Ureteral Avulsion during Semirigid Ureteroscopy: A Single-Centre Experience
A R Bhaskarapprakash1, Leelakrishna Karri1, P Velmurugan1
1Department of Urology, Sri Ramachandra Institute of Higher Education and Research, Chennai, India.
Surgery Research and Practice
|November 2, 2020
Summary
Ureteral avulsion is a rare but serious complication of semirigid ureteroscopy for impacted ureteral stones. This study shows successful management through various surgical techniques, highlighting the importance of careful ureteroscopy and prompt repair.
Area of Science:
- Urology
- Surgical Complications
- Endourology
Background:
- Semirigid ureteroscopy is a common procedure for ureteral stones.
- Ureteral avulsion is a rare but severe complication that can occur during ureteroscopy.
- Managing ureteral avulsions requires specialized surgical expertise.
Purpose of the Study:
- To present experience in managing ureteral avulsions after semirigid ureteroscopy.
- To report one of the largest series on ureteral avulsion management.
- To discuss outcomes of different surgical interventions for ureteral avulsion.
Main Methods:
- Retrospective and observational study over 18 years.
- Analysis of seven cases of ureteral avulsion following semirigid ureteroscopy.
- Review of management strategies including ileal replacement and ureteral reanastomosis.
Main Results:
- Seven male patients (mean age 35.7 years) experienced ureteral avulsion.
- All cases involved impacted ureteral stones, primarily proximal.
- Successful outcomes were achieved with ileal ureter replacement, uretero-neocystostomy, and uretero-ureterostomy.
Conclusions:
- Ureteral avulsion is a rare complication associated with impacted ureteral stones during ureteroscopy.
- Awareness and careful technique are crucial for prevention.
- Successful management is achievable through definitive or staged surgical repair.
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