Endoscopic management of ureteral calculus in a patient with ureterosigmoidostomy diversion

Retrograde endoureterotomy as a treatment option for impacted calculus in the ureterointestinal junction

INTRODUCTION

In patients with a history of radical cystectomy and with intestinal diversion, urolithiasis in the upper urinary tract is a frequent event.

MATERIAL AND METHODS

We describe for the first time a case of retrograde endoureterotomy used to treat a calculus proximal to the ureterointestinal junction.

RESULTS

This technique is of interest when antegrade access is not possible. In our example, after passing the guidewire percutaneously, and externalize it through the stoma, the left meatus was reached with a resectoscope inserted through the ileal duct. After the use of a balloon to prevent migration of the calculus, a retrograde endoureterotomy was performed with a Collins knife and the stone removed. The patient's progress was satisfactory.

CONCLUSION

Endoscopic management of calculi in patients with intestinal diversion can be performed with different approaches. We recommend retrograde endoureterotomy as a feasible treatment option for the removal of impacted calculi at the ureterointestinal junction.