One step endourologic management of severely encrusted stent in solitary kidney with renal impairment. A case report.
Removing a severely encrusted stent, without an initial preventive descaling of the calcification that envelopes it, can lead to serious complications such as the breaking up of the stent, lesions and ureteral avulsion. We report a case regarding an entirely endourological treatment of an encrusted stent in a single kidney patient with renal insufficiency. The time the stent had been in place was 6 months. The patient underwent bladder lithotripsy of the distal tip of the encrusted stent, ureterolithotripsy to free the intraureteral tract of any incrustation and percutaneous nephrolithotomy to deal with the stone burden around the proximal tip. The stent, once free from fragments, was removed, via anterograde, without causing any friction in the excretory tract. The anesthesia time was 3.5 h. The postoperative period was normal without any septic complications or bleeding. We observed a slight worsening of the creatininemia which, after 3 days, could be compared with the preoperative blood levels. Ten days after the operation, renal function returned to normal. Even for patients with just one kidney and renal insufficiency the endourological management of encrusted stents does not lead to a high morbidity and is quite feasible as a one step operation.
Di Grazia
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Department of Urology, Garibaldi Hospital, Catania, Italy. eugeniodigrazia@hotmail.com
La Rosa
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Amuso
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D000368:Aged; D002114:Calcinosis / Q000209:etiology / Q000601:surgery*; D004724:Endoscopy; D005260:Female; D006801:Humans; D007668:Kidney / Q000002:abnormalities*; D011183:Postoperative Complications / Q000209:etiology / Q000601:surgery*; D051437:Renal Insufficiency / Q000209:etiology / Q000601:surgery*; D012720:Severity of Illness Index; D015607:Stents