Fibrin sealant for the management of genitourinary injuries, fistulas and surgical complications.
OBJECTIVE
We report our preliminary experience with the use of fibrin sealant to manage iatrogenic urinary tract injuries, complex urinary fistulas, and urological surgical complications.


METHODS
Topical fibrin sealant was used in 19 patients for iatrogenic urinary tract injury during gynecological or general surgical procedures (7), complex urinary fistulas (5) or urological surgical complications (7).


RESULTS
Successful resolution of the injury, fistula or complication was attained after a single application of fibrin sealant in the 18 patients (94.7%) in whom a direct injection technique was used. The only failure (formation of a vesicovaginal fistula) occurred with the air driven sprayed sealant delivery technique after sutured closure of iatrogenic cystotomy during vaginal hysterectomy.


CONCLUSIONS
Liquid fibrin sealant appears to be safe and prudent for use in urological "damage control" from trauma, fistulas or surgical complications. Direct injection over a sutured urinary anastomosis appears to be highly effective in preventing urinary drainage. Additional study is needed to define further the role and best use of tissue adhesives in urology.
Evans
L Andrew
LA
Urology Service, Brooke Army Medical Center, Fort Sam Houston, Texas, USA.
Ferguson
Kenneth H
KH
Foley
John P
JP
Rozanski
Thomas A
TA
Morey
Allen F
AF
D005260:Female; D052776:Female Urogenital Diseases / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D015718:Fibrin Tissue Adhesive / Q000008:administration & dosage*; D005402:Fistula / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D006801:Humans; D007049:Iatrogenic Disease; D008297:Male; D052801:Male Urogenital Diseases; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D012086:Reoperation; D016896:Treatment Outcome; D014566:Urogenital System / Q000293:injuries* / Q000601:surgery; D014567:Urography
D015718:Fibrin Tissue Adhesive