Ureteral Avulsion During Retrograde Intrarenal Surgery: When the Unexpected Happens
David Denis1,2, Sergio Moreno1,3, Alfredo Velasco1,3
1Department of Urology, Clinica Santa Maria, Santiago, Chile.
Journal of Endourology Case Reports
|October 26, 2020
Summary
This case report details managing a rare ureteral disinsertion during urinary stone treatment. Prompt intervention and decision-making are crucial for successful outcomes in such complex urological cases.
Area of Science:
- Urology
- Surgical Complications
- Nephrolithiasis Management
Background:
- Bilateral urinary stones present complex treatment challenges.
- Ureteroscopy is a common procedure for stone removal.
- Complications, though rare, require careful management.
Purpose of the Study:
- To report a rare complication of ureteral disinsertion during ureteroscopy.
- To discuss the management strategies for this specific complication.
- To highlight the importance of timely decision-making in surgical interventions.
Main Methods:
- A 49-year-old female patient with bilateral urinary stones underwent ureteroscopy.
- Semirigid ureteroscopy was followed by flexible ureteroscopy due to stone localization.
- Open conversion for ureteral reimplant was performed during the same procedure.
Main Results:
- Ureteral disinsertion occurred on the left side during the procedure.
- Successful left ureteral reimplant was achieved via open conversion.
- The patient was later rehospitalized for left pyelonephritis on postoperative day 9.
Conclusions:
- Ureteral disinsertion is a rare but serious complication of ureteroscopy.
- Management requires prompt recognition and conversion to open surgery for reimplantation.
- Postoperative pyelonephritis necessitates vigilant monitoring and treatment.
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