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[Ureteral iatrogenic ligature. Endoscopic resolution]
J L Miján Otiz1, A Jiménez Pacheco, M Pareja Vilchez
1Servicio de Urología, Hospital Universitario San Cecilio, Granada.
Actas Urologicas Espanolas
|December 21, 2006
Summary
Iatrogenic ureteral trauma, a complication of abdominal/pelvic surgery, occurs in 0.05-30% of cases, often affecting the lower ureter. Reconstruction varies by injury level, with supportive measures and endourology offering treatment options.
Area of Science:
- Urology
- Surgical Complications
- Medical Malpractice
Background:
- Iatrogenic ureteral trauma is a known complication of abdominal and pelvic surgeries.
- Incidence rates vary significantly across different surgical series, ranging from 0.05% to 30%.
Observation:
- The lower ureter is the most frequently injured site, likely due to its proximity to pelvic and abdominal structures.
- While isolated ureteral trauma is more common, bilateral ureteral trauma is a rare but significant complication.
- Gynecological surgeries represent the most common cause, followed by colon and vascular surgeries.
Findings:
- Reconstruction techniques are contingent upon the specific level and nature of the ureteral injury.
- Supportive management and endoscopic (endourology) interventions are valuable treatment modalities.
Implications:
- Understanding injury patterns and causes can inform surgical planning to minimize ureteral damage.
- Effective management strategies, including endourology, can improve patient outcomes and reduce morbidity associated with ureteral injuries.
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