DOCSLIB.ORG

Cystoscopy & Ureteroscopy & Fragmentation of Stone (Lithoclast)

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Cystoscopy & Ureteroscopy & Fragmentation of Stone (Lithoclast) (Affix identification label here) 2018 URN: Cystoscopy & Ureteroscopy Family name: & Fragmentation of Stone Given name(s): (Lithoclast) Address: Date of birth: Sex: M F I Facility: A. Interpreter / cultural needs • Damage to the bladder by puncturing the bladder wall. This may need further surgery. An Interpreter Service is required? Yes No • Swelling at the exit of the bladder which may result in If Yes, is a qualified Interpreter present? Yes No urine retention. A tube (catheter) may need to be A Cultural Support Person is required? Yes No inserted to drain the urine until the swelling goes down. © The State of Queensland (Queensland Health), Health), (Queensland Queensland of State The © If Yes, is a Cultural Support Person present? Yes No • Bacteria may get into the blood stream with the development of septicaemia (blood infection). Further B. Condition and treatment treatment with antibiotics may be necessary. • Bleeding which may stain the urine colour and The doctor has explained that you have the following sometimes cause blockage of urine flow. condition: (Doctor to document in patient’s own words) • Burning and scalding of urine for a few days after the Permission to reproduce should be sought from [email protected] from sought be should reproduce to Permission .......................................................................................................................................................................... procedure. This usually settles. • The catheter may not be able to be passed through the .......................................................................................................................................................................... ureteric opening and up to the kidney because of a This condition requires the following procedure. (Doctor to blockage. document - include site and/or side where relevant to the • Rarely, damage to ureter. A stricture may form. Very procedure) rarely an open operation may be required to repair the damage. .......................................................................................................................................................................... .......................................................................................................................................................................... D. Significant risks and procedure options The following will be performed: (Doctor to document in space provided. Continue in Medical A cystoscopy is where the doctor looks and examines the Record if necessary.) inside of the bladder and urethra using a fine telescopic-type instrument called a cystoscope. .......................................................................................................................................................................... If a stone is seen, it will be broken into small pieces, and ......................................................................................................................................................................... removed using a fragmentation machine (lithoclast). A special HERE TITLE FORM INSERT HERE TITLE FORM INSERT PROCEDURALCONSENT FORM tube called a stent may be placed in the ureter to prevent it .......................................................................................................................................................................... from blocking after the procedure. The stent will be removed later once any swelling has gone down. .......................................................................................................................................................................... C. Risks of a cystoscopy & ureteroscopy & E. Risks of not having this procedure fragmentation of stone (lithoclast) (Doctor to document in space provided. Continue in Medical DO DO NOT WRITE IN THIS BINDING MARGIN Record if necessary.) There are risks and complications with this procedure. They include but are not limited to the following. .......................................................................................................................................................................... General risks: • Infection can occur, requiring antibiotics and further .......................................................................................................................................................................... treatment. .......................................................................................................................................................................... • Bleeding could occur and may require a return to the operating room. Bleeding is more common if you have .......................................................................................................................................................................... been taking blood thinning drugs such as Warfarin, Aspirin, Clopidogrel (Plavix or Iscover) or Dipyridamole F. Anaesthetic (Persantin or Asasantin). This procedure may require an anaesthetic. (Doctor to • Small areas of the lung can collapse, increasing the risk document type of anaesthetic discussed) of chest infection. This may need antibiotics and physiotherapy. .......................................................................................................................................................................... 