Document Detail

Management of nephrolithiasis after Cohen cross-trigonal and Glenn-Anderson advancement ureteroneocystostomy.
MedLine Citation:
PMID:  17162032     Owner:  NLM     Status:  MEDLINE    
PURPOSE: Ureteroneocystotomy is frequently performed for ureteral injury or vesicoureteral reflux. The Glenn-Anderson technique advances the ureteral orifice distal to its native position, while the Cohen technique crosses the orifice to the opposite trigone. Each treatment can alter access to the upper genitourinary tracts. We report our experience with subsequent nephrolithiasis in these patients. MATERIALS AND METHODS: We performed a retrospective chart review of all patients treated with ureteroneocystotomy since 1980 who had nephrolithiasis. RESULTS: Nephrolithiasis developed in 9 patients with prior Cohen ureteroneocystotomy and in 15 with prior Glenn-Anderson ureteroneocystotomy. Stones size was 2 to 20 mm (mean 6.4). In the Cohen group ureteroscopy was attempted and failed in 2 patients, requiring percutaneous nephrolithotomy. Attempted shock wave lithotripsy failed in 2 patients, of whom 1 required percutaneous nephrolithotomy and 1 required observation. Primary percutaneous nephrolithotomy was performed in 1 patient. One patient required nephrectomy for chronic pyelonephritis related to nephrolithiasis. Two patients had active stone disease and were awaiting further treatment, while 1 passed the stone. In the Glenn-Anderson group ureteroscopy was successful in all 4 attempts. Attempted shock wave lithotripsy in 2 patients was successful in 1. The other patient required subsequent percutaneous nephrolithotomy. Primary percutaneous nephrolithotomy was required in 2 patients. All other patients were asymptomatic and under observation. CONCLUSIONS: Treatment for upper tract nephrolithiasis is effected by prior ureteroneocystotomy. Minimally invasive treatments were less successful after Cohen ureteroneocystotomy than after Glenn-Anderson ureteroneocystotomy. In this study patients with prior cross-trigonal ureteroneocystotomy required more invasive therapies for symptomatic nephrolithiasis.
Amy E Krambeck; Matthew T Gettman; Ahmad H BaniHani; Douglas A Husmann; Stephen A Kramer; Joseph W Segura
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of urology     Volume:  177     ISSN:  0022-5347     ISO Abbreviation:  J. Urol.     Publication Date:  2007 Jan 
Date Detail:
Created Date:  2006-12-12     Completed Date:  2007-01-26     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376374     Medline TA:  J Urol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  174-8     Citation Subset:  AIM; IM    
Department of Urology, Mayo Medical School, Mayo Clinic, Rochester, Minnesota 55905, USA.
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MeSH Terms
Child, Preschool
Cystostomy / adverse effects*,  methods*
Middle Aged
Nephrolithiasis / etiology*,  therapy*
Retrospective Studies
Ureter / surgery*

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