Mahajan Ramesh V, Maheshwari Pankaj N, Aditya Ramkhilawan
Department of Urology, Fortis Hospital Mulund, Mumbai, India.
J Endourol Case Rep. 2020 Dec 29;6(4):476-478. doi: 10.1089/cren.2020.0173. eCollection 2020.
The type of the stent to be used after endoureterotomy is a matter of discussion and debate. Endopyelotomy stent is commonly used after endoureterotomy for the management of upper and the lower ureteral strictures. For the strictures in the middle segment of the ureter (lower part of upper ureter, midureter, and upper part of lower ureter), the bulbous portion of the endopyelotomy stent may not adequately cover the endoureterotomy site leading to early recurrence. Presented here is a young man who underwent endoureterotomy for a postureteroscopy stricture at the L4-L5 vertebral level. The endopyelotomy stent that was placed after endoureterotomy upmigrated, and the bulbous portion of the endopyelotomy stent got stuck above the recurrent stricture site. This difficult clinical situation needed a percutaneous access for stent removal. We propose that tandem stents have an advantage over endopyelotomy stent postendoureterotomy for stricture in the middle portion of the ureter as it provides a good splint for healing without any risk of stent migration and complications.
输尿管内切开术后使用的支架类型是一个存在讨论和争议的问题。肾盂内切开术支架常用于输尿管内切开术后对上、下输尿管狭窄的处理。对于输尿管中段（上段输尿管下部、输尿管中段、下段输尿管上部）的狭窄，肾盂内切开术支架的球囊部分可能无法充分覆盖输尿管内切开术部位，从而导致早期复发。本文介绍了一名年轻男性，他因输尿管镜检查后在L4 - L5椎体水平出现狭窄而接受了输尿管内切开术。输尿管内切开术后放置的肾盂内切开术支架向上移位，其球囊部分卡在复发性狭窄部位上方。这种困难的临床情况需要经皮途径取出支架。我们认为，对于输尿管中段狭窄，串联支架在输尿管内切开术后比肾盂内切开术支架具有优势，因为它为愈合提供了良好的支撑，且没有支架移位和并发症的风险。
