Department of Urology, Manchester Royal Infirmary, Manchester, UK
Department of Urology, Manchester Royal Infirmary, Manchester, UK.
BMJ Case Rep. 2024 Aug 22;17(8):e228059. doi: 10.1136/bcr-2018-228059.
Following an ileal conduit (IC) urinary diversion for intractable urinary incontinence, a woman in her 50s presented with deteriorating renal function during a routine follow-up. This decline prompted further investigation with an ultrasound scan (USS), which demonstrated bilateral hydroureteronephrosis and an atrophic left kidney. Although the mercaptoacetyltriglycine (MAG-3) renogram was inconclusive in revealing urinary obstruction, a subsequent computed tomography (CT) scan uncovered a calcified tube-like structure within the IC and hydroureteronephrosis extending to this level.To address the obstructive uropathy, a right nephrostomy was inserted, which resulted in improved renal function. A looposcopy was then performed, revealing an encrusted urethral catheter within the IC. Using techniques adapted from percutaneous nephrolithotomy, we were able to endoscopically fragment the encrustation on the catheter and remove it intact through the IC.
一位 50 多岁的女性因难治性尿失禁行回肠导管（IC）尿流改道术后，在常规随访中肾功能逐渐恶化。超声检查（USS）显示双侧输尿管积水和左肾萎缩，进一步检查发现这种下降。虽然巯基乙酰三甘氨酸（MAG-3）肾图不能明确显示尿路梗阻，但随后的 CT 扫描显示 IC 内有钙化管状结构，输尿管积水延伸至该水平。为了解决梗阻性尿路病，插入了右侧肾造口术，从而改善了肾功能。然后进行了膀胱镜检查，发现 IC 内有一个结壳的尿道导管。我们使用经皮肾镜取石术的技术，能够在内窥镜下对导管上的结壳进行粉碎，并通过 IC 将其完整取出。
