One-Step Laparoscopic Surgery for Two Regions : Pelvi-Ureteric Junction Obstruction and Mid Ureteral Obstruction Due to Umbilical Ligament
佐々木, 雄太郎 ,
塩崎, 啓登 ,
泉, 和良川西, 泰夫
泌尿器科紀要 = Acta urologica Japonica
23 , 2017-01-31 , 泌尿器科紀要刊行会
The patient first presented with left flank pain at the age of 15. Computed tomography (CT) and ultrasonography performed at that time revealed left hydronephrosis and hydroureter. Mid-ureteral obstruction was suspected, and he underwent balloon catheter dilation of the mid-ureteral obstruction. Hydronephrosis, hydroureter and flank pain improved after surgery. However, at 21 years of age, he again presented with left flank pain. CT and ultrasonography revealed pelvi-ureteric junction obstruction and mid-ureteral obstruction. The suspected cause of the mid-ureteral obstruction was the umbilical ligament. Renal scintigraphy showed an obstructive pattern in the left kidney, with 52% split renal function. He thus underwent laparoscopic pyeloplasty and end-to-end anastomosis of the mid-ureter with the one-step approach. No intra- or postoperative complications occurred, and the D-J stent was removed 6 weeks after surgery. At 12 months after surgery, he has had no recurrent flank pain and left renal function is normal.