Management of Iatrogenic Ureteral Injury

Song, Ki Shin; Park, Suk Sahn

Abstract

We treated 11 patients with iatrogenic ureteral injuries during a 4-year period: Gynecologic operations were the most common antecedent surgical procedures (82 percent). The diagnosis of ureteral injuries was made immediately in 4 patients and was delayed 3 to 56 days in 7. Three of the 4 injuries recognized during an operation were repaired successfully at the time of injury ; the primary repair in the remaining patient leaked and ultimately resulted in a nephrectomy because of subhepatic and retroperitoneal abscess formation. In the delayed diagnosis group, retrograde ureteral catheterization was successful in only 1 of all attempts. Of the 7 patients with injuries recognized in the postoperative period. 4 were managed successfully with ureteral stenting or percutaneous nephrostomy alone 3 required surgical after temporary percutaneous nephrostomy drainage.