Management of iatrogenic ureteral injury

Lee, Tae Hoon; Shin, Joong Ho

Abstract

We treated 19 patients with ureteral injuries during the recent 7 years. Gynecologic operations were the most common antecedent surgical procedures(89%). The diagnosis of ureteral injuries was made immediately in 3 patients and was delayed 3 to 78 days in 16 patients. All of the 3 injuries recognized during an operation were repaired at the time of injury. Of the 16 patients with injuries recognized in the postoperative period, 1 patient was managed with percutaneous nephrostomy. 14 patients received corrective surgery successfully, but the corrective surgery in remaining patient was railed and ultimately resulted in a nephrectomy because of avascular necrosis of ureter during operation. Therefore, it is better to do corrective surgery primarily in patients with ureteral injuries recognized postoperatively in order to decrease percutaneous nephrostomy associated morbidity and hospital admission period.