Complete Ureteral Avulsion

Gupta, Vikas; Sadasukhi, Trilok Chand; Sharma, Kamlesh; Yadav, Ram Narayan; Mathur, Rajendra Mohan; Tomar, Vinay; Yadav, Sher Singh; Priyadarshi, Shivam; Gupta, Priti

doi:10.1100/tsw.2005.13

Cited by 18 publications

(17 citation statements)

References 2 publications

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“…Several minor and major complications have been reported due to ureteroscopy such as asymptomatic ureteral perforations, ileus, fever, perforation and rarely avulsions during basketing, intussusception or sepsis. Necrosis of ureteral segments after ureteroscopy for stone removal has also been reported (Bernhard & Reddy, 1996;Gupta et al, 2005;Kijvikai, Haleblian, Preminger, & de la Rosette, 2007;Taie, Jasemi, Khazaeli, & Fatholahi, 2012). Theoretically, although URS is a minimally invasive procedure, its negative effect on sexual function must be considered.…”

Section: Discussionmentioning

confidence: 99%

Ureterorenoscopy with stenting and its effect on male sexual function: A controlled randomised prospective study

et al. 2016

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Seventy-two male patients, who were included in this study, underwent ureteroscopic stone surgery (study group). Forty-two healthy males were enrolled as control group. Changes in sexual function were evaluated using International Index of Erectile Function questionnaire in pre-operative, first and third postoperative terms. Overall satisfaction in relation to the age, operation time, presence of stents, body mass index, educational status, previous operations, International Index of Erectile Function score, International Prostate Symptom Score, Quality of Life, income status, Male Sexual Health Questionnaire, stone-free rates and Beck's depression scale were evaluated. Erectile and ejaculatory functions, quality of life and lower urinary tract symptoms were negatively affected due to ureteroscopic stone surgery, while educational status, psychogenic aspect and income status remained stable. In conclusion, ureteroscopic stone surgery with JJ catheterisation seems to have a progressively decreasing negative effect on male sexual function and whenever possible, stenting should be avoided. If JJ stenting is necessary, patients should be informed that they may experience sexual dysfunction at least for 3 months and if stenting proves necessary the indwelling should be kept as short as possible.

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Section: Discussionmentioning

confidence: 99%

Ureterorenoscopy with stenting and its effect on male sexual function: A controlled randomised prospective study

et al. 2016

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“…Boari flap and psoas hitch are recommended for the middle third of ureteral avulsion. For distal ureteral injuries, ureteral re-implantation is recommended (13). If avulsion is diagnosed during the postoperative period, a percutaneous nephrostomy can be placed, and a definitive treatment can be performed when the patient is stable (7).…”

Section: Discussionmentioning

confidence: 99%

The management of total avulsion of the ureter from both ends: Our experience and literature review

Sevinc¹,

Balaban²,

Özkaptan³

et al. 2016

Arch Ital Urol Androl

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Objective: To evaluate the treatment modalities of total ureteral avulsion and to clarify the risk factors of this serious complication. Methods: This study retrospectively analyzed the data of 3 patients with complete ureteral avulsion during ureteroscopy. Of the three patients, two had distal ureteral complete avulsion, and one total ureteral avulsion on both ends. Ureteroneocystostomy (UNC) was immediately performed after distal ureteral avulsion cases. Ileal ureter substition was performed on the same session after the total ureteral avulsion in both ends. Two of the patients were under chronic use of corticosteroid treatment due to diagnosis of idiopathic trombocytopenic purpura and myastenia gravis and all patients had unsuccesful shockwave litotripsy (SWL) treatment history with at least 1 month period before surgery. Results: The patient who had ileal ureter substitution was followed at 3-month intervals by ultrasonography and renal function tests and she was uneventful after a 2 year follow-up period. The patients treated with UNC were followed up at 3 month interval by ultrasonography and renal function tests. They had normal renal function 1 year after the operation Conclusion: Complete ureteral avulsion is a rare but severe complication. Treatment modality can vary and ileal ureter can be applied succesfully in the total ureter avulsion in both ends when bladder capacity is not enough for a Boari flap. Failed SWL and/or corticosteroid treatment history of patients seems to increase the risk of the ureteral avulsion.KEY WORDS: Avulsion; Lithotripsy; Ureterorenoscopy. quency of complications varies between 0.5% and 10% in the literature (1-3). Ureteral avulsion is the most serious complication and occurs in 0-0.5% patients (4). Treating ureteral avulsion is a challenge. Patient comorbidities, the condition of the kidney, severity of the ureteral damage, and experience of the surgeon can affect the choice of treatment. In this study, we aimed to discuss our experience and possible leading factors of this serious complication in the light of the current literature. MATERIALS AND METHODSWe retrospectively analyzed three ureteral avulsion cases and treatment modalities at two referral hospitals between January 2008 and October 2014. All patients underwent rigid ureteroscopic procedures for removing ureteral stones, and ureteral avulsion occurred during the retrograde examination of the ureter. Of the three patients (1 man, 2 women; age: 28-65 years, one right, two left), the avulsed ureter was repaired during the same session of the ureterorenoscopic surgery. The ureter stones were located in the distal ureter in two patients and in the proximal ureter in one patient. All patients had unsuccessful SWL treatment and at least a 2 week interval before further investigation and treatment were applied. Two patients who have been diagnosed with idiopathic thrombocytopenic purpura and myastenia gravis received chronic corticosteroid treatment. The patients were evaluated with abdominal X-ray, ultrasonography, int...

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“…Its treatment varies depending on the affected ureteral segment and the functional status of renal unit 2,3 . Depending on the injured segment, various ureteral reconstruction techniques can be used 3,4 .…”

Section: Technique Technique Technique Technique Techniquementioning

confidence: 99%

“…T raumatic lesions of the ureter are relatively frequent events and may be caused by iatrogenic lesions, most often after gynecological or urological operations, or after blunt or penetrating abdominal trauma. Some techniques can be employed for the treatment of such lesions, ranging from uretero-enterostomy to ileal interposition [1][2][3][4] . Muscle flaps have long been experimentally studied as substitutes for segments of the urinary tract 5 .…”

Section: Introduction Introduction Introduction Introduction Introducmentioning

confidence: 99%

Ureteral reconstruction with abdominal wall muscle flap: experimental study in rabbits

Smith

Silva

Ferreira

et al. 2014

Rev. Col. Bras. Cir.

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Complete Ureteral Avulsion

Abstract: Complete avulsion of the ureter is one of the most serious complications of ureteroscopy. It requires open or laparoscopic intervention for repair. This case report emphasizes its management and presents recommendations for prevention in current urological practice.

Cited by 18 publications

References 2 publications

Ureterorenoscopy with stenting and its effect on male sexual function: A controlled randomised prospective study

Ureterorenoscopy with stenting and its effect on male sexual function: A controlled randomised prospective study

The management of total avulsion of the ureter from both ends: Our experience and literature review

Ureteral reconstruction with abdominal wall muscle flap: experimental study in rabbits

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