A New Technique for Retrograde Flexible Ureteroscopy after Cohen Cross-Trigonal Ureteral Reimplantation

Abstract

Purpose: Retrograde ureteral access after cross-trigonal ureteral reimplantation can be challenging. We present our experience with retrograde ureteral catheterization and flexible ureteroscopy after Cohen cross-trigonal reimplantation in patients presenting with ureteral stones. Materials and Methods: Cystoscopy is performed and a Tiemann ureteral catheter is inserted into the involved ureteral orifice. A retrograde ureterography is performed and hydrophilic guide wire is passed up to the kidney. A dual-lumen ureteral access sheath is then passed under x-ray control underneath the ureteral stone. The flexible ureterorenoscope is passed under x-ray control up to the stone which is then fragmented with a holmium laser. Results: From June 2006 to June 2010, this technique was successful in 8 patients without acute or delayed sequelae. Conclusions: Where the endourological expertise is readily available, the ureter can be accessed retrogradely even after Cohen cross-trigonal ureteral reimplantation in a safe, straightforward and effective modality.

Successful percutaneous flexible ureteroscopy for treatment of distal ureteral stones under modified Valdivia position after Cohen reimplantation

“…Retrogradely Inserted guide wire under cystoscopic guidance with curved tip vascular access catheter and angletipped glide wire De Castro 9 Retrograde 13 Supra-pubic retrograde ureteral catheterization under cystoscopic guidance Lusuardi 10 Retrograde 8 Retrogradely inserted Tiemann ureteral catheter under cystoscopic guidance. And then fURS is passed to the stone Khalil 11 Retrograde 1 Retrogradely inserted curved guide wire into the ureteral orifice and then inserted fURS Adam 3 Retrograde 1 Supra-pubic puncture was done and guide wire was inserted under cystoscope with grasping forceps Emiliani 12 Retrograde 3 7-Fr angled orifice catheter and angled stiff wire is used for first access.…”

Endoscopic combined intrarenal surgery without ureteral access sheath performed for renal stone after Cohen reimplantation

“…In previous reports on endoscopic lithotripsy for urinary stones after Cohen reimplantation, Inoue et al 3 performed antegrade URS without preoperative placement of ureteral stent. Lusardi et al 4 performed URS without preoperative ureteral stent placement or use of UAS. Emiliani et al 5 performed URS without preoperative ureteral stent placement; however, by inserting a 10/ 12Fr UAS.…”

Retrograde Approach to a Diverticular Kidney Stone through a Vesicoureteral Cohen's Reimplantation: A Novel Surgical Technique

“…A systematic medline database review found only exceptional descriptions of surgical techniques of retrograde catheterization of the Cohen [1, 3]. To our knowledge, we describe the fourth retrograde ureteral access technique.…”

“…The retrograde access through Cohen's reimplantation for the minimally invasive treatment of an intradiverticular symptomatic kidney stone combines two major anatomical difficulties [1, 2]. Our technique allows resolving this anatomical problem by the use of a flexible ureterorenoscope coupled with the Holmium-YAG laser.…”