Treatment of Bilateral obstructive uropathy
Treatment of obstructive uropathy is a common urological referral. The two treatment options are nephrostomy tube or ureteric stent insertion. Both are equally effective at providing collecting system drainage and as both have different specific advantages and disadvantages, choice is often made on a case-by-case basis. Percutaneous nephrostomy has the advantages of bypassing the level of ureteric obstruction and not requiring a general anaesthetic, which can sometimes lead to deterioration in an already acutely unwell patient. The procedure can be technically difficulty in overweight patients, and those without hydronephrosis, and is not without risk of significant haemorrhage. Retrograde uretericstent insertion has a lower rate of significant bleeding than percutaneous nephrostomy insertion; however it is sometimes not possible to gain access to the kidney, such as in cases of large impacted stones or abnormal urinary tract anatomy due to pelvic disease. Here, we present a case with a rare cause of bilateral ureteric obstruction secondary to an iatrogenic pelvic haematoma.
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