Dr. Parag Gulhane Urologist in Hadapsar did a Successful RIRS for a 23 mm Pelvic Stone in a COPD Patient.
Case Report:
Patient Background:
A patient with a history of chronic obstructive pulmonary disease (COPD) presented with right flank and lower abdominal pain. Initial imaging revealed a substantial 23 mm hyperdense calculus in the right pelvic ureteric junction.
Diagnostic Findings:
Preoperative CT urography confirmed the stone's presence with an average HU of +1200 and mild urothelial thickening. The patient also had renal cortical cysts in both kidneys.
Surgical Approach:
Considering the patient's COPD status, Retrograde Intrarenal Surgery (RIRS) was chosen as the intervention of choice. The procedure, performed without pre-stenting, achieved complete stone clearance in a single stage under spinal anesthesia. The sheath-in to sheath-out time was notably efficient at 60 minutes.
Postoperative Outcome:
Postoperative sonography demonstrated the successful elimination of the stone. The right kidney showed normal morphology with residual pelvicalyceal fullness. A ureteric stent was visible in the right ureter coiled in the urinary bladder. The left kidney exhibited normal features with no signs of hydronephrosis.
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