title: Cut-to-the-light technique and potassium titanyl phosphate laser ureterotomy for complete ureteral obstruction.
abstract: We describe a case of complete ureteral obstruction managed by endoscopic recanalization using a 'cut-to-the-light' technique followed by potassium titanyl phosphate (KTP) laser ureterotomy. A 53-year-old man developed a ureteral obstruction following the transurethral resection of a bladder tumor (TUR-Bt) at the left ureteral orifice. The length of the obstructed segment was estimated at 1 cm based on combined antegrade and retrograde contrast studies. Histopathological analysis indicated that the obstruction was caused by fibrosis. The 'cut-to-the-light' technique was used for recanalization, and KTP laser ureterotomy was performed to obtain an adequate ureteral lumen. A 14 F/7 F endoureterotomy stent was removed 6 weeks after the operation. No significant complications and no signs of stenosis were observed 24 months after endoscopic repair. Endoscopic recanalization is a safe, effective technique for the management of a completely obliterated ureteral segment, especially in combination with subsequent KTP laser ureterotomy.
authors.affiliation: Division of Urology, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Kazumasa
authors.initials: K
authors.lastname: Goda
authors.forename: Gaku
authors.initials: G
authors.lastname: Kawabata
authors.forename: Tomihiko
authors.initials: T
authors.lastname: Yasufuku
authors.forename: Isao
authors.initials: I
authors.lastname: Hara
authors.forename: Masato
authors.initials: M
authors.lastname: Fujisawa
authors.forename: Sadao
authors.initials: S
authors.lastname: Kamidono
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Okada
mesh_terms: D004724:Endoscopy / Q000379:methods*; D006801:Humans; D053685:Laser Therapy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010710:Phosphates; D014025:Titanium; D014517:Ureteral Obstruction / Q000601:surgery*
chemical_list: D010710:Phosphates; C064806:potassium titanylphosphate; D014025:Titanium