Abstract
The stricture of the calix, renal pelvis, or ureter secondary to renal tuberculosis has been managed by nephrectomy, partial nephrectomy, ureteroileoneocystoplasty, or even pancaliceal-ileoneocystoplasty. To salvage the renal parenchyma, percutaneous endocalicotomy with or without endopyelotomy was performed in 10 patients. The main sites of stricture were an upper calix in six cases and a lower calix in four. A cold knife was used to incise the stricture, and a stenting two-section 14F endopyelotomy catheter was retained for 6 to 8 weeks. Postoperative intravenous urography revealed marked shrinkage of the dilated calix in seven cases, moderate shrinkage in one, and no change in two (success rate 80%). One of the patients in whom the procedure failed underwent partial nephrectomy, and the other is being followed. The only significant complication was one case of pyelonephritis. Endocalicotomy is a safe, less invasive, successful (in cases that a guidewire could pass), and parenchyma-saving procedure. Retrograde pyelography is mandatory just before the surgery because stricture can worsen during antituberculosis chemotherapy.
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