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Does Endourological Intervention a Suitable Treatment Options in Management of Iatrogenic Thermal Ureteral Injury?
  • Oguz Ozden Cebeci,
  • Tayyar Alp Özkan
Oguz Ozden Cebeci
Saglik Bilimleri Universitesi
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Tayyar Alp Özkan
Acibadem Hospitals Group
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Abstract

Introduction This study aimed to evaluate the etiological factors and their effects on long-term clinical outcomes in patients with iatrogenic ureteral injury (IUI). Material and Method Twenty-seven patients who underwent surgery because of IUI were evaluated between January 2011 and April 2018. Patients were classified according to the time of diagnosis and the need for reoperation after the urologic intervention. The IUI cases detected during gynecological surgery were called ‘perioperative’ IUI, and those diagnosed late as ‘postoperative’ (delayed) IUI. The IUI type was categorized as ‘cold transection’ due to surgical dissection or ligation and ‘thermal injury’ if it depended on any energy-based surgical device. Results Postoperative diagnosed cases consisted of exclusively after laparoscopic surgery (p=.025). Patients with thermal injury to the ureter were mostly diagnosed postoperatively (p= .021). Patients who underwent endourological intervention, 31.25% (N = 5/16) were diagnosed during gynecologic surgery, and 68.75% (n = 11/16) were diagnosed postoperatively. For open reconstructive surgery, these rates were observed to be 72.72% (n = 8/11) and 27.28% (n = 3/11), respectively (p=.034). IUI was due to thermal injury in all patients who developed complications after the urological intervention (p = .046), and the first urological intervention was endoscopic double loop stenting (p = .005). One of these patients was diagnosed in the perioperative period and seven in the postoperatively (p = .016). Conclusion Treatment success rates are low in patients who underwent endourological intervention after thermal IUI. Therefore, surgical techniques in which the traumatic ureter segment is excised should be preferred to avoid complications. Key Words Ureter, Iatrogenic, Thermal Injury, Iatrogenic Ureteral Injury, Endourological Intervention.

Peer review status:IN REVISION

07 Jan 2021Submitted to International Journal of Clinical Practice
07 Jan 2021Submission Checks Completed
07 Jan 2021Assigned to Editor
12 Mar 2021Reviewer(s) Assigned
17 Mar 2021Review(s) Completed, Editorial Evaluation Pending
16 May 20211st Revision Received
21 May 2021Submission Checks Completed
21 May 2021Assigned to Editor
21 May 2021Review(s) Completed, Editorial Evaluation Pending
05 Jun 2021Reviewer(s) Assigned
06 Jun 2021Editorial Decision: Revise Minor