The article describes the clinical case of percutaneous nephrolithotomy of the sutures calculus and removal of ligatures from the region of pyeloureteroanastomosis in a patient with a transplanted kidney. The patient in 2010 underwent an intervention in the volume of an anastomosis of the renal transplant with the ipsilateral native ureter for the stricture of the donor ureter in the lower third. The transplant graft was a random finding during the ultrasound in 2017. Despite the pronounced retention of the upper urinary tract, there was no dysfunction of the transplanted kidney. Finally, the diagnosis was established intraoperatively during removal of the calculus, when ligatures were visualized. percutaneous nephrolithotomy and removal of ligatures passed without complications.
An analysis of 6 patients with sutures calculus of the bladder in the artificial ureteral orifice. In all cases, the kidney transplantation was carried out in one 52 hospital in Moscow. Diagnosis sutures calculus with ultrasound is an average of 6.5 years after a kidney transplant. During the ultrasound revealed hyperechoic formation, on the lateral wall of the bladder, not displaced when the patient's position changes. Patients were troubled by periodically arising macrogematuria. In order to get rid of sutures calculus, ligatures, transurethral contact pneumatic cystolithotripsy has been performed in all cases.
The use of non-absorbable suture material for the application of urinary tract anastomoses is guaranteed to lead to the formation of sutures calculus in the long-term postoperative period. Despite the fact that sutures calculus after kidney transplantation do not have a pronounced negative effect on the health and life of patients, nevertheless they necessitate inpatient treatment, surgical intervention, which is highly undesirable for immunocompromised patients.
Authors declare lack of the possible conflicts of interests.