ENDOUROLOGICAL TREATMENT OF URETERAL INJURIES

Over the last 8 years, 30 patients with ureteric injuries underwent en doscopic treatment. There were 14 failures, 5 because of blockage or d iversion of the catheter in the fistulous gap and 9 because it was imp ossible to penetrate the stenotic tract. All failures occurred when tr eatment was attempted more than 3 weeks after the trauma. Sixteen lesi ons were successfully treated by placing a 6 to 10 F double pigtail ca theter in the damaged ureter and leaving it for at least 3 months. Pat ients were followed up for 24 months. No recurrences were seen and goo d long-term results were achieved in all cases. In our experience, end ourological treatment can be recommended for recent strictures < 2 cm in length, or for small fistulas in which continuity of the ureteric w all is still partially preserved. Despite the risk of failure, especia lly following late treatment of an injury, it should be considered a s afe and effective procedure that is accepted well by the patients and that avoids the need for open surgery and its possible complications.