Troubleshooting for Ureteroscopy Complicated by Unexpected Guidewire Looping and Entrapment

Abstract

This report presents a bizarre and unusual case of looping and entrapment of a hydrophilic guidewire in the ureter of a 65-year-old woman with a stone in the lower ureter at the time of ureteroscopy and laser lithotripsy. We describe endourology maneuvers to remove the retained guidewire. Looping and entrapment of guidewire is a rare complication that urologists may face when they do not follow the basic principles of guidewire insertion. In that case, successful resolution is based both on surgeon's inspiration to apply the appropriate endourology maneuvers and availability of a variety of endourology tools in the theater. Both may lead urologists to avoid more invasive and morbid approaches for their patients.

Ureteral Guidewire Looping and Entrapment above an Impacted Ureter Stone

“…Nevertheless, looping above the stone and entrapment of a guidewire inside the ureter is an extremely rare complication. There is only one case in the literature, where the authors present looping of a guidewire below the stone during rigid ureteroscopy and laser lithotripsy [5].…”