[Ureteral lesions after surgery of the aortic bifurcation. Report of 6 cases].
OBJECTIVE
The objective of this study was to evaluate the management and current treatment options for ureteric complications after vascular surgery based on a series of 6 cases.


METHODS
6 patients were treated between 1990 and 1998 (mean age: 64.7 years) for ureteric complications after aortic bifurcation surgery. The mean interval between vascular surgery and urological management was 11.6 years (+/- 4.04). All patients were assessed by intravenous urography (IVU), and 4 patients were assessed by abdominal computed tomography (CT). These complications consisted of: 2 cases of ureteric stenosis, 1 case of inflammatory peri-ureteritis, 2 cases of chronic peri-ureteritis and 1 case of compression by a false aneurysm. The lesion was situated in the iliac ureter in every case.


RESULTS
Treatment consisted of temporary double J stenting (n = 1), ureter release (n = 1), endoscopic dilatation (n = 1), psoas bladder reconstruction (n = 1) and corticosteroid therapy (n = 2), with 4 successes, 1 failure (corticosteroid therapy), and 1 death from another cause.


CONCLUSIONS
Ureteric lesion after vascular surgery is a rare complication, often discovered incidentally. The iliac ureter is predominantly affected. IVU and CT are the reference examinations. Treatment options primarily depend on the patient's general state.
Clemens
L
L
Service d'Urologie, CHR Saint-Jacques, 2, place Saint-Jacques, 25030 Besançon.
Bernardini
S
S
Chabannes
E
E
Debiere
F
F
Bittard
H
H
D000368:Aged; D001012:Aorta, Abdominal / Q000601:surgery*; D006801:Humans; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis* / Q000628:therapy*; D013997:Time Factors; D014515:Ureteral Diseases / Q000175:diagnosis* / Q000628:therapy*
Atteinte urétérale après chirurgie du carrefour aortique. A propos de 6 cas.