Document Detail

Ureteric injury: a challenging condition to diagnose and manage.
MedLine Citation:
PMID:  23318355     Owner:  NLM     Status:  MEDLINE    
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.
Hamid Abboudi; Kamran Ahmed; Justine Royle; Mohammed Shamim Khan; Prokar Dasgupta; James N'Dow
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review     Date:  2013-01-15
Journal Detail:
Title:  Nature reviews. Urology     Volume:  10     ISSN:  1759-4820     ISO Abbreviation:  Nat Rev Urol     Publication Date:  2013 Feb 
Date Detail:
Created Date:  2013-02-11     Completed Date:  2013-10-29     Revised Date:  2014-02-20    
Medline Journal Info:
Nlm Unique ID:  101500082     Medline TA:  Nat Rev Urol     Country:  England    
Other Details:
Languages:  eng     Pagination:  108-15     Citation Subset:  IM    
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MeSH Terms
Disease Management
Ureter / injuries*,  surgery
Urologic Diseases / diagnosis*,  therapy*
Grant Support
MR/J006742/1//Medical Research Council; //Medical Research Council

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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