Skip to main content
Top
Published in: International Urogynecology Journal 6/2010

01-06-2010 | Original Article

Double-J stenting: initial management of injured ureters recognized late after gynecological surgery

Authors: Jae Sik Kim, Dong Hwan Lee, Hong Jin Suh

Published in: International Urogynecology Journal | Issue 6/2010

Login to get access

Abstract

Introduction and hypothesis

To evaluate the efficacy of double-J stenting as an initial procedure to manage ureteral injuries detected late after gynecological surgery.

Methods

Eight patients whom the insertion of double-J stent was done primarily were evaluated. Medical records were investigated retrospectively.

Results

Ureteral injuries were unilateral in seven and in one patient was bilateral (nine ureters in total). In two patients that double-J stentings were failed underwent open surgery. In six patients (seven ureters), double-J stentings were successful either by cystoscopy or ureteroscopy and four ureters were recovered without sequelae. However, in three ureters, stenosis was remained and managed by ureteral dilation with placement of double-J stent. But, one was lost at follow-up schedule.

Conclusions

Ureteral double-J stenting, as first-line treatment, could avoid invasive urological surgery in damaged ureter detected after gynecological surgery. More cases are needed for accurate conclusions.
Literature
1.
go back to reference Neuman MN, Eidelman AE, Langer R, Golan A, Bukovsky I, Caspi E (1991) Iatrogenic injuries to the ureter during gynecologic and obstetric operations. Surg Gynecol Obstet 173:268–272PubMed Neuman MN, Eidelman AE, Langer R, Golan A, Bukovsky I, Caspi E (1991) Iatrogenic injuries to the ureter during gynecologic and obstetric operations. Surg Gynecol Obstet 173:268–272PubMed
2.
go back to reference Witters S, Comelisson M, Vereecken R (1986) Iatrogenic ureteral injury: aggressive or conservative treatment. Am J Obstet Gynecol 155:582–584PubMed Witters S, Comelisson M, Vereecken R (1986) Iatrogenic ureteral injury: aggressive or conservative treatment. Am J Obstet Gynecol 155:582–584PubMed
3.
go back to reference Ku JH, Kim ME, Jeon YS, Lee NK, Park YH (2003) Minimally invasive management of ureteral injuries recognized late after obstetric and gynecological surgery. Injury 34:480–483CrossRefPubMed Ku JH, Kim ME, Jeon YS, Lee NK, Park YH (2003) Minimally invasive management of ureteral injuries recognized late after obstetric and gynecological surgery. Injury 34:480–483CrossRefPubMed
4.
go back to reference Dowling RA, Corriere JN Jr, Sandler CM (1986) Iatrogenic Ureteral injury. J Urol 135:912–915PubMed Dowling RA, Corriere JN Jr, Sandler CM (1986) Iatrogenic Ureteral injury. J Urol 135:912–915PubMed
5.
go back to reference Parpala-Spårman T, Paananen I, Santala M, Ohtonen P, Hellström P (2008) Increasing numbers of ureteric injuries after the introduction of laparoscopic surgery. Scand J Urol Nephrol 42:422–427CrossRefPubMed Parpala-Spårman T, Paananen I, Santala M, Ohtonen P, Hellström P (2008) Increasing numbers of ureteric injuries after the introduction of laparoscopic surgery. Scand J Urol Nephrol 42:422–427CrossRefPubMed
6.
go back to reference Zinman LH, Libertino JA, Roth RA (1978) Management of operative ureteral injury. Urology 12:290–303CrossRefPubMed Zinman LH, Libertino JA, Roth RA (1978) Management of operative ureteral injury. Urology 12:290–303CrossRefPubMed
7.
go back to reference Pearse HD, Hodges CV (1976) Surgical and traumatic ureteral injuries. In: Smith RB, Skinner DG (eds) Complications of urological surgery, 1st edn. Saunders, Philadelphia Pearse HD, Hodges CV (1976) Surgical and traumatic ureteral injuries. In: Smith RB, Skinner DG (eds) Complications of urological surgery, 1st edn. Saunders, Philadelphia
8.
go back to reference Buchsbaum HJ (1982) Office and surgical gynecology. In: Buchsbaum HJ, Schmitt JD (eds) Gynecologic and obstetric urology, 2nd edn. Saunders, Philadelphia Buchsbaum HJ (1982) Office and surgical gynecology. In: Buchsbaum HJ, Schmitt JD (eds) Gynecologic and obstetric urology, 2nd edn. Saunders, Philadelphia
9.
10.
go back to reference Aschner PW (1953) Accidental injury to ureters and bladder in pelvic surgery. J Urol 69:774–786PubMed Aschner PW (1953) Accidental injury to ureters and bladder in pelvic surgery. J Urol 69:774–786PubMed
