Abstract
BackgroundForeign bodies in the kidney have rarely been reported. However, they can be a clinical problem for urologists. We report on a patient with a residual segment of guidewire coating embedded in the renal parenchyma following computed tomography (CT)-guided percutaneous nephrostomy drainage (PCND), and our successful minimally invasive management with retrograde intrarenal surgery (RIRS).Case presentationA 40-year-old female with urosepsis due to a right upper ureteral stone with hydronephrosis received emergent CT-guided PCND and subsequent ureteroscopic lithotripsy, double J stent insertion, and percutaneous catheter removal. Follow-up radiography showed a coiled object within the upper pole parenchyma of the right kidney, which might be the remnant of a guidewire used during the PCND procedure. Flexible ureteroscopy (fURS) was performed. Under fluoroscopy, the foreign body was localized, the renal parenchyma was incised with laser, and the foreign body was retrieved using a stone basket.ConclusionAlthough guidewire breakage is uncommon, clinicians should keep it in mind during interventional procedures. Several methods can be used to eradicate foreign objects from the urinary tract, and the first choice should always be the least invasive one. RIRS with fURS is considered as a safe, efficient, and minimally invasive option for the extraction of foreign bodies from the kidney. To the best of our knowledge, this is the first comprehensive case report detailing the removal of a foreign object by RIRS in the English literature.
Highlights
Foreign bodies in the kidney have rarely been reported and it has seldom been elaborated in the urological literature [1]
To the best of our knowledge, this is the first comprehensive case report detailing the removal of a foreign object by retrograde intrarenal surgery (RIRS) in the English literature
We hereby report a patient with a residual guidewire segment left behind in the kidney during computed tomography (CT)-guided percutaneous nephrostomy drainage (PCND), and our successful minimally invasive management with retrograde intrarenal surgery (RIRS)
Summary
Foreign bodies in the kidney have rarely been reported and it has seldom been elaborated in the urological literature [1]. Foreign bodies in the urinary tract can be a clinical problem for urologists. Foreign bodies can be introduced to the kidney by penetration during a traumatic incident, by oral ingestion, and intestinal perforation, and sometimes even because of the accidental leaving of items in the body during medical procedures [2,3,4,5,6]. We hereby report a patient with a residual guidewire segment left behind in the kidney during computed tomography (CT)-guided percutaneous nephrostomy drainage (PCND), and our successful minimally invasive management with retrograde intrarenal surgery (RIRS). To the best of our knowledge, this is the first comprehensive case report detailing the removal of a foreign object by RIRS in the English literature
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