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Questions posted in the
The Urology Forum have been answered by urologists from Henry Ford Health System and by Dr. Kevin Pho.
Question Title: Torn ureter in stone removalForum: The Urology Forum
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| My wife, age 73,underwent a kidney stone removal internally by way of the urethra. The stone was successfully removed from the ureter but in the process the ureter wall was ruptured. A ureter stent was inserted as a result and is to be left in place for one month. It has now been 2 1/2 weeks and she has been in considerable discomfort as a result of this. My questions are these: 1)How common is it to tear the ureter in this procedure? Precen- 2)Is there risk in removal of the stent? How much risk, if so? Ernest
_ Dear Ernest, Complications after ureteroscopy stone basketing can be classified as major (those requiring immediate or delayed surgical intervention) or minor ( those responding to conservative or ureteral catheter drainage). The reported incidence is upto 35% in some older series, however, more recent series the complication rate is less than 10%. It is difficult to comment on your wife’s case, because I have not seen the films. Some stones become impacted in the wall of the ureter and are nearly impossible to remove without opening a false passage in the ureter. Ureteral perforations occurs in up to 28% of all procedures and ureteral perforation is the most common complication. The stent drainage of the ureter is the appropriate way to manage this situation and more likely than not there will be no long term sequellae. However, ureteral strictures have been reported in upto 5% of patients following ureteroscopy, and occassionally, vesico-ureteral reflux (urine going up the ureter the wrong way). I think your urologist is handling the situation well and I would talk to him or her about any further questions or concerns. This information is provided for general medical educational purposes only. Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition. More individualized care is available at the Henry Ford Hospital and its satellites (1 800 653-6568). Sincerely,
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