Endourological management of mucosal ureteral avulsion: Case report

Abstract

The ureteral avulsion is the most horrific complication of ureteroscopy. The traditional treatment of ureteral avulsion is open ureteral repair. However, mucosal avulsion is a new terminology that could be managed endoscopically. Herein, we present a patient with mucosal avulsion. This case was followed-up with imaging and there wasn't any evidence of ureteral stenosis. We believe that mucosal ureteral avulsion could be managed by endourology techniques in selected patients. However, pros and cons of this treatment option should be carefully discussed with patients and long term follow up is necessary in these group of patients.

The Predictive Factors of Renal Loss After Iatrogenic Ureteral Avulsion in The Medicolegal Perspective

“…Furthermore, the use of a basket or a large-diameter (>9 Fr) ureteroscope, the urologist’s lack of experience, and ureteral inflammation have been reported as risk factors for ureteral avulsion. [ 6 ]…”

“…The classical treatment of ureteral avulsion is open repair. [ 6 , 7 ] During this surgery, ureteral reimplantation, autotransplantation, or nephrectomy is applied depending on the localization of the injury, condition of the ureter, experience of the surgeon, and general condition of the patient. [ 3 ] However, due to the limited case series and reports on this subject in the literature, there is still no consensus on the optimal surgical method, and ureteral avulsion, a catastrophic complication, can also result in the requirement of nephrectomy.…”