Iatrogenic Ureteral Injuries: A 20-Year Experience in Treating 165 Injuries

Selzman, Andrew A.; Spirnak, J. Patrick

doi:10.1016/s0022-5347(01)66332-8

Cited by 300 publications

(210 citation statements)

References 22 publications

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“…Endometriosis rarely involves the upper urinary tract, (1-2 % of all cases of stenosis), 84 % of which are associated with concomitant bladder involvement [3,4]. The incidence of iatrogenic ureteral injury ranges between 0.1 % and 2.5 % of all the surgical procedures [5,6]; during recent years, an increasing incidence of iatrogenic strictures has been observed, due to the widespread diffusion of abdominal and gynaecological laparoscopic surgery and upper urinary tract endoscopy [7].…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic and robotic ureteral stenosis repair: a multi-institutional experience with a long-term follow-up

et al. 2016

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The treatment of ureteral strictures represents a challenge due to the variability of aetiology, site and extension of the stricture; it ranges from an end-to-end anastomosis or reimplantation into the bladder with a Boari flap or Psoas Hitch. Traditionally, these procedures have been done using an open access, but minimally invasive approaches have gained acceptance. The aim of this study is to evaluate the safety and feasibility and perioperative results of minimally invasive surgery for the treatment of ureteral stenosis with a long-term follow-up. Data of 62 laparoscopic (n = 36) and robotic (n = 26) treatments for ureteral stenosis in 9 Italian centers were reviewed. Patients were followed according to the referring center's protocol. Laparoscopic and robotic approaches were compared. All the procedures were completed successfully without open conversion. Average estimated blood loss in the two groups was 91.2 ± 71.9 cc for the laparoscopic and 47.2 ± 32.3 cc for the robotic, respectively (p = 0.004). Mean days of hospitalization were 5.9 ± 2.4 for the laparoscopic group and 7.6 ± 3.4 for the robotic group (p = 0.006).No differences were found in terms of operative time and post-operative complications. After a median followup of 27 months, the robotic group yielded 2 stenosis recurrence, instead the laparoscopic group shows no cases of recurrence (p = 0.091). Minimally invasive approach for ureteral stenosis is safe and feasible. Both robotic and pure laparoscopic approaches may offer good results in terms of perioperative outcomes, low incidence of complications and recurrence.

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Section: Introductionmentioning

confidence: 99%

Laparoscopic and robotic ureteral stenosis repair: a multi-institutional experience with a long-term follow-up

et al. 2016

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“…The most common sites of ureteral injury during hysterectomy are along the pelvic wall lateral to the uterine artery, the area of uretero-vesical junction, and the base of infundibulo-pelvic ligament [19]. The timing of repair of ureteric injuries is somewhat controversial, with some urologists advocating immediate repair whereas others favor delayed repair [20].…”

Section: Discussionmentioning

confidence: 99%

Early Postoperative Outcomes in Patients With Uterine Cervical Cancer

Gavrilescu¹,

Filip²,

Huțanu³

et al. 2013

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EARLY POSTOPERATIVE OUTCOMES IN PATIENTS WITH UTERINE CERVICAL CANCER (Abstract):BACKGROUND: Uterine cervical cancer still presents high percentages of locally advanced tumors on diagnosis due to the lack of screening programs. The multidisciplinary approach in these cases requires neoadjuvant radio-chemotherapy followed in selected cases by surgery. The aim of this study was the assessment of early postoperative outcomes in a consecutive series of cervical cancer patients. METHODS: We performed a comparative analysis in terms of patients and tumor characteristics, type of surgery and postoperative complications on 83 patients with radical surgery divided in terms of neoadjuvant treatment protocol. Two groups were designed: group A, patients who underwent neoadjuvant therapy (n=38; 45.78%) and group B, patients operated without neoadjuvant therapy (n=45; 54.22%). RESULTS: The patients mean age was 54.1±11.6 years old. Most cases on diagnosis were stage IIB (41 cases, 49.39%) followed by stage IB (24 cases, 28.9%). Neoadjuvant treatment was performed in 38 patients (45.78%) (stage IIA -1 patient, IIB -31 patients, IIIA -1 patient and IIIB -5 patients), with a complete response in 16 (42.1%). Most common intervention was type II radical hysterectomy with pelvic lymphadenectomy in 54 cases (65%). There was no difference in terms of deep vein thrombosis, postoperative urinary and medical morbidity. Digestive complications were relatively higher in neoadjuvant group (28.94% in group A vs. 6.66% in group B, P=0.008) with a longer hospitalization (8.1±2.7 days for group A vs. 6.6±1.6 for group B, P=0.01). CONCLUSION: Radical hysterectomy is a relatively safe technique in terms of postoperative morbidity for patients with cervical cancer despite the use of neoadjuvant therapy. This provides the chance for cure in early stages and a local control for more advanced cases.

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“…Congenital ureteral strictures are mostly located at the ureteropelvic junction (UPJ) and the ureterovesical junction (UVJ) [1]. Acquired strictures may occur after open and endoscopic stone surgery, but also following open and laparoscopic surgery of urological, vascular or gynecologic origin [2,3]. The increased use of ureterorenoscopy has led to an increase in the incidence of iatrogenic ureteral strictures.…”

Section: Introductionmentioning

confidence: 99%

“…The increased use of ureterorenoscopy has led to an increase in the incidence of iatrogenic ureteral strictures. Acquired strictures may also be caused by stone passage, radiotherapy and after chronic inflammation, such as tuberculosis [2,3].…”

Section: Introductionmentioning

confidence: 99%

Acucise® Endoureterotomy: A Forgotten Treatment Option in Ureteral Strictures of Benign Origin between the Ureteropelvic and Ureterovesical Junctions; Long-Term Results

Campschroer¹,

Mtwt

Jlhr³

2015

UNOAJ

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Iatrogenic Ureteral Injuries: A 20-Year Experience in Treating 165 Injuries

Abstract: Endourological procedures are the most common cause of iatrogenic ureteral injuries. When identified at injury and treated properly such injuries seldom lead to loss of renal function.

Cited by 300 publications

References 22 publications

Laparoscopic and robotic ureteral stenosis repair: a multi-institutional experience with a long-term follow-up

Laparoscopic and robotic ureteral stenosis repair: a multi-institutional experience with a long-term follow-up

Early Postoperative Outcomes in Patients With Uterine Cervical Cancer

Acucise® Endoureterotomy: A Forgotten Treatment Option in Ureteral Strictures of Benign Origin between the Ureteropelvic and Ureterovesical Junctions; Long-Term Results

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