11.
go back to reference Symmonds RE (1976) Ureteral injuries associated with gynecologic surgery: prevention and management. Clin Obstet Gynecol 19:623CrossRefPubMed Symmonds RE (1976) Ureteral injuries associated with gynecologic surgery: prevention and management. Clin Obstet Gynecol 19:623CrossRefPubMed
12.
go back to reference Blandy JP, Badenoch DF, Fowler CG, Jenkins BJ, Thomas NW (1991) Early repair of iatrogenic injury to the ureter or bladder after gynecological surgery. J Urol 146:761–765PubMed Blandy JP, Badenoch DF, Fowler CG, Jenkins BJ, Thomas NW (1991) Early repair of iatrogenic injury to the ureter or bladder after gynecological surgery. J Urol 146:761–765PubMed
13.
go back to reference Gangi MP, Agee RE, Spence CR (1976) Surgical injury to ureter. Urology 8:22–27CrossRef Gangi MP, Agee RE, Spence CR (1976) Surgical injury to ureter. Urology 8:22–27CrossRef
14.
go back to reference Giberti C, Germinale F, Lillo M, Bottino P, Simonato A, Carminani G (1996) Obstetric and gynaecological ureteric injuries: treatment and results. Br J Urol 77:21–26PubMed Giberti C, Germinale F, Lillo M, Bottino P, Simonato A, Carminani G (1996) Obstetric and gynaecological ureteric injuries: treatment and results. Br J Urol 77:21–26PubMed
15.
go back to reference Koonings PP, Huffman JL, Schlaerth JB (1992) Ureteroscopy: a new asset in the management of postoperative ureterovaginal fistulas. Obstet Gynecol 80:548–549PubMed Koonings PP, Huffman JL, Schlaerth JB (1992) Ureteroscopy: a new asset in the management of postoperative ureterovaginal fistulas. Obstet Gynecol 80:548–549PubMed
16.
go back to reference Sakellariou P, Protopapas AG, Voulgaris Z, Kyritsis N, Rodolakis A, Vlachos G, Diakomanolis E, Michalas S (2002) Management of ureteric injuries during gynecological operations: 10 years experience. Eur J Obstet Gynecol Reprod Biol 101:179–184CrossRefPubMed Sakellariou P, Protopapas AG, Voulgaris Z, Kyritsis N, Rodolakis A, Vlachos G, Diakomanolis E, Michalas S (2002) Management of ureteric injuries during gynecological operations: 10 years experience. Eur J Obstet Gynecol Reprod Biol 101:179–184CrossRefPubMed
18.
go back to reference Liatsikos EN, Karnabatidis D, Katsanos K, Kraniotis P, Kagadis GC, Constantinides C et al (2006) Ureteral injuries during gynecologic surgery: treatment with a minimally invasive approach. J Endourology 20:1062–1067CrossRef Liatsikos EN, Karnabatidis D, Katsanos K, Kraniotis P, Kagadis GC, Constantinides C et al (2006) Ureteral injuries during gynecologic surgery: treatment with a minimally invasive approach. J Endourology 20:1062–1067CrossRef
19.
go back to reference McAninch J, Santucci RA (2002) Genitourinary trauma. In: Walsh PC, Retik AB, Vaughan ED, Wein AJ (eds) Campbell's urology, 8th edn. Saunders, Philadelphia, pp 3707–3744 McAninch J, Santucci RA (2002) Genitourinary trauma. In: Walsh PC, Retik AB, Vaughan ED, Wein AJ (eds) Campbell's urology, 8th edn. Saunders, Philadelphia, pp 3707–3744
20.
go back to reference Ghali AM, El Malik EM, Ibrahim AI, Ismail G, Rashid M (1999) Ureteric injuries: diagnosis, management, and outcome. J Trauma 46:150–158CrossRefPubMed Ghali AM, El Malik EM, Ibrahim AI, Ismail G, Rashid M (1999) Ureteric injuries: diagnosis, management, and outcome. J Trauma 46:150–158CrossRefPubMed
21.
go back to reference Chou MT, Wang CJ, Lien RC (2009) Prophylactic ureteral catheterization in gynecologic surgery: a 12-year randomized trial in a community hospital. Int Urogynecol J 20:689–693CrossRef Chou MT, Wang CJ, Lien RC (2009) Prophylactic ureteral catheterization in gynecologic surgery: a 12-year randomized trial in a community hospital. Int Urogynecol J 20:689–693CrossRef
Metadata
Title
Double-J stenting: initial management of injured ureters recognized late after gynecological surgery
Authors
Jae Sik Kim
Dong Hwan Lee
Hong Jin Suh
Publication date
01-06-2010
Publisher
Springer-Verlag
Published in
International Urogynecology Journal / Issue 6/2010
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI
https://doi.org/10.1007/s00192-009-1092-6

Other articles of this Issue 6/2010

International Urogynecology Journal 6/2010 Go to the issue