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Late urologic complications in aorto-iliac reconstructions
G Vitacchiano1, L Pedrini, A Saccà
1Cattedra di Chirurgia Vascolare, Università di Bologna.
The Italian Journal of Surgical Sciences
|January 1, 1989
Summary
Aortoiliac reconstruction can cause hydroureteronephrosis due to retroperitoneal fibrosis. This study found 4% of patients developed this condition, often asymptomatic, highlighting the need for monitoring after surgery.
Area of Science:
- Vascular Surgery
- Urology
- Radiology
Background:
- Aortoiliac reconstruction is performed for chronic peripheral obstructive arterial disease.
- Post-operative hydroureteronephrosis can occur due to prosthesis malposition, fibrosis, or dissection.
- The correlation between hydroureteronephrosis and prosthetic infections warrants consideration.
Observation:
- A retrospective study examined 100 patients undergoing aortoiliac reconstruction.
- Follow-up ranged from 23 to 146 months (average 72 months).
- Four patients (4%) developed unilateral hydroureteronephrosis, linked to retroperitoneal fibrosis.
Findings:
- Hydroureteronephrosis was consistently asymptomatic in the observed cases.
- Intravenous pyelography was used for moderate to severe hydroureteronephrosis.
- One patient required ureterolysis, ureteral wrapping, and catheterization for severe hydroureteronephrosis.
Implications:
- Retroperitoneal fibrosis is a significant cause of hydroureteronephrosis post-aortoiliac reconstruction.
- Asymptomatic hydroureteronephrosis necessitates careful monitoring.
- Prospective studies are crucial for understanding the long-term prognosis of patients undergoing aorto-iliac reconstruction.