Surgery for ureteral repair after gynaecological procedures: a single tertiary centre experience

Παπανικολάου, Αλέξιος; Tsolakidis, Dimitrios; Theodoulidis, V; Ioannidis, Evangelos; Vatopoulou, Anastasia; Kellartzis, D

doi:10.1007/s00404-012-2659-x

Cited by 13 publications

(10 citation statements)

References 9 publications

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“…Some advocate for immediate repair while others favour delayed repair [3,28,29]. The timing of repair in this study varied depending on the time of presentation and clinical state of the patient at presentation.…”

Section: Discussionmentioning

confidence: 99%

Urological Complications of Obstetrics and Gynaecology Surgeries in a Developing Country

2015

J Urol Nephrol

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Background: Urological complications of obstetrics and gynaecology surgeries are associated with significant morbidity and occasional mortality. Certain factors affect the prevalence and outcome of treatment. Aim:To evaluate the risk factors and outcome of treatment of urological complications of obstetrics and gynaecology practice. Results: During this period, 8,270 obstetrics and gynaecology surgeries were performed; Twenty five patients (0.31%) had urological complications. The mean age was 38.4 years (range 24-62 years). The commonest initial diagnosis was uterine fibroids in 9 patients followed by uterine rupture in 8 patients. Total abdominal hysterectomy (12 patients) was the commonest surgery. Twenty-one patients had ureteric injury. Seven patients had bladder injury; one patient had injury to the bladder and both ureters. Eight injuries were identified intra-operatively. Ureteric re-implantation was the commonest repair. Twenty two patients (88%) had satisfactory outcome, one patient (4%) died due to chronic renal failure while two patients (8%) had sepsis. Conclusion:We conclude that conditions that distort pelvic anatomy and emergencies were the major risk factors. Early operative repairs achieved satisfactory results. Early detection and treatment of urological complications of obstetrics and gynaecology surgeries is important. Good knowledge of anatomy of urogenital system and meticulous surgical technique by the surgeon will reduce the incidence of complications.

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Section: Discussionmentioning

confidence: 99%

Urological Complications of Obstetrics and Gynaecology Surgeries in a Developing Country

2015

J Urol Nephrol

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“…In the absence of infection, reoperation may be undertaken immediately after diagnosis, when operative management is deemed appropriate. 38,[41][42][43][44] Urethral Injuries Postoperatively detected urethral injuries usually present as urethrovaginal fistulae and should be repaired as such, using urologic expertise when nonresponsive to Foley catheter drainage.…”

Section: Ureteral Injuriesmentioning

confidence: 99%

Prevention, Recognition, and Management of Urologic Injuries During Gynecologic Surgery

Sharp

Adelman

2016

Obstetrics &Amp; Gynecology

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The urethra, bladder, and ureters are particularly susceptible to injury during gynecologic surgery. When preventive measures fail, prompt recognition and management of injury can avoid long-term sequelae such as fistula formation and loss of renal function. Intraoperative identification should be the primary goal when an injury occurs, although this is not always possible. Postoperative injury recognition requires a high level of suspicion and vigilance. In addition to history and physical examination, appropriate radiologic studies can be useful in localizing injury and planning management strategies. Some injuries may require Foley catheter drainage or ureteral stenting alone, whereas others will require operative intervention with ureteral resection and reanastomosis or reimplantation. Prompt restoration of urinary drainage or diversion will avoid further renal compromise.

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“…It is documented in the literature that ureteric injury is a complication following gynecologic procedures. 1 2 3 4 5 6 Untreated ureteral injury can lead to acute kidney injury and hydronephrosis, with long-term consequences.…”

Section: Study Rationale and Contextmentioning

confidence: 99%

Is Hydronephrosis a Complication after Anterior Lumbar Surgery?

Parks

Behrbalk

Mosharraf

et al. 2015

Global Spine Journal

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Study Design Prospective follow-up design. Objective Ureteral injury is a recognized complication following gynecologic surgery and can result in hydronephrosis. Anterior lumbar surgery includes procedures like anterior lumbar interbody fusion (ALIF) and total disk replacement (TDR). Anterior approaches to the spine require mobilization of the great vessels and visceral organs. The vascular supply to the ureter arising from the iliac arteries may be compromised during midline retraction of the ureter, which could theoretically lead to ureter ischemia and stricture with subsequent hydronephrosis formation. Methods Potential candidates with previous ALIF or TDR via anterior retroperitoneal access between January 2008 and March 2012 were chosen from those operated on by a single surgeon in a university hospital setting (n = 85). Renal ultrasound evaluation of hydronephrosis was performed on all participants. Simple descriptive and inferential statistics were used to generate results. Results A total of 37 voluntary participants were recruited (23 male, 14 female subjects; average age 51.8 years). The prevalence of hydronephrosis in our population was 0.0% (95% confidence interval 0 to 8.1%). Conclusions Retraction of the ureter across the midline in ALIF and TDR does not result in an increase in hydronephrosis and appears to be a safe surgical technique.

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Surgery for ureteral repair after gynaecological procedures: a single tertiary centre experience

Abstract: Although the need for ureteral repair is relatively infrequent during gynaecological operations, prompt recognition and treatment within accepted guidelines result in successful outcome.

Cited by 13 publications

References 9 publications

Urological Complications of Obstetrics and Gynaecology Surgeries in a Developing Country

Urological Complications of Obstetrics and Gynaecology Surgeries in a Developing Country

Prevention, Recognition, and Management of Urologic Injuries During Gynecologic Surgery

Is Hydronephrosis a Complication after Anterior Lumbar Surgery?

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