A 66-year-old male was monitored in outpatient clinics for benign prostatic hypertrophy.
He has episodes of self-limiting monosymptomatic hematuria and negative urinocultive.
An echographic finding confirmed renal pyelocaliectasis grade II of the right kidney and in IVU, a functional annulation of the right kidney was observed, which is why the right ur percutaneous nephrostomy was performed.
Eight months earlier, the patient was echographically normal and had no pathological findings.
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His personal history included: no known allergies.
HTA.
Diabetes Mellitus type II.
Cardiomyopathy.
Intracerebral carotid aneurysm without sequelae
The physical examination performed is the following: blasting and depressible abdomen, non-painful, non-megaly, painless free renal fossa.
External genitals without pathological signs.
A rectal examination was compatible with BPH grade I-II.
The following ADDITIONAL EXPLORATIONS are carried out:
ANALYSIS: Glucose 145 mg/dl, Creatinine 1.4 mg/dl. Normal parameters.
URINARIA CITOLOGIA: Compatible with low-grade transitional cell carcinoma.
DESCELLANEOUS PYLOGRAPHY - sacral-iliac ureter: Repletion defect at the sacral-iliac ureter level of approximately 20 mm in length, with signs of gap.
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JUSTIFIC SUPPLY ARÑON DUTY: Creatinine clearance below 5 ml/minute.
ABDOMINO-PELVICO TAC: infrarenal Aneurysm.
Hydronephrotic atrophy of the right kidney without visualization of intraureteral endocardial images.
Dude paravesical lymph nodes
These findings and the suspicion of a tumor in the right ureter, the patient underwent surgery, performing right radical nephroureterectomy with satisfactory postoperative evolution.
Histopathological examination of the specimen revealed chronic pyelonephritis and arteriography changes, as well as ureteral inflammatory lesion obliterating the lumen with infiltrated lymphocytes in the muscular layers, erosion of the urothelial layer and presence of Acti
After 9 years of follow-up, the patient maintains acceptable renal function (serum creatinine 2.1 mg/dl) and is controlled by symptomatic BPH.
