Minimmally invasive resolution of a left ureteral stenosis after Schistosoma haematobium infection

Lorca, Javier; Hevia, Vital; Nicolas, V.; González, Ana Saiz; Guerrero, Clara Sánchez; Revilla, F.J. Burgos

doi:10.1016/j.eucr.2019.100889

Cited by 4 publications

(8 citation statements)

References 4 publications

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“…One study on 10 patients looked at the ability of CT scans to show the typical alterations of UGS, including OU [ 48 ]. CT scans were also described with comparable results in another 8 case reports [ 35 , 49 – 55 ].…”

Section: Diagnosissupporting

confidence: 69%

“…Plain X-rays were used in 8 reports. Whilst 12 studies have used US alone for the diagnosis of OU [ 12 , 19 – 29 ], others have used two methods to confirm the complication (intravenous urography in five case reports [ 30 – 34 ], anterior urography in one patient from a case series [ 33 ], CT scan in one case report [ 35 ]) or an invasive procedure (cystoscopy in one case report [ 35 ]). Very few studies compared the performances of radiological methods: only one study compared the performances of intravenous urography (considered the gold standard) and cystography, finding suboptimal performances of the latter (Sensitivity (Se) 26.8%; specificity (Sp) 66.7%; positive predictive value (PPV) 84.6%; negative predictive value (NPV) 11.8%) [ 36 ].…”

Section: Diagnosismentioning

confidence: 99%

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Diagnosis and management of complicated urogenital schistosomiasis: a systematic review of the literature

et al. 2023

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Background Currently, there are no standardized guidelines for the diagnosis or management of the complications of urogenital schistosomiasis (UGS). This systematic review of the literature aims to investigate the state of the art in reference to diagnostic approaches and the clinical management of this condition. Methods A systematic review of literature published between January 1990 and January 2021 was conducted in the MEDLINE database, scoping for articles regarding diagnostic means or therapeutic options for the complications of UGS, namely obstructive uropathy, bladder cancer, abortion, ectopic pregnancy, infertility, kidney failure, urolithiasis and the need for invasive procedures. Relevant data were then extracted from the articles deemed eligible according to the inclusion criteria. Main results In total, 3052 articles were identified by the research query, of which 167 articles fulfilling inclusion criteria after title/abstract screening and full-text evaluation were included, 35% on both diagnostic and therapeutic aspects, and 51% on diagnosis and 14% on therapy. Ultrasound was the most frequently tool employed for the diagnosis of UGS complications showing a good performance. Concerning the management of hydronephrosis, the majority of available evidences came from community-based studies where universal treatment with praziquantel was used leading to decrease of prevalence of obstructive uropathy. Concerning studies on surgical procedures, laser endoureterotomy followed by stenting was mostly employed in adult patients leading to a crude cure rate of 60% (43 of 71 patients). In the case of severe hydronephrosis, surgery consisting of ureteral re-implantation showed excellent results with a crude cure rate of 98% (157 cured patients of 160 treated). Concerning bladder cancer, data on 93 patients with a clear diagnosis of UGS-related bladder were available reporting a variable and sometime combined approach based on disease stage. Available data on diagnosis and management of abortion, ectopic pregnancy, infertility, kidney failure, urolithiasis and the need for invasive procedures due to UGS are also presented. Conclusions The review produced a complete picture of the diagnostic and therapeutic options currently available for complicated UGS. These results can be useful both for guiding clinicians towards correct management and for tracing the direction of future research.

