1/12. Extracorporeal shock wave lithotripsy as monotherapy for staghorn calculi--is reduced renal function a relative contraindication?Extracorporeal shock wave lithotripsy as monotherapy for staghorn calculus is not without complications. We describe a case in which, due to markedly reduced renal function following lithotripsy for a staghorn calculus, broken fragments of calculi forming steinstrasse became cemented together to form a solid calcified tube extending from the renal pelvis to the ureteric orifice. This resulted in further loss of kidney function. The patient eventually required nephro-ureterectomy. Extreme care should be taken when using extracorporeal shock wave lithotripsy to treat staghorn calculi in kidneys with markedly diminished function to prevent further loss of function due to treatment.- - - - - - - - - - ranking = 1keywords = calculus (Clic here for more details about this article) |
2/12. Double infundibular obliteration with abscess formation after percutaneous nephrolithotomy.A case of an unusual complication after percutaneous nephrolithotomy. After removal of an infectious staghorn calculus followed by SWL, the patient developed a double infundibular stricture leaving the kidney divided into three separate compartments. In spite of the absence of clinical symptoms of infection, this was further complicated by abscess formation and finally, function loss of the upper part of the kidney. Combined retro- and anterograde endoscopic surgery failed to re-establish the complete continuity of the uretero-caliceal system and the patient had to undergo partial nephrectomy. Possible etiologies, contributing factors and means of prevention for this rare complication are discussed.- - - - - - - - - - ranking = 0.5keywords = calculus (Clic here for more details about this article) |
3/12. Beware! Fungal urosepsis may follow endoscopic intervention for prolonged indwelling ureteral stent.We present a 38-year-old lady with a prolonged indwelling ureteral stent that had been placed for pain relief after development of Steinstrasse following extracorporeal lithotripsy for a 2.5-cm left renal calculus. The patient developed candidal urosepsis within 6 hours after ureteroscopy and percutaneous nephrolithotomy (PCNL) for the removal of residual fragments. She subsequently recovered on systemic antifungal therapy in the form of intravenous amphotericin B and achieved complete stone clearance after repeat ureteroscopy and PCNL. Fungal urosepsis is known to complicate the postoperative course in chronically debilitated patients with poor nutritional status or those with diabetes or other significant comorbities. To our knowledge, this is the first reported case of a patient with no significant comorbities developing fungal urosepsis after endoscopic intervention for a long-term indwelling ureteral stent.- - - - - - - - - - ranking = 0.5keywords = calculus (Clic here for more details about this article) |
4/12. Ureteral involvement in stage I xanthogranulomatous pyelonephritis--(a case report).A case of xanthogranulomatous pyelonephritis (Stage-I: Nephric) with ureteral involvement is described. The patient had undergone right nephrectomy with the working diagnosis of calculus pyonephrosis and non-functioning kidney. Histopathological examination of the nephrectomy specimen revealed xanthogranulomatous pyelonephritis confined to the kidney and non-contiguous involvement of ureter. Post-operative recovery was uneventful and there had been no evidence of disease recurrence till one year's follow-up.- - - - - - - - - - ranking = 0.5keywords = calculus (Clic here for more details about this article) |
5/12. Migration of a ureteric calculus to the bladder via a ureterocolic and a vesicocolic fistula.Following a difficult nephrectomy for pyonephrosis, two large calculi in the left pelvic ureter were not removed. The upper of these two calculi finally found its way into the bladder after ulcerating into the sigmoid colon and thence into the bladder. The calculi and the residual ureter were removed and the fistulae closed, with a successful outcome.- - - - - - - - - - ranking = 2keywords = calculus (Clic here for more details about this article) |
6/12. Spontaneous perforation of the ureter diagnosed on technetium 99m DTPA excretory urography.A case of nontraumatic rupture of the ureter secondary to a nonopaque calculus is presented. Because of the inherent high image contrast caused by the leak of technetium 99m-DTPA-labeled urine, the technetium 99m-DTPA excretory urogram is seen as an alternative to the intravenous urogram or contrast-enhanced computed tomography in selected cases of suspected ureteral rupture.- - - - - - - - - - ranking = 0.5keywords = calculus (Clic here for more details about this article) |
7/12. Flexible ureteropyeloscopy: diagnosis and treatment in the upper urinary tract.Flexible ureteropyeloscopy was performed on 59 patients with 2.7, 3.2 or 3.6 mm. endoscopes with a deflectable tip. Techniques for use of these flexible endoscopes are discussed in detail. The endoscope could be passed into the ureter in 58 patients and into the kidney in 52 (88 per cent). The entire collecting system was visualized in 23 of the most recent 29 patients (79 per cent). A diagnosis was achieved in all 23 patients with an intrarenal filling defect demonstrated radiographically. The source of gross hematuria alone could be defined in 9 of 17 patients. Surveillance for tumor was achieved in 5 of 5 patients and for residual calculus in 4 of 4. The endoscope was used to establish continuity successfully in 3 patients with an obstructed ureteropelvic junction. An instrument with a deflectable tip and some technique for irrigation are essential for intrarenal inspection and complete visualization of the ureter. This procedure is valuable in selected patients and it rapidly may become the technique of choice for the diagnosis of intrarenal filling defects. It also is of value in patients with benign, essential hematuria.- - - - - - - - - - ranking = 0.5keywords = calculus (Clic here for more details about this article) |
8/12. Spontaneous rupture of ureter.A patient with spontaneous ureteral rupture in the absence of obstruction or calculus disease is presented. In addition to ureteral rupture this patient also had a penile squamous cell carcinoma and infected inguinal lymph nodes. A review of the literature discloses that all reported cases with spontaneous rupture of the ureter had an underlying process leading to that rupture. It is considered, therefore, that rupture of the ureter should be designated as "traumatic" or "nontraumatic." The term "spontaneous," implying a primary event, is a misnomer. No such case has been reported occurring in an otherwise healthy individual.- - - - - - - - - - ranking = 0.5keywords = calculus (Clic here for more details about this article) |
9/12. Two cases of spontaneous ureteral rupture secondary to outlet obstruction.Two patients with outlet obstruction and spontaneous extravasation of contrast material from their ureters during an intravenous urogram (IVU) are reported. Both cases are unusual in that spontaneous ureteral extravasation is rare and usually occurs with calculus disease. These patients had no evidence of calculi; therefore, the increased intraluminal pressure alone appears to have caused ureteral rupture.- - - - - - - - - - ranking = 0.5keywords = calculus (Clic here for more details about this article) |
10/12. Ureterovaginal fistula: an unusual complication of stone fragments after extracorporeal shock wave lithotripsy in situ.We report a case of impaction of stone fragments in the lower ureter after extracorporeal shock wave lithotripsy in situ of an upper ureteral calculus resulted in a ureterovaginal fistula. Ureteroscopic retrieval of fragments and stenting provided symptomatic relief. The pathogenesis of this complication, which to our knowledge has not been reported previously, is discussed.- - - - - - - - - - ranking = 0.5keywords = calculus (Clic here for more details about this article) |
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