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Complete ureteral transection associated with percutaneous lumbar disk nucleotomy
T A Flam1, E Spitzenpfeil, M Zerbib
1Clinique Urologique, Hôpital Cochin, Paris, France.
The Journal of Urology
|October 1, 1992
Summary
A rare complication of percutaneous nucleotomy for disk herniation is complete ureteral transection. This ureteral injury, contralateral to the surgical approach, required open surgical repair due to its severity.
Area of Science:
- Urology
- Neurosurgery
- Surgical Complications
Background:
- Percutaneous nucleotomy is a minimally invasive procedure for treating lumbar disk herniation.
- Complications, though rare, can occur and require careful consideration.
- Ureteral injuries are an uncommon but serious potential adverse event.
Observation:
- A case of complete ureteral transection was identified following percutaneous nucleotomy.
- The ureteral injury was located on the side opposite the percutaneous access.
- The severity of the ureteral transection precluded endourological treatment options.
Findings:
- Complete ureteral transection is a potential, albeit infrequent, complication of percutaneous nucleotomy.
- Contralateral ureteral injuries highlight the potential for referred or distant damage.
- Intubated ureteroureterostomy was successfully employed for surgical management.
Implications:
- This case underscores the importance of vigilance for unexpected urological complications during spinal procedures.
- It emphasizes the need for tailored surgical strategies when endourological management is not feasible.
- Highlights the critical role of advanced surgical techniques in managing severe iatrogenic ureteral injuries.