Ureteral Injury During Colorectal Surgery: Two Case Reports and a Literature Review

Abstract

Abstract:Iatrogenic ureteral injury (IUI) is a dreaded complication of abdominopelvic surgery. Although rare, it is associated with severe consequences. This complication most commonly occurs during gynecological procedures but may also occur during colorectal surgeries. We present two cases of IUI in patients in whom the ureteric stents were electively placed. The first case was a 71-year-old male with no significant medical history. The patient underwent an elective laparoscopic sigmoidectomy for complicated diverticulitis. During the procedure, a proximal IUI occurred, and was recognized and repaired. The second case occurred in a 68-year-old male with a history of multiple complicated abdominal surgeries. The patient underwent a second redo low anterior resection for a long preanastomotic stricture. The IUI occurred in the right fibrosed presacral plane, approximately 3 cm proximal to the bladder. The ureter was reimplanted to the bladder during the same procedure. We will also present a literature review of IUI, including the risk factors, intraoperative prevention, and repair options.

Uretero-vesical anastomotic stricture: a case report and review of management

“…Uretero-vesical anastomosis, ureteroneocystostomy or ureteric re-implantation is performed to re-establish urine flow from the kidneys to the urinary bladder in cases of distal ureteric stricture, ureteric injuries during pelvic surgeries, and in treating vesico-ureteric anomalies such as vesico-ureteric reflux and obstructive mega-ureter [2,6,7].…”

Findings beyond Crohn’s disease encountered on magnetic resonance enterography: a pictorial review of diseases inside and outside the bowel

“…In addition, the complex abdominal surgery in the management of Crohn's disease is associated with a risk of ureteral injury, which may result in obstructive hydronephrosis. (8) Obstructive hydronephrosis, therefore, may be observed when a patient with Crohn's disease is referred for MR enterography to investigate non-specific abdominal symptoms.…”

Trauma ureteral em histerectomia total abdominal: revisão narrativa

“…Já nas situações de lesão bilateral, o paciente irá cursar com anúria no pós-operatório precoce, sendo dessa forma a lesão rapidamente identificada. Quando a obstrução é unilateral, sendo este o caso mais comum, o paciente pode apresentar alguns sinais e sintomas associados à lesão do trato urinário (YELLINEK S, et al, 2018).…”