Muhammad Rafiq Zaki, Mujahid Hussain, Tahir Mehmood, Nauman Ahmed, Rashid Naeem, Tashbeeb Gulzar, Tanvir Hussain.
Successful Renal Autotransplant after Complete Ureteric Avulsion during Ureteroscopy.
J Sharif Med Dent Coll Jan ;6(1):47-50.

An eighteen years old male patient was operated for left upper ureteric stone with a plan of ureteroscopy and intracorporeal lithotripsy in a private hospital of Lahore. During procedure ureteric avulsion occurred, evident by entrapment of ureteric tissue on ureteroscope. Percutaneous nephrostomy (PCN) was done after this complication of ureteroscopy. On 20 postoperative day, the patient visited our department at National Medical Centre, Defence Lahore. On his nephrostogram only 2-3 cm segment of proximal ureter was left. The patient was afebrile with normal range leucocyte count. After a discussion with the patient and his attendants, we planned for autotransplant which was done on the left side of the pelvis using cold ischemia along with PCN tube. The ureter was anastomosed with the urinary bladder in an extravesical mucosa to mucosa interrupted suture technique. The drain was placed and wound closed. The patient remained vitally stable. The drain was removable & the patient was discharged after 3 days. On the 5 post operative day, his PCN tube was blocked and Foley's catheter was removed on 7post operative day. On the 10th post operative day, Doppler ultrasound was done which showed good perfusion, normal size and good corticomedullary differentiation of operated kidney. The PCN tube was removed on 12 post operative day and ureteral stent was removed after 4 weeks. Keywords: Ureteric avulsion. Autotransplant. Complication of ureteroscopy.

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