We report the case of a 35-year-old woman with a history of lithiasic surgery in another center and in both kidneys.
As reported, she had undergone right pyelolithotomy 15 years ago.
Two years later he underwent left pyelolithotomy and 10 months before being seen in our Service (year 2005) new nephrolithotomy on left kidney for complex renal lithiasis.
The patient presents an episode of urinary infection complicated by pyelonephrosis and septicemia, after which a double J catheter is placed that is ill-positioned, subpyelic, which does not resolve the left renal drainage.
In the patient's intravenous urography, infectious radiodense lithiasis is observed, as well as complex multiple hydronephrosis, on kidney with severe grade III-IV nephrolithiasis due to previous kidney surgery.
It has relatively preserved renal function.
We also observed post-surgical changes with moderate parenquimatose renal unit.
The patient's laboratory test showed normal urea and creatinine levels.
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Contralateral kidney location and age of the patient were determined by exploratory lumbotomy to try conservative surgery consisting of inferior polar nephrectomy with superior nephrolithotomy and reconstruction of the urinary tract
In the postoperative period, the patient required transfusion of two concentrates due to persistent anemia.
The subsequent evolution did not present major complications, being discharged on the seventh day.
Pathology of the specimen reported changes compatible with post-lithiasic chronic pyelonephritis and analysis of the calculus revealed its composition of amonic phosphate magnificent.
Two and a half years after surgery, the patient reported only mild left flank discomfort.
The control urography showed absence of lithiasis with some left nephrographic delay and right excretory pathway without changes compared to previous ones.
The renogram showed a left renal function of 30%, with 70% right kidney contractor.
It continues with normal kidney function values, and has only experienced an episode of UTI that has resolved with ciprofloxacin.
Presence of small bilateral subclinical lithiasic remains according to imaging techniques.
