Abstract
Flexible Ureterorenoscopy (F-URS) has dramatically changed the era of Renal stone management. One of its rare complications is retained objects. Some reports, described accidental breakage is reusable ureteroscope. Here we present 36-year-old male patient who underwent to F-URS in another institute March 2018. Four months later presented to our hospital with right flank pain. Renal Us showed mild hydronephrosis associated with 13 mm renal stones. Patient underwent F-URS, when we found the broken tip of disposable ureteroscope retained from the first operation. Urologist should always pay careful attention to the flexible ureteroscpe to check for any sign of breakage before and after the procedure.
Keywords: Flexible ureteroscopy, Laser, Disposable ureteroscope
Introduction
As per today, F-URS is one of the armamentariums for Renal stone treatment.1 As all endoscopic procedures, there are expected usual complications. One of the complications is breakage of the instruments.1 Accidental breakage can occur due to number of factors like multiple use of disposable instruments, quality of accessory items or technical error. The aim of our work is to report first case of retained broken tip of flexible ureterscope.
Case report
A 36-year-old male patient underwent laser flexible ureterorenoscopy (L-FURS) for renal stones in another institute on March 2018. 4 months later, patient presented to our center complaining of right flank pain. Renal Us showed mild hydronephrosis associated with renal stone of 13 mm. Flexible ureteroscopy was performed, endoscopic exploration revealed retained unusual object in the right upper ureter. Infact, that object was broken tip of disposable ureteroscope. Basket was used to remove the broken tip smoothly. This retained broken tip is clearly seen over the table [Fig. 1].
Fig. 1.
(A) Endoscopic vision of Ureteroscope retained broken tip in the right upper ureter (B) Use of basket to remove it (C) Retained broken tip of the ureteroscope over the table.
Discussion
Foreign bodies in the urinary upper tract are unusual presentation. They are known source of infection, obstruction or stone formation. A wide range of foreign bodies has been reported in the urinary bladder.2 In opposite, in the literature we found only one paper reported ureteral foreign body which was guide wire introducer.3 In opposite this is the first report to have broken tip of disposable ureteroscope in the literature. F-URS now has been used more by urologists worldwide, therefore, it is essential to perform proper examination of your endoscopic devices preoperatively as well as postoperatively.
Conclusion
It is recommended and highly advised to check your endoscopic device pre-& postoperative in order to avoid missing objects in the urinary tract. This will reduce the possible late complication such as re-operative procedures.
References
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