Case report: relief of acute obstruction of the Detour subcutaneous pyelovesical bypass

J Endourol. 2006 Sep;20(9):669-71. doi: 10.1089/end.2006.20.669.

Abstract

A 36-year-old patient was admitted to the emergency department with complaints of severe flank pain, nausea, vomiting, anuria, and general illness. Five months earlier, we had placed a subcutaneous pyelovesical prosthesis (Detour; Porges) of the ureter for treatment of a chronically dilated upper urinary tract in a solitary right kidney previously treated by double-J stenting. Ultrasonography of the right kidney revealed severe hydronephrosis. A percutaneous nephrostomy catheter was placed, and antegrade pyelography showed complete obstruction of the prosthesis. Urinalysis and culture demonstrated a Candida infection. A systemic antimycotic was administered, and fluid management was started. On the third day, diuresis appeared, and antegrade nephrostomography confirmed patency of the bypass.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antifungal Agents / therapeutic use
  • Candidiasis / diagnosis*
  • Candidiasis / therapy
  • Fluconazole / therapeutic use
  • Fluid Therapy
  • Humans
  • Hydronephrosis / surgery
  • Male
  • Nephrectomy / adverse effects
  • Polytetrafluoroethylene
  • Prostheses and Implants
  • Prosthesis-Related Infections / diagnosis*
  • Prosthesis-Related Infections / therapy
  • Silicone Elastomers
  • Ureter / surgery
  • Ureteral Obstruction / microbiology*
  • Ureteral Obstruction / therapy*
  • Urinary Diversion / instrumentation*

Substances

  • Antifungal Agents
  • Silicone Elastomers
  • Fluconazole
  • Polytetrafluoroethylene