1. Postoperative Renal Abscess Following Tip-Flexible Suctioning Ureteral Access Sheath and Digital Ureteroscopic Lithotripsy: A Case Report.
- Author
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Lin Xiong, Shan Kwan, Kristine Joy, Geng-Geng Wei, Xiang Xu, and Zhen-Quan Lu
- Subjects
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ENDOTRACHEAL suctioning , *ABSCESSES , *KIDNEY stones , *LITHOTRIPSY , *LUMBAR pain , *SEPTIC shock , *RENAL colic , *BRAIN abscess - Abstract
Objective: Unknown etiology Background: The tip-flexible suctioning ureteral access sheath (TFS-UAS) can be bent under flexible ureteroscopes, which facilitates removal of renal stone segments by irrigation and suctioning effects. Small-scale comparative studies found it safer and more efficacious than traditional UAS. However, complications such as renal abscess were not documented after TFS-UAS combined with digital FURS. Case Report: A 57-year-old woman had right lumbar pain that persisted for 1 year. A plain computed tomography (CT) scan revealed multiple renal pelvicalyceal stones (maximum diameter 20×9 mm). She was admitted to undergo elective surgery with a TFS-UAS combined with digital flexible ureteroscopic lithotripsy. The operation was deemed successful and she was given postoperative antibiotics for 2 days before discharge. Eight postoperative days later, she was admitted to the emergency department due to high fever (39.6°C). Plain CT revealed intact double-J stents and no abnormalities. She was readmitted to the urological department to receive antibiotic therapy, which progressed to septic shock (blood pressure 80/50 mmHg) and required immediate transfer to the intensive care unit. Contrast-enhanced CT revealed a right renal abscess. She was promptly resuscitated and given stronger antibiotics. She recovered well and was discharged with 2-week oral levofloxacin treatment. Follow-up ultrasound found no renal abscess. Conclusions: While TFS-UAS with digital FURs is an effective approach for multiple renal stones, there is a risk of postoperative renal abscess, possibly due to altered intrarenal pressure. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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