Changing Trends in the Management of Iatrogenic Ureteral Injuries

Abstract

The primary management of ureteral injury by percutaneous nephrostomy resulted in significantly decreased reoperation and morbidity rates, and enabled spontaneous recovery of the injured ureter in the majority of patients.

Iatrogenic Ureteric Injuries: Incidence, Aetiological Factors and the Effect of Early Management on Subsequent Outcome

“…Treatment options for ureteric injuries instituted in this series included PCN insertion with expectation of spontaneous resolution, ureteric catheter placement or ''J'' stent insertions in cases of ureteric mucosa injury, ureteric perforations and false passages. As reported by others and confirmed in this study, most of these injuries healed without any serious sequelae [7,16]. Major reconstructive procedures like psoas hitch, Boari flap, auto-transplantation or appendix interposition are ideal surgical treatment when there is ureteric injury resulting in loss of ureteric segments [10,17].…”

Increasing numbers of ureteric injuries after the introduction of laparoscopic surgery

“…The present group used a percutaneous nephrostomy tube as the primary treatment modality if hydronephrosis was present, and antibiotic prophylaxis was also a routine. A urinary tract infection occurred in 13% of cases, compared with 50% reported by Lask et al [17]. The present authors used a percutaneous nephrostomy tube in 58% of cases of delayed injury, and suggest that this may be related to the lower infection rate.…”

Les complications urologiques de la chirurgie gynécologique

“…Dans notre série l'endo-urologie n'était pas utilisée, la chirurgie ouverte ayant été pratiquée chez toutes les patientes. Cette tendance n'était pas observée chez d'autres auteurs qui pratiquaient le traitement endo-urologique en première intention [11,12]. Les autres techniques comme la trans urétéro-urétérostomie, l'uretère iléal, l'auto-transplantation étaient exceptionnelles [13].…”