Permanent Ureteral Occlusion

2018 ◽  
Author(s):  
Almamoon I. Justaniah
Keyword(s):  
Clinical Presentation ◽  
Percutaneous Nephrostomy ◽  
Spontaneous Healing ◽  
Ureterovaginal Fistula ◽  
Cyanoacrylate Glue ◽  
Pelvic Malignancy ◽  
Urine Diversion ◽  
Ureteral Injuries ◽  
Prior Surgery ◽  
Ureteral Occlusion

Distal ureteral injuries are uncommon. When present, urine leakage may ensue. Common etiologies are gynecologic surgeries (75%), trauma, pelvic malignancy, and radiation therapy. Clinical presentation varies according to the location of leakage or fistula. For example, patients with ureterovaginal fistula may present with vaginal discharge. Patients with intra-abdominal leakage may develop urinoma or abscess. Unfortunately, most of these patients are poor surgical candidates due to prior surgery and/or radiation. Therefore, operative repair can be challenging and at times not a valid option. Transrenal ureteral occlusion may provide the best available option for such patients. A trial of urine diversion via percutaneous nephrostomy tube may allow spontaneous healing. If this fails, ureteral occlusion proximal to the leak/fistula can be attempted with a success rate up to 100%. Occlusion techniques include ureteral clipping, radiofrequency cauterization, embolization coils, Amplatzer vascular plugs, detachable balloons, absolute alcohol, and isobutyl-2-cyanoacrylate (glue).

Endoscopic Management of Total Ureteral Occlusion and Ureterovaginal Fistula

1995 ◽  
Vol 9 (5) ◽  
pp. 391-396 ◽  
Author(s):  
JAMES E. LINGEMAN ◽  
MICHAEL Y.C. WONG ◽  
JAY R. NEWMARK
Keyword(s):  
Endoscopic Management ◽  
Ureterovaginal Fistula ◽  
Ureteral Occlusion

scholarly journals URINARY TRACT INJURIES FOLLOWING OBSTETRIC AND GYNECOLOGIC SURGERIES -A PROSPECTIVE STUDY IN A TERTIARY CARE HOSPITAL.

2020 ◽  
pp. 67-68
Author(s):  
Khumallambam Ibomcha Singh ◽  
Konsam Jina Devi ◽  
Kangjam Sholay Meitei
Keyword(s):  
Urinary Tract ◽  
Vesicovaginal Fistula ◽  
Tertiary Care ◽  
Ureteral Injury ◽  
Gynecologic Surgery ◽  
Bladder Injury ◽  
Care Hospital ◽  
Ureterovaginal Fistula ◽  
Ureteral Injuries ◽  
Urological Complications

Purpose: Urinary tract injuries occur frequently during surgery in the pelvic cavity. Inadequate diagnosis and treatment may lead to severe complications and morbidities. This study examined the clinical features of urologic complications following obstetric and gynecologic surgery and their management. Materials and Methods: We prospectively analysed 14,678 obstetric and gynecologic surgery cases from May 2015 to May 2019. Twenty-one patients with urological complications were enrolled. This study assessed the etiology and surgical approach, type, and treatment method of the urologic injury. Results: Of these 21 patients, 11 had bladder injury, 1 had ureteral injury, 1 had combined bladder and ureteral injury, 8 had vesicovaginal fistula and 5 had ureterovaginal fistula. With respect to injury rate by specific surgery, radical hysterectomy was the highest with 5 of 21 cases. Out of 11 cases of bladder injury, only one underwent laparoscopic bladder repair and the rest had transabdominal primary repair during surgery with a 100% success rate. Two of 7 ureteral injuries were identified intraoperatively. One underwent ureteroureterostomy and another had ureteroneocystostomy with no major complications. All 8 cases of vesicovaginal fistula had open transabdominal O’ connor repair and all 5 cases of ureterovaginal fistula were cured after ureteroneocystostomy following percutaneous nephrostomy. Conclusions: Urinary bladder injury was the most common urological injury during obstetric and gynecologic surgery, followed by ureteral injury. The types of injured states, diagnostic difficulty, and time to complete cure were much greater among patients with ureteral injuries. Early diagnosis and necessary urologic intervention are important for better outcome.

scholarly journals Traumatic Perforation of Tympanic Membrane: A Rural Profile of Bangladesh

2017 ◽  
Vol 28 (2) ◽  
pp. 79-82
Author(s):  
Jahangir Alam Mazumder ◽  
Syed Mohiuddin Nasir ◽  
Shazibur Rashid ◽  
Arif Morshed Khan
Keyword(s):  
Tympanic Membrane ◽  
Rural Areas ◽  
Healing Rate ◽  
Clinical Presentation ◽  
Surgical Intervention ◽  
Age Group ◽  
Spontaneous Healing ◽  
Early Appearance ◽  
Major Mode ◽  
Type Of Injury

