{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T04:42:13Z","timestamp":1766378533220,"version":"3.37.3"},"reference-count":16,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,7,10]],"date-time":"2021-07-10T00:00:00Z","timestamp":1625875200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,7,10]],"date-time":"2021-07-10T00:00:00Z","timestamp":1625875200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Women's Health"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Malignant obstruction and associated hydronephrosis is a common complication of advanced cervical cancer. Percutaneous nephrostomy (PCN) followed by antegrade stenting is often required to relieve obstruction as retrograde access fails in considerable proportion of such patients. Reno-pleural fistula is a rare complication of PCN which creates a patent connection between the renal collecting system and the thoracic cavity, and urine accumulation in the pleural space can cause pleural effusion (i.e., urinothorax). Upward or downward migration is a complication of indwelling ureteric stents. Further migration with extrusion outside of the urinary tract is uncommon. Herein we present an unprecedented case in adult of ureteric stent upward migration through a reno-pleural fistula into the thoracic cavity managed by thoracoscopy.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>A 66-year-old female was diagnosed of advanced stage cervical cancer with suspicious bladder invasion. Given her bilateral hydronephrosis with impaired renal function, she underwent bilateral PCN and subsequent antegrade ureteric stenting. However, she presented with dyspnea, right back pain, and oliguria four days after bilateral PCN catheter removal. Computed tomography reported massive right pleural effusion and an intrathoracic ureteric stent within reno-pleural fistula. Thoracoscopy with thoracostomy was performed to remove the ureteric stent and urine in right pleural space. A week later, urinothorax had resolved and right PCN was performed again. She was discharged after regaining normal renal function with right PCN and a left ureteric stent in place.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>A reno-pleural fistula can serve as a route for ureteric stent migration and that continuous drainage of urine can cause urinothorax once the stent reaches the thoracic cavity. Anytime a supracostal approach is used for PCN, even when using small caliber catheters, clinicians should pay special attention given the risk of pleural injury and subsequent complications.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12905-021-01405-2","type":"journal-article","created":{"date-parts":[[2021,7,10]],"date-time":"2021-07-10T10:02:44Z","timestamp":1625911364000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Intrathoracic ureteric stent migration through a reno-pleural fistula: a case report of rare antegrade ureteric stenting complication"],"prefix":"10.1186","volume":"21","author":[{"given":"Yi-Hsuan","family":"Chen","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcelo","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1288-9412","authenticated-orcid":false,"given":"Yu-Hsin","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,7,10]]},"reference":[{"key":"1405_CR1","doi-asserted-by":"publisher","first-page":"1303","DOI":"10.1007\/s00520-014-2482-y","volume":"23","author":"K Patel","year":"2015","unstructured":"Patel K, Foster NR, Kumar A, et al. Hydronephrosis in patients with cervical cancer: an assessment of morbidity and survival. Support Care Cancer. 2015;23:1303\u20139.","journal-title":"Support Care Cancer"},{"key":"1405_CR2","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1111\/iju.14119","volume":"27","author":"GM Sali","year":"2020","unstructured":"Sali GM, Joshi HB. Ureteric stents: overview of current clinical applications and economic implications. Int J Urol. 2020;27:7\u201315.","journal-title":"Int J Urol"},{"key":"1405_CR3","doi-asserted-by":"crossref","unstructured":"Kulkarni, R, Stent migration. Ureteric Stenting 2017: p. 227\u2013237.","DOI":"10.1002\/9781119085713.ch23"},{"key":"1405_CR4","doi-asserted-by":"publisher","first-page":"1242","DOI":"10.1016\/S0022-5347(05)65745-X","volume":"166","author":"R Munver","year":"2001","unstructured":"Munver R, Delvecchio FC, Newman GE, et al. Critical analysis of supracostal access for percutaneous renal surgery. J Urol. 2001;166:1242\u20136.","journal-title":"J Urol"},{"key":"1405_CR5","doi-asserted-by":"publisher","first-page":"99","DOI":"10.1089\/cren.2016.0050","volume":"2","author":"KS Kaler","year":"2016","unstructured":"Kaler KS, Cwikla D, Clayman RV. Delayed nephropleural fistula after percutaneous nephrolithotomy. J Endourol Case Rep. 2016;2:99\u2013102.","journal-title":"J Endourol Case Rep"},{"key":"1405_CR6","doi-asserted-by":"crossref","unstructured":"Yang YR, Chen SJ, Yen PY et al. Hydronephrosis in patients with cervical cancer is an indicator of poor outcome, Medicine 2021. 100: e24182","DOI":"10.1097\/MD.0000000000024182"},{"key":"1405_CR7","doi-asserted-by":"publisher","first-page":"243","DOI":"10.1111\/j.1445-2197.2004.02947.x","volume":"74","author":"N Lawrentschuk","year":"2004","unstructured":"Lawrentschuk N, Russell JM. Ureteric stenting 25 years on: routine or risky? 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Management of nephropleural fistula after supracostal percutaneous nephrolithotomy. 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