Endoscopic Management of Iatrogenic Ureteral Injury: A Case Report and Review of the Literature

Klett, Dane; Mazzone, Andrew; Summers, Stephen J.

doi:10.1089/cren.2019.0020

Cited by 6 publications

(3 citation statements)

References 4 publications

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“…Many studies have shown that in patients with a history of pelvic surgery, endoluminal procedures (be they endotomy, balloon dilation, multiple stent retention, etc.) have poor long-term outcomes and may make patients undergo multiple operations [7][8][9]. Repeated ureteroscopic surgery will not only increase the di culty of subsequent surgical procedures but also greatly increase the psychological and physiological burden of patients and also increase the economic burden on these patients [10].…”

Section: Discussionmentioning

confidence: 99%

Clinical efficacy of ureteroscopy-assisted laparoscopic ureteroplasty in the treatment of ureteral stricture after pelvic surgery

Xiao,

Liu,

Zhu

et al. 2024

Preprint

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Objective This study is to investigate the safety and efficacy of ureteroscope-assisted laparoscopic ureteroplasty in treating ureteral stricture after pelvic surgery. Methods A retrospective analysis of the clinical data of 95 patients treated for ureteral stricture at Ganzhou People's Hospital from June 2017 to March 2023 after pelvic surgery. In this group, 49 patients underwent ureteroscope and laparoscopic ureteroplasty under lithotomy position. The control group consisted of 46 patients who underwent simple laparoscopic ureteroplasty in a supine position. Postoperative data from both groups were collected and compared, including operation time, amount of blood loss during surgery, postoperative hospital stay, incidence of complications, success rate of ureteroplasty, and effectiveness of the operation. Results The success rate of end-to-end ureteral anastomosis in the observation group was 93.88%, and the operation effectiveness rate was 100%. The success rate in the control group was 78.26% and the operation effectiveness rate was 89.1%.The average operation time and intraoperative blood loss in the observation group were (121.3±44.6) min and (137.5 ±34.2) ml, respectively, while in the control group they were (151.2±52.3) min and (165.6±45.8) ml. The difference were statistically significant (P<0.05). The incidence of perioperative complications in the observation group was 2%, significantly lower than that in the control group (19.6%) (P<0.05). Conclusion Ureteroscope-assisted laparoscopic ureteroplasty for ureteral stricture after pelvic surgery has the advantages of shortened operation time, increased success rate, and reduced incidence of complications, making it an optional surgical scheme in clinical practice.

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Section: Discussionmentioning

confidence: 99%

Clinical efficacy of ureteroscopy-assisted laparoscopic ureteroplasty in the treatment of ureteral stricture after pelvic surgery

Xiao,

Liu,

Zhu

et al. 2024

Preprint

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“…Overall, CT urography with both nephrographic and excretory phases (the latter is performed 5-20 minutes after contrast administration), emerges as the "gold standard" method for suspected ureteral injuries 58 . In rare instances where the ureter is sutured despite the absence of transection, attempting balloon dilation of the ligated portion may obviate the need for surgery 59,60 . Partial ureteral transection is preferably managed through percutaneous nephrostomy tube placement, wire recanalization of the ureteral lumen and stent placement 10 .…”

Section: Ureteral Injuriesmentioning

confidence: 99%

Urological injuries following gynecologic surgery: clinical manifestations, diagnosis and management

Ziogou,

Giannakodimos,

Giannakodimos

et al. 2024

HJOG

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Iatrogenic urinary tract injury constitutes a rare but serious complication of gynecologic surgery, occurring in 0.3% to 1.5% of all procedures. Delayed diagnosis and repair are associated with increased postoperative morbidity, mortality and a long-term negative impact on the quality of life. Intraoperative detection of urinary tract injuries allows for prompt repair, facilitates management and speeds up recovery. Bladder injuries are 3 times more common than ureteral injuries, and usually are recognized and repaired immediately with minimal complications. Undetected ureteral injuries lead to severe postoperative complications such as the formation of genitourinary fistulas, sepsis, renal loss and death. In this review we aim to describe the postoperative clinical manifestations, the diagnostic methods and therapeutic strategies for the management of urinary tract injuries, whether in the acute or delayed setting, in an effort to reduce the potential impact of subsequent complications to both patient and surgeon. Timely and effective repair of urinary tract injuries is critical to improve patient outcome, mitigate litigation risk, and allow an uneventful postoperative recovery in a careful manner.

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“…In the infrequent case where the ureter is sutured without being transected, balloon dilation of the ligated portion can be attempted to avoid surgery [ 100 , 147 ]. Also, in partial ureteral transection, minimally invasive techniques, including percutaneous nephrostomy tube placement, wire recanalization of the ureteral lumen and stent placement, are preferred [ 98 ].…”

Section: Key Questionsmentioning

confidence: 99%

2023 WSES guidelines for the prevention, detection, and management of iatrogenic urinary tract injuries (IUTIs) during emergency digestive surgery

de’Angelis,

Schena,

Marchegiani

et al. 2023

World J Emerg Surg

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Iatrogenic urinary tract injury (IUTI) is a severe complication of emergency digestive surgery. It can lead to increased postoperative morbidity and mortality and have a long-term impact on the quality of life. The reported incidence of IUTIs varies greatly among the studies, ranging from 0.3 to 1.5%. Given the high volume of emergency digestive surgery performed worldwide, there is a need for well-defined and effective strategies to prevent and manage IUTIs. Currently, there is a lack of consensus regarding the prevention, detection, and management of IUTIs in the emergency setting. The present guidelines, promoted by the World Society of Emergency Surgery (WSES), were developed following a systematic review of the literature and an international expert panel discussion. The primary aim of these WSES guidelines is to provide evidence-based recommendations to support clinicians and surgeons in the prevention, detection, and management of IUTIs during emergency digestive surgery. The following key aspects were considered: (1) effectiveness of preventive interventions for IUTIs during emergency digestive surgery; (2) intra-operative detection of IUTIs and appropriate management strategies; (3) postoperative detection of IUTIs and appropriate management strategies and timing; and (4) effectiveness of antibiotic therapy (including type and duration) in case of IUTIs.

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Endoscopic Management of Iatrogenic Ureteral Injury: A Case Report and Review of the Literature

Cited by 6 publications

References 4 publications

Clinical efficacy of ureteroscopy-assisted laparoscopic ureteroplasty in the treatment of ureteral stricture after pelvic surgery

Clinical efficacy of ureteroscopy-assisted laparoscopic ureteroplasty in the treatment of ureteral stricture after pelvic surgery

Urological injuries following gynecologic surgery: clinical manifestations, diagnosis and management

2023 WSES guidelines for the prevention, detection, and management of iatrogenic urinary tract injuries (IUTIs) during emergency digestive surgery

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