Endoscopic treatment of urothelial encrusted pyelo-ureteritis disease: A case series.

Background: Urothelial encrusted pyelo-ureteritis disease is an infrequent condition and there is no unified surgical treatment and reference standard to consult. We have used a minimally invasive endoscopic method to treat three such cases, which yielded excellent results.

Case Summary: The first case was a 45-year-old man who had unilateral ureteropelvic junction (UPJ) atresia and contralateral stenosis and was treated by double endoscopic surgery using an anterograde percutaneous nephroscope coupled with a rigid retrograde ureteroscope. The second case was a 12-year-old boy who received a percutaneous nephroscopy on one side and a percutaneous nephroscopy with a rigid ureteroscope on the other side due to the presence of bilateral UPJ stenosis. The third case was a 32-year-old woman with bilateral lower ureteral stricture treated using a rigid retrograde ureteroscope. Endoscopic surgeries were successfully performed on all the three patients. Varying degrees of encrustation and erosion of the urothelium were observed during the operation. The calcified layer composition analysis showed magnesium ammonium phosphate or carbonate apatite. Two patients achieved a good prognosis.

Conclusion: Minimally invasive endoscopic treatment for urothelial encrusted pyelo-ureteritis disease can yield better results.