To determine the various etiological factors, clinical presentation and outcome of traumatic perforation of tympanic membrane (TM) in a rural area of Bangladesh. A retrospective study of 210 cases of traumatic perforation of TM in upazilla health complex, Nangalkot and Muradnagar, Comilla, Bangladesh within the period of March 2013 to February 2014. The study showed middle age people of 20-39 years age group were mostly affected (61.89%), where males are more than females at the ratio of 1.18:1. Domestic violence was a major factor (50%) and husbands are only culprit for 35.13% of housewives and slap was the major mode of injury (52.86%) affecting the left ear mostly (70.95%). Spontaneous healing rate was very satisfactory and it was 88% within 03 months in our study. Traumatic perforation of TM is a common type of injury in rural areas. Unnecessary surgical intervention or unskilled handling should be discouraged. Early appearance and watchful treatment reduces the morbidity.Medicine Today 2016 Vol.28(2): 79-82

Percutaneous nephrostomy in obstructing pelvic malignancy does not facilitate further oncological treatment

2020 ◽  
Vol 52 (9) ◽  
pp. 1625-1628
Author(s):  
Samuel Stephen Folkard ◽  
Srijit Banerjee ◽  
Richard Menzies-Wilson ◽  
Joseph Reason ◽  
Evangelos Psallidas ◽  
...  
Keyword(s):  
Percutaneous Nephrostomy ◽  
Pelvic Malignancy ◽  
Oncological Treatment

scholarly journals Iatrogenic Ureterovaginal Fistulae: Difficulties in Diagnosis and Treatment in Our Case series

2019 ◽  
pp. 01-06
Author(s):  
Cristina Palmer, DO ◽  
Bilal Farhan, MD ◽  
Gamal Ghoniem, MD FACS
Keyword(s):  
Case Series ◽  
Ureteral Injury ◽  
Pelvic Surgery ◽  
Fistula Formation ◽  
Gynecologic Surgery ◽  
Ureterovaginal Fistula ◽  
Vaginal Cuff ◽  
Ureterovesical Junction ◽  
Ureteral Injuries ◽  
Damage Risk

Ureteral injury is a known complication of pelvic surgeries, including gynecological, urologic, colorectal, and vascular surgeries. This can occur by transvaginal, laparoscopic, or transabdominal approach [1,2]. Gynecological surgery remains by far the most common means of injury (75%), followed by colorectal surgeries (14%) [3-5], with reports of ureteral injury during gynecologic surgery from 0.35% to 1.5% [4,6]. Total abdominal and laparoscopic hysterectomies are the most common procedures where ureteral injury occurs [1,5]. Injury occurs most often at the level where the ureter courses under the uterine vessels, followed by the ureterovesical junction and the base of the infundibulopelvic ligament [4,7,8]. Many ureteral injuries occur during uncomplicated, routine surgery [8,9]. An abnormal connection between the ureter and vagina, or ureterovaginal fistula, allows for a conduit through which urine can continually leak. This is specific to the combination of ureteral injury and hysterectomy where the urine finds its way to the freshly closed vaginal cuff. Genitourinary fistula formation remains one of the most feared complications of pelvic surgery, with lasting emotional damage, risk for infections, infertility, reoperation, and increased hospital stay [5,10]. Our objective is to present the difficulties encountered in management of our cases and how to rectify them.

Therapeutic Ureteral Occlusion with Ifabond Cyanoacrylate Glue: An Interesting Solution

2017 ◽  
Vol 84 (3) ◽  
pp. 203-205 ◽  
Author(s):  
Marco Oderda ◽  
Sergio Lacquaniti ◽  
Flavio Fraire ◽  
Jacopo Antolini ◽  
Marco Camilli ◽  
...  
Keyword(s):  
Therapeutic Option ◽  
Minimally Invasive Approach ◽  
Cyanoacrylate Glue ◽  
Percutaneous Injection ◽  
Invasive Approach ◽  
Distal Ureter ◽  
Urinary Leakage ◽  
Novel Approach ◽  
Interesting Solution ◽  
Ureteral Occlusion

