A 65 year old female patient presented with burning micturation, pain in right flank, fever since 3 months followed by not passing urine(Anuria) since 1 week.
She was diagnosed to have Kidney failure with serum creatinine 3.5 dated 12/12/2011
On 13/12/2011-Serum Creatinine was 4.9
Ultrasound :reveals Right severe hydronephrosis with renal staghorn calculus 42mm,Left hydroureteronephrosis, changes of Cystitis.
CT scan of abdomen : shows Right renal staghorn calculus with satellite calculi and gross hydronephrosis with thinning of the cortex.
Left moderate hydroureteronephrosis – compensatory functioning. Grossly thickened urinary bladder wall.
Cystoscopy-Severe Trigonitis, bladder thick walled, illdefined mass at bladder outlet, ureteric orifices not identified.
EUM-narrow dilated with Hegar dilators. Mucosal biopsy taken
As Ureteric orifices were not seen so fluroguided Bilateral PCN was done. Serum creatinine was repeated after Cystoscopy 2.3. Right PCNL was done with
Single Track and stone was completely cleared, and then Serum creatinine was 1.0
In view of infiltrative bladder growth and bilateral hydroureteronephrosis, Radical cystectomy + Ileal conduit was done.
Final HPE Report - Infiltrative Squamous cell carcinoma stage pT4 N0 M0
Post Operative Recovery uneventful
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