Medicina Fluminensis, Vol. 50 No. 1, 2014.
Other
Endoscopic treatment of urinary reservoir calculus
Dean Markić
orcid.org/0000-0001-5696-0850
; Klinika za urologiju, KBC Rijeka, Rijeka
Josip Španjol
; Klinika za urologiju, KBC Rijeka, Rijeka
Dražen Rahelić
; Klinika za urologiju, KBC Rijeka, Rijeka
Maksim Valenčić
; Klinika za urologiju, KBC Rijeka, Rijeka
Abstract
Aim: Some type of urinary diversion must be performed in patients after cystectomy, usually with an isolated part of bowel (ileum or colon) transposed into the urinary tract, serving for derivation or containment of urine. Metabolic disorders, bacterial colonization and significant residual urine are risk factors in patients with urinary diversion, which increase risk of urolithiasis. In this case report we present a patient with pouch stone and treatment modality. Case report: Anterior pelvic exenteration with urinary diversion (Mainzpouch I) was performed in a 65-years-old woman because of recurrent vulvar cancer. Due to recidual macrohematuria, the patient underwent computerised tomography, which revealed a stone in the pouch. Maximum stone length was 24 mm. Considering the pouch type and stone length, we chose endoscopic lithotripsy with trans-stomal approach. Lithotripsy was successfully performed with the electrokinetic lithotripter and all stone fragments were removed. Postoperative course was uneventful, without surgical complications. Conclusion: Endoscopic treatment is recommended in patients pouch stones due to its efficacy. Trans-stomal approach is suitable when the stone diameter is relatively small and all standard urologic equipment can be used, as demonstrated in our patient. Recovery after such operation is fast and complications are rare.
Keywords
continent urinary diversion; lithotripsy; Mainz pouch; urolithiasis
Hrčak ID:
118592
URI
Publication date:
3.3.2014.
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