International journal of surgery case reports · 2025
Comprehensive surgical strategy for incarcerated ureteral calculi in the context of double renal pelvis malformations: A case report.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Ошибки и ограничения
История · было → стало
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Zeng Deyu, Guo Qiong
Аннотация
INTRODUCTION AND IMPORTANCE: Managing incarcerated ureteral calculi is crucial to prevent obstructive uropathy, renal dysfunction, and urosepsis. Double ureteral malformations with complex calculi pose challenges due to anatomical variations, requiring a multidisciplinary approach.
CASE PRESENTATION: A 35-year-old female with flank pain and hydronephrosis was diagnosed with double renal pelvis malformations and impacted ureteral calculi. A staged approach was used: laparoscopy corrected ureteral malformations, followed by flexible ureteroscopy and percutaneous nephroscopic holmium laser lithotripsy. Complete calculus clearance was confirmed intraoperatively and postoperatively.
CLINICAL DISCUSSION: Double ureteral malformations complicate endoscopic navigation, requiring combined laparoscopic correction and lithotripsy. Challenges included limited space and risk of iatrogenic injury. Holmium laser (0.8-1.2 J) enabled precise fragmentation while preserving mucosa. Preoperative 3D CT urography was vital for surgical planning.
CONCLUSION: At 6-month follow-up, the patient had patent ureteral drainage, no calculus recurrence, and stable renal function. Integrated laparoscopy-endoscopy strategies achieved a 100 % calculus-free rate with minimal complications, emphasizing the importance of image-guided, patient-specific management in complex urolithiasis.
CASE PRESENTATION: A 35-year-old female with flank pain and hydronephrosis was diagnosed with double renal pelvis malformations and impacted ureteral calculi. A staged approach was used: laparoscopy corrected ureteral malformations, followed by flexible ureteroscopy and percutaneous nephroscopic holmium laser lithotripsy. Complete calculus clearance was confirmed intraoperatively and postoperatively.
CLINICAL DISCUSSION: Double ureteral malformations complicate endoscopic navigation, requiring combined laparoscopic correction and lithotripsy. Challenges included limited space and risk of iatrogenic injury. Holmium laser (0.8-1.2 J) enabled precise fragmentation while preserving mucosa. Preoperative 3D CT urography was vital for surgical planning.
CONCLUSION: At 6-month follow-up, the patient had patent ureteral drainage, no calculus recurrence, and stable renal function. Integrated laparoscopy-endoscopy strategies achieved a 100 % calculus-free rate with minimal complications, emphasizing the importance of image-guided, patient-specific management in complex urolithiasis.