Ureteral Complications during Surgery
Historically, ureteral complications during surgery have been occurring since the earliest performances of major abdominal or pelvic surgery. In the early 1960s, few diagnostic techniques were available to diagnose ureteral injury and determine the subsequent timely treatment required. Illustrations...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-02-01
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| Series: | Uro |
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| Online Access: | https://www.mdpi.com/2673-4397/3/1/7 |
| _version_ | 1797608766631313408 |
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| author | Raymond A. Dieter George B. Kuzycz William Jacob Dieter |
| author_facet | Raymond A. Dieter George B. Kuzycz William Jacob Dieter |
| author_sort | Raymond A. Dieter |
| collection | DOAJ |
| description | Historically, ureteral complications during surgery have been occurring since the earliest performances of major abdominal or pelvic surgery. In the early 1960s, few diagnostic techniques were available to diagnose ureteral injury and determine the subsequent timely treatment required. Illustrations from two different time periods of possible operative ureteral injury, ligation, or transection following major complicated surgical procedures are presented, along with the diagnostic and therapeutic approach currently followed. The first individual had apparently sustained a ureteral injury during a prior surgical procedure, which, with limited diagnostic options, was not recognized until she visited us years later—as was the case for many early ureteral injuries. Major abdominal or pelvic surgery may be extensive and complicated, especially when dense fibrosis, scarring, and benign or malignant mass formation are present. Unfortunately, surgical complications, including bleeding and ureteral concerns, may develop during these extensive procedures. A more recent patient underwent major, life-threatening retroperitoneal surgery due to a chronic aortoenteric fistula (17 months total preoperative hospitalization elsewhere), during which the left ureter was transected. In our second patient, recognition and correction of the ureteral transection during the aortic surgery, upon completion of the aortic repair, prevented a potential major renal complication. The timely diagnosis of the operative ureteral injury and the repair prior to wound closure prevented major postoperative complications. As some physicians believe that surgically induced ureteral injuries are increasing in frequency, we present this report to enhance awareness of the possibility of injury and the potential value of recognition prior to abdominal closure. In addition, current operative and postoperative strategies available to identify and reduce potential ureteral injury complications when they occur are discussed. |
| first_indexed | 2024-03-11T05:48:03Z |
| format | Article |
| id | doaj.art-5be7053f93e54bf5bcf8ff06cc25d84d |
| institution | Directory Open Access Journal |
| issn | 2673-4397 |
| language | English |
| last_indexed | 2024-03-11T05:48:03Z |
| publishDate | 2023-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Uro |
| spelling | doaj.art-5be7053f93e54bf5bcf8ff06cc25d84d2023-11-17T14:16:44ZengMDPI AGUro2673-43972023-02-0131485310.3390/uro3010007Ureteral Complications during SurgeryRaymond A. Dieter0George B. Kuzycz1William Jacob Dieter2Department of Cardiothoracic Surgery, Northwestern System at Cadence Health (Emeritus), 22W240 Stanton Road, Glen Ellyn, IL 60137, USADepartment of Cardiothoracic Surgery, Northwestern System at Cadence Health (Emeritus), 795 Crescent Blvd., Glen Ellyn, IL 60137, USALincoln Memorial University-DeBusk College of Osteopathic Medicine, 2911 Millstream Lane, Knoxville, TN 37931, USAHistorically, ureteral complications during surgery have been occurring since the earliest performances of major abdominal or pelvic surgery. In the early 1960s, few diagnostic techniques were available to diagnose ureteral injury and determine the subsequent timely treatment required. Illustrations from two different time periods of possible operative ureteral injury, ligation, or transection following major complicated surgical procedures are presented, along with the diagnostic and therapeutic approach currently followed. The first individual had apparently sustained a ureteral injury during a prior surgical procedure, which, with limited diagnostic options, was not recognized until she visited us years later—as was the case for many early ureteral injuries. Major abdominal or pelvic surgery may be extensive and complicated, especially when dense fibrosis, scarring, and benign or malignant mass formation are present. Unfortunately, surgical complications, including bleeding and ureteral concerns, may develop during these extensive procedures. A more recent patient underwent major, life-threatening retroperitoneal surgery due to a chronic aortoenteric fistula (17 months total preoperative hospitalization elsewhere), during which the left ureter was transected. In our second patient, recognition and correction of the ureteral transection during the aortic surgery, upon completion of the aortic repair, prevented a potential major renal complication. The timely diagnosis of the operative ureteral injury and the repair prior to wound closure prevented major postoperative complications. As some physicians believe that surgically induced ureteral injuries are increasing in frequency, we present this report to enhance awareness of the possibility of injury and the potential value of recognition prior to abdominal closure. In addition, current operative and postoperative strategies available to identify and reduce potential ureteral injury complications when they occur are discussed.https://www.mdpi.com/2673-4397/3/1/7ureterureteral ligationureteral transectionureteral repairretroperitoneal tumorretroperitoneal scarring |
| spellingShingle | Raymond A. Dieter George B. Kuzycz William Jacob Dieter Ureteral Complications during Surgery Uro ureter ureteral ligation ureteral transection ureteral repair retroperitoneal tumor retroperitoneal scarring |
| title | Ureteral Complications during Surgery |
| title_full | Ureteral Complications during Surgery |
| title_fullStr | Ureteral Complications during Surgery |
| title_full_unstemmed | Ureteral Complications during Surgery |
| title_short | Ureteral Complications during Surgery |
| title_sort | ureteral complications during surgery |
| topic | ureter ureteral ligation ureteral transection ureteral repair retroperitoneal tumor retroperitoneal scarring |
| url | https://www.mdpi.com/2673-4397/3/1/7 |
| work_keys_str_mv | AT raymondadieter ureteralcomplicationsduringsurgery AT georgebkuzycz ureteralcomplicationsduringsurgery AT williamjacobdieter ureteralcomplicationsduringsurgery |