rare congenital malfomation in female patients with urinary incontinence. However, in my point of view, the author need to  illustrate seveal important point in detail and clearly before considering if could be accepted. 1) if the girl had coexisting genital malformations, this is very esstial because urinary and genital systems had very close relationship in embryologic development and the malformtions is commonly seen in both. Clarifying the status of genital organs is very essential for this 12-year-old girl, not only for completing diagnosis, but planning a good and considerable surgical protocal, eg. if the concurrent correction of treatment for genital organ malformation should be done. 2) Author emphasize the merit of using MRU in diagnosing urinary tract anomalies, even better than "golden standard" method, IVP. About which point, author need to provide convincible  evidence to readers, eg. high-quality illustrations of MRU, introducing the strongpoints of this method in evaluating pelvic structures, et al.

  • Competing interests:
    No
  • Invited by the author to review this article? :
    Yes
  • Have you previously published on this or a similar topic?:
    Yes
  • References:
    Wang S, Lang JH, Zhu L. Mayer-Rokitansky-K?ester-Hauser (MRKH) syndrome with rectovestibular fistula and imperforate anus. Eur J Obstet Gynecol Reprod Biol. 2010, 153(1):77-80. Wang S, Lang JH, Cheng XM. Cytologic regression in women with atypical squamous cells of unknown significance and negative human papillomavirus test. Am J Obstet Gynecol 2009, 201(6): 569-570.
  • Experience and credentials in the specific area of science:

    adolescence gynecology, general gynecology, gynecologic oncology

  • How to cite:  S W .Review of Unusual Pattern of Pyeloureteral Duplication associated with Vaginal Ectopic Ureter In a 12-year Old Girl Identified By Magnetic Resonance Urography[Review of the article 'Unusual Pattern Of Pyeloureteral Duplication Associated With Vaginal Ectopic Ureter In A 12-year Old Girl Identified By Magnetic Resonance Urography: A Case Report ' by Scafuri A].WebmedCentral 2011;2(3):WMCRW00565
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1 Is the subject of the article within the scope of the subject category? Partly
2 Are the interpretations / conclusions sound and justified by the data? Partly
3 Is this a new and original contribution? No
4 Does this paper exemplify an awareness of other research on the topic? No
5 Are structure and length satisfactory? Yes
6 Can you suggest brief additions or amendments or an introductory statement that will increase the value of this paper for an international audience? No
7 Can you suggest any reductions in the paper, or deletions of parts? No
8 Is the quality of the diction satisfactory? Yes
9 Are the illustrations and tables necessary and acceptable? Yes
10 Are the references adequate and are they all necessary? Yes
11 Are the keywords and abstract or summary informative? Yes
  • Other Comments:

    No

  • Competing interests:
    No
  • Invited by the author to review this article? :
    No
  • Have you previously published on this or a similar topic?:
    Yes
  • References:
    Urology. 2010 Jul;76(1):55-6. Epub 2009 Nov 22. An atrophic crossed fused kidney with an ectopic vaginal ureter causing urine incontinence. Lin VC, Weng HC, Kian-Lim E, Lin IC, Yu TJ. Department of Urology, E-Da Hospital, Kaohsiung, Taiwan, Republic of China. victorlin0098@gmail.com
  • Experience and credentials in the specific area of science:

    Laparoscopic Surgery, Oncology, Voiding Dysfunction, Molecular biology

  • How to cite:  Lin V .Unusual Pattern Of Pyeloureteral Duplication Associated With Vaginal Ectopic Ureter In A 12-year Old Girl Identified By Magnetic Resonance Urography: A Case Report[Review of the article 'Unusual Pattern Of Pyeloureteral Duplication Associated With Vaginal Ectopic Ureter In A 12-year Old Girl Identified By Magnetic Resonance Urography: A Case Report ' by Scafuri A].WebmedCentral 2011;2(2):WMCRW00524
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MRU and ectopic ureters
Posted by Dr. milind joshi on 05 Feb 2011 02:23:49 PM GMT

1 Is the subject of the article within the scope of the subject category? Yes
2 Are the interpretations / conclusions sound and justified by the data? Partly
3 Is this a new and original contribution? No
4 Does this paper exemplify an awareness of other research on the topic? Yes
5 Are structure and length satisfactory? No
6 Can you suggest brief additions or amendments or an introductory statement that will increase the value of this paper for an international audience? Yes
7 Can you suggest any reductions in the paper, or deletions of parts? No
8 Is the quality of the diction satisfactory? No
9 Are the illustrations and tables necessary and acceptable? No
10 Are the references adequate and are they all necessary? Yes
11 Are the keywords and abstract or summary informative? Yes
  • Other Comments:

