41ST ETCE EVENT sponsored by TAKEDA
Course Vice Director:
1 supine PCNL and 3 RIRS for urolithiasis have been carried out uneventfully.
In one patient (see the history below), who was initially scheduled for supine PCNL and URS, only nephrostomy tube has been accomplished due to tight iatrogenic proximal ureteral stricture.
Picture 1: Coronal CT scan of the 1st patient : multiple right renal stones itogheter with several uretel fragments into the ureter are showed. The patient underwent 3 previous RIRSs in an other hospital for big renal urolithiasis. The patient experienced recurrent UTIs and urosepsis sustained by Klebsiella P.. Today unfortunately ureteroscopy was unsuccessful as well due to a long unnegotiable ureteral stenosis of the proximal ureter . As a consequence, only a nephrostomy tube was placed for severe hydropyonephrosis. Significant Pyuria contraindicated also PCNL.
Picture 2: Axial CT scan of the 2nd patient (right RIRS): several stone fragments in lower calyx are showed in a patient who underwent 6 previous ESWL treatments in an other hospital (HU 1000).
Picture 3: Axial CT scan of the 3rd patient (left RIRS): several stone fragments in lower renal pole are showed. RIRS showed that all millimetric stones were submucosal as in presence of medullary sponge kidney so any laser treatment was not accomplished.
Picture 4: abdominal X-ray of the 4th patient (left PCNL): several stone fragments in lower calyx are showed in a patient affected with cystinuria, who underwent two previous unsuccessful RIRSs.
Picture 5: Axial CT scan of the 5th patient (right RIRS): a 1,4 cm renal stone in a caliceal diverticula of the lower renal pole is showed. Caliceal diverticulum, once identified, was cut, spilling out about 50 millimetric stones.
Dr Kalantary Rad, Urologist at Fondazione Poliambulanza Brescia, Brescia (Italy)
Dr Lissiani Andrea, Urologist at Ospedali Riuniti, University of Trieste, Trieste (Italy)
Dr Paganelli Giovanni Aurelio, Urologist at Ospedale SS Capitanio e Gerosa, Lovere (Italy)
Dr Remotti Marco, Urologist at Ospedale E. Morelli , Sondalo (Italy)
Dr Tamai Aldo, Urologist at Casa di cura Eretemia, Vicenza (Italy)
Luca Lamberti, sale representative, Cook Medical Italy