Entrapped Endopyelotomy Stent After Endoureterotomy for Midsegment Ureteral Stricture: The Lessons Learned.

Abstract

Background: The type of the stent to be used after endoureterotomy is a matter of discussion and debate. Endopyelotomy stent is commonly used after endoureterotomy for the management of upper and the lower ureteral strictures. For the strictures in the middle segment of the ureter (lower part of upper ureter, midureter, and upper part of lower ureter), the bulbous portion of the endopyelotomy stent may not adequately cover the endoureterotomy site leading to early recurrence. Case Presentation: Presented here is a young man who underwent endoureterotomy for a postureteroscopy stricture at the L4-L5 vertebral level. The endopyelotomy stent that was placed after endoureterotomy upmigrated, and the bulbous portion of the endopyelotomy stent got stuck above the recurrent stricture site. This difficult clinical situation needed a percutaneous access for stent removal. Conclusion: We propose that tandem stents have an advantage over endopyelotomy stent postendoureterotomy for stricture in the middle portion of the ureter as it provides a good splint for healing without any risk of stent migration and complications.