    This topic is very important as it is one of the surgically correctable cause of incontinence. The most important part in the history of the patient was incontinence in spite having normal voiding in a female child which was missed initially. The child should have been investigated completely at the first instance in stead of waiting for few years as mentioned in the article. This presentation is very classical for female child only where the ectopic ureter opens distal to the sphincter. In a male child, the presentation may be of urinary retension or hydroureter with hydronephrosis as the ectopic ureter always opens proximal to the somatic sphincter and hence there is no incontinence.

    In the article, the statement that Intravenous urography (IVU) is the investigation of choice for the diagnosis of ectopic system is not a correct statement. In fact, most of the ectopic ureters have some amount of renal dysplasia in the associated renal moiety depending upon the position of the ectopic ureter. Functional status of the moiety is the principle behind the use of the IVU as the investigative modality. Obviously, when the moiety is dysfunctional there is no use of the IVU. The criteria for diagnosis of ectopic system on IVU are corroborative and not objective. Hence, MRU becomes the natural investigation of choice because it does not depend upon the functional status of the renal moiety for diagnosis.

    Although, the renal moiety is dysplastic in nature, by virtue of the blood supply, albeit less, some amount of ultrafiltrate is present which gives rise to the symptom of incontinence in these patients.

    In the patient described in the article, IVU is showing duplex system on the right side which should have given strong suspicion for presence of duplex system on the opposite side. Also, left side lower moiety is showing more calyces than the opposite side which also is a suggestion of duplex system which is not discussed in the article.

    The MRU picture is suggestive of small dysplastic renal moiety and it is supported by the picture of ascending pyelography.

    By analyzing the available MRU picture, the option of heminephroureterectomy of the upper renal moiety could also be contemplated as a therapeutic option in stead of ureteroureterostomy.

    Better MRU images should have been provided by using the 3 D reconstruction technique.                   

     

  • Competing interests:
    none
  • Invited by the author to review this article? :
    No
  • Have you previously published on this or a similar topic?:
    Yes
  • References:
    journal of pediatric surgery 2009 sept. issue indian journal of urology 2008 issue indian journal of urology 2010 jan issue.
  • Experience and credentials in the specific area of science:

    we have published  three articles as original paper on the related topic in the internation journals and the fourth one is in the review process. We have the largest case series of ectopic ureter which were managed by laparoscopic nephroureterectomy successfully and is published already. 

  • How to cite:  joshi m .MRU and ectopic ureters[Review of the article 'Unusual Pattern Of Pyeloureteral Duplication Associated With Vaginal Ectopic Ureter In A 12-year Old Girl Identified By Magnetic Resonance Urography: A Case Report ' by Scafuri A].WebmedCentral 2011;2(2):WMCRW00438
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1 Is the subject of the article within the scope of the subject category? Yes
2 Are the interpretations / conclusions sound and justified by the data? Yes
3 Is this a new and original contribution? Yes
4 Does this paper exemplify an awareness of other research on the topic? Yes
5 Are structure and length satisfactory? Yes
6 Can you suggest brief additions or amendments or an introductory statement that will increase the value of this paper for an international audience? No
7 Can you suggest any reductions in the paper, or deletions of parts? No
8 Is the quality of the diction satisfactory? Yes
9 Are the illustrations and tables necessary and acceptable? Yes
10 Are the references adequate and are they all necessary? Yes
11 Are the keywords and abstract or summary informative? Yes
  • Other Comments:

    The authors have reported a very interested case with atypical manifestations that on its own is worthy of discussion, however I would like to suggest authors to provide better quality images.

  • Competing interests:
    No
  • Invited by the author to review this article? :
    No
  • Have you previously published on this or a similar topic?:
    No
  • References:
    None
  • Experience and credentials in the specific area of science:

    practice as a general urologist

  • How to cite:  Rasputin V .review of Unusual Pattern Of Pyeloureteral Duplication Associated With Vaginal Ectopic Ureter In A 12-year Old Girl Identified By Magnetic Resonance Urography: A Case Report [Review of the article 'Unusual Pattern Of Pyeloureteral Duplication Associated With Vaginal Ectopic Ureter In A 12-year Old Girl Identified By Magnetic Resonance Urography: A Case Report ' by Scafuri A].WebmedCentral 2011;2(1):WMCRW00370
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