Ureteral orifice edema and stenting challenges in diabetic patients: Lessons from a case report.

Abstract

Rationale: Ureteral stones, particularly in elderly patients, pose significant clinical challenges due to their association with severe pain, infection, and urinary obstruction. While the introduction of minimally invasive techniques, such as ureteroscopy and ureteral stenting, has revolutionized treatment, gaps remain in understanding how comorbid conditions like diabetes affect patient outcomes.

Patient concerns: A 68-year-old male patient was admitted to our hospital for 3 days due to left lumbar and abdominal pain accompanied by fever.

Diagnoses: Abdominal computed tomography revealed sediment calculi in the left lower ureter and significant exudative changes in the left kidney. Through laboratory examination, procalcitonin and other inflammatory indicators were significantly elevated. The diagnosis was ureteral calculi with infection.

Interventions: Transurethral ureteral stenting.

Outcomes: The patient was discharged 3 days after surgery, and the inflammation index returned to normal. The ureteral stent was removed at a 2-week follow-up.

Lessons: Key findings include the identification of significant challenges in locating the ureteral orifice, the successful use of stenting to manage both infection and obstruction, and the importance of minimally invasive interventions in diabetic patients. The case also emphasizes the role of diabetes in complicating ureteral stone management due to its impact on immune response and healing. This report contributes to the existing literature by providing insights into the complex anatomical and pathological factors that can complicate ureteral stent placement in diabetic and elderly patients.