title: [Surgical solutions to iatrogenic ureteral lesions in 31 cases].
abstract: OBJECTIVE
  To conduct a critical review of the etiological, clinical and diagnostic aspects of iatrogenic ureteral lesions caused by various surgical disciplines, primarily focused on the different therapeutical options used.
  
  
  METHODS
  Between January 1985 and December 1995, 31 iatrogenic lesions of the ureter, 19 female and 10 male, mean age 52 years, were examined. The right ureter was involved in 19 cases and the left one in 12 (2 bilateral). The ureteral lesion resulted from gynaecological surgery in 19 cases (61%), general surgery in 6 (19%), vascular surgery in 3 (10%) and urology in 3 (10%). In 9 cases (29%) it was diagnosed during surgery: in 14 cases (45%) as a result of clinical signs and symptoms and in 8 cases (25%) casually. Surgery was the option chosen in 22 cases, while in 9 conservative treatment was followed.
  
  
  RESULTS
  Surgery solved 91% of damaged ureters, and the best results were seen in patients where lesion was repaired immediately. Conservative treatment was resolutive in all cases.
  
  
  CONCLUSIONS
  Gynaecological surgery continues to be the most frequent cause of iatrogenic lesions of the ureter. Ureteral damage in males is now increasing due to the demands from general oncologic surgery, which is usually appreciated by the surgeon which allows immediate repair. Lesions caused by gynaecologic and vascular surgery are commonly overlooked and are diagnosed post-surgically either because of their clinical manifestations or accidentally. The different surgical techniques currently available allow a successful repair of this kind of lesions. Conservative therapy is appropriate in cases that fulfil a series of basic requirements.
authors.affiliation: Servicio y Cátedra de Urología, Hospital del Mar, Facultad de Medicina, U.A.B. Barcelona.
authors.forename: O
authors.initials: O
authors.lastname: Arango Toro
authors.forename: O
authors.initials: O
authors.lastname: Bielsa Gali
authors.forename: R
authors.initials: R
authors.lastname: Coradellas Angel
authors.forename: G
authors.initials: G
authors.lastname: Nohales Taurines
authors.forename: N
authors.initials: N
authors.lastname: Carrasco Cánovas
authors.forename: M
authors.initials: M
authors.lastname: Herrero Polo
authors.forename: A
authors.initials: A
authors.lastname: Gelabert Mas
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007431:Intraoperative Complications / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D014513:Ureter / Q000293:injuries* / Q000601:surgery*