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Miah S, Connor MJ, Wiseman O, Shah N. Retrograde migration of a vesicoureteric junction calculus: A potential pitfall of the noncontrast limited pelvic computerized tomography. Urol Ann 2021; 13:80-82. [PMID: 33897171 PMCID: PMC8052898 DOI: 10.4103/ua.ua_25_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 08/16/2020] [Indexed: 11/18/2022] Open
Abstract
Retrograde ureteric calculus migration is a rare phenomenon. Herein, we report two such cases where each patient presented with a calculus, measured at 5 mm and 6 mm, respectively, at the vesicoureteric junction (VUJ) on noncontrast computerized tomography kidneys, ureters, and bladder (CTKUB). Following acute presentation with renal colic, each patient opted for conservative management of their ureteric stone and became asymptomatic when undergoing their follow-up imaging. The first patient underwent a follow-up noncontrast limited pelvic computerized tomography (CT) where it had appeared that the radiolucent VUJ calculus had passed. This stone was then discovered incidentally 3 months later in the upper ureter when the patient had undergone a CT colonography. The other patient underwent a follow-up X-ray KUB where the stone was shown to have migrated to the lower renal pole calyx which was confirmed with noncontrast CTKUB imaging. In all reported cases of retrograde VUJ calculus migration, the use of a noncontrast limited pelvic CT scan either missed or would have missed this phenomenon. This potential pitfall of the noncontrast limited pelvic CT scan should be appreciated and the use of full upper renal tract imaging should be considered for the follow-up of radiolucent VUJ calculus cases whereby there is no clear history of calculus passage.
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Affiliation(s)
- Saiful Miah
- Department of Urology, Buckinghamshire NHS Trust, Wycombe Hospital, Wycombe, UK
| | - Martin J Connor
- Department of Surgery and Cancer, Imperial College, Charing Cross Hospital, London, UK
| | - Oliver Wiseman
- Department of Urology, Cambridge University Hospitals, Cambridge, UK
| | - Nimish Shah
- Department of Urology, Cambridge University Hospitals, Cambridge, UK
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Hall MK, Samson PC, Kessler R, Lehnhardt K, Easter B, Thiel J, Wessells H, Bailey MR, Harper JD. Pearl-unjammed: the Seattle stone maneuver for ureteropelvic junction urolithiasis. J Am Coll Emerg Physicians Open 2020; 1:252-256. [PMID: 32613205 PMCID: PMC7329006 DOI: 10.1002/emp2.12047] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Renal colic encounters are common; in the United States alone, they represent greater than one million annual emergency department (ED) visits. Most of these stones are managed conservatively with a trial of passage. However, some lead to repeat colic episodes, secondary ED visits, increased anxiety, and increased cost. Of the 5%-10% of symptomatic stones that become lodged at the ureteropelvic junction and are larger than 5 mm, most require operative intervention. In the process of executing a NASA-funded study of ultrasonic repositioning of kidney stones, the subject was administered fluid to dilate the collecting system, placed in Trendelenburg bed positioning, and rolled to both sides. During this process a symptomatic, obstructing 9-mm ureteropelvic junction stone moved back into the kidney's lower pole/infundibulum and symptoms were immediately resolved. The patient remained asymptomatic for a period of 5 weeks at which point elective intervention was scheduled. This case demonstrates that ureteropelvic junction stones may be repositioned in a non-invasive manner, turning a stone that requires urgent intervention into one that can be managed electively.
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Affiliation(s)
- M Kennedy Hall
- Department of Emergency Medicine, University of Washington School of Medicine, Seattle, Washington
| | - Patrick C Samson
- Department of Urology, Weill Medical College of Cornell University, New York, New York
| | - Ross Kessler
- Department of Emergency Medicine, University of Washington School of Medicine, Seattle, Washington
| | - Kris Lehnhardt
- Department of Emergency Medicine and Center for Space Medicine, Baylor College of Medicine, Houston, Texas.,Exploration Medical Capability, Human Research Program, NASA Johnson Space Center, Houston, Texas
| | - Benjamin Easter
- Exploration Medical Capability, Human Research Program, NASA Johnson Space Center, Houston, Texas.,Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, Colorado
| | - Jeff Thiel
- Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, Washington
| | - Hunter Wessells
- Department of Urology, University of Washington School of Medicine, Seattle, Washington
| | - Michael R Bailey
- Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, Washington.,Department of Urology, University of Washington School of Medicine, Seattle, Washington
| | - Jonathan D Harper
- Department of Urology, University of Washington School of Medicine, Seattle, Washington
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Haeberlin A, Schürch K, Niederhauser T, Sweda R, Schneider MP, Obrist D, Burkhard F, Clavica F. Cardiac electrophysiology catheters for electrophysiological assessments of the lower urinary tract-A proof of concept ex vivo study in viable ureters. Neurourol Urodyn 2018; 38:87-96. [DOI: 10.1002/nau.23816] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Accepted: 08/16/2018] [Indexed: 12/30/2022]
Affiliation(s)
- Andreas Haeberlin
- ARTORG Center for Biomedical Engineering Research; University of Bern; Bern Switzerland
- Department of Cardiology; Bern University Hospital and University of Bern; Bern Switzerland
| | - Klaus Schürch
- ARTORG Center for Biomedical Engineering Research; University of Bern; Bern Switzerland
| | - Thomas Niederhauser
- Institute for Human Centered Engineering; University of Applied Sciences; Biel Switzerland
| | - Romy Sweda
- ARTORG Center for Biomedical Engineering Research; University of Bern; Bern Switzerland
- Department of Cardiology; Bern University Hospital and University of Bern; Bern Switzerland
| | | | - Dominik Obrist
- ARTORG Center for Biomedical Engineering Research; University of Bern; Bern Switzerland
| | - Fiona Burkhard
- Department of Urology; Bern University Hospital; Bern Switzerland
| | - Francesco Clavica
- ARTORG Center for Biomedical Engineering Research; University of Bern; Bern Switzerland
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Fallatah M, Tahaineh S, Abu Mughli R, Fallatah SM. Upward migration of a ureteric stone in a military trainer: a case report. Res Rep Urol 2017; 9:15-17. [PMID: 28176914 PMCID: PMC5261851 DOI: 10.2147/rru.s124200] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Retrograde ureteric stone migration is an extremely rare phenomenon with only one previously reported case in the literature. We report on a case of upward spontaneous migration of a ureteric stone in a 39-year-old male military trainer in Saudi Arabia who was diagnosed with upper left ureteric stone based on non-contrast spiral computerized tomography kidney ureter bladder (CT-KUB) scan. The plan was to treat the patient conservatively with alpha blockers and oral hydration. Two weeks after treatment started, repeated CT-KUB scan revealed an upward migration of the stone to the left renal calyx. Accordingly, we highly recommend performing a prior stone localizing imaging test to avoid unnecessary procedures or operations.
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Affiliation(s)
| | | | - Rawan Abu Mughli
- Radiology Department, Security Forces Hospital, Makkah, Saudi Arabia
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