Ureteric injuries during laparoscopic gynecologic surgeries

Nerli, Rajendra B; Ghagane, Shridhar C; Kadeli, Vishal; Hiremath, Murigendra B

doi:10.4103/jss.jss_16_19

Cited by 6 publications

(4 citation statements)

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“…The incidence of ureteric injury varies between 0.1% and 30%, depending on the type of surgery. 12 Ureteric injury occurs in radical Wertheim hysterectomies (1-30%). 13 Hoffman et al reported a 2.2% incidence with radical total hysterectomies, 2.4% for rectosigmoid colectomy 2 radical hysterectomy was associated with highest incidence of 2.5%,low anterior resections, 0.24% have been reported.…”

Section: Discussionmentioning

confidence: 99%

Ureteric injuries during cancer surgery presentation and management over a 20-year

et al. 2021

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Background: Iatrogenic ureteral injury rare 0.3-1.5%. complication of abdominopelvic cancer surgery. We aimed to study the risk and management of ureteral injury among cancer patients. Methods: Diagnosis can be achieved retrograde pyelography, ureteroscopy, CT, or intravenous urography. Results: Years 2000 to 2020, 2904 patients in the Department of Surgical oncology, Assuit University, and 47 ureteral injury cases were identified. (1.62), 4/231 cervical cancer, 9/611 ovarian cancer and 7/462 endometrial cancer.,11/818 colon cancer,12/620 rectal cancer, 1/11 prostatic cancer, 3/151 retroperitoneal sarcoma. 34% (radical abdominal hysterectomy 8.5% Wertheim hysterectomies 4%), colorectal surgery colectomy 25.5%, low anterior resection2.1% in radical prostatectomy and 6.4% in retroperitoneal tumor, intraoperative diagnosis 48.9%, 8.5% in laparoscopic surgeries, the distal third (53.2%),23.4% catheterization, complete transection 31.9%; partial 14.9%, ligation 8.5%, laceration in 19.1%, resection. 8.5%; and devascularization in 17%. Fever in 14.9%, abdominal or flank pain in 38.5%. Oligura in 6.4%, ileus in 19.3%, urinary leakage (vaginally or via abdominal wound) in 10.6% rise creatinine in 10.6%, hydronephrosis in 6.4%, urinoma in 27.7%, extravasation in 8.5% asymptomatic in 4.3%, 40.4% percutaneous nephrostomy. 19.1%primary repair Ureteroneocystostomy in (17%) Boari flap in 12.7%, Psoas hitch in 23.4% stenting in 14.9%, 8.5% ileum interposition, anastomosis to contralateral ureter in 4.3%, ureteral stricture 6.4%, ureterovaginal fistulas in 10.6%, acute renal failure 2.1%, peritonitis 4.3, urinary tract infection in 14.9%.Conclusions: The recognition and immediate repair of ureteral injuries early during the same procedure was highly desirable and to avoid a second operation.

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Section: Discussionmentioning

confidence: 99%

Ureteric injuries during cancer surgery presentation and management over a 20-year

et al. 2021

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“…16 One recent study about laparoscopic gynecological surgeries reported that incidence of all major complications are declining, but the ureteric injury incidence has stayed constant at approximately 1%. 17 Another study of uterine prolapse surgery also reported that hydronephrosis associated with obstructiveuropathy may lead to a tortuous ureter which place the ureter in non-anatomical position and prone it for more risk of injury. 18 Limitation of injury can be achieved by intimate knowledge of the pelvic anatomy, careful visualization and palpation of ureter and in some instances by prophylactic ureteric stenting.…”

Section: Discussionmentioning

confidence: 99%

Iatrogenic ureteric injuries in urological surgeries- a tertiary hospital experience.

Mansoor

2020

TPMJ

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Objectives: To review our experience in the management of iatrogenic ureter injuries caused by different urological procedures. Study Design: Descriptive Case series. Setting: Department of Urology, Jinnah Postgraduate Medical Centre Karachi. Period: January 2011 to December 2018. Material & Methods: We included all cases of iatrogenic ureteric injuries induced by urology department only. Gynecological and general surgical iatrogenic injuries were excluded in this study. All pertinent details like indication for surgery, type of surgery, location of injury, laterality, type of injury, time of recognition of injury (i-e intra-operative, early and late), treatment modality and their surgical outcomes were recorded. Results: We managed 56 iatrogenic ureteric injuries in 47 patients during study period. Mean age was 43.14+ 8.86 years. There were 31 males (66%) and 16 females (34%). Right sided injury was observed in 29 patients (61.7%), left sided injury in 16 patients (34.0%) while bilateral injuries were seen in 2 patients (4.3%). Regarding site of injury proximal ureteric injuries were the most common accounting for 32 patients (68.1%). Intraoperative diagnosis was the most common time for diagnosis seen in 30 patients (63.8%). The endoscopic urological surgeries were the most common cause of urological iatrogenic ureteric injury accounts for 71.4% of cases. Open upper tract surgeries were responsible for 8 cases (14.2%). One patient sustained proximal ureteric injury during retro-peritoneal lymph node dissection (RPLND). Laparoscopic urological surgeries were responsible for four cases of injury. One patient developed ureteric avulsion. 13 patients presented with late Ureteric stricture. We have five nephrectomies while three patients needed permanent nephrostomies. Our success rate was 83%. Conclusions: Endo-urological procedures are the commonest causes of ureteric injuries in our study. Prompt diagnosis and early corrective intervention can result in satisfactory outcome in about 83% of cases.

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“…Surgical management of ureteric injuries depends on the site and size of the defect; type of injury and condition of the patient and expertise of the surgeon. 4…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic Ureteric Reimplantation in Distal Ureteric Injury Post-total Laparoscopic Hysterectomy: A Case Series

Dadhich¹,

Mehta²,

Dadhich³

et al. 2020

Journal of South Asian Federation of Obstetrics and Gynaecology

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Introduction: Ureteral injuries have been recognized as a potential complication of gynecological surgical procedures since the inception of our discipline; incidence ranging from 0.5 to 1.5% and morbidity associated with it may be serious. Traditionally, most ureterovaginal fistulas have been repaired by ureteroneocystostomy. Open ureteral reimplantation is a potentially morbid surgical procedure. Endourological techniques are highly successful in treating posthysterectomy ureteral injuries. The objective of this presentation is to relate our experience and result with laparoscopic ureteral reimplantation. Materials and methods: Five patients with complaints of leakage of urine per vaginum postoperatively on day 12-24 (post-TLH) presented for treatment. After diagnosis, treatment of ureterovaginal fistula was performed completely laparoscopically. Laparoscopic ureteral reimplantation was done. Results: No major intraoperative or postoperative complications were encountered. The operating room time was 120 minutes (range 120-240 minutes). The average hospital stay was 4 days. Patients had a successful outcome defined as no evidence of radiographic obstruction and no clinical complaints of persistent renal colic or any other urinary symptoms. Conclusion:Our experience demonstrates that laparoscopic ureteral reimplantation is an effective minimally invasive treatment option for distal ureteral strictures.

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Ureteric injuries during laparoscopic gynecologic surgeries

Cited by 6 publications

References 0 publications

Ureteric injuries during cancer surgery presentation and management over a 20-year

Ureteric injuries during cancer surgery presentation and management over a 20-year

Iatrogenic ureteric injuries in urological surgeries- a tertiary hospital experience.

Laparoscopic Ureteric Reimplantation in Distal Ureteric Injury Post-total Laparoscopic Hysterectomy: A Case Series

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