Abstract
Introduction:
Various treatments have been reported for encrusted foreign bodies (FBs) in the upper urinary tract, but a consensus on the best therapeutic approach is lacking. We reported a case of a calcified piece of wire in the upper urinary tract that was effectively managed with an endoscopic procedure.
Materials and Methods:
A 77-year-old man had been referred to another institute for a left ureteral stone of ∼1 cm, in 2016. First, a percutaneous nephrostomy tube and an antegrade ureteral Double-J stent had been placed. Subsequently, the patient had undergone left ureteroscopy and laser lithotripsy. In December 2020, he presented to our department for recurrent left flank pain. A computed tomography (CT) scan showed a calcified tubular FB of ∼10 cm, extending from the renal pelvis to the upper ureter. The patient was submitted to retrograde intrarenal surgery. Holmium:YAG laser lithotripsy was carried out. Proceeding with the fragmentation of the stone burden, a sheared wire was released. When complete stone clearance was achieved, the wire was grabbed with a Nitinol basket, and it was removed. At the end of the procedure, a Double-J stent and a Foley catheter were placed.
Results:
No intra- and postoperative complications were recorded. The operative time was 135 minutes. A CT scan at 1 month after surgery showed complete stone clearance, except for clinically insignificant residual fragments in the inferior renal calices.
Conclusion:
The endourologic management of calcified FBs could be a safe and feasible alternative to open or percutaneous surgery.
Patient Consent Statement:
Authors have received and archived patient consent for video recording/publication in advance of video recording of procedure.
No competing financial interests exist.
Runtime of video: 4 mins 58 secs
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