Submucosal migration of ureteric calculi: related to ESWL?
Three patients were reinspected by ureteroscopy after repeat ESWL. Ureteroscopy initially did not disclose an intraluminal stone and only visualized a severe inflammatory reaction of the ureteric wall and a boss of the ureter at the level of the fluoroscopically suspected stone location. An intact stone in all 3 cases was finally exposed by tactile contact at the top of the ureteroscope after perforating the mucosa with a guide wire. Retrospectively, the combination of long-standing stone impaction together with damage to the ureteric mucosa during shockwave interaction may cause an inflammatory reaction with submucosal migration of the stone.
Vandeursen
H
H
Department of Urology, University Hospital Sint-Pieter, Catholic University of Leuven, Belgium.
Baert
L
L
D000368:Aged; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D008096:Lithotripsy / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D009092:Mucous Membrane / Q000293:injuries; D014513:Ureter / Q000293:injuries*; D014514:Ureteral Calculi / Q000175:diagnosis / Q000628:therapy*