12/2018 Increased risk in obese people of wound infection, chest • – infection, heart and lung complications, and thrombosis. .......................................................................................................................................................................... • Heart attack or stroke could occur due to the strain on V5.00 V5.00 the heart. G. Patient consent • Blood clot in the leg (DVT) causing pain and swelling. In I acknowledge that the doctor has explained; rare cases part of the clot may break off and go to the • my medical condition and the proposed procedure, lungs. including additional treatment if the doctor finds • Death as a result of this procedure is possible. something unexpected. I understand the risks, including the risks that are specific to me. 9290 Specific risks: • the anaesthetic required for this procedure. I understand SW • Rarely damage to the urethra. A false passage may be produced causing leakage of urine or in the long term, a the risks, including the risks that are specific to me. narrowing that may affect flow of urine. • other relevant procedure/treatment options and their associated risks. Page 1 of 2 Continues over page ►►► (Affix identification label here) URN: Cystoscopy & Ureteroscopy Family name: & Fragmentation of Stone Given name(s): (Lithoclast) Address: Date of birth: Sex: M F I Facility: • my prognosis and the risks of not having the procedure. Patients who lack capacity to provide consent • that no guarantee has been made that the procedure will improve my condition even though it has been carried out Consent must be obtained from a substitute decision with due professional care. maker/s in the order below. • the procedure may include a blood transfusion. Does the patient have an Advance Health Directive (AHD)? • tissues and blood may be removed and could be used for diagnosis or management of my condition, stored and Yes Location of the original or certified copy of the AHD: disposed of sensitively by the hospital. ............................................................................................................................................................... • if immediate life-threatening events happen during the procedure, they will be treated based on my discussions No Name of Substitute with the doctor or my Acute Resuscitation Plan. Decision Maker/s: • a doctor other than the consultant/specialist may .................................................................................................................................................................. conduct/assist with the clinically appropriate Signature: procedure/treatment/investigation/examination. I .................................................................................................................................................................. understand this could be a doctor undergoing further training. I understand that all surgical trainees are Relationship to patient: supervised according to relevant professional guidelines. .................................................................................................................................................................. DO NOT WRITE IN THIS BINDING MARGIN I was able to ask questions and raise concerns with the doctor Date: ....................................................... PH No: ................................................................. about my condition, the proposed procedure and its risks, and my treatment options. My questions and concerns have been Source of decision making authority (tick one): discussed and answered to my satisfaction. Tribunal-appointed Guardian I understand I have the right to change my mind at any time, Attorney/s for health matters under Enduring Power including after I have signed this form but, preferably following of Attorney or AHD a discussion with my doctor. Statutory Health Attorney I understand that image/s or video footage may be recorded If none of these, the Adult Guardian has provided as part of and during my procedure and that these image/s
Load more

Recommended publications
  • Urology 1 Cystoscopes
    Urology 1 Cystoscopes 2 Urethrotomes 3 Resectoscopes 4 Uretero-Renoscopes 5 Nephroscopes 6 Lithotripsy (UreTron) 7 Laser Therapy 8 Small Caliber 9 Fluid Management 10 Accessories Richard Wolf Medical Instruments Corporation assumes no responsibility or liability for any errors or omissions in the content of this catalog. The information contained in this catalog is provided on an “as is” basis with no guarantees of completeness, accuracy, usefulness, or timeliness, and without warranties of any kind whatsoever, expressed or implied. 1777- 02.01-1118USA Cysto-Urethroscopes 8650 E-line design CYSTOSCOPES The E-line design guarantees optimum handling and safe, fatigue-free operation as well as a wide range of possible combinations. Basic Set for Cystoscopy Cysto-urethroscope sheath, 19.5 Fr. with obturator 8650.0341 Adapter with 1 instrument port 8650.264 Insert with Albarran deflector, 2 instrument ports 8650.204 Sterile universal sealing valve (pack of 5) 4712348 Viewing obturator 8650.724 Biopsy forceps Marburg 8650.614 Grasping forceps 8650.684 PANOVIEW telescope, 0° 8650.414 PANOVIEW telescope, 70° 8650.415 Otis urethrotome 8517.00 822.31 822.13 822.31 Flexible connector 822.13 Tray 8585030 1777- 02.01-1118USA 2 PANOVIEW Telescopes Overview CYSTOSCOPES Ø Viewing direction Color code Application mm 0° blue Standard 4 8650.414 12° orange Standard 4 8654.431 Standard 4 8654.422 30° red Long sheath 4 8668.433* 70° yellow Standard 4 8650.415 * Only 25° available. 1777- 02.01-1118USA 3 Cysto-Urethroscope 8650 for telescope 4 mm, 0°, 12°, 30°, 70° and adapters CYSTOSCOPES Sheaths and obturators Adapters Sheath incl.
