title: Complete Occlusion of a Subcutaneous Pyelovesical Bypass Graft (Detour® System) Caused by Uric Acid Stone Formation.
abstract: Subcutaneous pyelovesical bypass graft (SPBG) is a urinary diversion treatment option for ureteral obstruction. Initially its use was limited to palliative care patients. However, the indication profile has been extended to selected patients with benign conditions causing ureteral obstruction and hydronephrosis. Occlusion of SPBGs is rarely reported and mostly related to infections. We describe the clinical case of a patient with SPBG after iatrogenic ureteral stricture who was not suitable for other reconstructive treatment forms due to distinct retroperitoneal scarring after multiple previous surgeries. Several months after the SPBG insertion, the patient developed complete occlusion of the system with uric acid stone material. Sufficient endoscopic intervention was not feasible. After forced chemolitholysis, the stone mass could be completely dissolved. Since then the patient has remained symptom-free.
authors.affiliation: Department of Urology, University Medical Center, Freiburg, Germany.
authors.forename: Konrad
authors.initials: K
authors.lastname: Wilhelm
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Schultze-Seemann
authors.forename: Arkadiusz
authors.initials: A
authors.lastname: Miernik
mesh_terms: D003251:Constriction, Pathologic; D004724:Endoscopy; D006801:Humans; D006869:Hydronephrosis / Q000150:complications*; D008875:Middle Aged; D014057:Tomography, X-Ray Computed; D014513:Ureter / Q000601:surgery*; D014517:Ureteral Obstruction / Q000601:surgery*; D014527:Uric Acid / Q000737:chemistry*; D014547:Urinary Diversion / Q000009:adverse effects*; D013520:Urologic Surgical Procedures; D014656:Vascular Surgical Procedures
chemical_list: D014527:Uric Acid
keywords: Detour® system; Subcutaneous pyelovesical bypass graft; Ureteral stricture; Uric acid stone