Results of Minimally Invasive Treatment of Late Recognised Ureteral Lesion after Non-urologic Operation
Abstract
Objective: To assess results of the treatment of ureteral lesion with minimally invasive strategy. Material and methods: From 1991 to 2004, we treated 12 patients with iatrogenic ureteral injuries.
Eleven patients were diagnosed after gyneacologic operation and one after appendectomy. The injuries were detected 5-45 days (average 13.1 days) after initial procedure.
Results: Nine patients were treated by stent placement, 5 had spontaneous recovery of injured ureters during 24-177 days (average 117 days). Dilatation of the ureteral stricture were needed in 2 patients.
The time of stent placement was 191 and 277 days, respectively. Open repair were needed in 2 patients after 90 and 99 days, because of ureteral stricture and ureterovaginal fistula.
Percutaneous nephrostomy with ureteral stent placement was performed in 3 patients, all lesions were completely recovered in 98 days (range 42-175 days). Conclusion: Treatment of the late recognized iatrogenic ureteral lesion with stent placement, percutaneous nephrostomy drainage or both, are one of the possible options and represents safe and minimally invasive strategy.