PD35-06 IATROGENIC URETERAL INJURY REPAIR: COMPARISON BETWEEN EARLY AND DELAYED REPAIR

Abstract

You have accessJournal of UrologyTrauma/Reconstruction/Diversion: Ureter (including Pyeloplasty) and Bladder Reconstruction (including fistula), Augmentation, Substitution, Diversion I (PD35)1 Sep 2021PD35-06 IATROGENIC URETERAL INJURY REPAIR: COMPARISON BETWEEN EARLY AND DELAYED REPAIR Tarek Taha, Ben Sionov, Ami Sidi, and Alexander Tsivian Tarek TahaTarek Taha More articles by this author , Ben SionovBen Sionov More articles by this author , Ami SidiAmi Sidi More articles by this author , and Alexander TsivianAlexander Tsivian More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002039.06AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Iatrogenic injury of the ureter during various surgeries is a potential risk for late complications and poses therapeutic challenges. Repairing of the ureteral injury may reduce the risk of future complications and restore early functioning of the affected organ. The timing for repair is not yet agreed upon by most surgeons, some tend to perform urinary diversion using nephrostomy or JJ stent insertion, and some recommend immediate repair of the injury. In our study we aim to compare perioperative and postoperative outcomes between early and late repair of iatrogenic ureteral injury METHODS: Between January 2006 and August 2019, 44 patients with iatrogenic ureteral injuries were gathered retrospectively. Patients were divided into two groups: Group A (n=28) patients who had an early repair injury (<1 week) and Group B (n=16) patients who underwent late repair of ureteral injury (>2 weeks). The comparison between the two groups was performed using operative parameters and events that were recorded postoperatively and during the follow-up period RESULTS: Median follow-up period was similar between both groups (18.8 vs 21.3-month, p=0.35), median age in group A was higher than group B (51.3 vs 42.6, p=0.28). Median operative time was shorter in group A compared to group B but is statistically insignificant (152.7 vs 165.7 min, p=0.15). Median estimated blood loss intraoperatively was slightly higher in group A compared to group B (88.1 vs 41.8, p=0.16). The median length stay was similar between both groups (3.6 vs 4, p=0.21). The median time to urethral catheter removal was shorter in group B (5.8 vs 7 days, p=0.01) and the median time to ureteral stent removal was similar between both groups (4.8 vs 4.6 week, P = 0.33), no complications occurred during surgery in either group. During the postoperative and follow-up period, 6 complications (21.4%) were recorded in group-A versus 3 (18.75%) in group-B. All complications were Clavien I, II. There was no difference in creatinine value in both groups at 1 month (0.84 vs 0.94, p=0.214),6 month (0.82 vs 0.82, p=031) and 12 months (0.91 vs 0.94, p=0.31) postoperatively During follow-up, two patients from group A (7.1%) and two patients from Group B (12.5%) underwent re-repair due to re-stenosis in the anastomotic area CONCLUSIONS: In our study, there were no differences in the outcomes between early and delayed repair. Early repair is recommended to reduce the suffering and the frustration of the patients due to the complication after their primary surgery or because of the using of PCN and JJ stent until the definitive repairing surgery of the ureteral injury Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e590-e591 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Tarek Taha More articles by this author Ben Sionov More articles by this author Ami Sidi More articles by this author Alexander Tsivian More articles by this author Expand All Advertisement Loading ...