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Ureterocalycostomy - final resort in the management of secondary pelvi-ureteric junction obstruction: our experience.

Gite VA, Siddiqui AK, Bote SM, Patil SR, Kandi AJ, Nikose JV - Int Braz J Urol (2016 May-Jun)

Bottom Line: In our study, one child and two adults in whom one redo-ureterocalycostomy and two ureterocalycostomies were performed for severely scarred PUJ.The causes for secondary PUJ obstruction were post-pyelolithotomy in one case, post-pyeloplasty and ureterocalycostomy for PUJ obstruction in the second patient and the third patient had long upper ureteric stricture post-ureteropyeloplasty due to tuberculosis.In all these cases ureterocalycostomy proved to be salvage/final resort for preserving functional renal unit.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, Grant Govt. Medical College & Sir J.J. Group of Hospitals, Mumbai -Mumbai, India.

ABSTRACT
Ureterocalycostomy can be performed in patients in whom desired methods of treating secondary PUJ (Pelvi-Ureteric Junction) obstructions either failed or could not be used. In our study, one child and two adults in whom one redo-ureterocalycostomy and two ureterocalycostomies were performed for severely scarred PUJ. The causes for secondary PUJ obstruction were post-pyelolithotomy in one case, post-pyeloplasty and ureterocalycostomy for PUJ obstruction in the second patient and the third patient had long upper ureteric stricture post-ureteropyeloplasty due to tuberculosis. In all these cases ureterocalycostomy proved to be salvage/final resort for preserving functional renal unit.

No MeSH data available.


Related in: MedlinePlus

Intraoperative photo–completion of procedure.
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f02: Intraoperative photo–completion of procedure.

Mentions: Case 1: A 5 year-old male child had 1.5cm PUJ calculus with total intrarenal pelvis. He underwent pyelolithotomy in general surgery unit. During the procedure, he had PUJ disruption which was sutured over double J (DJ) stent. Post operative course was uneventful. DJ stent was removed after 6 weeks. Patient developed pain and fever after stent removal. He had progressive hydronephrosis on serial ultrasound (USG) scans. Retrograde Pyelography (RGP) with DJ stenting was tried but guide wire could not be passed beyond PUJ. Then the patient was submitted to ureterorenoscopy (URS) and complete blockage beyond the level of upper ureter was detected. Percutaneous nephrostomy tube (PCN) was placed as drainage procedure and nephrostogram (Figure-1) was done after 2 weeks, which confirmed complete PUJ blockage. Due to the presence of intrarenal pelvis and gross periureteric fibrosis we decided to perform ureterocalycostomy (Figure-2) as first choice which was performed after 6 months from primary procedure.


Ureterocalycostomy - final resort in the management of secondary pelvi-ureteric junction obstruction: our experience.

Gite VA, Siddiqui AK, Bote SM, Patil SR, Kandi AJ, Nikose JV - Int Braz J Urol (2016 May-Jun)

Intraoperative photo–completion of procedure.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4920567&req=5

f02: Intraoperative photo–completion of procedure.
Mentions: Case 1: A 5 year-old male child had 1.5cm PUJ calculus with total intrarenal pelvis. He underwent pyelolithotomy in general surgery unit. During the procedure, he had PUJ disruption which was sutured over double J (DJ) stent. Post operative course was uneventful. DJ stent was removed after 6 weeks. Patient developed pain and fever after stent removal. He had progressive hydronephrosis on serial ultrasound (USG) scans. Retrograde Pyelography (RGP) with DJ stenting was tried but guide wire could not be passed beyond PUJ. Then the patient was submitted to ureterorenoscopy (URS) and complete blockage beyond the level of upper ureter was detected. Percutaneous nephrostomy tube (PCN) was placed as drainage procedure and nephrostogram (Figure-1) was done after 2 weeks, which confirmed complete PUJ blockage. Due to the presence of intrarenal pelvis and gross periureteric fibrosis we decided to perform ureterocalycostomy (Figure-2) as first choice which was performed after 6 months from primary procedure.

Bottom Line: In our study, one child and two adults in whom one redo-ureterocalycostomy and two ureterocalycostomies were performed for severely scarred PUJ.The causes for secondary PUJ obstruction were post-pyelolithotomy in one case, post-pyeloplasty and ureterocalycostomy for PUJ obstruction in the second patient and the third patient had long upper ureteric stricture post-ureteropyeloplasty due to tuberculosis.In all these cases ureterocalycostomy proved to be salvage/final resort for preserving functional renal unit.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, Grant Govt. Medical College & Sir J.J. Group of Hospitals, Mumbai -Mumbai, India.

ABSTRACT
Ureterocalycostomy can be performed in patients in whom desired methods of treating secondary PUJ (Pelvi-Ureteric Junction) obstructions either failed or could not be used. In our study, one child and two adults in whom one redo-ureterocalycostomy and two ureterocalycostomies were performed for severely scarred PUJ. The causes for secondary PUJ obstruction were post-pyelolithotomy in one case, post-pyeloplasty and ureterocalycostomy for PUJ obstruction in the second patient and the third patient had long upper ureteric stricture post-ureteropyeloplasty due to tuberculosis. In all these cases ureterocalycostomy proved to be salvage/final resort for preserving functional renal unit.

No MeSH data available.


Related in: MedlinePlus