Ureteric obstruction after dacron vascular replacement.

Ureteric obstruction is a recognised complication of aortic bifurcation grafting where the graft material is in close proximity to the ureter as it crosses the common iliac vessels. We have assessed the value of routine postoperative urography in (1) a retrospective 6-year study of ruptured aortic aneurysm repair (11 patients reviewed) and (2) a prospective 18-month study of all patients receiving intra-abdominal dacron grafts (24 assessable patients) in a district general hospital. Renal function was normal in all cases and only 1 ureter was shown at urography to be minimally dilated but not significantly obstructed out of 32 'at risk' ureters in 18 patients in the 2 studies. This complication is uncommon, and no particular advantage can be demonstrated in positioning the ureters either behind or in front of the graft limbs. There is no place for routine urography which should be reserved for the patient with symptoms of ureteric obstruction.