The management of total avulsion of the ureter from both ends: Our experience and literature review

  • Cuneyd Sevinc Medicana International Istanbul Hospital, Urology Clinic, Istanbul, Turkey.
  • Muhsin Balaban | muhsinbalaban1980@yahoo.com Medicana International Istanbul Hospital, Urology Clinic, Istanbul, Turkey.
  • Orkunt Ozkaptan Medicana International Istanbul Hospital, Urology Clinic, Istanbul, Turkey.
  • Ugur Yucetas Istanbul Training and Research Hospital, Urology Clinic, Istanbul, Turkey.
  • Tahir Karadeniz Medicana International Istanbul Hospital, Urology Clinic, Istanbul, Turkey.

Abstract

Objective: To evaluate the treatment modalities of total ureteral avulsion and to clarify the risk factors of this serious complication. Methods: This study retrospectively analyzed the data of 3 patients with complete ureteral avulsion during ureteroscopy. Of the three patients, two had distal ureteral complete avulsion, and one total ureteral avulsion on both ends. Ureteroneocystostomy (UNC) was immediately performed after distal ureteral avulsion cases. Ileal ureter substition was performed on the same session after the total ureteral avulsion in both ends. Two of the patients were under chronic use of corticosteroid treatment due to diagnosis of idiopathic trombocytopenic purpura and myastenia gravis and all patients had unsuccesful shockwave litotripsy (SWL) treatment history with at least 1 month period before surgery. Results: The patient who had ileal ureter substitution was followed at 3-month intervals by ultrasonography and renal function tests and she was uneventful after a 2 year follow-up period. The patients treated with UNC were followed up at 3 month interval by ultrasonography and renal function tests. They had normal renal function 1 year after the operation Conclusion: Complete ureteral avulsion is a rare but severe complication. Treatment modality can vary and ileal ureter can be applied succesfully in the total ureter avulsion in both ends when bladder capacity is not enough for a Boari flap. Failed SWL and/or corticosteroid treatment history of patients seems to increase the risk of the ureteral avulsion.

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Author Biographies

Cuneyd Sevinc, Medicana International Istanbul Hospital, Urology Clinic, Istanbul
Urology
Muhsin Balaban, Medicana International Istanbul Hospital, Urology Clinic, Istanbul
Urology
Orkunt Ozkaptan, Medicana International Istanbul Hospital, Urology Clinic, Istanbul
Urology
Ugur Yucetas, Istanbul Training and Research Hospital, Urology Clinic, Istanbul
Urology
Tahir Karadeniz, Medicana International Istanbul Hospital, Urology Clinic, Istanbul
Urology
Published
2016-07-04
Info
Issue
Section
Original Papers - Stones and Infections
Keywords:
Avulsion, Lithotripsy, Ureterorenoscopy
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How to Cite
Sevinc, C., Balaban, M., Ozkaptan, O., Yucetas, U., & Karadeniz, T. (2016). The management of total avulsion of the ureter from both ends: Our experience and literature review. Archivio Italiano Di Urologia E Andrologia, 88(2), 97-100. https://doi.org/10.4081/aiua.2016.2.97

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