Ureteric injury: a challenging condition to diagnose and manage

Hamid Abboudi, Kamran Ahmed*, Justine Royle, Mohammed Shamim Khan, Prokar Dasgupta, James N'Dow

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

101 Citations (Scopus)

Abstract

Although ureteric injury is relatively uncommon, it is a serious event that can result in intra-abdominal sepsis, renal failure, and loss of the ipsilateral renal unit. Most injuries are iatrogenic and remain undiagnosed until the patient presents with symptoms postoperatively. In addition to compromising patient safety, missed ureteric injuries frequently result in litigation. Over the past 20 years, there has been a rapid uptake of laparoscopic and robotic techniques within urology and other surgical specialties. This trend, coupled with increased use of ureteroscopy, has increased the risk of injury to the ureter. The key to diagnosing and managing a ureteric injury is to have a low threshold for suspecting its presence. Diagnosis can be achieved using retrograde pyelography, ureteroscopy, CT, or intravenous urography. Initial management should involve ureteric stent placement or percutaneous nephrostomy drainage. In selected patients, surgical reconstruction might be the optimal approach. Decisions regarding surgical technique (open, laparoscopic, or robotic) are guided by the clinical situation and surgical expertise available.

Original languageEnglish
Pages (from-to)108-115
Number of pages8
JournalNature Reviews Urology
Volume10
Issue number2
DOIs
Publication statusPublished - Feb 2013

Keywords

  • LAPAROSCOPIC RADICAL PROSTATECTOMY
  • JUNCTION DISRUPTION SECONDARY
  • SINGLE-INSTITUTION EXPERIENCE
  • BLUNT ABDOMINAL-TRAUMA
  • UPPER URINARY-TRACT
  • GYNECOLOGIC SURGERY
  • DELAYED DIAGNOSIS
  • CESAREAN-SECTION
  • EXTERNAL TRAUMA
  • PSOAS HITCH

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