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Section: Diagnosissupporting

confidence: 69%

Section: Diagnosismentioning

confidence: 99%

Diagnosis and management of complicated urogenital schistosomiasis: a systematic review of the literature

et al. 2023

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“…Balloon dilation appears more durable than mechanical dilation which is prone to high recurrence rates 9,10 . Formal reconstruction offers the highest success rate with multiple approaches described including ureteral reimplantation with Boari flap or psoas hitch, buccal graft augmentation, and ileal‐ureter replacement 11–16 . In some extreme cases, bilateral ileal replacement has been performed for complete ureteral involvement 17 .…”

Section: Discussionmentioning

confidence: 99%

“… 9 , 10 Formal reconstruction offers the highest success rate with multiple approaches described including ureteral reimplantation with Boari flap or psoas hitch, buccal graft augmentation, and ileal‐ureter replacement. 11 , 12 , 13 , 14 , 15 , 16 In some extreme cases, bilateral ileal replacement has been performed for complete ureteral involvement. 17 Minimal data exist for robotic surgery in this setting but has been utilized for cystectomy with ileal conduit urinary diversion in a patient with end‐stage bladder dysfunction from chronic schistosomiasis.…”

Section: Discussionmentioning

confidence: 99%

A unique case of Schistosoma‐related ureteral stricture: Diagnosis and surgical reconstruction

Seaman,

Bracamonte,

Kim

2023

IJU Case Reports

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BackgroundChronic infection with Schistosoma haematobium can lead to pathology of the upper and lower urinary tracts. While well known as a cause of squamous cell carcinoma of the bladder, relatively little research exists on ureteral involvement. Here, we present a unique case of bilateral ureteral obstruction from schistosomiasis with concomitant ureteral stone disease.Case presentationA 43‐year‐old male Somalian immigrant was diagnosed with a right proximal ureteral stone and bilateral multifocal ureteral narrowing causing obstruction with preserved renal function. He underwent a staged repair with right robotic pyelolithotomy and non‐transecting ureteroureterostomy, followed by left robotic ureteroureterostomy with stricture excision. Pathology revealed Schistosoma ova.ConclusionUreteral stricture from schistosomiasis represents a rare diagnosis for urologists in non‐endemic countries. Bilateral ureteral narrowing and concomitant ureteral stone burden presented both diagnostic and reconstructive challenges, requiring a staged repair. Minimally invasive reconstruction was achieved using robotic assistance with good functional outcome.

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“…CT is also an important tool for the evaluation of ureteral obstructions due to schistosoma infection: an interesting report from Lorca et al described the case of a 34-year old Spanish female, with a previous diagnosis of S. haematobium infection after a trip to Myanmar, treated with praziquantel; after two years, uro-CT images detected left hydronephrosis due to a wall-thickening of the left distal ureter: postoperative pathological examination revealed the granulomatous reaction to schistosome eggs deposited in the left ureteral wall [ 43 ]. A similar case was reported by Pal and collaborators, in which a right hydronephrosis caused by S. haematobium infection in 41-year-old male (migrated from Zimbabwe to the United Kingdom 20 years before) was detected through CT imaging [ 44 ].…”

Section: X-rays Ultrasound and Computed Tomography Findingsmentioning

confidence: 99%

Medical Imaging in the Diagnosis of Schistosomiasis: A Review

et al. 2021

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Schistosomiasis is one of the most important parasitic diseases and it is endemic in tropical and subtropical areas. Clinical and laboratory data are fundamental for the diagnosis of schistosomiasis, but diagnostic imaging techniques such as x-rays, ultrasound (US), computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography/computed tomography (PET/CT) may be helpful in the evaluation of disease severity and complications. In this context, the aim of this review is to explore the actual role of diagnostic imaging in the diagnosis of schistosomiasis, underlining advantages and drawbacks providing information about the utilization of diagnostic imaging techniques in this context. Furthermore, we aim to provide a useful guide regarding imaging features of schistosomiasis for radiology and nuclear medicine physicians of non-endemic countries: in fact, in the last years non-endemic countries have experienced important flows of migrants from endemic areas, therefore it is not uncommon to face cases of this disease in daily practice.

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Minimmally invasive resolution of a left ureteral stenosis after Schistosoma haematobium infection

Cited by 4 publications

References 4 publications

Diagnosis and management of complicated urogenital schistosomiasis: a systematic review of the literature

Diagnosis and management of complicated urogenital schistosomiasis: a systematic review of the literature

A unique case of Schistosoma‐related ureteral stricture: Diagnosis and surgical reconstruction

Medical Imaging in the Diagnosis of Schistosomiasis: A Review

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