A decision was then made to attempt bilateral SPBG insertion.
Given the option of ureterolysis or SPBG insertion, the patient chose the latter.
The stone was removed via flexible ureteroscopy and basket extraction through the SPBG, and the serum creatinine returned to baseline levels.
She was deemed not suitable for ureterolysis, and nephrostomy tubes were inserted in preparation for SPBG graft placement (Fig.
We describe for the first time the bilateral insertion of SPBG as a treatment for ureteral obstruction in RPF.
In a previous study involving renal transplant recipients, 2 out of 8 patients developed distal dislodgement following SPBG insertion with successful reinsertion.
16] In the latter group, bacterial colonization of the SPBG was asymptomatic, while fungal colonization led to 1 death following removal of the prosthesis in this immunosuppressed patient.
Fortunately, SPBG implants are easily accessible to flexible ureteroscopy, thus allowing for the removal of potential obstructive stones or fungus balls.