title: Management of iatrogenic ureteric injury with retrograde ureteric stenting: an analysis of factors affecting technical success and long-term outcome.
abstract: Background Iatrogenic ureteral injuries arise as serious complication following obstetrics, gynecological, general, and urological surgery with incidence in the range of 0.5-10%. Retrograde placement of double-J ureteric stent is a possible treatment option if the injury is not recognized at the time of surgery. Purpose To assess technical success and long-term outcome associated with retrograde ureteric stent insertion for iatrogenic ureteric injury. Material and Methods Between 1999 and 2011, 26 patients with initially unrecognized iatrogenic ureteric injury underwent initial management with retrograde ureteric stenting. Full case-notes were available for review in 25 patients. Results The mean interval from injury to attempted stenting was 19.4 days. Successful retrograde ureteric stenting was achieved in 21/25 patients (81%). Retrograde stenting failed in four patients, and nephrostomy followed by alternative procedures were performed instead. At a median follow-up interval of 9.7 months, normal anatomy was demonstrated on 12/21 patients (57%) and a stricture was observed in 6/21 patients (28%) with three requiring surgical intervention. Conclusion Retrograde stenting is a safe and efficient initial management in patients with iatrogenic ureteric injuries.
authors.affiliation: Oxford University Hospital NHS Foundation Trust, Oxford, UK.
authors.forename: Daniel
authors.initials: D
authors.lastname: Chung
authors.affiliation: Oxford University Hospital NHS Foundation Trust, Oxford, UK.
authors.forename: James
authors.initials: J
authors.lastname: Briggs
authors.affiliation: Oxford University Hospital NHS Foundation Trust, Oxford, UK.
authors.forename: Benjamin W
authors.initials: BW
authors.lastname: Turney
authors.affiliation: Oxford University Hospital NHS Foundation Trust, Oxford, UK.
authors.forename: Charles Ross
authors.initials: CR
authors.lastname: Tapping
mesh_terms: D000328:Adult; D000368:Aged; D019468:Disease Management; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007049:Iatrogenic Disease; D008297:Male; D008875:Middle Aged; D015607:Stents; D016896:Treatment Outcome; D014513:Ureter / Q000293:injuries* / Q000601:surgery*; D014570:Urologic Diseases / Q000601:surgery*
keywords: Computed tomography (CT); iatrogenic ureteric injury; retrograde ureteric stent insertion; ureteric stent insertion; urology