    [Show full text]
  • Cystoscopy to Understand a Cystoscopy, It Is Helpful to Become Familiar with the Urinary System (Figure 1)
    Northwestern Memorial Hospital Patient Education TESTS AND PROCEDURES Cystoscopy To understand a cystoscopy, it is helpful to become familiar with the urinary system (Figure 1). The system’s main purpose is to remove urinary waste products from your body. Urine is produced by the kidneys, moves through the ureters and is stored in the bladder. The bladder is a balloon-like organ that stores urine. The urethra is the tube that carries urine from the bladder out of your body. If you have Figure 1. Urinary system any questions or concerns, Kidneys please ask your physician or nurse. Ureters Bladder Urethra A cystoscopy is a procedure that allows your physician to look at the inside of your urethra and bladder. A telescope-like instrument called a cystoscope is passed through your urethra into your bladder. During the procedure, your physician may also do the following, as needed: ■ Remove stones from your bladder or ureters ■ Place or remove a ureteral stent ■ Insert medication into your bladder ■ Remove small pieces of tissue for testing (biopsy) from your urinary tract A cystoscopy may be done in a physician’s office or in the hospital’s operating room (OR). Your physician will discuss which option is best for you. Preparation and procedure If the test is done in the OR, you will be asked to sign a written consent. The OR procedure and any special preparation will be explained to you. There may be some discomfort during the examination. Some patients may require sedation or anesthesia. Depending on the type of medication used for your procedure, you will be told if you need to stop eating and drinking before your procedure.
    [Show full text]
  • Testosterone Replacement Therapy Is Associated with an Increased Risk of Urolithiasis
    World Journal of Urology (2019) 37:2737–2746 https://doi.org/10.1007/s00345-019-02726-6 ORIGINAL ARTICLE Testosterone replacement therapy is associated with an increased risk of urolithiasis Tyler R. McClintock1 · Marie‑Therese I. Valovska2 · Nicollette K. Kwon3 · Alexander P. Cole1,3 · Wei Jiang3 · Martin N. Kathrins1 · Naeem Bhojani4 · George E. Haleblian1 · Tracey Koehlmoos5 · Adil H. Haider3,6 · Shehzad Basaria7 · Quoc‑Dien Trinh1,3 Received: 16 November 2018 / Accepted: 7 March 2019 / Published online: 23 March 2019 © Springer-Verlag GmbH Germany, part of Springer Nature 2019 Abstract Purpose To determine whether TRT in men with hypogonadism is associated with an increased risk of urolithiasis. Methods We conducted a population-based matched cohort study utilizing data sourced from the Military Health System Data Repository (a large military-based database that includes benefciaries of the TRICARE program). This included men aged 40–64 years with no prior history of urolithiasis who received continuous TRT for a diagnosis of hypogonadism between 2006 and 2014. Eligible individuals were matched using both demographics and comorbidities to TRICARE enrollees who did not receive TRT. The primary outcome was 2-year absolute risk of a stone-related event, comparing men on TRT to non-TRT controls. Results There were 26,586 pairs in our cohort. Four hundred and eighty-two stone-related events were observed at 2 years in the non-TRT group versus 659 in the TRT group. Log-rank comparisons showed this to be a statistically signifcant dif- ference in events between the two groups (p < 0.0001). This diference was observed for topical (p < 0.0001) and injection (p = 0.004) therapy-type subgroups, though not for pellet (p = 0.27).
    [Show full text]
  • Urology Services in the ASC
    Urology Services in the ASC Brad D. Lerner, MD, FACS, CASC Medical Director Summit ASC President of Chesapeake Urology Associates Chief of Urology Union Memorial Hospital Urologic Consultant NFL Baltimore Ravens Learning Objectives: Describe the numerous basic and advanced urology cases/lines of service that can be provided in an ASC setting Discuss various opportunities regarding clinical, operational and financial aspects of urology lines of service in an ASC setting Why Offer Urology Services in Your ASC? Majority of urologic surgical services are already outpatient Many urologic procedures are high volume, short duration and low cost Increasing emphasis on movement of site of service for surgical cases from hospitals and insurance carriers to ASCs There are still some case types where patients are traditionally admitted or placed in extended recovery status that can be converted to strictly outpatient status and would be suitable for an ASC Potential core of fee-for-service case types (microsurgery, aesthetics, prosthetics, etc.) Increasing Population of Those Aged 65 and Over As of 2018, it was estimated that there were 51 million persons aged 65 and over (15.63% of total population) By 2030, it is expected that there will be 72.1 million persons aged 65 and over National ASC Statistics - 2017 Urology cases represented 6% of total case mix for ASCs Urology cases were 4th in median net revenue per case (approximately $2,400) – behind Orthopedics, ENT and Podiatry Urology comprised 3% of single specialty ASCs (5th behind
    [Show full text]
  • Clinical Significance of Cystoscopic Urethral Stricture
