[Iatrogenic ureteral injury].

Arch Esp Urol

Servicio de Urología, Hospital General de Enfermedades Z 9, Instituto Guatemalteco de Seguridad Social, Guatemala.

Published: December 2003

Objectives: To determine the most frequent causes of ureteral injury, and the way to correct severe damage of the ureter.

Methods: We reviewed the medical records of 25 patients who suffered ureteral injuries during abdominal or pelvic surgery in a five-year period; endoscopic injuries were excluded.

Results: The most common presentation included pain, urinary incontinence and fever. Hysterectomy was the most frequent operation causing ureteral injuries. The diagnosis was made by intravenous urography and ultrasound. Ureteral reimplantation using a Boari's flap, without other complications, was the preferred treatment due to ureteral damage. Right side and distal third of the ureter where the most frequently affected sites.

Conclusions: In cases of iatrogenic injuries of the distal third of the ureter with severe lesions, ureteral reimplantation with a Boari's flap may be the option.

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