Toussi Amir, Boswell Timothy, Potretzke Aaron
Department of Urology, Mayo Clinic, Rochester, Minnesota.
J Endourol Case Rep. 2018 Dec 17;4(1):195-197. doi: 10.1089/cren.2018.0063. eCollection 2018.
Urinary stone disease in cross-fused renal ectopia is rare and the aberrant anatomy poses challenges to treatment options. The available literature on treatment modalities remains limited. In this study, we present a case of ureteral stone in a cross-fused renal ectopia managed through retrograde approach. We present a case of a 69-year-old woman with an obstructing ureteral stone in a cross-fused renal ectopia managed with ureteroscopic stone extraction. With the use of a ureteral access sheath, holmium laser, and Nitonol basket, the stone was fragmented and removed through retrograde access. The stone composition was 100% calcium oxalate monohydrate and her 24-hour urine collection was only significant for low volume. With special modifications and attention to the individual patient's anatomy, retrograde approach with the use of an access sheath is safe and effective for treatment of ureteral stones in patients with cross-fused renal ectopia.
交叉融合型肾异位中的尿路结石病较为罕见,异常的解剖结构给治疗方案带来了挑战。关于治疗方式的现有文献仍然有限。在本研究中,我们报告了一例通过逆行途径治疗交叉融合型肾异位合并输尿管结石的病例。我们报告了一例69岁女性患者,其交叉融合型肾异位合并梗阻性输尿管结石,采用输尿管镜取石术进行治疗。通过使用输尿管接入鞘、钬激光和镍钛诺网篮,结石被粉碎并通过逆行途径取出。结石成分是100%的一水草酸钙,她24小时尿液收集结果仅显示尿量少。通过特殊的调整并关注个体患者的解剖结构,使用接入鞘的逆行途径对于治疗交叉融合型肾异位患者的输尿管结石是安全有效的。