    UCSF UC San Francisco Previously Published Works Title Clinical significance of cystoscopic urethral stricture recurrence after anterior urethroplasty: a multi-institution analysis from Trauma and Urologic Reconstructive Network of Surgeons (TURNS). Permalink https://escholarship.org/uc/item/3f57n621 Journal World journal of urology, 37(12) ISSN 0724-4983 Authors Baradaran, Nima Fergus, Kirkpatrick B Moses, Rachel A et al. Publication Date 2019-12-01 DOI 10.1007/s00345-019-02653-6 Peer reviewed eScholarship.org Powered by the California Digital Library University of California World Journal of Urology https://doi.org/10.1007/s00345-019-02653-6 ORIGINAL ARTICLE Clinical signifcance of cystoscopic urethral stricture recurrence after anterior urethroplasty: a multi‑institution analysis from Trauma and Urologic Reconstructive Network of Surgeons (TURNS) Nima Baradaran1 · Kirkpatrick B. Fergus2 · Rachel A. Moses3 · Darshan P. Patel3 · Thomas W. Gaither2 · Bryan B. Voelzke4 · Thomas G. Smith III5 · Bradley A. Erickson6 · Sean P. Elliott7 · Nejd F. Alsikaf8 · Alex J. Vanni9 · Jill Buckley10 · Lee C. Zhao11 · Jeremy B. Myers3 · Benjamin N. Breyer2 Received: 13 December 2018 / Accepted: 24 January 2019 © Springer-Verlag GmbH Germany, part of Springer Nature 2019 Abstract Purpose To assess the functional Queryoutcome of patients with cystoscopic recurrence of stricture post-urethroplasty and to evaluate the role of cystoscopy as initial screening tool to predict future failure. Methods Cases with cystoscopy data after anterior urethroplasty in a multi-institutional database were retrospectively studied. Based on cystoscopic evaluation, performed within 3-months post-urethroplasty, patients were categorized as small-caliber (SC) stricture recurrence: stricture unable to be passed by standard cystoscope, large-caliber (LC) stricture accommodating a cystoscope, and no recurrence.
    [Show full text]
  • Cystoscopy Into the Bladder Via the Urethra, It Is About As Thick As a a Guide for Women
    A flexible cystoscope is a thin telescope which is passed Cystoscopy into the bladder via the urethra, it is about as thick as a A Guide for Women pencil. As the cystoscope is flexible, it usually passes easily 1. What is a Cystoscopy? moved so the doctor can look at all the inside lining of the along the curves of the urethra. The flexible tip can also be 2. Why is a Cystoscopy performed? bladder and the opening of the ureters. 3. Preparation for the test 4. About the test 5. Are there any risks? A rigid cystoscope is a shorter rigid telescope, it allows 6. What to expect afterwards? a greater variety of devices to pass down side channels so that the doctor can for example take samples or inject into the bladder. Sometimes, it is necessary to perform a rigid What is a Cystoscopy? Cystoscopy is the name for a procedure allowing a doctor to look into your bladder and urethra with a special telescope cystoscopy at a later date after a flexible cystoscopy. called a cystoscope. Preparation for the test If you are having an outpatient procedure in most cases you When you have a bladder problem, your doctor may use a will be able to eat and drink normally prior to the test. If you cystoscope to see inside your bladder and urethra. The ure- are having general anesthesia, you should refrain from eat- thra is the tube that carries urine from the bladder to the ing and drinking for 6 to 8 hours prior to your cystoscopy.
    [Show full text]
  • Complications of Ureteroscopic Approaches, Including Incisions
    18 Complications of Ureteroscopic Approaches, Including Incisions Farjaad M. Siddiq, MD and Raymond J. Leveillee, MD CONTENTS INTRODUCTION PREPARATION FOR URETEROSCOPY URETERAL ACCESS DILATION OF THE URETERAL ORIFICE: IS IT NECESSARY? COMPLICATIONS OF URETEROSCOPY URETERAL STENTS: ARE THEY NECESSARY? POSTOPERATIVE IMAGING COMPLICATIONS OF URETEROSCOPIC MANAGEMENT OF UPPER TRACT TCC COMPLICATIONS OF URETEROSCOPIC INCISIONS CONCLUSION REFERENCES SUMMARY Ureteroscopy has progressed from cystoscopic examination of a dilated ureter in a child in 1929 and the initial use of rigid ureteroscopes in the 1980s, to its current state of small caliber semirigid and flexible instruments. In this chapter the authors review complications of ureteroscopy including those associated with incisional techniques where one would anticipate a higher incidence of complications. They review the his- tory and development of modern ureteroscopes, focusing on engineering advances. Clinical points made include proper patient selection and preparation; proper use of dilators, wires, and ureteral access sheaths; and the incidence, identification, and man- agement of complications associated with ureterorenoscopy (both intraopertively and postoperatively). Key Words: Ureteroscopy; calculi; urinary stones; stricture or ureter; urothelial carcinoma; surgical complications. From: Advanced Endourology: The Complete Clinical Guide Edited by: S. Y. Nakada and M. S. Pearle © Humana Press Inc., Totowa, NJ 299 300 Siddiq and Leveillee INTRODUCTION Ureteroscopy has progressed from cystoscopic examination of a dilated ureter in a child with posterior urethral valves by Young and McKay (1) in 1929 and the initial use of a rigid ureteroscope by Perez-Castro Ellendt and Martinez-Pineiro (2,3) in the early 1980s, to its current state of small caliber semirigid and flexible instruments.
