Posted by C S Loh on February 23, 1998 at 10:58:32:
In Reply to: Re: Radiation Cystitis and Stones posted by CLDing on February 21, 1998 at 10:47:59:
I would treat her ureteric stone endoscopically. This may be difficult because of DXT induced fibrosis. In situ ESWL is worth a try if the stone is accesible. I woudl also treat renal stone with ESWL.
The question here is that of diverting somebody who are stones former. Although diverted patients can satisfactorily undergo ESWL for renal stones, diversion would preclude rigid ureteroscopic procedures. Occasionally, the upper tracts remain accessible with endoscopes (Flex. cystoscope most useful), this is rather an exception than the rule. I would be inclined to exhaust local management of her haematuria and hold back from cystectomy and diversion to facilitate stone management. Of course, if she has a uncontrolable bleed, cystectomy may be the only option.
Why was she given prednisolone?