PURPOSE: To present experience and feasibility of endoscopic realignment for treatment of delayed recognized iatrogenic complete transected ureteral injuries. PATIENTS AND METHODS: Patients suffering from iatrogenic complete transected ureteral injuries were treated by two surgeons. Five women and 3 men with a mean age of 50.8 years (range 22-69) received diagnosis during the immediate postoperative period (2-6 days after surgery). Ureteral continuity was re-established using a technique combining antegrade flexible ureteroscopy and retrograde rigid ureteroscopy. Then, three ipsilateral 5F double J stents were inserted to assure ureteral patency. RESULTS: All eight realignment procedures were successful, and no major complications occurred. Average injury length was 1.9 cm (range 1.5-3.0). Average hospitalization time was 8 days (range 3-14). Nephrostomy tubes and stents were removed after a mean period of 3.9 weeks (range 2-6) and 6.8 months (range 5.9-7.1), respectively. At a mean follow-up of 21.5 months (range 10-56), 6 patients were stent-free without image evidence of obstruction, a patient developed strictures was treated with balloon dilation and another exchanged double J stents periodically. No patient has developed significant renal impairment. CONCLUSION: Endoscopic realignment is a safe and efficient method as an initial procedure to manage iatrogenic complete transected ureteral injuries in properly selected cases.
PURPOSE: To present experience and feasibility of endoscopic realignment for treatment of delayed recognized iatrogenic complete transected ureteral injuries. PATIENTS AND METHODS: Patients suffering from iatrogenic complete transected ureteral injuries were treated by two surgeons. Five women and 3 men with a mean age of 50.8 years (range 22-69) received diagnosis during the immediate postoperative period (2-6 days after surgery). Ureteral continuity was re-established using a technique combining antegrade flexible ureteroscopy and retrograde rigid ureteroscopy. Then, three ipsilateral 5F double J stents were inserted to assure ureteral patency. RESULTS: All eight realignment procedures were successful, and no major complications occurred. Average injury length was 1.9 cm (range 1.5-3.0). Average hospitalization time was 8 days (range 3-14). Nephrostomy tubes and stents were removed after a mean period of 3.9 weeks (range 2-6) and 6.8 months (range 5.9-7.1), respectively. At a mean follow-up of 21.5 months (range 10-56), 6 patients were stent-free without image evidence of obstruction, a patient developed strictures was treated with balloon dilation and another exchanged double J stents periodically. No patient has developed significant renal impairment. CONCLUSION: Endoscopic realignment is a safe and efficient method as an initial procedure to manage iatrogenic complete transected ureteral injuries in properly selected cases.
Authors: A V Brewer; A M Elbahnasy; E Bercowsky; K L Maxwell; A L Shalhav; S A Kahn; E M McDougall; R V Clayman Journal: J Endourol Date: 1999-05 Impact factor: 2.942
Authors: Jason Hafron; Michael C Ost; Beng Jit Tan; James D Fogarty; David M Hoenig; Benjamin R Lee; Arthur D Smith Journal: Urology Date: 2006-10 Impact factor: 2.649
Authors: Mohammad Arabi; Abdulaziz Mat'hami; Mohammad T Said; Muhammad Bulbul; Maurice Haddad; Aghiad Al-Kutoubi Journal: Avicenna J Med Date: 2016 Jan-Mar