TY - JOUR
TI - Ureteral injuries during gynecologic surgery: Treatment with a minimally
invasive approach
AU - Liatsikos, E. N.
AU - Karnabatidis, D.
AU - Katsanos, K.
AU - Kraniotis, P.
AU - and Kagadis, G. C.
AU - Constantinides, C.
AU - Assimakopoulos, K. and
AU - Voudoukis, T.
AU - Athanasopoulos, A.
AU - Perimenis, P.
AU - Nikiforidis,
AU - G.
AU - Siablis, D.
JO - Journal of Endourology Case Reports
PY - 2006
VL - 20
TODO - 12
SP - 1062-1067
PB - MARY ANN LIEBERT INC PUBL
SN - null
TODO - 10.1089/end.2006.20.1062
TODO - null
TODO - Purpose: To report the safety and efficacy of percutaneous nephrostomy
and primary antegrade recanalization for treatment of iatrogenic
ureteral strictures after gynecologic surgery.
Patients and Methods: Ten women had symptoms suggestive of ureteral
obstruction during the immediate postoperative period (5 days-1 week
after surgery). Under analgesia and conscious sedation, standard
percutaneous nephrostomy was performed, and a long 7F sheath was placed
in the upper ureter. The obstructions were traversed with the aid of a
0.0035-inch Glidewire and a 5F angled Glide catheter (Terumo, Japan).
Subsequently, the areas were dilated with angioplasty balloons to a
maximum diameter of 7 mm. Finally, an 8F percutaneous internal/external
nephroureteral drainage stent was inserted to secure ureteral patency.
Follow-up was carried out by serial nephrostomography until removal of
the stent and by renal ultrasonography thereafter.
Results: Twelve obstructions with a mean length of 1.4 cm (range 0.4-1.9
cm) were managed. The technical success rate was 100%. No major
complications occurred, and normal renal function was restored. The mean
follow-up was 12 months. In 60% of the patients, a patent ureter was
depicted at 1 week, whereas in four patients, repeat dilation of the
obstructed segment was required. The stents were removed after a mean
period of 4.8 weeks.
Conclusion: Percutaneous nephrostomy and primary antegrade ureteral
balloon dilation is safe and efficacious for treating ureteral injury
after pelvic surgery and obviates open surgical manipulations.
ER -