Objective The aim of this study was to present a novel approach for complete and permanent ureteral occlusion using a percutaneous injection of Ifabond cyanoacrylate glue. Methods We describe in detail all the steps of our surgery, performed on a 79-year-old patient with urinary leakage from ureteral stump following radical cystectomy. N-hexyl-cyanoacrylate glue (Ifabond) was used to occlude the distal ureter and solve the leakage. Results Our approach was successful, sparing our already frail patient further surgical procedures. Six months pyelography confirmed the complete ureteral blockage with absence of extravasation. Conclusions In complicated scenarios with urinary leakages and frail patients, synthetic glues such as Ifabond might represent an interesting therapeutic option to solve the fistulas, leading to durable success with a minimally invasive approach.

scholarly journals Ureteric injuries during cancer surgery presentation and management over a 20-year

2021 ◽  
Vol 8 (2) ◽  
pp. 593
Author(s):  
Ali Zedan Tohamy ◽  
Haisam A. Samy ◽  
Tark Salah ◽  
Marwa T. Hussien ◽  
Mohamed Hussein
Keyword(s):  
Primary Repair ◽  
Surgical Oncology ◽  
Intravenous Urography ◽  
Ureteral Injury ◽  
Abdominal Hysterectomy ◽  
Percutaneous Nephrostomy ◽  
Cancer Surgery ◽  
Ureteral Stricture ◽  
Boari Flap ◽  
Ureteral Injuries

Background: Iatrogenic ureteral injury rare 0.3-1.5%. complication of abdominopelvic cancer surgery. We aimed to study the risk and management of ureteral injury among cancer patients.  Methods: Diagnosis can be achieved retrograde pyelography, ureteroscopy, CT, or intravenous urography. Results: Years 2000 to 2020, 2904 patients in the Department of Surgical oncology, Assuit University, and 47 ureteral injury cases were identified. (1.62), 4/231 cervical cancer, 9/611 ovarian cancer and 7/462 endometrial cancer.,11/818 colon cancer,12/620 rectal cancer, 1/11 prostatic cancer, 3/151 retroperitoneal sarcoma. 34% (radical abdominal hysterectomy 8.5% Wertheim hysterectomies 4%), colorectal surgery colectomy 25.5%, low anterior resection2.1% in radical prostatectomy and 6.4% in retroperitoneal tumor, intraoperative diagnosis 48.9%, 8.5% in laparoscopic surgeries, the distal third (53.2%),23.4% catheterization, complete transection 31.9%; partial 14.9%, ligation 8.5%, laceration in 19.1%, resection. 8.5%; and devascularization in 17%. Fever in 14.9%, abdominal or flank pain in 38.5%. Oligura in 6.4%, ileus in 19.3%, urinary leakage (vaginally or via abdominal wound) in 10.6% rise creatinine in 10.6%, hydronephrosis in 6.4%, urinoma in 27.7%, extravasation in 8.5% asymptomatic in 4.3%, 40.4% percutaneous nephrostomy. 19.1%primary repair Ureteroneocystostomy in (17%) Boari flap in 12.7%, Psoas hitch in 23.4% stenting in 14.9%, 8.5% ileum interposition, anastomosis to contralateral ureter in 4.3%, ureteral stricture 6.4%, ureterovaginal fistulas in 10.6%, acute renal failure 2.1%, peritonitis 4.3, urinary tract infection in 14.9%.Conclusions: The recognition and immediate repair of ureteral injuries early during the same procedure was highly desirable and to avoid a second operation.

scholarly journals Emergent Percutaneous Nephrostomy for Pyonephrosis: A Primer for the On-Call Interventional Radiologist

2020 ◽  
Vol 37 (01) ◽  
pp. 074-084 ◽  
Author(s):  
Christopher Florido ◽  
Josi L. Herren ◽  
Mithil B. Pandhi ◽  
Matthew M. Niemeyer
Keyword(s):  
Septic Shock ◽  
Clinical Presentation ◽  
Percutaneous Nephrostomy ◽  
Shock Treatment ◽  
Safe Procedure ◽  
Success Rates ◽  
Technical Success ◽  
Interventional Radiologist ◽  
Systemic Antibiotics ◽  
Collecting System

AbstractPyonephrosis is gross accumulation of pus within an obstructed renal collecting system that, if left untreated, can lead to potentially fatal septic shock. Treatment requires urgent decompression coupled with systemic antibiotics. Percutaneous nephrostomy (PCN) placement, first described in 1976 for the treatment of pyonephrosis, is now widely utilized for emergent decompression in these patients. When performed by an experienced interventional radiologist, PCN is a safe procedure with technical success rates of over 96 to 99%. This article will address the clinical presentation of pyonephrosis, and will discuss the indications, technique, complications, and outcomes of emergent PCN placement. Additionally, the expanded indications for PCN placement in nonemergent scenarios will also be described.

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