Transurethral fulguration for empyema of ectopic ureteral stump

Ikeda, Daisuke; Matsutani, Ryo; Fukuda, Mamoru; Fuse, H; Hirano, Shoji

doi:10.1046/j.1442-2042.2003.00714.x

Cited by 15 publications

(17 citation statements)

References 8 publications

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“…The natural history of development of ureteral stump empyema after nephrectomy is usually of long-term duration extending up to 20 years [3, 6]. Surprisingly, the current case of empyema presented within days after nephrectomy.…”

Section: Discussionmentioning

confidence: 97%

“…Ureteral stump empyema is an uncommon variant of ureteral stump syndrome [6, 7]. It evolves from retained pus in an obstructed stump [3].…”

Section: Discussionmentioning

confidence: 99%

“…In spite of the emergence of minimally invasive techniques for the management of ureteral stumps [2, 6], urgent laparotomy and radical excision were performed to avoid possibilities of repeated scenarios which may impede infection eradication and, in turn, planned kidney transplantation. In spite of the near surgeries within 14 days, judicious management saved this patient from these life-threatening risks.…”

Section: Discussionmentioning

confidence: 99%

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Rapidly Emerging Megaureteral Stump Empyema after Pretransplant Nephrectomy: A Case Report

Gadelkareem¹

2018

Dubai Med J

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Acute presentation of ureteral stump empyema after pretransplant nephrectomy has not been reported so far. We report on a 25-year-old male patient with end-stage renal disease due to congenital vesicoureteral reflux and a long-term history of management of infected kidneys including the last step of pretransplant right native nephrectomy. Within 2 weeks after operation, he presented with clinically visible ureteral stump empyema. Computed tomography and surgical exploration confirmed the diagnosis of a huge retentive stump of obstructive-refluxing megaureter which was excised with a smooth postoperative course. So, ureteral stump empyema may develop after a pretransplant nephrectomy and threaten the transplant process and the patient’s life. Consecutive nephrectomy and ureterectomy procedures to keep the iliac fossa fresh for kidney transplantation do not outweigh the risks of ureteral stump infections. Therefore, simultaneous nephroureterectomy is mandatory in the case of obstructive-refluxing megaureter.

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Section: Discussionmentioning

confidence: 97%

“…Ureteral stump empyema is an uncommon variant of ureteral stump syndrome [6, 7]. It evolves from retained pus in an obstructed stump [3].…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Rapidly Emerging Megaureteral Stump Empyema after Pretransplant Nephrectomy: A Case Report

Gadelkareem¹

2018

Dubai Med J

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“…The most popular treatment of empyema of the ureteral stump is the surgical resection of the stump, regardless of underlying diseases such as ectopic ureter, vesicoureteral reflux, or calculi in the stump [6]. However, some authors report transurethral fulguration as a safe and effective method for all patients with ureteral stump syndrome, as well those with as empyema of ectopic ureteral stump [11,12].…”

Section: Discussionmentioning

confidence: 99%

Empyema of the Ureteral Stump. An Unusual Complication Following Nephrectomy

Labanaris

Zugor

Smiszek

et al. 2010

The Scientific World JOURNAL

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A ureteral stump, which is the segment of the ureter left in place after nephrectomy, may occasionally give rise to a pathologic process called ureteral stump syndrome, which is clinically interpreted as febrile urinary tract infections, lower quadrant pain, and hematuria. Empyema of the ureteral stump, which belongs to this syndrome, is an uncommon disease entity presenting with a reported incidence of 0.8–1%. We present a case of empyema of the ureteral stump in a female patient 5 years postnephrectomy for a nonfunctioning kidney, and discuss the clinical presentation, radiologic diagnosis, and therapeutic options of this uncommon disease entity.

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“…The authors, however, decided to lay open the DUS and obliterate the UO in the vestibule with diathermy to prevent any further discharge. Similar techniques performing transurethral incision of the ectopic dilated DUS followed by fulguration of the stump have been described [8,9].…”

Section: Introductionmentioning

confidence: 95%

Symptomatic ureteral stump: a safe, alternate strategy to excision

2019

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Aim Ureteral stump syndrome is a recognised but uncommon complication following routine hemi-nephrectomy. Laparoscopic excision of the distal ureteral stump (DUS) is a popular treatment option when feasible, however, carries risks of injury to the residual moiety ureter in a duplex system. We present our strategy adopted in a girl with symptomatic DUS with an adherent common sheath to the normal lower moiety ureter. Methods A female infant underwent a laparoscopic right hemi-nephrectomy for a dilated upper moiety of a duplex kidney with an ectopic ureter. On further follow-up, she developed recurrent and troublesome vaginal discharge which continued for a few years. An ultrasound showed a dilated DUS. The decision was made to excise it using minimally invasive technique. ResultsThe DUS was noted to be completely adherent to the normal lower moiety ureter. Dissection was difficult without causing iatrogenic injury to the adjacent ureter. An alternate surgical technique was adopted in this scenario. The proximal end of the stump was identified and opened. It was then split as far down to the urethra as possible. A double-J stent was subsequently left in the lower moiety ureter. Conclusion Laparoscopic excision of the DUS can be challenging in a duplex system with a common sheath. Laying open of the stump away from the lower moiety ureter is an alternate technique which is safe and effective.

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Transurethral fulguration for empyema of ectopic ureteral stump

Cited by 15 publications

References 8 publications

Rapidly Emerging Megaureteral Stump Empyema after Pretransplant Nephrectomy: A Case Report

Rapidly Emerging Megaureteral Stump Empyema after Pretransplant Nephrectomy: A Case Report

Empyema of the Ureteral Stump. An Unusual Complication Following Nephrectomy

Symptomatic ureteral stump: a safe, alternate strategy to excision

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