    [Show full text]
  • Suprapubic Catheter Insertion Using an Ultrasound-Guided Technique and Literature Review BJUIBJU INTERNATIONAL Preman Jacob , Bhavan Prasad Rai * and Alistair W
    Suprapubic catheter insertion using an ultrasound-guided technique and literature review BJUIBJU INTERNATIONAL Preman Jacob , Bhavan Prasad Rai * and Alistair W. Todd Department of Radiology , * Department of Urology, Raigmore Hospital, Inverness, UK Accepted for publication 9 November 2011 Suprapubic catheter (SPC) insertion is a What ’ s known on the subject? and What does the study add? common method of bladder drainage in The conventional ‘ blind ’ technique for suprapubic catheter (SPC) insertion relies on contemporary urological practice. The adequate fi lling of the bladder to displace bowel away from the site of needle procedure involves insertion of a sharp puncture. However, in a small percentage of patients this fails to happen, which trocar into the bladder percutaneously, can occasionally lead to life-threatening bowel injury. Recently published British usually by palpation, percussion or Association of Urological Surgeons (BAUS) guidelines have recommended that cystoscopy for guidance. Although ultrasonography (US) may be helpful to identify bowel loops and recommends its generally considered a safe procedure, the usage whenever possible. risk of bowel injury is estimated at up to 2.4% with a mortality rate of 1.8%. This paper describes the technique of US-guided needle puncture and SPC insertion Recently published British Association of to reduce the likelihood of bowel injury. The paper addresses training, equipment Urological Surgeons (BAUS) guidelines have and logistical issues associated with this advice. We have reviewed the available recommended that ultrasonography (US) publications on the outcomes from this technique and also present our experience. may be helpful to identify bowel loops and recommends its usage whenever possible.
    [Show full text]
  • Discharge Instructions for Ureteroscopy, Laser Lithotripsy and Stent Insertion
    Dr. Kevin G. Kwan, BSc (Hons), MD, FRCS(C) Minimally Invasive Surgery and General Urology Assistant Clinical Professor Division of Urology, Department of Surgery McMaster University Chief of Surgery, Milton District Hospital Georgetown Hospital • Milton District Hospital • Oakville Trafalgar Memorial Hospital Suite 205 - 311 Commercial Street • Milton • Ontario • L9T 3Z9 • Tel: (905) 875-3920 • Fax: (905) 875-4340 Email: [email protected] • Web: www.haltonurology.com Discharge Instructions for Ureteroscopy, Laser lithotripsy and Stent insertion Ureteroscopy is a procedure where a scope is passed through the urethra and bladder and into the ureter (the tubes that carry urine from the kidneys to the bladder) to the point where the stone is located. A small laser fiber is then used to break the stone into small pieces that are then extracted or flushed out. In most cases, to ensure that the kidney drains urine well after surgery, a ureteral stent is left in place. Ureteroscopy can also be performed for stones located within the kidney. Similar to ureteral stones, kidney stones can be fragmented and removed with baskets. Occasionally, a kidney stone will fragment with a laser into very small pieces (grains of sand), too small to be basketed. A stent is usually left in place to allow these pieces to clear over time. Ureteral Stenting: Almost always after ureteroscopy, a ureteral stent will be placed. This is a thin, hollow, plastic tube that is used temporarily to keep the ureter open and facilitates drainage of urine down to the bladder until it heals. It also allows the urine to drain and any small stone fragments to pass freely.
