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.
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http://dx.doi.org/10.1089/end.2006.20.669 | DOI Listing |
Prog Urol
May 2021
Department of Urology, Assistance Publique - Hôpitaux de Paris, Hôpital Saint-Louis, Paris, France. Electronic address:
Background: We present the long-term results and complications of the DETOUR® prosthesis, a permanent subcutaneous pyelovesical bypass for the treatment of ureteral obstruction.
Patients And Methods: Between 2006 et 2018, 34 prosthesis were implanted in 28 patients (mean age 65,8 years) with ureteral obstruction of malignant or benign etiologies. The prosthesis, composed to an inner tube of silicone and an outer tube of expanded polytetrafluoroethylene, is placed subcutaneously between the kidney and the bladder.
Arch Ital Urol Androl
June 2020
Neurology Department, Henry Dunant Hospital Center, Athens.
Subcutaneous pyelovesical bypasses are the best choice for the long-term palliative treatment of ureteral obstructions. In rare cases this obstruction is due to polyarteritis nodosa. We present the only reported patient with a bilateral Detour bypass in a Hautmann's neobladder.
View Article and Find Full Text PDFJ Endourol
March 2019
1 Department of Urology, Guy's and St Thomas' Hospitals, London, United Kingdom.
Objectives: To present our experience of the Detour extra-anatomic stent (EAS; Porges-Coloplast, Denmark) to bypass ureteric obstruction. Use of the EAS is indicated in patients with complex ureteric strictures or malignant disease, where long-term nephrostomy drainage is undesirable.
Materials And Methods: Between December 2001 and October 2017, 20 Detour EAS were implanted into 13 patients.
Aktuelle Urol
September 2018
Klinik für Urologie, Uro-Onkologie, spezielle urologische und roboter-assistierte Chirurgie, Universitätsklinikum Köln, Köln.
If prostate cancer recurs after primary treatment, deprivation therapy with LHRH analogues or antagonists is the treatment of choice in men with metastatic prostate cancer. However, this treatment only achieves palliative results. Median time to progression ranges between 11 and 78 months.
View Article and Find Full Text PDFCent European J Urol
October 2017
Biernacki Hospital Mielec, Department of Urology, Mielec, Poland.
Introduction: Many patients suffer from unilateral or bilateral hydronephroses caused by pelvic tumors, retroperitoneal fibrosis, occlusion due to radiation therapy or iatrogenic damage to the ureter. Currently, percutaneous nephrostomy or double J stents are primarily used. Nephrostomy deteriorates a patient's quality of life and leads to frequent infections, blockage of tubes, or bleeding, while uretral stents are associated with septicemia and irritative bladder symptoms.
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