[A case of ureteral bilharziasis followed for 22 years]

The authors report on one case of urinary schistosomiasis monitored for 22 years. It illustrated the problems posed by the "bilharzial uretero-hydronephrosis". They analyse the different therapy problems which have to have been successively solved: Low double ureteral stenosis. The difficulty to be certain of such a stenosis is recalled. The possibility of a reflux or an ureteral atony must be eliminated. True stenosis must be operated without delay; Kidney cancer revealed 20 years later through chronic renal failure by vesico-ureteric reflux caused by the first surgical intervention (latero-lateral vesico-ureteric anastomosis); Iatrogenic vesico-ureteral reflux, treated by uretero-vesical implantation on "psoic" bladder with anti-reflux submucous path. The future of such a chronic renal failure is linked to the capability of the remaining ureter to ensure an acceptable passage of urine, and to the rehabilitation possibility of the kidney. Finally, the authors recalled the difficult therapeutic indications in case of ureteral attack due to bilharziosis.