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Urinary Tract Calculi VI: Surgical Management

Urinary Tract Calculi VI: Surgical Management

Procedures for Kidney StonesMedical intervention is necessary when kidney stones or renal calculi are too large to pass spontaneously (typically greater than 5 millimeters) when stones are accompanied by symptomatic infection (such as fever or pyelonephritis), when they impair kidney function, or when they cause persistent symptoms like severe pain, nausea, or urinary retention. Additionally, patients with only one kidney or those who cannot be treated with medical management also require...

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Related Experiment Video

Updated: Mar 2, 2026

Vessel-sparing Excision and Primary Anastomosis

Vessel-sparing Excision and Primary Anastomosis

Published on: January 7, 2019

Laparoscopic Reconstruction in Post-Tubercular Urinary Tract Strictures: Technical Challenges.

Bastab Ghosh¹, Kartik Sridhar¹, Dilip Kumar Pal¹

¹Department of Urology, Institute of Post Graduate Medical Education and Research , Kolkata, India .

Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A

|May 11, 2017

Summary

Laparoscopic reconstructive surgery for genitourinary tuberculosis (GUTB) is feasible despite challenging adhesions. This minimally invasive approach offers successful outcomes for urinary tract obstruction in GUTB patients.

Keywords:

genitourinary tuberculosis laparoscopic dismembered pyeloplasty laparoscopic ureteral reimplantation laparoscopic ureteroureterostomy

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Area of Science:

Urology
Minimally Invasive Surgery
Infectious Diseases

Background:

Genitourinary tuberculosis (GUTB) causes significant morbidity and mortality, often requiring surgical intervention.
Historically, GUTB was considered a contraindication to laparoscopic surgery due to dense adhesions.
Recent evidence suggests laparoscopy is a viable option for GUTB management.

Purpose of the Study:

To identify challenges in laparoscopic urinary tract reconstructive surgery for GUTB-related obstruction.
To evaluate the feasibility and outcomes of laparoscopic surgery in GUTB patients.

Main Methods:

Retrospective review of 6 patients undergoing laparoscopic reconstructive surgery for GUTB-related urinary tract obstruction (Jan 2014 - Dec 2015).
Procedures included laparoscopic pyeloplasty, ureteroneocystostomy, and ureteroureterostomy.
All patients received pre-operative antitubercular treatment.

Main Results:

Laparoscopic surgery was successfully performed in 5 out of 6 patients, with one conversion to open surgery due to dense adhesions.
Procedures performed: bilateral pyeloplasty (1), unilateral pyeloplasty (1), ureteroneocystostomy (2), ureteroureterostomy (2).
All patients experienced uneventful recovery, and functional imaging confirmed unobstructed urinary flow post-stent removal.

Conclusions:

Laparoscopic reconstructive surgery is feasible for genitourinary tuberculosis, even with challenging adhesions.
This approach contrasts with previous studies deeming GUTB a relative contraindication to laparoscopy.
Successful outcomes demonstrate the efficacy of minimally invasive techniques in managing GUTB-related urinary obstruction.