U J - Spring 2012.pdf


455Vol. 9   |   No. 2   |   Spring 2012   |U R O LO G Y   J O U R N A L

Department of Urology, Monash 
Medical Center, Victoria, Australia

*E-mail: yktay2@gmail.com

We report a rare case of an ectopically placed ureteral stent, which was acceptable and functional. obstructing 8 × 15-mm proximal right-sided ureteral calculus. There were also multiple non-
obstructing renal calculi on the left side. An antegrade ureteral stent was placed to relieve his infected and 
obstructed right kidney.
During stent placement, the interventional radiologist was unable to keep the distal end of the ureteral stent 
coiled in the ileal conduit. Unintentionally, the distal end of the guidewire was fed into the contralateral ure-
ter. This resulted in the ureteral stent being placed across both renal collecting systems via the ileal conduit. 
The inadvertent placement of the ureteral stent into both ureters is rare; that the patient had a Bricker anas-
tomosis, which makes it even less likely. Subsequent nephrostogram demonstrated bilateral patent ureters.
Once the sepsis resolved, the patient underwent a right percutaneous nephrolithotomy. During this pro-
cedure, the ectopic ureteral stent was also removed. An elective left percutaneous nephrolithotomy was 
performed to clear his left renal calculi.
Urinary tract infection and lower urinary tract reconstruction are associated with a higher incidence and 
recurrence rates of urolithiasis.  Surgical options for the ureteral calculi include ureteroscopic lithotripsy, 
pyeloscopic lithotripsy, percutaneous nephrolithotomy, and extracorporeal shockwave lithotripsy.  It is 

disobstructing the urinary system via an ileal conduit, a nephrostomy and antegrade ureteral stent should 
be placed without delay. This provides control of the urinary tract and an opportunity to plan the most ap-

Yeng Kwang Tay,* Dan Spernat, John Stuckey, Sree Appu

When is an Ectopically Placed Ureteral Stent Acceptable?

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Pictorial  Urology