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Related Experiment Videos

Ureteral injury.

W G Guerriero1

  • 1Scott Department of Urology, Baylor College of Medicine, Houston, Texas.

The Urologic Clinics of North America
|May 1, 1989
PubMed
Summary
This summary is machine-generated.

Ureteral injuries from surgery or stones are often manageable with prompt recognition and treatment. Conservative drainage and stenting effectively heal most iatrogenic ureteral perforations, while avulsions may require open repair.

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Area of Science:

  • Urology
  • Surgical Injury Management
  • Endourology

Background:

  • Ureteral injuries from external trauma or surgery typically require recognition and a tailored treatment plan.
  • Endoscopic ureteral procedures for stones and strictures have increased, leading to a higher incidence of iatrogenic ureteral perforation (up to 20%).
  • Management decisions can be complex due to legal, economic, and emotional factors.

Purpose of the Study:

  • To review the management strategies for ureteral injuries.
  • To highlight the efficacy of conservative approaches for iatrogenic ureteral perforations.
  • To emphasize the importance of prompt recognition and appropriate treatment for ureteral trauma.

Main Methods:

  • Review of management principles for ureteral injuries.

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  • Discussion of treatment options including surgical repair, conservative drainage, and diversion.
  • Emphasis on percutaneous nephrostomy and ureteral stenting for iatrogenic injuries.

    • Main Results:

    • Most ureteral injuries are managed straightforwardly with recognition and a treatment plan.
    • Iatrogenic ureteral perforations from endoscopic procedures rarely have sequelae when managed with proximal diversion, percutaneous nephrostomy, and ureteral stenting.
    • Conservative management with 3-10 days of drainage is usually sufficient for healing these injuries.

    Conclusions:

    • Prompt recognition and appropriate management are crucial for ureteral injuries.
    • Conservative management, including drainage and stenting, is highly effective for iatrogenic ureteral perforations.
    • Avulsion injuries may necessitate open operative correction.