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Antegrade flexible ureteroscopy for bilateral ureteral stones in a patient with severe hip joint ankylosis.

Kim BS, Lee JN, Choi JY, Park YK, Kim TH - Korean J Urol (2010)

Bottom Line: In the past several decades there has been a remarkable development of small-caliber, flexible ureteroscopes and various ancillary instruments for stone manipulation and retrieval.Percutaneous antegrade ureteroscopy can be substituted in select cases for retrograde ureteroscopy.This case illustrates the role of antegrade flexible ureteroscopy combined with the holmium:YAG laser as a minimally invasive, safe, and effective technique for the management of stones in a patient who cannot undergo a retrograde approach.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, Kyungpook National University School of Medicine, Daegu, Korea.

ABSTRACT
In the past several decades there has been a remarkable development of small-caliber, flexible ureteroscopes and various ancillary instruments for stone manipulation and retrieval. Percutaneous antegrade ureteroscopy can be substituted in select cases for retrograde ureteroscopy. We report a case of a 60-year-old man with severe ankylosis in both hip joints who was diagnosed with bilateral ureteral stones. The patient underwent antegrade flexible ureteroscopy and laser lithotripsy. This case illustrates the role of antegrade flexible ureteroscopy combined with the holmium:YAG laser as a minimally invasive, safe, and effective technique for the management of stones in a patient who cannot undergo a retrograde approach.

No MeSH data available.


Related in: MedlinePlus

Plain abdominal radiograph showing an 18.1 mm stone in the right ureter, an 18.5 mm stone in the left ureter, and ankylosis of the bilateral hip joints (see each stone inside the circles).
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Figure 1: Plain abdominal radiograph showing an 18.1 mm stone in the right ureter, an 18.5 mm stone in the left ureter, and ankylosis of the bilateral hip joints (see each stone inside the circles).

Mentions: A 60-year-old man was referred to the emergency department with a 2-day history of febrile sensation, nausea, and emesis. He also complained of occasional, tolerable, left-lower quadrant abdominal pain in the past three months. He had suffered from bacterial coxitis about 10 years ago and it was aggravated to severe ankylosis in both hip joints that had not been treated. His range of motion was only 20-30 degrees. He had no previous history of urinary tract stones. Plain film radiography showed an 18.1 mm calcification in the right ureteral course, an 18.5 mm calcification in the left ureteral course, and bilateral hip joint ankylosis (Fig. 1). The patient's initial serum creatinine level was 5.1 mg/dl and a nonenhanced computed tomography scan was checked to rule out other causes of obstructive nephropathy. The computed tomography scan revealed both ureteral stones to be in the area of both upper ureters with significant hydronephrosis (Fig. 2). Percutaneous nephrostomy tubes were inserted into the dilated pelvocaliceal system of both kidneys for the immediate relief of the obstructive nephropathy. After this intervention and adequate intravenous antibiotics, the patient's symptoms subsided and his serum creatinine level was normalized.


Antegrade flexible ureteroscopy for bilateral ureteral stones in a patient with severe hip joint ankylosis.

Kim BS, Lee JN, Choi JY, Park YK, Kim TH - Korean J Urol (2010)

Plain abdominal radiograph showing an 18.1 mm stone in the right ureter, an 18.5 mm stone in the left ureter, and ankylosis of the bilateral hip joints (see each stone inside the circles).
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC2991580&req=5

Figure 1: Plain abdominal radiograph showing an 18.1 mm stone in the right ureter, an 18.5 mm stone in the left ureter, and ankylosis of the bilateral hip joints (see each stone inside the circles).
Mentions: A 60-year-old man was referred to the emergency department with a 2-day history of febrile sensation, nausea, and emesis. He also complained of occasional, tolerable, left-lower quadrant abdominal pain in the past three months. He had suffered from bacterial coxitis about 10 years ago and it was aggravated to severe ankylosis in both hip joints that had not been treated. His range of motion was only 20-30 degrees. He had no previous history of urinary tract stones. Plain film radiography showed an 18.1 mm calcification in the right ureteral course, an 18.5 mm calcification in the left ureteral course, and bilateral hip joint ankylosis (Fig. 1). The patient's initial serum creatinine level was 5.1 mg/dl and a nonenhanced computed tomography scan was checked to rule out other causes of obstructive nephropathy. The computed tomography scan revealed both ureteral stones to be in the area of both upper ureters with significant hydronephrosis (Fig. 2). Percutaneous nephrostomy tubes were inserted into the dilated pelvocaliceal system of both kidneys for the immediate relief of the obstructive nephropathy. After this intervention and adequate intravenous antibiotics, the patient's symptoms subsided and his serum creatinine level was normalized.

Bottom Line: In the past several decades there has been a remarkable development of small-caliber, flexible ureteroscopes and various ancillary instruments for stone manipulation and retrieval.Percutaneous antegrade ureteroscopy can be substituted in select cases for retrograde ureteroscopy.This case illustrates the role of antegrade flexible ureteroscopy combined with the holmium:YAG laser as a minimally invasive, safe, and effective technique for the management of stones in a patient who cannot undergo a retrograde approach.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, Kyungpook National University School of Medicine, Daegu, Korea.

ABSTRACT
In the past several decades there has been a remarkable development of small-caliber, flexible ureteroscopes and various ancillary instruments for stone manipulation and retrieval. Percutaneous antegrade ureteroscopy can be substituted in select cases for retrograde ureteroscopy. We report a case of a 60-year-old man with severe ankylosis in both hip joints who was diagnosed with bilateral ureteral stones. The patient underwent antegrade flexible ureteroscopy and laser lithotripsy. This case illustrates the role of antegrade flexible ureteroscopy combined with the holmium:YAG laser as a minimally invasive, safe, and effective technique for the management of stones in a patient who cannot undergo a retrograde approach.

No MeSH data available.


Related in: MedlinePlus