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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-Guillotine technique.
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f03: Intraoperative photo-Guillotine technique.

Mentions: Case 2: A 35 year old male underwent left pyeloplasty for left pelviuretric junction obstruction. After DJ removal, at 6 weeks he developed pyonephrosis and perinephric abscess for which percutaneous nephrostomy and drainage of abscess was done. At that time, on evaluation by nephrostogram, DTPA renal scan and retrograde pyelography, he was found to have functioning and obstructed renal unit. On nephrostomogram he had complete obstruction distal to pelviuretric junction. He was submitted to left ureterocalycostomy with DJ and PCN elsewhere. DJ stent was removed subsequently. Patient presented to us 9 months ago with features of pyonephrosis on left side for which he underwent left PCN insertion. Subsequently he was re-evaluated by nephrostomogram, computerised tomogram, intravenous pyelography (CT-IVP), DTPA scan and found to have normal functioning obstructed left renal unit without drainage beyond ureterocalycostomy site. RGP and DJ stenting were tried but failed due to inability to pass the guide wire beyond anastomotic site, suggestive of anastomotic stricture. We performed a redo-ureterocalycostomy by guillotine technique (Figure-3) with DJ stenting. Intraoperatively we found gross perianastomotic site fibrosis and anastomotic site stricture. Contour of lower pole of kidney was maintained suggestive of previous anastomosis by incision/coring technique.


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-Guillotine technique.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

f03: Intraoperative photo-Guillotine technique.
Mentions: Case 2: A 35 year old male underwent left pyeloplasty for left pelviuretric junction obstruction. After DJ removal, at 6 weeks he developed pyonephrosis and perinephric abscess for which percutaneous nephrostomy and drainage of abscess was done. At that time, on evaluation by nephrostogram, DTPA renal scan and retrograde pyelography, he was found to have functioning and obstructed renal unit. On nephrostomogram he had complete obstruction distal to pelviuretric junction. He was submitted to left ureterocalycostomy with DJ and PCN elsewhere. DJ stent was removed subsequently. Patient presented to us 9 months ago with features of pyonephrosis on left side for which he underwent left PCN insertion. Subsequently he was re-evaluated by nephrostomogram, computerised tomogram, intravenous pyelography (CT-IVP), DTPA scan and found to have normal functioning obstructed left renal unit without drainage beyond ureterocalycostomy site. RGP and DJ stenting were tried but failed due to inability to pass the guide wire beyond anastomotic site, suggestive of anastomotic stricture. We performed a redo-ureterocalycostomy by guillotine technique (Figure-3) with DJ stenting. Intraoperatively we found gross perianastomotic site fibrosis and anastomotic site stricture. Contour of lower pole of kidney was maintained suggestive of previous anastomosis by incision/coring technique.

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