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Preoperative CT examination for urinary lithiasis. The patient was candiadated for calculi removal by laparotomic pyelotomy.

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Comment by Giuseppe Pelle on April 27, 2008 at 10:33am
Yes I Know, but the Urologist that has in cure the patient is not particulary opened to the alternative approaches; this is the reality where i'm growing. Fortunely not all the doctor here are in this way.

I think the presence of renal scarring with corticalization of the mid and upper caliceal group, the abnormal distension without significant signs of elevated pressure in the upper collecting system and the Horseshoe kydney, may be considered high suspicious for VU reflux.
But this is only my opinion....

Thank you for your kind answer
Comment by Phil Haslam on April 27, 2008 at 9:58am
Hi Gipo, these stones could probably be removed by pcnl. laparotomy is definately not indicated. We have not performed open stone surgery in our centre for at least 15 years. the dilated ureter may be relux or possibly obstructed at the lower end.

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