An unusual experience with ureterorenoscopy: a case report

A 42 years lady was reported. Patient was worked up and was found to have stone in the upper third of the right ureter. She underwent a session of Extracorporeal Shock Wave Lithotripsy (ESWL) but the stone was too hard to fragment in a single session. She then underwent ureterorenoscopy (URS) the next day. The ureteric orifice was very tight for negotiation of ureterorenoscope due to tight ureteric stricture. We finally managed to negotiate beyond the stricture up to the level of stone impaction. However, during withdrawal of the scope, nearly the whole length of the ureter was avulsed out along with the latter. Immediate exploration of the abdomen was performed and we found complete avulsion of the entire length of the ureter. We performed an ileal transposition to bridge the gap formed after avulsion of ureter.