Endourological treatment of ureteric injuries

Abstract

Over the last 8 years, 30 patients with ureteric injuries underwent endoscopic treatment. There were 14 failures, 5 because of blockage or diversion of the catheter in the fistulous gap and 9 because it was impossible to penetrate the stenotic tract. All failures occurred when treatment was attempted more than 3 weeks after the trauma. Sixteen lesions were successfully treated by placing a 6 to 10 F double pigtail catheter in the damaged ureter and leaving it for at least 3 months. Patients were followed up for 24 months. No recurrences were seen and good long-term results were achieved in all cases. In our experience, endourological treatment can be recommended for recent strictures < 2 cm in length, or for small fistulas in which continuity of the ureteric wall is still partially preserved. Despite the risk of failure, especially following late treatment of an injury, it should be considered a safe and effective procedure that is accepted well by the patients and that avoids the need for open surgery and its possible complications.