Background and Purpose: Injury to the ureter is the most common urologic complication of pelvic surgery, with an incidence that ranges from 1% to 10%. Most cases of ureteral injuries are related to gynecologic procedures. The ureter is particularly vulnerable to detachment or ligation during hysterectomy because of its position from the lateral edge of the cervix. We report a case series of female patients who underwent the ureteral rendezvous procedure for ureteral detachment. Patients and Methods: Between January 2009 and April 2013, 18 ureteral rendezvous procedures were performed for patients with complete detachment. We assessed the operative and clinical outcomes of these patients over a mean follow-up duration of 26.5 months and describe the three most representative cases. Results: The endoscopic rendezvous technique was performed in all cases to manage ureteral detachment. CT urography at discharge and 6 and 12 months after discharge confirmed the restoration of ureteral integrity without any leakage in 66% (12/18) patients, indicated ureteral stenosis in 22% (4/18) patients, and indicated ureteral leakage in 12% (2/18) patients. The overall long-term success rate for all 18 patients was 78% (14/18) at a mean follow-up of 26.5 months. Conclusions: The endoscopic rendezvous procedure reduces the need for invasive open surgical repair and represents the optimal initial option in patients with iatrogenic ureteral lesions before invasive procedures with higher morbidity are attempted. © Copyright 2015, Mary Ann Liebert, Inc.

Endoscopic rendezvous procedure for ureteral iatrogenic detachment. Report of a case series with long-term outcomes / Pastore, ANTONIO LUIGI; Palleschi, Giovanni; Silvestri, Luigi; Leto, Antonino; Autieri, Domenico; Ripoli, Andrea; Maggioni, C; Al Salhi, Y; Carbone, Antonio. - In: JOURNAL OF ENDOUROLOGY. - ISSN 0892-7790. - STAMPA. - 29:4(2015), pp. 415-420. [10.1089/end.2014.0474]

Endoscopic rendezvous procedure for ureteral iatrogenic detachment. Report of a case series with long-term outcomes

PASTORE, ANTONIO LUIGI;PALLESCHI, GIOVANNI;SILVESTRI, LUIGI;LETO, ANTONINO;AUTIERI, DOMENICO;RIPOLI, ANDREA;Al Salhi Y;CARBONE, Antonio
2015

Abstract

Background and Purpose: Injury to the ureter is the most common urologic complication of pelvic surgery, with an incidence that ranges from 1% to 10%. Most cases of ureteral injuries are related to gynecologic procedures. The ureter is particularly vulnerable to detachment or ligation during hysterectomy because of its position from the lateral edge of the cervix. We report a case series of female patients who underwent the ureteral rendezvous procedure for ureteral detachment. Patients and Methods: Between January 2009 and April 2013, 18 ureteral rendezvous procedures were performed for patients with complete detachment. We assessed the operative and clinical outcomes of these patients over a mean follow-up duration of 26.5 months and describe the three most representative cases. Results: The endoscopic rendezvous technique was performed in all cases to manage ureteral detachment. CT urography at discharge and 6 and 12 months after discharge confirmed the restoration of ureteral integrity without any leakage in 66% (12/18) patients, indicated ureteral stenosis in 22% (4/18) patients, and indicated ureteral leakage in 12% (2/18) patients. The overall long-term success rate for all 18 patients was 78% (14/18) at a mean follow-up of 26.5 months. Conclusions: The endoscopic rendezvous procedure reduces the need for invasive open surgical repair and represents the optimal initial option in patients with iatrogenic ureteral lesions before invasive procedures with higher morbidity are attempted. © Copyright 2015, Mary Ann Liebert, Inc.
adult; aged; article; clinical article; double J stent; endoscopic surgery; female; follow up; hospital discharge; human; hysterectomy; iatrogenic disease; middle aged; percutaneous nephrostomy; priority journal; surgical technique; ureter injury; ureter obstruction; ureter surgery; ureteral iatrogenic detachment; ureteral rendezvous procedure; ureteroneocystostomy; ureteroscopy; urine incontinence; urography; young adult; adverse effects; computer assisted surgery; fluoroscopy; injuries; postoperative complication; procedures; stenosis, occlusion and obstruction; surgery; ureter; ureter disease
01 Pubblicazione su rivista::01a Articolo in rivista
Endoscopic rendezvous procedure for ureteral iatrogenic detachment. Report of a case series with long-term outcomes / Pastore, ANTONIO LUIGI; Palleschi, Giovanni; Silvestri, Luigi; Leto, Antonino; Autieri, Domenico; Ripoli, Andrea; Maggioni, C; Al Salhi, Y; Carbone, Antonio. - In: JOURNAL OF ENDOUROLOGY. - ISSN 0892-7790. - STAMPA. - 29:4(2015), pp. 415-420. [10.1089/end.2014.0474]
File allegati a questo prodotto
File Dimensione Formato  
Pastore_Endoscopic-rendezvous-procedure_2015.pdf

solo gestori archivio

Tipologia: Versione editoriale (versione pubblicata con il layout dell'editore)
Licenza: Tutti i diritti riservati (All rights reserved)
Dimensione 226.23 kB
Formato Adobe PDF
226.23 kB Adobe PDF   Visualizza/Apri   Richiedi una copia

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/629788
Citazioni
  • ???jsp.display-item.citation.pmc??? 9
  • Scopus 16
  • ???jsp.display-item.citation.isi??? 16
social impact