Department of Urology, The First Affiliated Hospital of Chongqing Medical University, No. 1 Road Youyi, Yuzhong District, Chongqing, China.
BMC Urol. 2020 Mar 30;20(1):35. doi: 10.1186/s12894-020-00604-7.
Duplex kidneys are one of the most common renal congenital abnormalities, mostly asymptomatic and of no clinical significance. There are little reports about the left ureterocele and stone of calyceal diverticulum in patients with bilateral incomplete duplex kidneys managed by flexible ureteroscopy.
A 69-year-old Chinese woman was presented with left waist pain for 1 month. A preoperative computed tomography (CT) scan and intravenous pyelogram revealed the left ureterocele which located in the left ureterovesical junction, and stone of calyceal diverticulum which located in the upper kidney of left incomplete duplex kidneys. The ureterocele was confirmed in view of ureteroscopy and the holmium laser was used for the resection of ureterocele. It took us a lot of efforts to find out the stone because of diverticular neck stenosis. Fortunately, when diverticular neck stenosis was incised internally by holmium laser, the stone was discovered clearly and removed using the holmium laser and nitinol stone basket through flexible ureteroscopy. A double-J ureteral stent was inserted and remained in place for 1 month. The symptom disappeared postoperatively and no complications were developed during the placement of the stent. There were no stone residents observed on CT scan before removing the ureteral stent 1 month later.
Flexible ureteroscopy with holmium laser is feasible to manage the ureterocele and calyceal diverticulum stones in patients with bilateral incomplete duplex kidneys in one operation.
重复肾是最常见的肾先天性异常之一，大多数无症状且无临床意义。关于双侧不完全重复肾患者中，经软性输尿管镜处理的左输尿管口囊肿和肾盂憩室结石的报道较少。
一名 69 岁的中国女性因左侧腰痛 1 个月就诊。术前 CT 扫描和静脉肾盂造影显示左侧输尿管口囊肿位于左侧输尿管膀胱交界处，左不完全重复肾的上肾盏有肾盂憩室结石。输尿管镜检查证实了输尿管口囊肿，使用钬激光行输尿管口囊肿切除术。由于憩室颈部狭窄，我们花了很大的努力才找到结石。幸运的是，当我们用钬激光对内切开憩室颈部时，清楚地发现了结石，并通过软性输尿管镜使用钬激光和镍钛合金取石篮取出结石。留置双 J 输尿管支架 1 个月。术后症状消失，支架留置期间无并发症。1 个月后取出输尿管支架前的 CT 扫描未见结石残留。
软性输尿管镜联合钬激光治疗双侧不完全重复肾患者的输尿管口囊肿和肾盂憩室结石可行，可在一次手术中处理。
