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Formerly Journal of Turgut Ozal Medical Center - ISSN 1300-1744

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Retrospective view and treatment of iatrogenic ureteral injuries (p.458-53)

Retrospective view and treatment of iatrogenic ureteral injuries (p.458-53)

Recep Eryilmaz1, Rahmi Aslan1, Murat Demir2, Arif Mehmet Duran1, Felat Ciftci3, Kerem Taken1
1Van Yuzuncu Yil University, Faculty of Medicine, Depatmant of Urology, Van, Turkey
2Van Training and Research Hospital, Clinic of Urology, Van, Turkey
3Inonu University, Faculty of Medicine, Depatmant General Surgery, Malatya, Turkey
Copyright © 2020 by authors and Annals of Medical Research Publishing Inc.

Abstract

Aim: Ureteral injuries are rare. Iatrogenic ureteral injury is the most common cause of ureteral traumas. This letter aims, evaluation of iatrogenic ureteral traumas and treatments.
Material and Methods: Thirty two patients with major iatrogenic ureteral trauma were enrolled. Sonography, intravenous pyelography, CT of abdomen (contrast-enhanced and non-contrast enhanced), antegrade X-rays or diagnostic ureterenoscopy are used for the diagnosis. All patients were undergone endoscopic ureterenoscopy before the ureter was surgically repaired. Next, the surgical technique was decided. Injuries that can be managed with endoscopic approach were treated by inserting a Double J stent. For patients who were not eligible for endoscopic treatment, treatment was decided according to the location of ureteral injury.
Results: Of the patients, 25 were female and 7 were male and mean age was 46.31±16.485 years. Ureteral injury was secondary to gynecologic intervention in 16 patients, general surgery procedures in 6 patients and urologic surgery in 10 patients. According to AAST, Grade 4-5 injury was identified in 71.9% of 32 patients, while Grade 3 and Grade 2 injuries were noted in 15.6% and 12.5% of patients, respectively. Four patients were treated in late period, while intraoperative or early treatment was instituted for 28 patients.
Conclusion: Iatrogenic ureteral injuries develop mostly after laparoscopic or endoscopic pelvic surgeries. We should prefer endoscopic insertion of Double J stent for the first-line treatment.

Keywords: Latrogenic; ureter; traumas; treatment

 

 

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doi: 10.5455/annalsmedres.2019.11.713

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Annals of Medical Research is the scientific official journal of the Inonu University Faculty of Medicine. It is published monthly. The essential aim of the Annals of Medical Research is to publish scientifically high quality clinical and experimental research articles on fields of medicine which can contribute to the literature data. In addition, review articles, case reports, editorials, letters to the editors and manuscripts on publication ethics and medical history, which can contribute to the education and practices of physicians and health sector professionals within the scope of the journal’s target audience and which can increase the level of scientific communication between the authors and readers, are included in the scope of the journal.

 

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