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Perforated Ureter
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Avatar universal
Perforated Ureter
  I am a 36 year old male and have been passing calcium oxalate stones since I was 19 years old. For the first time, I had a large stone become impacted in my ureter. As a result, underwent 2 ureteroscopic surgeries to remove the stone. The first procedure utilized the basket technique and was unsuccessful in removing the stone. The second procedure (4 weeks later) utilized a laser and was successful breaking up the stone. Both procedures required a ureteral stent. Today, I had a KUB x-ray to determine if the stent could be removed. My urologist indicated that the x-ray revealed that apparently several pieces of the stone were now outside of the ureter and had possibly passed through the ureter during the second procedure. He wants to leave the stent in for at least another 2 weeks and repeat the KUB x-ray. Fortunately, I have experienced minimal discomfort after both procedures. I was surprised that a stone could perforate my ureter and not result in significant complications.
  My questions are as follows:
  1.Should I be concerned that my ureter was perforated by stone fragments during the laser procedure?
  2.Why didn
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Dear Dan,
The concern after perforation of the ureter once the stent is removed would be a stricture.  This is a narrowing that can cause obstruction, just like a stone can.  You will not know if a stricture forms in that ureter for some time after the stent is removed.  
Perforation of the ureter is not painful during the  procedure because you are under anesthetic.  If treated properly with a stent to avoid obstruction and proper healing you may never know the perforation is present.  
Losing stone into the abdomen (more specifically the retroperitoneum) is really not a problem without infection.  You would know if the stone was infected because you would still have problems with fevers and chills.  
Perforation is an uncommon occurrence, but when a stone is impacted in the ureter, anything can happen.  It is difficult to separate the stone from the wall of the ureter without tearing or causing perforation.  I don
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A related discussion, perforation of ureter during shock wave lithotripsy was started.
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