| Summary: | Introduction. Iatrogenic ureteral injuries can occur during various
abdominopelvic and retroperitoneal surgical procedures including
gynecological, urological, colorectal and vascular. Objective. The aim of our
study was to examine the incidence and types of iatrogenic ureteral injuries
occurred over the period of 16 years, as well as to evaluate the values of
applied diagnostic and therapeutic procedures. Methods. A retrospective
analysis of clinical data (medical records and operative reports) of 55
patients (11 male and 44 female; mean age 54.5 years) with verified
iatrogenic ureteral injury from 1998 to 2014, was performed. Results.
Iatrogenic ureteral injuries occurred during gynecological procedures in 55%,
urological in 25%, colorectal in 15% and vascular in 5% of cases. Mechanisms
of injury were incomplete transection (n=23), complete transection (n=1),
ligation (n=7), partial perforation (mucosal abrasion) (n=13) and total
perforation (n=1). The most frequent diagnostic procedures for postoperative
identification of ureteral injuries were abdominal ultrasonography, excretory
urography, antegrade pyeloureterography and retrograde ureteropyelography.
Early therapeutic procedures were applied in 35 (64%), while delayed in 20
cases (36%). Early (<30 days) or late (>30 days) postoperative complications
were verified in 14 cases (25%). Conclusion. Among different surgeries that
may lead to the development of iatrogenic ureteral injury, gynecological
procedures represent the most common cause. Rapid diagnosis enables immediate
ureteral repair and is associated with low morbidity rates, representing a
major factor contributing to the treatment success and ultimately preserving
the renal function.
|
|---|
