V04-09 MALPOSITION OF METALLIC SILICONE COVERED STENT. INTRAOPERATIVE RESOLUTION

Abstract

INTRODUCTION AND OBJECTIVE: Allium stents are useful in ureteral stenosis. Correct position is paramount. The objective is to present a case where this device was useful to solve an intraoperative complication. METHODS: We present a case of a 41 years old male with history of Prune Belly syndrome. He had a left nephrectomy in 1981 at age 3. 10 years later a right ureteric reimplant was performed, needing to redo the reimplant 6 years latter for ureterovesical stenosis. 5 years latter an open anastomosis plasty was required and a double J catheter was placed. At that time, it was decided to leave the anastomosis with a permanent double J catheter that was periodically replaced until 2018. In April 2018a nephrostomy tube was required as it was impossible to place a double J stent. In September 2019 the pyelogram showed a 2 cm stenosis in the distal ureter. An antegrade double J stent was placed. Placement of an allium stent was proposed. RESULTS: Navigation of the wire guide through the ureter was difficult due to its tortuosity. Allium stent was placed but descendent pyelogram showed contrast in the ureter and the stent outside the urinary tract. Stent was then removed and another hydrophilic wire was correctly placed in the kidney allowing a correct stent positioning. Patient had a good evolution and was discharged the next day. A computed tomography scan 1 month after surgery showed the stent in the right position with no urine collections. CONCLUSIONS: Confirming stent positioning is important as malpositioning may occur. In this case, another Allium stent was useful to solve this complication. Source of Funding: None