A Case Report of Left Pyelonephritis With Low-Grade Contralateral Vesicoureteral Reflux After Robot-Assisted Right Nephroureterectomy

IF 0.5 Q4 Medicine

IJU Case Reports Pub Date : 2026-08-17 DOI:10.1002/iju5.70251

Shuhei Kusano, Shohei Tobu, Minika Yukimoto, Kyohei Matsushita, Akihiro Maeda, Yuka Kakinoki, Hiroaki Kakinoki, Maki Kawasaki, Mitsuru Noguchi

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Abstract

Introduction

Pyelonephritis with contralateral vesicoureteral reflux (VUR) after robot-assisted radical nephroureterectomy (RANU) in a solitary kidney has rarely been reported.

Case Presentation

A 73-year-old woman with preoperative lower urinary tract symptoms (LUTS; IPSS 15, OABSS 7) underwent right RANU for urothelial carcinoma of the renal pelvis (cT3N0M0). On postoperative day (POD) 12 she developed fever, and on POD 16 she was readmitted with left pyelonephritis and Escherichia coli bacteremia. Contrast-enhanced computed tomography revealed multiple wedge-shaped hypoenhancing areas in the left kidney, consistent with acute focal bacterial nephritis. Inflammatory markers improved promptly with antibiotics. Cystography on POD 21 demonstrated left grade 1 VUR limited to the storage phase, which resolved spontaneously 1 month after discharge.

Conclusion

Latent lower urinary tract dysfunction may unmask contralateral VUR in patients with a solitary kidney after RANU. Preoperative LUTS evaluation and prompt cystography during postoperative infection may help preserve contralateral renal function.

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机器人辅助右肾输尿管切除术后左肾盂肾炎伴低级别对侧膀胱输尿管反流1例

机器人辅助根治性肾输尿管切除术（RANU）后肾盂肾炎伴对侧膀胱输尿管反流（VUR）的报道很少。一例73岁女性，术前有下尿路症状（LUTS; IPSS 15, OABSS 7），因肾盂尿路上皮癌（cT3N0M0）行右侧RANU。术后第12天出现发热，第16天因左肾盂肾炎和大肠杆菌血症再次入院。增强计算机断层扫描显示左肾多发楔形低强化区，符合急性局灶性细菌性肾炎。使用抗生素后炎症指标迅速改善。POD 21的膀胱造影显示左侧1级VUR局限于储存期，在出院1个月后自行消退。结论隐匿性下尿路功能障碍可暴露单侧肾肾切除术后对侧VUR。术前LUTS评估和术后感染时及时膀胱造影可能有助于保护对侧肾功能。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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