Introduction and Objectives
The aim of our study was to evaluate the etiology, diagnosis and treatment of the spontaneous rupture of the renal pelvis.
Material and Methods
From 1999–2008, we evaluated and treated 11 patients (6 women and 5 men) with spontaneous rupture of the renal pelvis. The diagnosis was confirmed by abdominopelvic CT with contrast agent or by intravenous urography and by retrograde ureteropyelography. The cause of spontaneous rupture of the renal pelvis was a ureteral stone in 8 cases and ureteral stricture in 3 cases.
Results
Four patients with ureterolithiasis in lower ureter underwent primary ureteroscopic lithotripsy and stenting and no auxiliary treatment was required. Four patients with ureterolithiasis in upper ureter we treated with sole stenting and the secondary intervation was performed 28 – 60 days (average 37 days) after initial procedure. The patients with ureteral stricture were primary treated with stent placement. One patient underwent endoluminal incision 45 days after initial procedure and two seriously ill patients were managed with chronic ureteral stent changes. All rupture of renal pelvis recovered without complication.
Conclusions
Spontaneous rupture of the renal pelvis is a rare complication of the obstructive uropathy. Sole stenting of the ureter is reseverd for ureteral stricture and for stones of the upper ureter or pelvic ureteric junction. Ureteroscopic lithotripsy followed by double-J stenting of the ureter is a treatment of choice for stones of the lower ureter with rupture of renal pelvis.
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Copyright
© 2009 European Association of Urology. Published by Elsevier Inc. All rights reserved.
