A new technique for retrograde flexible ureteroscopy after Cohen cross-trigonal ureteral reimplantation

Urol Int. 2011;87(3):260-2. doi: 10.1159/000328390. Epub 2011 Aug 26.

Abstract

Purpose: Retrograde ureteral access after cross-trigonal ureteral reimplantation can be challenging. We present our experience with retrograde ureteral catheterization and flexible ureteroscopy after Cohen cross-trigonal reimplantation in patients presenting with ureteral stones.

Materials and methods: Cystoscopy is performed and a Tiemann ureteral catheter is inserted into the involved ureteral orifice. A retrograde ureterography is performed and hydrophilic guide wire is passed up to the kidney. A dual-lumen ureteral access sheath is then passed under x-ray control underneath the ureteral stone. The flexible ureterorenoscope is passed under x-ray control up to the stone which is then fragmented with a holmium laser.

Results: From June 2006 to June 2010, this technique was successful in 8 patients without acute or delayed sequelae.

Conclusions: Where the endourological expertise is readily available, the ureter can be accessed retrogradely even after Cohen cross-trigonal ureteral reimplantation in a safe, straightforward and effective modality.

MeSH terms

  • Adolescent
  • Adult
  • Equipment Design
  • Female
  • Humans
  • Lasers
  • Male
  • Replantation / methods
  • Treatment Outcome
  • Ureter / physiopathology
  • Ureter / surgery*
  • Ureteral Calculi / surgery*
  • Ureteroscopes*
  • Ureteroscopy / methods*
  • Urology / methods*
  • X-Rays