A Rare Complication: Removing the Guide Wire Pieces Remaining in the Calyx After Nephrostomy by Retrograde Ureterorenoscopy

Case Report

Abstract

Introduction: Ureterorenoscopy is a frequently applied technique in stone surgery, and its complications are rare with the development of endoscopic materials. In cases where progress cannot be made through the ureter, antegrade interventions or a catheter must be inserted. In this case, we tried to explain the management and removal of the guidewire pieces that could not be performed with URS and remained in the calyx during the insertion of the nephrostomy catheter.

Case: In a 64-year-old patient who applied to the external center with the complaint of left flank pain, a left ureteral stone was detected, then URS was performed and the stone could not be reached due to proximal ureteral cyst. Subsequently, a nephrostomy catheter was inserted. The patient then underwent flexible URS and guidewire fragments were seen. An annual DJ catheter was applied and then the patient was passed through the dilated ureter with a rigid URS and the existing guyite pieces were removed.

Discussion and Conclusion: Ureteric strictures are rare complications with a rate of 9% and improvements. It usually does not require additional intervention, but rare and challenging situations may occur, as in our case. Complications such as failure to enter the collecting system, bleeding, and infection may also occur during percutaneous nephrostomy. In this type of URS cases, the limits of endoscopic interventions should be taken into consideration and contrast-enhanced images revealing the anatomy should be taken.