MP05-10 NATURAL HISTORY OF URETERAL INJURY IN AN IN-VIVO PORCINE MODEL

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP05-10 NATURAL HISTORY OF URETERAL INJURY IN AN IN-VIVO PORCINE MODEL Sohrab N. Ali, Paul Piedras, Seyed Amiryaghoub M. Lavasani, Seyed Hossein H. Sharifi, Antonio R. H. Gorgen, Andrei D. Cumpanas, Yi Xi Wu, Zachary E. Tano, Pengbo Jiang, Roshan M. Patel, Jaime Landman, and Ralph V. Clayman Sohrab N. AliSohrab N. Ali More articles by this author , Paul PiedrasPaul Piedras More articles by this author , Seyed Amiryaghoub M. LavasaniSeyed Amiryaghoub M. Lavasani More articles by this author , Seyed Hossein H. SharifiSeyed Hossein H. Sharifi More articles by this author , Antonio R. H. GorgenAntonio R. H. Gorgen More articles by this author , Andrei D. CumpanasAndrei D. Cumpanas More articles by this author , Yi Xi WuYi Xi Wu More articles by this author , Zachary E. TanoZachary E. Tano More articles by this author , Pengbo JiangPengbo Jiang More articles by this author , Roshan M. PatelRoshan M. Patel More articles by this author , Jaime LandmanJaime Landman More articles by this author , and Ralph V. ClaymanRalph V. Clayman More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003216.10AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Ureteroscopy (URS) accompanied by passage of a ureteral access sheath (UAS) is a common procedure for the treatment of urolithiasis; however, the ureter may sustain an injury during UAS placement. The post-ureteroscopic lesion scale (PULS) is a validated scoring system for endoscopic detection of ureteral injury. PULS Grade 3 (perforation with less than 50% partial transection) and Grade 4 (greater than 50% partial transection) are considered severe injuries generally requiring prolonged stent placement. The natural history of these lesions if left unstented, is unknown. METHODS: Female Yorkshire pigs underwent ureteral sizing with Cook® urethral dilators (10-24 Fr) using a validated force sensor with forces limited to < 6 N; passage of the urethral dilators resulted in PULS Grade ≥3 in 13 ureters. These animals were excluded from the original study but were survived for another week without stent placement. On the seventh day, URS was performed to assess ureteral healing and PULS grade. Exact fisher test and Two-Tailed T-test were used to evaluate differences in PULS grade, location (proximal, mid, or distal) and number of dilator passages. RESULTS: Among thirteen PULS lesion Grades ≥3 (nine Grade-3 and four Grade-4) in 10 pigs, URS one week later revealed healing in ten ureters (77%) (nine Grade-0 and one Grade-2) (Figure 1); however, three ureteral strictures were noted, all associated with prior Grade-3 lesions (23%). In addition, there was no difference in the location of primary lesions becoming strictures (50% in proximal, 0% in medial and 33% in distal, p=0.2133). Ureters without stricture formation had a higher mean number of dilator passages compared to those that did not stricture, (5.2 vs 3.0, p=0.0374). CONCLUSIONS: Despite PULS 3 or 4 lesions, in the absence of ureteral stenting, the urothelium in 75% of ureters healed completely within a week. Source of Funding: none © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e47 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Sohrab N. Ali More articles by this author Paul Piedras More articles by this author Seyed Amiryaghoub M. Lavasani More articles by this author Seyed Hossein H. Sharifi More articles by this author Antonio R. H. Gorgen More articles by this author Andrei D. Cumpanas More articles by this author Yi Xi Wu More articles by this author Zachary E. Tano More articles by this author Pengbo Jiang More articles by this author Roshan M. Patel More articles by this author Jaime Landman More articles by this author Ralph V. Clayman More articles by this author Expand All Advertisement PDF downloadLoading ...