Management of complete ureteral obstructions with a transluminal puncture technique
INTRODUCTION: The traditional delayed treatment of iatrogenic complete ureteral obstruction is open surgery. An easy endourological technique, transluminal re-canalization of the ureter by guide-wire puncture under fluoro-endoscopic control, which has been performed on 4 patients, is described. SURG...
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| Format: | Article |
| Language: | English |
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Sociedade Brasileira de Urologia
2005-06-01
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| Series: | International Brazilian Journal of Urology |
| Subjects: | |
| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382005000300013 |
| _version_ | 1818299409382768640 |
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| author | Tulga Egilmez Sezgin Guvel Ferhat Kilinc Ozgur Yaycioglu Hakan Ozkardes |
| author_facet | Tulga Egilmez Sezgin Guvel Ferhat Kilinc Ozgur Yaycioglu Hakan Ozkardes |
| author_sort | Tulga Egilmez |
| collection | DOAJ |
| description | INTRODUCTION: The traditional delayed treatment of iatrogenic complete ureteral obstruction is open surgery. An easy endourological technique, transluminal re-canalization of the ureter by guide-wire puncture under fluoro-endoscopic control, which has been performed on 4 patients, is described. SURGICAL TECHNIQUE: With the guidance of C-arm fluoroscopy, by moving the C-arm to different planes, the tip of the ureteroscope is directed to the correct plane to meet the obliterated proximal end of the ureter and under direct vision, transluminal puncture is performed using the stiff end of a 0.035-inch guide wire. Once the stiff end of the guide-wire is in the lumen of the proximal ureter, an ureteral catheter is introduced over the guide wire, the guide wire is then removed and reinserted through the ureteral catheter with its soft end leading and a double J catheter is inserted. Ureteral stricture, if later encountered, is treated with balloon dilatation. RESULTS: Continuity of the ureter was restored in all 4 patients. The double J stents were removed 6 weeks later and a retrograde pyelography revealed resolution of the hydronephrosis without extravasation of urine. CONCLUSION: Although a very satisfactory result was achieved in our cases, more cases are needed to show if it can be an alternative to conventional surgical repair. However, we believe that this minimally invasive technique can be used for short obliterated ureteral segments and neither delays nor does it preclude further management using open surgery. |
| first_indexed | 2024-12-13T04:50:46Z |
| format | Article |
| id | doaj.art-e63a517f636d4a52bc7c4cc0d040d161 |
| institution | Directory Open Access Journal |
| issn | 1677-5538 1677-6119 |
| language | English |
| last_indexed | 2024-12-13T04:50:46Z |
| publishDate | 2005-06-01 |
| publisher | Sociedade Brasileira de Urologia |
| record_format | Article |
| series | International Brazilian Journal of Urology |
| spelling | doaj.art-e63a517f636d4a52bc7c4cc0d040d1612022-12-21T23:59:01ZengSociedade Brasileira de UrologiaInternational Brazilian Journal of Urology1677-55381677-61192005-06-0131326426810.1590/S1677-55382005000300013Management of complete ureteral obstructions with a transluminal puncture techniqueTulga EgilmezSezgin GuvelFerhat KilincOzgur YayciogluHakan OzkardesINTRODUCTION: The traditional delayed treatment of iatrogenic complete ureteral obstruction is open surgery. An easy endourological technique, transluminal re-canalization of the ureter by guide-wire puncture under fluoro-endoscopic control, which has been performed on 4 patients, is described. SURGICAL TECHNIQUE: With the guidance of C-arm fluoroscopy, by moving the C-arm to different planes, the tip of the ureteroscope is directed to the correct plane to meet the obliterated proximal end of the ureter and under direct vision, transluminal puncture is performed using the stiff end of a 0.035-inch guide wire. Once the stiff end of the guide-wire is in the lumen of the proximal ureter, an ureteral catheter is introduced over the guide wire, the guide wire is then removed and reinserted through the ureteral catheter with its soft end leading and a double J catheter is inserted. Ureteral stricture, if later encountered, is treated with balloon dilatation. RESULTS: Continuity of the ureter was restored in all 4 patients. The double J stents were removed 6 weeks later and a retrograde pyelography revealed resolution of the hydronephrosis without extravasation of urine. CONCLUSION: Although a very satisfactory result was achieved in our cases, more cases are needed to show if it can be an alternative to conventional surgical repair. However, we believe that this minimally invasive technique can be used for short obliterated ureteral segments and neither delays nor does it preclude further management using open surgery.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382005000300013ureteral obstructionurinary fistulaureteroscopysurgical proceduresminimally invasive |
| spellingShingle | Tulga Egilmez Sezgin Guvel Ferhat Kilinc Ozgur Yaycioglu Hakan Ozkardes Management of complete ureteral obstructions with a transluminal puncture technique International Brazilian Journal of Urology ureteral obstruction urinary fistula ureteroscopy surgical procedures minimally invasive |
| title | Management of complete ureteral obstructions with a transluminal puncture technique |
| title_full | Management of complete ureteral obstructions with a transluminal puncture technique |
| title_fullStr | Management of complete ureteral obstructions with a transluminal puncture technique |
| title_full_unstemmed | Management of complete ureteral obstructions with a transluminal puncture technique |
| title_short | Management of complete ureteral obstructions with a transluminal puncture technique |
| title_sort | management of complete ureteral obstructions with a transluminal puncture technique |
| topic | ureteral obstruction urinary fistula ureteroscopy surgical procedures minimally invasive |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382005000300013 |
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