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Updated: Mar 20, 2026
Vessel-sparing Excision and Primary Anastomosis
Published on: January 7, 2019
[Endoscopic management of postoperative ureteral wound. Retrospective unicentric study from October 2003 to June
M Guandalino1, N Vedrine1, F Galonnier1
1Service d'urologie, CHU Gabriel-Montpied, 58, rue Montalembert, 63000 Clermont-Ferrand, France.
Insights
Ureteral wounds, though rare, require prompt management. Early detection and knowledge of lesion location are key for successful treatment, with endoscopic approaches showing high efficacy for simpler injuries.
Area of Science:
- Urology
- Surgical Complications
Background:
- Ureteral wounds are infrequent, occurring in 0.5-1% of pelvic surgeries.
- Prognosis and management depend on the timing of intervention and the ureteral lesion's location.
- Early treatment is crucial for reducing morbidity and improving patient outcomes.
Purpose of the Study:
- To analyze the management and outcomes of ureteral wounds.
- To evaluate the effectiveness of different treatment modalities based on wound complexity.
Main Methods:
- Retrospective study from October 2003 to June 2014.
- Systematic chart review across urology, digestive surgery, vascular surgery, and gynecology departments.
- Analysis of 46 ureteral wounds in 43 patients.
Main Results:
- Most ureteral wounds (69.6%) were located in the pelvic ureter.
- Gynecological surgery was the primary cause (n=25).
- Endoscopic treatment achieved nearly 90% success in simple wounds, but only 30% in more complex cases requiring secondary surgical intervention.
Conclusions:
- Effective management hinges on early detection and precise knowledge of lesion characteristics.
- Endoscopic treatment offers a high success rate (nearly 90%) for simple ureteral wounds.
- For complex wounds, endoscopy serves as an initial step with a lower success rate (around 30% in this study).
Background:
Ureteral wounds are rare with an incidence of 0.5 to 1% of pelvic surgeries. Their supports and their prognosis remain dependant of the period of support and the level of ureteral lesion. The importance of early treatment reduces morbidity and improves patient prognosis.
Methods:
A retrospective study from October 2003 to June 2014 was performed in a university hospital using a systematic chart review of patients' urology, digestive surgery, vascular surgery and gynecology.
Results:
Forty-six wounds were found in 43 patients. The majority of the ureteral wound was found at the pelvic ureter, i.e. 69.6% of the study population (n=32). The main cause was gynecological surgery (n=25). In the simple wound group, endoscopic treatment was effective in nearly 90% of cases (n=6). In the other two groups, the efficacy was only 30% and imposed a surgical treatment as second-line.
Conclusion:
The management is based primarily on early detection or intraoperative, and on a correct initial knowledge of the location and size of the lesion. Endoscopic treatment can in most cases treated with a simple and minimally invasive operation an ureteral wound with nearly 90% success rate. In more complex wounds, endoscopy remains a step in the management with about 30% success rate in our study.
Level Of Evidence:
5.
