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Etiology, characteristics and management of ureteric injury: experience from a nationwide study

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机构: [1]Peking Univ, Hosp 1, Dept Urol, Natl Urol Canc Ctr,Inst Urol, 8 Xishiku St, Beijing 100034, Peoples R China [2]Capital Med Univ, Beijing Friendship Hosp, Dept Urol, Beijing, Peoples R China [3]Gannan Med Univ, Dept Urol, Affiliated Hosp 1, Ganzhou, Peoples R China [4]Fujian Med Univ, Fujian Prov Hosp, Dept Urol, Shengli Clin Med Coll, Fuzhou, Peoples R China [5]Emergency Gen Hosp, Dept Urol, Beijing, Peoples R China [6]Beijing Jian Gong Hosp, Dept Urol, Beijing, Peoples R China [7]Fudan Univ, Huashan Hosp, Dept Urol, 12 Urumqi Middle Rd, Shanghai 200040, Peoples R China [8]Sichuan Univ, Inst Urol, West China Hosp, Dept Urol, 37 Guo Xue Xiang, Chengdu 610041, Peoples R China
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关键词: Ureteric injury (UI) trauma iatrogenic injury endoscopy

摘要:
Background: To investigate the common etiologies, characteristics, and management of ureteric injury. Methods: A nationwide study was performed in 38 medical centers from Mar 2017 to Mar 2019. The data of patients with ureteric injury were retrospectively collected. Results: Overall, 294 patients were included in this study. Ten cases (3.4%) were due to abdominal injuries, and 284 cases (96.6%) were due to iatrogenic injuries, including 48.6% from urological procedures, 41.9% from gynecological procedures, 6.3% from general surgery, and 3.2% from other treatments. Most urological injuries (79.7%) were caused by endourological procedures. Injury occurred in the distal ureter in 178 cases (60.5%), the mid-ureter in 31 cases (10.5%), and the proximal ureter in 85 cases (28.9%). Only 51 patients (17.3%) were diagnosed immediately during primary surgery. Immediate ureter reconstruction was performed in 30 patients (58.8%), while delayed urinary diversion was performed in 148 patients (60.9%) in the delayed diagnosis group. The side and the location of the injury were different between the urological and nonurological injury groups (P<0.001). Ureteric injuries were diagnosed timelier in the urological group than in the nonurological group (P=0.037). Conclusions: Iatrogenic injury was the most common cause of ureteric injury. The majority of iatrogenic injuries were caused by urological procedures and were primarily due to aggressive endourological techniques. Depending on the condition of the patient, the time of diagnosis, and the location and length of the ureteric injury, different management strategies should be applied.

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出版当年[2022]版:
大类 | 4 区 医学
小类 | 4 区 泌尿学与肾脏学 4 区 男科学
最新[2023]版:
大类 | 3 区 医学
小类 | 4 区 男科学 4 区 泌尿学与肾脏学
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出版当年[2022]版:
Q3 UROLOGY & NEPHROLOGY Q4 ANDROLOGY
最新[2023]版:
Q3 UROLOGY & NEPHROLOGY Q4 ANDROLOGY

影响因子: 最新[2023版] 最新五年平均 出版当年[2022版] 出版当年五年平均 出版前一年[2021版] 出版后一年[2023版]

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第一作者机构: [1]Peking Univ, Hosp 1, Dept Urol, Natl Urol Canc Ctr,Inst Urol, 8 Xishiku St, Beijing 100034, Peoples R China
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通讯机构: [1]Peking Univ, Hosp 1, Dept Urol, Natl Urol Canc Ctr,Inst Urol, 8 Xishiku St, Beijing 100034, Peoples R China [7]Fudan Univ, Huashan Hosp, Dept Urol, 12 Urumqi Middle Rd, Shanghai 200040, Peoples R China [8]Sichuan Univ, Inst Urol, West China Hosp, Dept Urol, 37 Guo Xue Xiang, Chengdu 610041, Peoples R China [*1]Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Center, No. 8 Xishiku Street, Xicheng District, Beijing 100034, China [*2]Department of Urology, Huashan Hospital, Fudan University, No. 12 Urumqi Middle Road, Shanghai 200040, China [*3]Department of Urology, Institute of Urology, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu 610041, China
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