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Case Reports: Novel treatment (new drug/interventions; established drug/procedure in new situation)
Obstructive Uropathy: a retained urethral catheter within an ileal conduit
  1. M Fowz Azhar,
  2. Rahim Liaquat Kaba,
  3. Ian Pearce and
  4. Ben R Grey
  1. Department of Urology, Manchester Royal Infirmary, Manchester, UK
  1. Correspondence to Mr M Fowz Azhar; fowz.azhar{at}doctors.org.uk

Abstract

Following an ileal conduit (IC) urinary diversion for intractable urinary incontinence, a woman in her 50s presented with deteriorating renal function during a routine follow-up. This decline prompted further investigation with an ultrasound scan (USS), which demonstrated bilateral hydroureteronephrosis and an atrophic left kidney. Although the mercaptoacetyltriglycine (MAG-3) renogram was inconclusive in revealing urinary obstruction, a subsequent computed tomography (CT) scan uncovered a calcified tube-like structure within the IC and hydroureteronephrosis extending to this level.To address the obstructive uropathy, a right nephrostomy was inserted, which resulted in improved renal function. A looposcopy was then performed, revealing an encrusted urethral catheter within the IC. Using techniques adapted from percutaneous nephrolithotomy, we were able to endoscopically fragment the encrustation on the catheter and remove it intact through the IC.

  • Urinary tract infections
  • Interventional radiology
  • Urological surgery
  • Catheterisation / catheter care

https://doi.org/10.1136/bcr-2018-228059

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    Footnotes

    • Contributors MFA, RLK, IP and BRG: all contributed significantly to writing, planning, conducting and reporting. Furthermore, the senior two authors where also significantly involved in concept analysis and data interpretation.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.