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Ureteral stricture developing after partial nephrectomy with a microwave tissue coagulator: case report.

Toru Harabayashi¹, Nobuo Shinohara, Hidehiro Kakizaki

¹Department of Renal and Genito-Urinary Surgery, Graduate School of Medicine, Hokkaido University, Kita-15, Nishi-7, Kita-ku, Sapporo 060-8638, Japan. harachan@med.hokudai.ac.jp

Journal of Endourology

|January 28, 2004

Summary

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Microwave tissue coagulation during kidney tumor removal can cause ureteropelvic junction strictures. Surgeons should avoid excessive heat near the renal sinus to prevent urinary tract complications.

Area of Science:

Urology
Surgical Oncology

Background:

Partial nephrectomy is a standard procedure for kidney tumors.
Minimally invasive techniques like laparoscopy are increasingly used.
Potential complications, including thermal injury, must be considered.

Observation:

A 32-year-old man developed hydronephrosis 6 months after a partial nephrectomy.
Imaging revealed a severe stricture at the ureteropelvic junction.
The patient underwent laparoscopy-assisted partial nephrectomy for a 1.7-cm left kidney tumor.

Findings:

Postoperative hydronephrosis was attributed to ureteropelvic junction stricture.
Heat injury to the urinary tract was suspected as the cause.
The tumor's proximity to the renal sinus and use of a microwave tissue coagulator were noted.

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Implications:

Excessive microwave tissue coagulation near the renal sinus may lead to ureteropelvic junction strictures.
Careful application of thermal devices is crucial in partial nephrectomy.
Preventing heat-related complications is essential for optimal patient outcomes.