Bypass nefro vesical percutáneo subcutáneo en estenosis ureteral severa. Reporte de caso

Abstract

Background: In Ecuador, a total of four cases of Subcutaneous Percutaneous Nephrovesical Bypass or Detour Bypass treatment for severe ureteral stenosis were conducted. Severe Ureteral Stenosis is a common pathology in urology. Due to its diverse etiology, its diagnosis can be easily given if it is a complete stenosis of total obstruction, or it can be complex if this pathology is partial. Therefore, treatment with Percutaneous Subcutaneous Nephrobladder Bypass or artificial ureter is the most viable option for its high efficacy rate and post-surgical recovery, which improves the patient's quality of life. Objective: To describe a clinical case according to the anamnesis, physical examination, complementary examinations, diagnostic tests, treatment, and evolution. Clinical Case: The case of a 58-year-old female patient is presented. She has a record of retroperitoneal fibrosis secondary to partial nephrectomy for clear cell renal carcinoma. In addition, she presented a cholecystectomy, later an abdominal hernioplasty, and, besides a clinically repeated urinary tract infection. In the post-surgical contrasted CT urogram, it was evident that there was no improvement in the ureteral stenosis. Thus, a surgical procedure called Percutaneous Subcutaneous Nephrovesical Bypass was performed because the grade II ureteral kinking and pyeloectasia were not resolved in the first procedure