title: Case report: relief of acute obstruction of the Detour subcutaneous pyelovesical bypass.
abstract: A 36-year-old patient was admitted to the emergency department with complaints of severe flank pain, nausea, vomiting, anuria, and general illness. Five months earlier, we had placed a subcutaneous pyelovesical prosthesis (Detour; Porges) of the ureter for treatment of a chronically dilated upper urinary tract in a solitary right kidney previously treated by double-J stenting. Ultrasonography of the right kidney revealed severe hydronephrosis. A percutaneous nephrostomy catheter was placed, and antegrade pyelography showed complete obstruction of the prosthesis. Urinalysis and culture demonstrated a Candida infection. A systemic antimycotic was administered, and fluid management was started. On the third day, diuresis appeared, and antegrade nephrostomography confirmed patency of the bypass.
authors.affiliation: Department of Urology, Hospital AZ Sint Jan AV, Bruges, Belgium. bernard.bynens@azbrugge.be
authors.forename: Bernard G
authors.initials: BG
authors.lastname: Bynens
authors.forename: Jo F
authors.initials: JF
authors.lastname: Ampe
authors.forename: Hugo
authors.initials: H
authors.lastname: Denys
authors.forename: Peter M Van
authors.initials: PM
authors.lastname: Oyen
mesh_terms: D000328:Adult; D000935:Antifungal Agents / Q000627:therapeutic use; D002177:Candidiasis / Q000175:diagnosis* / Q000628:therapy; D015725:Fluconazole / Q000627:therapeutic use; D005440:Fluid Therapy; D006801:Humans; D006869:Hydronephrosis / Q000601:surgery; D008297:Male; D009392:Nephrectomy / Q000009:adverse effects; D011138:Polytetrafluoroethylene; D019736:Prostheses and Implants; D016459:Prosthesis-Related Infections / Q000175:diagnosis* / Q000628:therapy; D012826:Silicone Elastomers; D014513:Ureter / Q000601:surgery; D014517:Ureteral Obstruction / Q000382:microbiology* / Q000628:therapy*; D014547:Urinary Diversion / Q000295:instrumentation*
chemical_list: D000935:Antifungal Agents; D012826:Silicone Elastomers; D015725:Fluconazole; D011138:Polytetrafluoroethylene