MP18-20 ENDOSCOPIC RENDEZVOUS PROCEDURE FOR URETERAL IATROGENIC DETACHMENT: REPORT OF A CASE SERIES WITH LONG-TERM OUTCOMES

Abstract

You have accessJournal of UrologyTrauma/Reconstruction: Ureter, Bladder, External Genitalia and Urotrauma I1 Apr 2015MP18-20 ENDOSCOPIC RENDEZVOUS PROCEDURE FOR URETERAL IATROGENIC DETACHMENT: REPORT OF A CASE SERIES WITH LONG-TERM OUTCOMES Antonio Luigi Pastore, Giovanni Palleschi, Luigi Silvestri, Andrea Ripoli, Domenico Autieri, Yazan Al Salhi, and Antonio Carbone Antonio Luigi PastoreAntonio Luigi Pastore More articles by this author , Giovanni PalleschiGiovanni Palleschi More articles by this author , Luigi SilvestriLuigi Silvestri More articles by this author , Andrea RipoliAndrea Ripoli More articles by this author , Domenico AutieriDomenico Autieri More articles by this author , Yazan Al SalhiYazan Al Salhi More articles by this author , and Antonio CarboneAntonio Carbone More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.1052AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Injury to the ureter is the most common urologic complication of pelvic surgery, with an incidence that ranges from 1% to 10%. Most cases of ureteral injuries are related to gynecologic procedures. The ureter is particularly vulnerable to detachment or ligation during hysterectomy interventions due to its position from the lateral edge of the cervix. Here, we report a case series of female patients that underwent the ureteral rendezvous procedure for ureteral detachment. METHODS Between January 2009 and April 2013, 18 ureteral rendezvous procedures were performed for complete detachment. We assessed the operative and clinical outcomes of these patients over a mean follow-up duration of 26.5 months, and describe the three most representative cases. RESULTS The endoscopic rendezvous technique was performed in all cases to manage ureteral detachment. Computed tomography urography at discharge, and 6 and 12 months after discharge, confirmed the restored ureteral integrity without any leakage in 66% (12/18) cases, indicated ureteral stenosis in 22% (4/18) cases, and indicated ureteral leakage in 12% (2/18) cases. The overall long-term success rate for all 18 patients was 78% (14/18) at a mean follow-up of 26.5 months. CONCLUSIONS The endoscopic rendezvous procedure reduces the need for invasive open surgical repair and represents the optimal initial option in patients with iatrogenic ureteral lesions before invasive procedures with higher morbidity are attempted. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e214 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Antonio Luigi Pastore More articles by this author Giovanni Palleschi More articles by this author Luigi Silvestri More articles by this author Andrea Ripoli More articles by this author Domenico Autieri More articles by this author Yazan Al Salhi More articles by this author Antonio Carbone More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...