A rare complication of lumbar disk surgery: Ureteral avulsion

Demi̇rkesen, Oktay; Tunç, Burçin; Özkan, Burak

doi:10.1007/s11255-006-6651-x

Cited by 14 publications

(15 citation statements)

References 4 publications

(6 reference statements)

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“…If proximal ureter is traumatized other treatment modalities as autotransplantation should be kept in mind. [5,7] In our case report since complete full-thickness transection was seen at the middle 1 /3 segment of the ureter, and this complication was detected at no time, primary end-to-end anastomosis was performed without development of ureteral stricture or any other complication in the long term.…”

Section: Discussionmentioning

confidence: 69%

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A rare cause of ureteral injuries; simultaneous common iliac artery and ureter injury during posterior lumbar disc surgery

Başer

Alkış

Toktas

et al. 2016

Turkish Journal of Urology

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Major vascular injuries during lumbar disc surgery are rare but well-recognized complications. However, vascular injuries of the branches of the aorta and ureteral injuries are very rare. Although its incidence is not known definitely, it is estimated to be 1/1000. Ureteral injuries comprise less than 1% of all genitourinary traumas. In this article, we report clinical progress of a patient who had simultaneous internal iliac artery and ureteral injury during lumbar discectomy. The patient was managed with primary ureteroureterostomy. To our knowledge, this is the first case reported with simultaneous ureter and iliac artery trauma during lumbar disc surgery.

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Section: Discussionmentioning

confidence: 69%

“…Early signs, and symptoms of the injury include nonspecific manifestations as fever, abdominal/ flank pain, and hematuria. [7] In the long term symptomatic ureteral stricture is seen in only 1-2% of the cases. [8] During operation suspect ureteral injury can be detected by intraureteral injection of methylene blue dye.…”

Section: Discussionmentioning

confidence: 99%

A rare cause of ureteral injuries; simultaneous common iliac artery and ureter injury during posterior lumbar disc surgery

Başer

Alkış

Toktas

et al. 2016

Turkish Journal of Urology

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show abstract

“…Failing this, a temporary diverting percutaneous nephrostomy and antegrade combined with retrograde contrast imaging is performed to evaluate the nature and length of the ureteral injury. Surgical options include end to end ureterostomy, ureteric reimplantation, Boari bladder flap and even autotransplantation, rarely 2 3 5–7. Careful use of surgical instruments is key in preventing this iatrogenic complication.…”

Section: Discussionmentioning

confidence: 99%

Ureteral injury after posterior lumbar discectomy with interbody screw fixation

et al. 2013

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SUMMARYWe report a case of iatrogenic ureteral injury secondary to L5 laminectomy and microdiscectomy with L5-S1 bone graft with posterior lumbar interbodyfusion using presacral cancellous screw fixation, managed by initial ureteral stent placement and subsequent Boari bladder flap repair. A 33-year-old woman underwent L5 laminectomy and microdiscectomy with L5-S1 bone graft with posterior lumbar interbody fusion using presacral cancellous screw fixation. On postoperative day 10, she developed lower abdominal pain, vomiting and fever. Ultrasonogram and contrast-enhanced CT demonstrated a large pelvic urinoma secondary to a right lower ureteric injury. This was managed initially by ureteral stent placement and subsequent Boari bladder flap repair. Ureteral injury following spinal surgery is a rare surgical complication with significant morbidity and mortality. A high index of suspicion is essential for early appropriate management and renal salvage. BACKGROUND

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“…[1][2][3][4][5] Reported management options include ureteral stent placement, open ureteroureterostomy and renal autotransplantation. Other management options involve nephrostomy tube changes, transureteroureterostomy, renal mobilization, bowel interposition and nephrectomy.…”

Section: Introductionmentioning

confidence: 99%

Hand-assisted laparoscopic ureteroureterostomy with renal mobilization for delayed recognition of a proximal ureteral injury after lumbar disk surgery

Kaffenberger

Tomaszewski

Tsao

et al. 2013

CUAJ

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We present hand-assisted laparoscopic ureteroureterostomy (HALUU) with renal mobilization as a novel approach to the management of proximal ureteral injury after lumbar disk surgery. A 63-year-old female underwent L4-L5 diskectomy and facetectomy with cage placement for back and leg pain. Postoperatively, she developed fever, nausea, abdominal pain, ileus and leukocytosis. A computed tomography scan of the abdomen and pelvis with intravenous contrast and delayed imaging demonstrated a left proximal ureteral injury with contrast extravasation. Retrograde and antegrade ureteral stent placement was unsuccessful; a nephrostomy tube was placed. Antegrade and retrograde ureterograms revealed a 3-cm proximal ureteral defect. All treatment options were discussed, and the patient chose to undergo hand-assisted laparoscopic renal mobilization with ureteroureterostomy, which was completed successfully without complications. Operative time was 381 minutes; estimated blood loss was 50 mL. The patient was discharged after 2 days, her ureteral stent was removed in 8 weeks, and follow-up with furosemide-mercaptoacetyltriglycine (MAG-3) renal scan demonstrated 30% function without evidence of obstruction. Hand-assisted laparoscopic ureteroureterostomy with renal mobilization can be performed as definitive management of a medium-length proximal ureteral injury. This is the first case describing this management technique after lumbar disk surgery.Can Urol Assoc J 2010;4(3):E82-E85

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A rare complication of lumbar disk surgery: Ureteral avulsion

Cited by 14 publications

References 4 publications

A rare cause of ureteral injuries; simultaneous common iliac artery and ureter injury during posterior lumbar disc surgery

A rare cause of ureteral injuries; simultaneous common iliac artery and ureter injury during posterior lumbar disc surgery

Ureteral injury after posterior lumbar discectomy with interbody screw fixation

Hand-assisted laparoscopic ureteroureterostomy with renal mobilization for delayed recognition of a proximal ureteral injury after lumbar disk surgery

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