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Open Access Highly Accessed Case report

Ureterolithiasis after Cohen re-implantation – case report

Sonal Chaudhary1, Miranda Lee1, Henry O Andrews2 and Noor NP Buchholz2*

Author Affiliations

1 Barts and the London Queen Mary's School of Medicine and Dentistry, London, United Kingdom

2 Department of Urology, St. Bartholomew's Hospital, London, United Kingdom

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BMC Urology 2004, 4:2  doi:10.1186/1471-2490-4-2

Published: 10 March 2004

Abstract

Background

In the past decades, the widespread use of cross-trigonal ureteral reimplants for the treatment of children with vesicoureteral reflux has resulted in a large population of patients with transversely lying ureters. As this population gets older they will consequently be entering an age group at higher risk for stone and urothelial cancer formation. If ureteroscopy becomes necessary, the transverse position of the ureter makes ureteric access often impossible.

Case Presentation

We present the case of a young man who not only suffered from urolithiasis due to hyperparathyroidism, but also further jeopardized his treatment by omitting the fact that as a child he underwent Cohen reimplantation of the right ureter.

Conclusions

This case illustrates the particular difficulties the endoscopist may face in this group of patients. Patients with difficult ureteric access, abnormal anatomy, or those with known cross-trigonal ureteric reimplantations should be managed in a specialised endourology unit.