OVERCOMING A MAJOR CHALLENGE

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A 53 year old lady presented at Ruby General Hospital with complaints of right flank pain for about a year. She had been put under the expert care of Dr. Sujoy Basak (Consultant Urologist).

After a thorough evaluation, an USG revealed a 43 mm calculi (Stone, usually composed of mineral salts) in the pelvis of right kidney and mild Hydronephrosis (Swollen and stretched kidney due to a build-up of urine inside them) in left kidney. The digital X – ray of KUB revealed a large staghorn calculus (A type of kidney stone with branches that takes up a large portion of the urinary collecting area) and another small sized calculi in right kidney. Our 128 slice CE CT scan of KUB also confirmed the calculus measuring 4.5 cm X 3 cm, presence of stone within the ureters with mild proximal hydroureteronephrosis (Dilation of the ureter due to obstruction of urine outflow). The calculus in the left middle ureter at L5 level measured 1.4 cm.

The lady was a known patient of hypothyroidism along with a history of Ureteroscopy (URS) (A minimally invasive procedure for stone removal via urethra) with laser lithotripsy and DJ stenting for left ureteric calculus just a couple of months ago had been quite a challenge for the consultant. After discussion with the family members and with written and informed consent, the lady had been posted for surgery. Percutaneous Nephrolithotomy (PCNL :  A minimally invasive procedure to remove stones from the kidney by a small puncture through the skin) had been performed with DJ stenting using Retrograde Pyelogram (RGP). Though the consultant had given a brief that the complete stone clearance might require multiple steps, but, it had been done in one go by the expert Team. The postoperative period had been uneventful and the lady thanked the entire team and the hospital for the successful surgery.
Location: Kolkata, West Bengal, India

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