Iatrogenic ureteral injuries: a case series analysis with an emphasis on the predictors of late ureteral strictures and unfavorable outcome in different surgical specialties

Elawdy, Mohamed Mohamed; Osman, Yasser; Awad, Bassam A.; El-Mekresh, Mohsen; El-Halwagy, Samer

doi:10.1007/s00192-020-04578-w

Cited by 12 publications

(13 citation statements)

References 12 publications

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“…Among the articles researched, the anatomical, anatomopathological and technical risk factors stood out (BAŠIĆ et al, 2015). Anatomical circumstances, such as the adherence of the ureter to the peritoneum and its similarity to ovarian ligaments and the uterine artery, increase the chances of inadvertent transection or ligation (BAŠIĆ et al, 2015;ELAWDY et al, 2021). Although the ureter is located deep in the retroperitoneal space, protecting it from external traumatic injuries, the structure is more prone to iatrogenic injuries due to its proximity to important pelvic structures such as the uterine artery, cervix, vagina, colon, rectum, and vessels.…”

Section: Resultsmentioning

confidence: 99%

“…Although the ureter is located deep in the retroperitoneal space, protecting it from external traumatic injuries, the structure is more prone to iatrogenic injuries due to its proximity to important pelvic structures such as the uterine artery, cervix, vagina, colon, rectum, and vessels. iliac (BAŠIĆ et al, 2015;ELAWDY et al, 2021). Thus, more LUI were identified in women, which can be explained by the anatomical particularities of the female sex (PALANIAPPA et al, 2012).…”

Section: Resultsmentioning

confidence: 99%

“…Thus, more LUI were identified in women, which can be explained by the anatomical particularities of the female sex (PALANIAPPA et al, 2012). The distal ureter was the most vulnerable region for iatrogenic injury, accounting for more than 90% of all occurrences (BURKS & SANTUCCI, 2014;ELAWDY et al, 2021;ESPARAZ et al, 2015).…”

Section: Resultsmentioning

confidence: 99%

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Ureteral Injuries in Coloretal Surgery - Bibliographic Review

Lima¹,

Ayrizono²,

Lima³

2022

JHS

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Introduction: Iatrogenic ureteral injuries (UII) are surgical complications associated with high morbidity, with an incidence ranging from 0.3% to 1.5%, and most commonly observed in gynecological and colorectal surgeries. Objective: To evaluate the factors that influenced LUI in colorectal surgeries and their history of diagnosis and treatment performed. Method: Bibliographic review carried out on the PubMed platform, 29 articles were selected, published between 2005 and 2021. Results: LUI were more frequently observed in the distal ureter and in women. Among the risk factors, the anatomical ones stand out (adherence of the ureter to the peritoneum, similarity with the ovarian ligaments and uterine artery and its proximity to important pelvic structures), anatomopathological (congenital anomalies, pelvic tumors, colorectal cancer, previous surgery and irradiation). pelvic, endometriosis, inflammatory/infectious processes and inflammatory bowel disease) and technical (bleeding in the operative field, advanced tumor, malnutrition and surgeons on a learning curve). As protective factors, right and transverse colon colectomy and, in some studies, videolaparoscopic surgery were identified, the latter not being a consensus. The indication of prophylactic ureteral catheter is not clear in the literature. They are usually indicated in reoperations, large pelvic tumors, laparoscopic surgeries, previous radiotherapy, diverticulitis, occurrence of fistulas, Crohn's disease and obesity. In the immediate suspicion of LUI, careful intraoperative visual inspection and use of retrograde or anterograde ureteropyelography were reported. In late diagnosis, computed tomography with intravenous contrast was the most used exam. In the treatment of LUI, the type of surgical correction depended on the severity and location of the lesion. Conclusion: Colorectal cancer, neoadjuvant radiotherapy and chemotherapy, pelvic recurrence, malnutrition and surgery performed in teaching hospitals were important risk factors for LUI. The use of an adequate and judicious surgical technique and the early diagnosis of ureteral lesions were more decisive factors than the surgical approach used.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Ureteral Injuries in Coloretal Surgery - Bibliographic Review

Lima¹,

Ayrizono²,

Lima³

2022

JHS

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“…In addition, poor knowledge of anatomy of the pelvic area by surgeon and his qualification, anatomical variations, surgical bleeding, obesity, malignant tumor surgeries and presence of adhesions in pelvic are also risk factors that can lead to inadvertent damage of the ureter. 5 Frequency, clinical and therapeutical characteristics of iatrogenic ureteral injuries are not well described in our setting and no previous reports are available on the occurrence of such complications in our context. The aim of this study was to describe the epidemiological, anatomic and therapeutical aspects of iatrogenic ureteral injuries during pelvic surgery in Souro Sanou University Teaching Hospital.…”

Section: Introductionmentioning

confidence: 83%

“…Frequency of 3.5 cases per year was reported by El Abd in Egypt during 28 years. 5,6 Although iatrogenic ureteric injury is relatively uncommon, it is a serious event occurring during surgery with a real medicolegal implication. 7,8 The mean age was 37.72 years.…”

Section: Discussionmentioning

confidence: 99%

Iatrogenic Ureteral Injuries Associated with Gynecological and Surgical Procedures: Our Experience About 18 Cases and Literature Review

Ouattara

Paré

Kaboré³

et al. 2021

RRU

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Aim: To describe the epidemiological aspects, etiology and outcome of iatrogenic ureteral injury repair at the urology division of Souro Teaching Hospital of Bobo Dioulasso (Burkina-Faso). Patients and Methods: This was a retrospective descriptive study of consecutive patients with iatrogenic ureteric injuries who were referred and managed in the urology division of Souro Sanou Teaching Hospital (Bobo-Dioulasso) from January 2012 to December 2017. Variables studied were age, the time at the diagnosis, the causative event, the method of repair, and the outcome of the management. Results: The mean age was 37.72±3.5 years coming from the rural population in most cases. The mean time at the diagnosis was 15 days. The injuries were due to gynecologic surgeries with hysterectomy (66%) and caesarian section (33%). Ureteric reimplantation with antireflux system was performed in seventeen patients. The rate of treatment success was 94% and the postoperative course was uneventful for all the patients. Conclusion: Iatrogenic ureteric lesions at the department of urology of Sanou Sourou teaching hospital of Bobo Dioulasso were mainly caused by gynecologic and obstetric surgeries like hysterectomy and caesarian section.

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Ureteral Fistulae

Osman,

Elawdy

2023

The Ureter

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Iatrogenic ureteral injuries: a case series analysis with an emphasis on the predictors of late ureteral strictures and unfavorable outcome in different surgical specialties

Cited by 12 publications

References 12 publications

Ureteral Injuries in Coloretal Surgery - Bibliographic Review

Ureteral Injuries in Coloretal Surgery - Bibliographic Review

Iatrogenic Ureteral Injuries Associated with Gynecological and Surgical Procedures: Our Experience About 18 Cases and Literature Review

Ureteral Fistulae

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