Changing Trends in the Management of Iatrogenic Ureteral Injuries

Lask, Dov; Abarbanel, Joseph; Luttwak, Zvi; Manes, Aaron; Mukamel, E.

doi:10.1016/s0022-5347(01)66753-3

Cited by 66 publications

(36 citation statements)

References 7 publications

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“…A PCN should also be placed into the urinoma [90]; unless drained, the extravasated urine may lead to secondary retroperitoneal fibrosis and ureteric obstruction. At 2-3 weeks after surgery, re-exploration is typically difficult and complex because of inflammation, fibrosis, adhesions, haematoma and distorted anatomy.…”

Section: Urinary Diversionmentioning

confidence: 99%

Diagnosis and management of ureteric injury: an evidence‐based analysis

Brandes¹,

Coburn²,

et al. 2004

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The Consensus on Genitourinary Trauma continues this month with an evidence‐based analysis, by a team of experts under the chairmanship of Dr Jack McAninch, of current reports on the diagnosis and management of ureteric trauma. This is quite a unique document, and of interest to all urologists; not only as a consensus on how this condition should be managed, but also as a model of how to review current publications.

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Section: Urinary Diversionmentioning

confidence: 99%

Diagnosis and management of ureteric injury: an evidence‐based analysis

Brandes¹,

Coburn²,

et al. 2004

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“…In our patient the immediate open surgical intervention was mandatory (9). Whether laceration was produced during surgery, with dripping of urine in the retro-peritoneum during the following two weeks, or few days before presentation in the ED, by mechanic pressure due to urine stasis due to ligation, remains unclear.…”

Section: Late Presentation Of Ureteral Injury Following Laparoscopic mentioning

confidence: 88%

“…These conditions can be achieved when the fascial planes for some reason are discontinuous (7 (8). Accidental ligation performed by absorbable suture has a better prognosis, and may be best treated by proximal drainage alone with the positioning of a percutaneous nephrostomy tube (9). This conservative strategy may be applied only if the continuity of the ureter is preserved.…”

Section: Late Presentation Of Ureteral Injury Following Laparoscopic mentioning

confidence: 99%

Late presentation of ureteral injury following laparoscopic colorectal surgery

Priola¹,

Priola²,

Volpicelli³

2011

Journal of the Belgian Society of Radiology

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A 53-year-old man presented to our emergency department (ED) complaining of acute flank pain and fever progressively increasing for 3-days. His recent medical history included laparoscopic resection of a sigmoid colon carcinoma performed two weeks before. On physical examination the abdomen was mildly distended with slight contracture of the lower abdominal wall muscles, while regular bowel sounds were heard during auscultation. Laboratory blood tests were within the normal range, except for a white blood cell count of 16 x 10 9

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“…14 An 80% rate of spontaneous recovery of ureteral integrity after a mean period of 1 month has been reported with standard nephrostomy and external diversion of urine alone. 15 Endourologic options differ according to the operator's personal experience and preference. Endoscopic endoluminal incision with a cold knife, laser, or electrocautery and utilization of conventional or Acucise balloon catheters yields acceptable results.…”

Section: E Fmentioning

confidence: 99%

“…2,7,12 Percutaneous and endoscopic minimally invasive techniques represent alternative strategies that have been proposed to reduce morbidity and the duration of hospitalization. 9,[13][14][15][16][17] The goal of the present paper is to report our expe-rience with 10 patients who presented with iatrogenic ureteral strictures after gynecologic surgery and were treated with percutaneous nephrostomy and primary antegrade recanalization.…”

Section: Introduction Umentioning

confidence: 99%

Ureteral Injuries during Gynecologic Surgery: Treatment with a Minimally Invasive Approach

Liatsikos

Karnabatidis

Κατσάνος

et al. 2006

Journal of Endourology

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Purpose: To report the safety and efficacy of percutaneous nephrostomy and primary antegrade recanalization for treatment of iatrogenic ureteral strictures after gynecologic surgery.Patients and Methods: Ten women had symptoms suggestive of ureteral obstruction during the immediate postoperative period (5 days-1 week after surgery). Under analgesia and conscious sedation, standard percutaneous nephrostomy was performed, and a long 7F sheath was placed in the upper ureter. The obstructions were traversed with the aid of a 0.0035-inch Glidewire and a 5F angled Glide catheter (Terumo, Japan). Subsequently, the areas were dilated with angioplasty balloons to a maximum diameter of 7 mm. Finally, an 8F percutaneous internal/external nephroureteral drainage stent was inserted to secure ureteral patency. Follow-up was carried out by serial nephrostomography until removal of the stent and by renal ultrasonography thereafter.Results: Twelve obstructions with a mean length of 1.4 cm (range 0.4-1.9 cm) were managed. The technical success rate was 100%. No major complications occurred, and normal renal function was restored. The mean follow-up was 12 months. In 60% of the patients, a patent ureter was depicted at 1 week, whereas in four patients, repeat dilation of the obstructed segment was required. The stents were removed after a mean period of 4.8 weeks.Conclusion: Percutaneous nephrostomy and primary antegrade ureteral balloon dilation is safe and efficacious for treating ureteral injury after pelvic surgery and obviates open surgical manipulations.

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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.

Cited by 66 publications

References 7 publications

Diagnosis and management of ureteric injury: an evidence‐based analysis

Diagnosis and management of ureteric injury: an evidence‐based analysis

Late presentation of ureteral injury following laparoscopic colorectal surgery

Ureteral Injuries during Gynecologic Surgery: Treatment with a Minimally Invasive Approach

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