Ureteric lesions after surgery of the aortic bifurcation. Report of 6 cases.

Objective: The objective of this study was to evaluate the management and c urrent treatment options for ureteric complications after vascular surgery based on a series of 6 cases. Patients and Methods: :6 patients were treated between 1990 and 1998 (mean age: 64.7 years) for ureteric complications after aortic bifurcation surger y. The mean interval between vascular surgery and urological management was 11.6 years (+/- 4.04). All patients were assessed by intravenous urography (IVU), and 4 patients were assessed by abdominal computed tomography (CT). These complications consisted of: 2 cases of ureteric stenosis, 1 case of inflammatory peri-ureteritis, 2 cases of chronic peri-ureteritis and 1 case of compression by a false aneurysm. The lesion was situated in the iliac u reter in every case. Results: Treatment consisted of temporary double J stenting (n=1), ureter r elease (n=1), endoscopic dilatation (n=1), psoas bladder reconstruction (n= 1) and corticosteroid therapy (n=2), with 4 successes, 1 failure (corticost eroid therapy), and 1 death from another cause. Conclusion: Ureteric lesion after vascular surgery is a rare complication, often discovered incidentally. The iliac ureter is predominantly affected. IVU and CT are the reference examinations. Treatment options primarily depe nd on the patient's general state.