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Resumen Se presentan los resultados y complicaciones obtenidos en 360 procedimientos de ureterorrenoscopia transuretral (U.R.S.) por litiasis ureteral, realizados en nuestro Servicio desde enero de 1990 hasta agosto de 2000 en 354 pacientes: 55% mujeres y 45% varones. Se ha utilizado un ureterorrenoscopio rigido Storz 10.5 Ch. y ha sido necesario emplear litotricia intracorporea en un 17,31% de los casos. En todos los procedimientos la indicacion fue el tratamiento de litiasis ureterales con predominio de localizacion en el ureter pelviano (70,33%), obteniendo un porcentaje de exito global del 93,05% descendiendo de forma significativa a nivel del ureter lumbar. Las complicaciones serias solo representaron un 3,05% precisando cirugia correctora endoscopica en tres casos de estenosis ureteral. En nuestra experiencia, la U.R.S. es la tecnica de eleccion en el tratamiento de la litiasis ureteral a nivel pelviano y sacroiliaco donde los porcentajes de exito alcanzados son de 98,88% y 95,83% respectivamente.

Resumen Objetivo Analizar si la cateterizacion sistematica de la anastomosis ureterovesical en el trasplante renal mediante un cateter doble J disminuye la incidencia de las complicaciones urologicas tipo fistula y estenosis ureterales Material y metodos En el periodo comprendido entre agosto de 2003 y diciembre de 2004 realizamos 59 trasplantes renales de donante cadaver. Establecemos dos grupos, grupo A pacientes que durante el trasplante se les coloca un cateter doble J y grupo B pacientes trasplantados sin colocacion de cateter. Mediante un estudio retrospectivo analizamos la incidencia de fistulas urinarias, estenosis ureterales y procesos infecciosos en ambos grupos Resultados En el grupo A (con cateter doble J) se detectaron 1 caso de estenosis ureteral y 2 casos (7%) de fistula urinaria. En un paciente fue necesaria la retirada del cateter al producir obstruccion por coagulos. Trece pacientes (46%) presentaron un cultivo de orina positivo. En el grupo B (sin cateter doble J) se evidenciaron 4 casos (13%) de estenosis ureteral y 5 casos (16%) de fistula urinaria. Nueve pacientes (29%) presentaron un cultivo de orina positivo Conclusion El empleo del cateter doble J de forma profilactica en el trasplante renal, disminuye las fistulas urinarias y en mayor medida las estenosis ureterales

Purpose: We evaluated the treatment of ureteral stenosis using a self-expanding nitinol stent covered with expanded polytetrafluoroethylene (ePTFE). Materials and Methods: Between January 2001 and April 2003, 37 ePTFE covered metal stents were implanted in 20 patients with a total of 29 ureteral stenoses due to various causes. In general the stents were introduced by using a retrograde approach under combined endoscopic and fluoroscopic guidance with patients under spinal block and sedation. Followup assessments in 18 patients, including urography, were done 3, 6, 12, 18 and 24 months after the procedure. Followup endoscopic examinations were performed at 6 and 12 months in 8 patients. Results: Immediate ureteral patency was achieved during all insertion procedures and maintained in most patients. Four patients died of the neoplastic process 3 to 12 months after implantation. Four stent migrations occurred in 3 patients (22.2%), which was resolved by implanting a new stent. Nonobstructive mucous hyperplasia was observed in 5 patients (27.7%) at the end of the stent, although there was no internal calcification. In all cases the stents remained patent until the current time or until patient death. Conclusions: We found that ePTFE covered nitinol stents were safe and effective for ureteral stenosis. Their resistance to calcification was high with nonobstructive hyperplasia developing in only a few cases and only at the stent ends. The ideal material for covering stents would produce no mucous hyperplasia.

OBJECTIVE. Our purpose was to report our experience with four patients with renal colic who had a rare unilateral complication from urographic contrast media, with a dense and striated nephrogram affecting only the healthy kidney. All cases were reversible. CONCLUSION. An unusual complication of urography with a characteristic radiologic appearance is presented. This complication was transient and reversible in our patients. Unilateral tubular blockage induced by a contrast agent must be considered when the contralateral kidney shows evidence of ureteral obstruction. Editorial Comment: The authors describe 4 patients who had a dense, unilateral, striated nephrogram affecting a normal healthy kidney with contralateral ureteral obstruction. This complication was reversible and transient. They attributed this appearance to protein or uric acid precipitation in the renal tubules. Thus, among the patterns of unilateral striated nephrogram that has been reported, this new entity needs to be considered. Other entities that present such a pattern and that may be unilateral or bilateral include obstructed uropathy, acute pyelonephritis, acute thrombosis of the renal vein and so forth. In 1 patient proteinuria was observed, while the other 3 had hyperuricemia with urates in the urinary sediment after excretory urography. I have not seen this phenomenon but it is important to be aware of and include in the differential diagnosis.