Complete Occlusion of a Subcutaneous Pyelovesical Bypass Graft (Detour® System) Caused by Uric Acid Stone Formation

Wilhelm, Konrad; Schultze-Seemann, Wolfgang; Miernik, Arkadiusz

doi:10.1159/000366140

Cited by 4 publications

(4 citation statements)

References 11 publications

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“…These types of complications are rare and we find few references in the literature [ 10 , 15 ]. Wilhem et al reported an occlusion of the bypass with acid uric lithiasis, insufficiently managed through endoscopic intervention and solved with forced chemolitholysis [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

Long-term results of the treatment of complex ureteral stenosis with extra-anatomic ureteral bypasses

2020

Cent european J Urol

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Introduction Complex ureteral obstruction is a pathology that has always been a challenge for the urologist, especially in patients with high surgical risk or with a short life expectancy. Material and methods Between 2002 and 2017, 13 extra-anatomical bypasses were placed. A descriptive retrospective study was carried out. An analysis of the permeability time of the prosthesis was performed using Kaplan-Meyer curves. Demographic and etiological characteristics as well as early and late complications were analysed. Results Etiologies were benign in 39% (including 3 transplant recipients) and malignant in 69%. Permeability rates were 90.9% at each of 12, 24 and 48 months, respectively, and 75.8% at 60 months. There were no deaths in the early postoperative period, nor intraoperative complications. The most frequent complications were infections. Three of them were associated with bypass extrusion, which needed to be removed. A total of 5 prosthesis had to be removed. 40% of the patients did not present complications. Conclusions The extra-anatomical ureteral bypass is an alternative to permanent nephrostomy in the treatment of complex ureteral strictures. Their patency rates after long-term follow-up vary from 90% to 75% at 48 and 60 months, respectively. Their complication rates can be considered acceptable in the patients’ clinical contexts.

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Section: Discussionmentioning

confidence: 99%

Long-term results of the treatment of complex ureteral stenosis with extra-anatomic ureteral bypasses

2020

Cent european J Urol

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“… , Wilhelm et al . ). Patients are advised to increase their water intake and intermittently compress the subcutaneous tubing to help prevent obstructions.…”

Section: Nephrovesical Subcutaneous Ureteral Bypass/artificial Uretermentioning

confidence: 97%

“…However, urinary tract infection, Candida species positive urine cultures, fungal ball occlusion, stone occlusion, encrustation and death secondary to fungal infection-induced septic shock have been described in association with the device. (Burgos et al 2009, Gerullis et al 2010, Muller et al 2011, Wilhelm et al 2014. Patients are advised to increase their water intake and intermittently compress the subcutaneous tubing to help prevent obstructions.…”

Section: Nephrovesical Subcutaneous Ureteral Bypass/artificial Uretermentioning

confidence: 99%

Feline ureteral obstructions Part 2: surgical management

Clarke

2018

J of Small Animal Practice

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Feline obstructive ureteral disease will likely remain a common and frustrating cause of critical illness in cats for the foreseeable future. Since many cats are uraemic and cardiovascularly unstable secondary to obstructive nephropathy, prompt recognition using clinical intuition, blood work and diagnostic imaging is essential to make a timely diagnosis and decision about timing for intervention, if indicated. Multiple surgical and interventional procedures exist for the management of feline ureteral obstructions but there is no ideal technique and all currently available procedures carry risk of infection, re-obstruction, urine leakage and the need for additional procedures in the future. Therefore, until clear, evidencebased guideline exist, the decision about which ureteral procedure to perform in cats should be guided by nature of the obstruction, location, concurrent urolithiasis, infection and surgeon preference. In all likelihood, ureteral surgery, stents and ureteral bypass devices will continue to remain viable options and the decision about which procedure to use will be made on a case-by-case basis.

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“…These encrustations were managed successfully with ureteroscopy and Holmium laser lithotripsy. Previous attempts have failed ureteroscopic management of Detour encrustations 9 . This case demonstrates the feasibility of flexible ureteroscopy and Holmium laser lithotripsy of encrustations since there were no kinks in the Detour device.…”

Section: Cuaj -Spotlight In Urologymentioning

confidence: 99%

Spotlight — Management of pyelovesical bypass device stones

Almarzouq

Andonian²

2018

CUAJ

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Pyelovesical bypass devices or artificial ureters have been described as a last resort in patients with long ureteral strictures that fail traditional endoscopic and open repair. Herein, we describe a 52-year-old female who had a Detour (Coloplast, Humlebaek, Denmark) pyelovesical bypass device inserted after an iatrogenic ischemic injury to the distal two-thirds of the left ureter during pelvic surgery for recurrent endometrial stromal sarcoma. Six months after placement of the device, she presented with gross hematuria and recurrent urinary tract infections (UTIs) and was found to have encrustation of the distal silicone tip of the Detour device within the bladder. This was managed with resection of the distal silicone tip and flexible ureteroscopy with holmium laser lithotripsy. Despite suppressive antibiotic therapy and medical therapy for hypercalciuria, she presented four years later with intraluminal encrustations in the proximal end of the device. This was successfully managed with flexible ureteroscopy with holmium laser lithotripsy. Therefore, this case illustrates the feasibility of flexible ureteroscopy and holmium laser lithotripsy of Detour device encrustations as long as the device is not kinked and it allows the passage of the flexible ureteroscope up to the calcifications. In addition, patients contemplating insertion of such devices should be counselled regarding the risk of recurrent infections and encrustations.

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Complete Occlusion of a Subcutaneous Pyelovesical Bypass Graft (Detour® System) Caused by Uric Acid Stone Formation

Cited by 4 publications

References 11 publications

Long-term results of the treatment of complex ureteral stenosis with extra-anatomic ureteral bypasses

Long-term results of the treatment of complex ureteral stenosis with extra-anatomic ureteral bypasses

Feline ureteral obstructions Part 2: surgical management

Spotlight — Management of pyelovesical bypass device stones

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