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Ureterolithiasis after Cohen re-implantation--case report
Sonal Chaudhary1, Miranda Lee, Henry O Andrews
1Barts and the London Queen Mary's School of Medicine and Dentistry, London, United Kingdom. sonalch@yahoo.com
BMC Urology
|April 9, 2004
Summary
Transverse ureters from childhood surgery pose challenges for adult urological procedures like ureteroscopy. Specialized care is recommended for patients with difficult ureteric access or abnormal anatomy.
Area of Science:
- Urology
- Endourology
Background:
- Cross-trigonal ureteral reimplantation for pediatric vesicoureteral reflux creates a population with transversely lying ureters.
- This anatomical variation increases risks for stone and urothelial cancer formation in adulthood.
- Transverse ureters complicate ureteroscopy, often making ureteric access impossible.
Observation:
- A young man with hyperparathyroidism-induced urolithiasis presented with treatment difficulties.
- He had undergone a Cohen reimplantation of the right ureter in childhood, resulting in a transverse ureter.
- The patient initially omitted this crucial surgical history.
Findings:
- The case highlights significant challenges endoscopists face with patients who have undergone prior ureteral reimplantation.
- Difficult ureteric access due to anatomical abnormalities, such as transverse ureters, can impede necessary urological interventions.
Implications:
- Patients with challenging ureteric access, abnormal anatomy, or known cross-trigonal reimplantations require specialized endourology unit management.
- Early identification and management in specialized centers can improve outcomes for these complex cases.