RESUMEN
A 70-year-old male came to our clinic with a high fever and left scrotal swelling. Following a diagnosis of left-side epididymitis, antibiotic treatment was started, though the swelling did not improve. Since an additional examination revealed an abscess in the left scrotum, scrotal incision and drainage were performed. Although the symptoms subsided, urine outflow from the incision was observed. The patient then noted that he had inserted a glass ball into the urethral meatus when he was about 30 years old. It was considered that an abscess and fistula had formed due to inflammation caused by the foreign body. Thus a transurethral surgical procedure was used for crushing and removal. The fistula disappeared within three months after the operation and the patient has not been affected by dysuria since that time. Symptoms may appear several years following insertion of a foreign body into the urethra. To the best of our knowledge, the present case is the longest term of indwelling, approximately 40 years, following insertion of a foreign body reported in Japan.
Asunto(s)
Absceso , Cuerpos Extraños , Escroto , Uretra , Humanos , Masculino , Anciano , Absceso/cirugía , Absceso/diagnóstico por imagen , Escroto/cirugía , Cuerpos Extraños/cirugía , Cuerpos Extraños/diagnóstico por imagen , Cuerpos Extraños/complicaciones , Uretra/cirugía , Uretra/lesiones , Fístula Urinaria/cirugía , Fístula Urinaria/diagnóstico por imagen , Enfermedades Uretrales/cirugía , Enfermedades de los Genitales Masculinos/cirugía , Enfermedades de los Genitales Masculinos/diagnóstico por imagen , Factores de Tiempo , Fístula/cirugía , Fístula/etiologíaRESUMEN
Introduction: We report our initial experience with a novel ureteroplasty technique that combines the advantages of excisional tapering and folding. Methods and cases: Following dissection of the megaureter, the distal ureteral end was transected at a point with an appropriate caliber to create a neo-orifice, which was left intact. Only the proximally redundant part of the ureter was excised and closed over a 10F catheter, following which the ureter was anastomosed to the bladder with an indwelling ureteral stent. This procedure was performed in four pediatric patients. Case 1 involved a 6-year-old girl with continuous urinary incontinence due to ureteral ectopia in a duplex system. Cases 2 and 3 involved infants with refluxing megaureter. Case 4 involved a 9-year-old boy with a ureteral stone impacted in a megaureter. All four patients achieved successful outcomes without ureteral obstruction. Conclusion: This ureteroplasty technique is a promising alternative in specific patients.