    [Show full text]
  • Artificial Urinary Sphincter Zsi 375
    SWISS TECHNOLOGY ARTIFICIAL URINARY SPHINCTER ZSI 375 YEARS ANNIVERSARY 2007-2019 A technological breakthrough for male incontinence SECOND EDITION NOVEMBER 2019 ZSI 375 MANUAL Easy to implant Easy to use ‘Let every man judge according to his own standards, by what he has himself read, not by what others tell him.’ Albert Einstein (1949) The World As I See It ZSI 375 MANUAL ORIGINS AND GRATITUDE TO EARLY IMPLANTERS HISTORY OF THE ZSI 375 MANUAL This manual is a summary of the knowledge acquired to date on the Artificial Urinary Sphincter ZSI 375. It gathers in a single volume, the pedagogical sheets that have been developed and continuously improved for 12 years; it offers readers a better understanding of the functioning of the ZSI 375 Artificial Urinary Sphincter to optimise its use. We hope that this manual will provide you with additional information on the videos available on our website www.zsimplants.ch and complement our local technical team’s support. If you have any questions, do not hesitate to contact ZSI directly at [email protected] or your local ZSI team. Raphaël Gomez Llorens Global Marketing Manager Head of Training ACKNOWLEDGEMENTS TO EARLY IMPLANTERS From 2009 to 2019, over 4500 Artificial Urinary Sphincters (AUS) ZSI 375 were implanted in different versions. This success would not have been possible without the trust and motivation from visionary surgeons and distributors from Argentina, Austria, Colombia, Costa Rica, Germany, Italy, Poland, Portugal, Spain and Turkey. From as early as between 2009 and 2011, they promoted the technology and quality of ZSI products around the world.
    [Show full text]
  • Having a Supra Pubic Urinary Catheter
    Having a supra pubic urinary catheter UHB is a no smoking Trust To see all of our current patient information leaflets please visit www.uhb.nhs.uk/patient-information-leaflets.htm What is a supra pubic urinary catheter? A supra pubic urinary catheter is a hollow flexible tube that is used to drain urine from the bladder. It is inserted into the bladder through a cut in the tummy (abdomen), a few inches/centimetres below the navel (tummy button). This is usually done under a general anaesthetic in Theatre by a urological surgeon. Why do I need a supra pubic urinary catheter? Anyone who cannot empty their bladder may need a urinary catheter. A supra pubic urinary catheter may be chosen because it is more comfortable and less likely to give you an infection than other catheters. Other reasons may be: • The urethra (the tube where urine comes out) has been traumatised/damaged • For people who require long-term catheterisation and are sexually active • After some gynaecological operations e.g. surgery for prolapsed uterus (womb), bladder • Some wheelchair users find this method simpler to manage • People who cannot perform self-catheterisation • Long-term catheterisation for incontinence. Although this is not generally recommended sometimes medical staff feel it appropriate to avoid skin problems or other medical complications Advantages of a supra pubic urinary catheter • When a urethral catheter is used, the urethra (water tube) may become damaged over time, resulting in leakage of urine around the catheter. Additionally the balloon of a urethral catheter can cause damage to the bladder neck, leading to leakage of urine around the catheter.
    [Show full text]
  • Novel Technique for Performing Retrograde Pyelogram Through A
    Case Study DOI: 10.22374/jeleu.v1i1.2 NOVEL TECHNIQUE FOR PERFORMING RETROGRADE PYELOGRAM THROUGH A URETERIC STENT Jonathan Cobley1 MBBCh MRCS and Wasim Mahmalji1 MBBS FRCS 1Hereford County Hospital, Stonebow Road, Hereford, UK. Corresponding author: [email protected] Submitted: March 8, 2017. Accepted: March 9, 2018. Published: June 2, 2018. A female was diagnosed with kidney stones in Nepal two weeks later. Subsequent CT urogram showed an and treated with ureteroscopy and lasertripsy for a left obstructed left kidney secondary to a stricture and ureteric stone. She moved to the UK and was referred the patient complained of left-sided pain once again. for urology opinion with left-sided abdominal pain. POINT OF TECHNIQUE Non-contrast computed tomography of the renal tract (CT KUB) showed a 5–6 mm calculus below the Retrograde pyelogram was attempted but no contrast left pelviureteric junction (PUJ) and multiple lower made it beyond the stricture (see Figure 1). There was pole calculi. At ureteroscopy appearances were of a a pinhole stricture through which a guidewire was long-term ureteric stone which had the middle of it passed with great diffi culty and it was impossible to lasered in Nepal. Subequently, urothelium had started pass 6 French ureteric catheter through the stricture. healing over the remaining portion. Due to the severity of the stricture it was of paramount This was lasered to allow passage of a 6 French, importance to place a stent and to ensure its correct 24-cm ureteric stent to be left in situ prior to re-look placement however there was no retrograde pyelogram ureteroscopy.
    [Show full text]