Schott Florian, Becker Benedikt, Gross Andreas J, Netsch Christopher
Department of Urology, Asklepios Klinik Barmbek, Hamburg, Germany.
J Endourol Case Rep. 2017 Jul 1;3(1):90-92. doi: 10.1089/cren.2017.0049. eCollection 2017.
Urolithiasis is a well-known and common late complication in patients with urinary diversion. Patients without urinary diversion lead to symptoms such as hematuria and ureteral colic, whereas stones in patients with urinary diversion tend to be asymptomatic and are often diagnosed incidentally during staging examinations of oncologic diseases. We report the case of a 64-year-old male patient with a lower pole kidney stone and a stone in the ileal ureter substitution. He presented with diffuse abdominal and left-sided flank pain. CT revealed the diagnosis of urolithiasis in the ileal ureter substitution and the lower pole of the left kidney. We performed a combined retrograde, flexible ureteroscopy and a mini percutaneous nephrolithotomy (combined intrarenal surgery) without any complications and no residual stone fragments postoperatively. This case presentation demonstrates that in patients with urinary tract diversion, urolithiasis can still cause problems.
尿路结石是尿流改道患者中一种广为人知的常见晚期并发症。未进行尿流改道的患者会出现血尿和输尿管绞痛等症状，而尿流改道患者的结石往往没有症状，常在肿瘤疾病分期检查时偶然被诊断出来。我们报告一例64岁男性患者，其左肾下极有结石，回肠代输尿管处也有结石。他表现为弥漫性腹痛和左侧胁腹疼痛。CT检查确诊为回肠代输尿管处及左肾下极尿路结石。我们采用逆行、软性输尿管镜检查与微创经皮肾镜取石术联合治疗（联合肾内手术），术后无任何并发症，也无残留结石碎片。该病例表明，在尿路改道患者中，尿路结石仍会引发问题。
