Renal Stones Outlet Obstructed by Pararenal Pelvic Cyst Management

Abstract

s / Urological Science 26 (2015) S50eS81 S54 plane abdominal X-ray. Treatment outcomes, including disintegration rate, stone-free rate, and retreatment rate, for both groups were also compared. Results: Pre-SWL, the patient characteristics, treatment parameters, and stone-related parameter were similar for both groups. There were higher stone-free and disintegration rates in the electrohydraulic group for most stones, but the retreatment rate was higher in the electromagnetic group. There was no significant difference for stones at the middle and lower ureter and stones in the ureter bigger than 1 cm. The complication rates for pain, skin, or subcapsular hematoma were not significantly different between groups. Conclusion: The electrohydraulic lithotriptor (Medispec E3000) group has significantly higher disintegration and stone-free rates, but has similar complication rates compared to the electromagnetic lithotriptor (Medispec EM1000) group. There is no significant difference between the two groups for middle or lower ureteral stones and ureteral stones bigger than 1 cm. The electromagnetic lithotripter has the advantage of being useful for SWL even without anesthesia. NDP017: RENAL STONES OUTLET OBSTRUCTED BY PARARENAL PELVIC CYST MANAGEMENT Ping-Ju Tsai, Cheng-Chen Su, Chung-Sung Shen, Shih-Ya Hung. Division of Urology, Department of Surgery, Yuan's General Hospital, Kaohsiung, Taiwan We often incidentally indentified some renal cysts at OPD. The principles of non-obstructive simple renal cysts management is watchful waiting. However, some renal cysts need to be managed, such as malignancy tendency, renal pelvic-ureteral junction obstruction by those cysts. The management of renal cysts included aspiration combined with injection of scloerosing materials, and laparoscopic unroofing. We presented a 60-year-old male who has multiple low calyceal stones with focal hydrocalyx. The renal pelvic-ureteral junction was extrinsic compressed by one large parapelvic renal cyst. First, non-enhanced abdominal CT scan was arranged and thus we clearly know the relative locations of cyst and pelvic-ureteral junction. Laparoscopic unroofing of renal cyst was performed. After surgery, we arranged intravenous pyelogram for confirming the pelvic-ureteral junction patency. Watchful waiting for spontaneous passage of multiple small renal stones was planned. Unfortunately, stone streets formations in low third and upper third ureter were found later. Ureteroscopic lithotripsy and double-J catheter were performed smoothly. Extraperitoneal shock wave for residual renal stones was performed, too. Last, we removed the double-J catheter. The clearance of renal stone was excellent.