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Ureteric obstruction after dacron vascular replacement.

J M Thomas, N J Mortensen, C R Bayliss

    Annals of the Royal College of Surgeons of England
    |November 1, 1983
    PubMed
    Summary
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    Routine urography after aortic bifurcation grafting is not recommended. This imaging is unnecessary for asymptomatic patients, as ureteric obstruction is rare following aortic aneurysm repair or dacron grafts.

    Area of Science:

    • Urology
    • Vascular Surgery
    • Radiology

    Background:

    • Ureteric obstruction can occur after aortic bifurcation grafting due to graft proximity to the ureters.
    • Assessing the utility of routine postoperative urography is crucial for managing this potential complication.

    Purpose of the Study:

    • To evaluate the effectiveness of routine postoperative urography in detecting ureteric obstruction after aortic bifurcation grafting.
    • To determine if routine imaging is beneficial in patients undergoing aortic aneurysm repair or receiving intra-abdominal dacron grafts.

    Main Methods:

    • A retrospective review of 11 patients undergoing ruptured aortic aneurysm repair.
    • A prospective 18-month study of 24 patients receiving intra-abdominal dacron grafts.
    • Assessment of renal function and ureteric status via urography in 'at risk' patients.

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    Main Results:

    • Renal function remained normal in all patients.
    • Only one of 32 'at risk' ureters showed minimal dilation without significant obstruction.
    • No advantage was found in ureter positioning relative to the graft limbs.

    Conclusions:

    • Ureteric obstruction is an uncommon complication of aortic bifurcation grafting.
    • Routine postoperative urography is not indicated and should be reserved for symptomatic patients.