Abstract
Purpose: Ureteral injuries are uncommon and challenging. In this study we report our institutional experience with ureteral injuries. We evaluated the American Association for the Surgery of Trauma-Organ Injury Scale (AAST-OIS) for ureteral injuries as a predictor of outcomes for complexity of repair, morbidity, mortality and associated injuries. Materials and Methods: We performed a retrospective, 120-month study (January 1992 to December 2002) at an urban, level I trauma center. Results: In the 57 patients mean hospital Admission blood pressure ± SD was 115 ± 25 mm Hg, mean Revised Trauma Score was 7.38 ± 0.84 and mean Injury Severity Score was 15 ± 1.15. The mechanism of injury was penetrating in 55 cases (96.5%), including gunshot wound in 52 (54.5%) and stab wound in 2 (5.5%), and in blunt 2 of motor vehicle accidents (3.5%). The anatomical location was the left side in 33 cases (58%), right side in 23 (40%) and bilateral in 1 (2%). The distribution of injuries was proximal in 15 cases (26%), mid in 21 (37%) and distal in 21 (37%). Associated injuries were present in 56 patients (98%). An intraoperative diagnosis was made in 44 cases (77%). Of the patients 50 (88%) required complex repairs or an adjunct procedure, including a double pigtail stent in 33 (58%), ureteroureterostomy in 20 (35%), ureteroneocystostomy with a psoas hitch in 10 (18%), external diversion in 9 (16%), suprapubic cystostomy in 8 (14%), nephrostomy in 2 (3.5%), nephrectomy in 2 (3.5%) and ligation in 2 (3.5%). Injury grade was I to V in 5 (8%), 8 (13%), 13 (22.8%), 18 (31.6%) and 13 (22.8%) cases, respectively. Overall 51 patients (89%) survived. No deaths were related to ureteral injury. Renal salvage was achieved in 49 of the 51 surviving patients (96%). Conclusions: Ureteral injuries are uncommon. The complexity of repair and number of associated injuries increase with AAST-OIS injury grade. Mortality increases with AAST-OIS injury grade but it is not related to the ureteral injury. Excellent results can be achieved with complex techniques of primary repair, leading to renal salvage.
| Original language | English |
|---|---|
| Pages (from-to) | 1202-1205 |
| Number of pages | 4 |
| Journal | Journal of Urology |
| Volume | 173 |
| Issue number | 4 |
| DOIs | |
| State | Published - Apr 2005 |
| Externally published | Yes |
Fingerprint
All Science Journal Classification (ASJC) codes
- Urology
Cite this
Traumatic ureteral injuries : A single institution experience validating the american association for the surgery of trauma-organ injury scale grading scale. / Best, Charles D.; Petrone, Patrizio; Buscarini, Maurizio; Demiray, Sinan; Kuncir, Eric; Kimbrell, Brian; Asensio, Juan A.
In: Journal of Urology, Vol. 173, No. 4, 04.2005, p. 1202-1205.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Traumatic ureteral injuries
T2 - A single institution experience validating the american association for the surgery of trauma-organ injury scale grading scale
AU - Best, Charles D.
AU - Petrone, Patrizio
AU - Buscarini, Maurizio
AU - Demiray, Sinan
AU - Kuncir, Eric
AU - Kimbrell, Brian
AU - Asensio, Juan A.
