Prise en charge des lésions urétérales iatrogènes

Beaugerie, Laurent; Spie, R.; Favoulet, P; Cheynel, N.; Kretz, Benjamin; Gouy, Sébastien; Dubruille, Thomas; Fraisse, J.; Cuisenier, Jean

doi:10.1016/j.anchir.2005.02.017

Cited by 18 publications

(2 citation statements)

References 26 publications

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“…For completely transected or obliterated ureteral injuries, it is usually not possible to place a ureteral stent across the injured segment, and therefore, conservative management often fails. Consequently, patients often require open or laparoscopic repair with appropriate urinary reconstruction involving ureteral reimplantation, psoas hitch, Boari flap, transureteroureterostomy, renal descensus, ileal interposition, renal autotransplantation, or nephrectomy [18]. …”

Section: Discussionmentioning

confidence: 99%

Iatrogenic Obliteration of Ureter with Spontaneous Recanalization

Beiko

Mussari

2013

Case Reports in Medicine

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We report an unusual case of spontaneous and complete healing of a severe iatrogenic midureteral injury. Following percutaneous nephrostomy and 3 months on our surgical waiting list, the injured ureter underwent complete spontaneous recanalization. The patient is clinically well with no evidence of recurrent obstruction after 2 years of followup. To our knowledge, this is the first reported case of spontaneous recanalization of an iatrogenically induced complete ureteral obliteration.

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Section: Discussionmentioning

confidence: 99%

Iatrogenic Obliteration of Ureter with Spontaneous Recanalization

Beiko

Mussari

2013

Case Reports in Medicine

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“…Lacerations are treated with a double J stent with or without a suture. When this fails or after transections, ureteral reimplantation in the bladder (1,6,7), with or without a Boari flap, is generally performed. Ureteral reanastomosis, although reported to have an overall success rate of 94%, never gained widespread popularity (1).…”

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confidence: 99%

Laparoscopic management of ureteral lesions in gynecology

Cicco

Schonman

Craessaerts

et al. 2009

Fertility and Sterility

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Objective: To investigate the outcome of laparoscopic repair of ureteral injury in laparoscopic gynecologic surgery. Design: Prospective trial. Setting: University hospital. Patient(s): Forty patients with a ureteral lesion in laparoscopic surgery between 1991 and 2007. Intervention(s): Laparoscopic ureteral repair, laparoscopic-assisted or blind stent insertion. Main outcome measure(s): Treatment outcome of ureteral lesion analyzed by type of injury, time of diagnosis, and management. Result(s): In 4,350 consecutive laparoscopic gynecologic interventions, 42 lesions occurred, 5 during hysterectomy, 1 during adnexectomy, and 36 during deep endometriosis surgery. In the latter group (n ¼ 1,427), the incidence was 1.5% and 21% in women without and with hydronephrosis, respectively. In eight women in whom a stent was inserted after surgery without laparoscopic guidance, five were uneventful and three needed a second intervention. In all 34 women in whom a laparoscopic repair over a stent was performed, the outcome was uneventful, whether diagnosed and treated during surgery (n ¼ 25) or after surgery (n ¼ 9). Conclusion(s): Laparoscopic repair over a stent was uneventful for all lacerations, transections, and fistulas, whether performed during or after surgery, and was superior to blind stent insertion. In women with hydronephrosis and deep endometriosis, a preoperative stent insertion seems to be mandatory. (Fertil Steril Ò 2008;-:---.

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