Dr. Oliver Wiseman discusses his use of detailed imaging techniques, including contrast CT and reconstructed models, in a 58-year-old patient with left loin pain and a duplex system. An initial non-contrast CT seemed to indicate a calcification in the interpolar area, yet no stone was found during the initial ureteroscopic intervention. Dr. Wiseman discusses how the use of more detailed imaging better equipped him to identify the location and size of a calyceal diverticulum. He also discusses how this imaging helped him to recognize a very narrow infundibula, which informed his treatment strategy and selection of the right intervention modality for this patient.
Oliver Wiseman, MB BChir, MA, FRCS
Part 1: In the first installment of a two-part series on managing patients who have had a reconstruction, Mr. Oliver Wiseman talks about a strategy for gaining access in patients when a retrograde approach is unsuccessful. He presents his approach to gaining antegrade access in a 60-year-old male with bilateral upper ureteric stones who previously had a cystoprostatectomy and urethrectomy, as well as a key recommendation around post-operative imaging in these types of patients.
Part 2: In the second installment of the series on managing patients who have had a reconstruction, Mr. Oliver Wiseman discusses his approach to gaining retrograde access to treat a lower pole stone in a 45-year-old female with a transplant kidney. The patient had been referred to him after an unsuccessful stent insertion.