Comprehensive analysis of ureter injuries: A systematic review of the medical literature
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Abstract
This article presents an exhaustive systematic review of the medical literature focused on the detailed analysis of ureter injuries. Injuries to this anatomical conduit, which connects the kidneys to the bladder, can arise as a consequence of various causes, such as abdominal surgeries, trauma, gynecological and urological procedures, among others. The aim of this study is to provide a comprehensive and updated view of the etiology, epidemiology, classification, clinical manifestations, diagnosis and treatment options for ureteral injuries.
During the investigation, numerous scientific articles, case reports, and retrospective studies were extensively reviewed, with particular focus on identifying the risk factors associated with these lesions. Also highlighted were the various diagnostic approaches and imaging tools, including computed tomography (CT), retrograde urography, cystoscopy, and magnetic resonance imaging (MRI), which are critical for the accurate diagnosis and extensive evaluation of ureter injuries.
Significant differences in treatment options were observed, depending on the severity and location of the lesions, with endourological and laparoscopic techniques being the preferred options for milder cases, while complex reconstructive surgeries are reserved for more extensive and complex lesions. Innovative surgical techniques, including ureteral anastomosis, tissue grafting and the use of ureteral stents, are addressed with the goal of optimally restoring ureteral function and structure.
This systematic review highlights the importance of a multidisciplinary approach in the management of ureteral injuries, involving urologists, general surgeons, gynecologists and radiologists, to ensure timely diagnosis and effective treatment. Furthermore, the relevance of prevention and early identification of ureteral injuries is emphasized, with the purpose of minimizing complications and improving long-term clinical outcomes. In conclusion, this research provides a valuable source of information for the medical and surgical community, promoting a better understanding and comprehensive management of ureteral injuries.
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References
I. Cummincs JM, Parra RO, Bouter JA. Impact of delayed diagnosis on repair of ureteral injury. J Urol 1999; 16 (4S): 15.
II. Kuno K, Menzin A, Kauper HH, Sison C, Gar D. Prophylactic ureteral catheterization in gynecologic surgery. J Urol 1999; 162(4).
III. FAtanpry L. Ureterovaginal fistulas: diagnosis and surgical tactic. A propos de 19 personal cases. [French] J Urol 1992; 98: 213.
IV. Lask D, ABarsanet J, Lurrwak Z er at. Changing trends in the management of iatrogenic ureteral infuries. J Urol 1995; 154(S):; 1693.
V. Seczman AA, Spirnak JP. Iatrogenic ureteral injuries: a 20 year expertience in treating 165 injuries. J Urol 1996; 155(3): 878.
VI. TxHomPson IM, Ross G Jr. Long term result of bladder flap repair of ureteral injuries. J Urol 1974; 111: 483.
VII. MoriwaLa HG, Suan SA, Paret SM. Ureteric substitution with Boari bladder flap. Br J Urol 1990; 66: 369.
VIII. HenpREN WH, Hensi_e TW. Transureteroureterostomy. Experience with 75 cases. J Urol 1980; 123: 826.
IX. Bapenocn DF, Tirrar RC, THAKAR DR Er AL. Early repair of accidental injury to ureter or bladder following gynaecological surgery. Br J Urol 1987, 59: 516.
X. Guam AMA, Et Matix EMA, Isranim AIA, Isman G, Rasuip M. Ureteric injuries: Diagnosis, management and outcome. J Urol 1999; 162: 976.
XI. Yossepowrrcu O, Baniex J, Lisen PM. Urological inju- ries during cesarean section: intraoperative diagnosis and management. J Urol 2004; 172(1): 196.
XII. Asimos DG, Patrrerson LC, Taytor CL. Changing incidence and etiology of iatrogenic ureteral injuries. J Urol 1994; 152: 2240.
XIII. Poza A, Marzullo L, García G, Reig C. Repair of complex ureteral injuries: presentation of three clinical cases and analysis of different therapeutic options [Surgical repair of complex ureteral injuries: three clinical cases and analysis of different technical approaches]. Arch Esp Urol. 2022 Jan;75(1):77-81. Spanish. PMID: 35173069.
XIV. Therapeutic evaluation of ureterovaginal fistulae . Ulises López Téllez,I Rafael Barrero Calaña,I Roberto Milián Echevarría,I Isabel Caravia Pubillones,I Suset Collazo Alvarez,I Frank Caravia BernaldoII .Revista Cubana de Urología, Vol. 5, No. 2 (2016).
XV. Pereira BM, Ogilvie MP, Gomez-Rodriguez JC, Ryan ML, Peña D, Marttos AC, Pizano LR, McKenney MG. A review of ureteral injuries after external trauma. Scand J Trauma Resusc Emerg Med. 2010 Feb 3;18:6. doi: 10.1186/1757-7241-18-6. PMID: 20128905; PMCID: PMC2830948.
XVI. Ureteral Injuries: External and Iatrogenic Sean P. Elliott MD, Jack W. McAninch MD Urologic Clinics of North America Elsevier Volume 33, Issue 1, February 2006, Pages 55-66