PY - 2005/4
Y1 - 2005/4
N2 - Purpose: Ureteral injuries are uncommon and challenging. In this study we report our institutional experience with ureteral injuries. We evaluated the American Association for the Surgery of Trauma-Organ Injury Scale (AAST-OIS) for ureteral injuries as a predictor of outcomes for complexity of repair, morbidity, mortality and associated injuries. Materials and Methods: We performed a retrospective, 120-month study (January 1992 to December 2002) at an urban, level I trauma center. Results: In the 57 patients mean hospital Admission blood pressure ± SD was 115 ± 25 mm Hg, mean Revised Trauma Score was 7.38 ± 0.84 and mean Injury Severity Score was 15 ± 1.15. The mechanism of injury was penetrating in 55 cases (96.5%), including gunshot wound in 52 (54.5%) and stab wound in 2 (5.5%), and in blunt 2 of motor vehicle accidents (3.5%). The anatomical location was the left side in 33 cases (58%), right side in 23 (40%) and bilateral in 1 (2%). The distribution of injuries was proximal in 15 cases (26%), mid in 21 (37%) and distal in 21 (37%). Associated injuries were present in 56 patients (98%). An intraoperative diagnosis was made in 44 cases (77%). Of the patients 50 (88%) required complex repairs or an adjunct procedure, including a double pigtail stent in 33 (58%), ureteroureterostomy in 20 (35%), ureteroneocystostomy with a psoas hitch in 10 (18%), external diversion in 9 (16%), suprapubic cystostomy in 8 (14%), nephrostomy in 2 (3.5%), nephrectomy in 2 (3.5%) and ligation in 2 (3.5%). Injury grade was I to V in 5 (8%), 8 (13%), 13 (22.8%), 18 (31.6%) and 13 (22.8%) cases, respectively. Overall 51 patients (89%) survived. No deaths were related to ureteral injury. Renal salvage was achieved in 49 of the 51 surviving patients (96%). Conclusions: Ureteral injuries are uncommon. The complexity of repair and number of associated injuries increase with AAST-OIS injury grade. Mortality increases with AAST-OIS injury grade but it is not related to the ureteral injury. Excellent results can be achieved with complex techniques of primary repair, leading to renal salvage.
AB - Purpose: Ureteral injuries are uncommon and challenging. In this study we report our institutional experience with ureteral injuries. We evaluated the American Association for the Surgery of Trauma-Organ Injury Scale (AAST-OIS) for ureteral injuries as a predictor of outcomes for complexity of repair, morbidity, mortality and associated injuries. Materials and Methods: We performed a retrospective, 120-month study (January 1992 to December 2002) at an urban, level I trauma center. Results: In the 57 patients mean hospital Admission blood pressure ± SD was 115 ± 25 mm Hg, mean Revised Trauma Score was 7.38 ± 0.84 and mean Injury Severity Score was 15 ± 1.15. The mechanism of injury was penetrating in 55 cases (96.5%), including gunshot wound in 52 (54.5%) and stab wound in 2 (5.5%), and in blunt 2 of motor vehicle accidents (3.5%). The anatomical location was the left side in 33 cases (58%), right side in 23 (40%) and bilateral in 1 (2%). The distribution of injuries was proximal in 15 cases (26%), mid in 21 (37%) and distal in 21 (37%). Associated injuries were present in 56 patients (98%). An intraoperative diagnosis was made in 44 cases (77%). Of the patients 50 (88%) required complex repairs or an adjunct procedure, including a double pigtail stent in 33 (58%), ureteroureterostomy in 20 (35%), ureteroneocystostomy with a psoas hitch in 10 (18%), external diversion in 9 (16%), suprapubic cystostomy in 8 (14%), nephrostomy in 2 (3.5%), nephrectomy in 2 (3.5%) and ligation in 2 (3.5%). Injury grade was I to V in 5 (8%), 8 (13%), 13 (22.8%), 18 (31.6%) and 13 (22.8%) cases, respectively. Overall 51 patients (89%) survived. No deaths were related to ureteral injury. Renal salvage was achieved in 49 of the 51 surviving patients (96%). Conclusions: Ureteral injuries are uncommon. The complexity of repair and number of associated injuries increase with AAST-OIS injury grade. Mortality increases with AAST-OIS injury grade but it is not related to the ureteral injury. Excellent results can be achieved with complex techniques of primary repair, leading to renal salvage.
UR - http://www.scopus.com/inward/record.url?scp=15044350612&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=15044350612&partnerID=8YFLogxK
U2 - 10.1097/01.ju.0000155526.37963.ef
DO - 10.1097/01.ju.0000155526.37963.ef
M3 - Article
C2 - 15758748
AN - SCOPUS:15044350612
VL - 173
SP - 1202
EP - 1205
JO - Journal of Urology
JF - Journal of Urology
SN - 0022-5347
IS - 4
ER -