Percutaneous nephroscopy combined with flexible ureteroscopy for treating calyceal outlet occlusion after partial nephrectomy: a case report.

Abstract

Tumors located near the renal collecting system often led to collecting system injuries during partial nephrectomy, with urinary leakage caused by collecting system rupture being a common complication. We report a rare case of another type of collecting system injury: intraoperative suturing caused occlusion of the upper calyceal outlet of the right kidney, resulting in hydronephrosis of the upper calyx and persistent urinary leakage postoperatively. Using a combination of percutaneous nephroscopic and ureteroscopic approaches, we located the occluded calyceal outlet and successfully restored urine drainage from the obstructed calyx by performing laser incision and balloon dilation to open and enlarge the calyceal outlet. Our case demonstrates that for iatrogenic occlusion of renal calyceal outlets caused by partial nephrectomy, combining percutaneous nephroscopic and ureteroscopic endoscopic surgery can effectively resolve calyceal obstruction.