Management of full-length complete ureteral avulsion

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Vol. 42 (1): 160-164, January – February, 2016

doi: 10.1590/S1677-5538.IBJU.2015.0372


CHALLENGING CLINICAL CASE

Management of full-length complete ureteral avulsion

Kaifa Tang 1, Fa Sun 1, Yuan Tian 1, Yili Zhao 1
1 Department of Urology, Affiliated Hospital of Guizhou Medical University, Guiyang, China


ABSTRACT

Introduction: Complete ureteral avulsion is one of the most serious complications of ureteroscopy. The aim of this report was to look for a good solution to full-length complete ureteral avulsion.
Case presentation: A 40-year-old man underwent ureteroscopic management. Full-length complete avulsion of ureter occurred during ureteroscopy. Pyeloureterostomy plus greater omentum investment outside the avulsed ureter and ureterovesical anastomosis were performed 6 hours after ureteral avulsion. The patient was followed-up during 34 months. Double-J tube was removed at 3 months after operation. Twenty three months after the first operation, the patient developed hydronephrosis because of a new ureter upside stone, then rigid ureteroscopy and holmium laser lithotripsy were used successfully.
Conclusion: Pyeloureterostomy plus greater omentum investment outside the avulsed ureter and ureterovesical anastomosis may be a good choice for full-length complete ureteral avulsion.

Keywords: Ureteral avulsion, Greater omentum, Pyeloureterostomy, Ureterovesical anastomosis

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