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[Endoscopic ureteroureterostomy for a complete obstructed ureter: a case report]
G Kawabata1, T Haraguchi, Y Okamoto
1Department of Urology, Sanda City Hospital.
Nihon Hinyokika Gakkai Zasshi. the Japanese Journal of Urology
|February 5, 2000
Summary
This case study demonstrates successful endourological treatment for a completely obstructed ureter. A combination of ureteroscopy and KTP-laser incision resolved left hydronephrosis, with no recurrence at two years.
Area of Science:
- Urology
- Endourology
- Surgical Case Report
Background:
- A 66-year-old male developed panperitonitis due to sigmoid colon diverticulitis perforation.
- Post-operatively, the patient experienced stool and urine leakage, along with left hydronephrosis.
- Radiographic findings revealed a 1 cm defect in the lower left ureter.
Observation:
- Initial endourological attempts included transurethral and percutaneous approaches with rigid and flexible ureteroscopes.
- Antegrade puncture and biopsy forceps debridement were performed to address the ureteral obstruction.
- A double-J stent was placed after the initial procedure.
Findings:
- Subsequent procedures involved ureteroresectoscopy and a failed cold-knife incision.
- A successful full-thickness ureteral incision was achieved using KTP-laser via ureteroscopy.
- An endopyelotomy stent was placed, and subsequent imaging confirmed resolution of hydronephrosis.
Implications:
- This case highlights the efficacy of a multi-stage endourological approach for managing complex ureteral defects.
- KTP-laser endopyelotomy offers a viable treatment option for ureteral strictures.
- Successful management led to sustained improvement and no recurrence at two-year follow-up.