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Percutaneous Management of Iatrogenic Ureteral Injury

  • Devrim Akinci

J Urol Surg 2014;1(1):53-54

Twenty-five year old woman had pyelolitomy due to right renal stones and a DJS had been placed. After removal of the DJS, she developed right flank pain and fever. She had elevetad WBC. Delayed phase contrast enhanced computed tomography (CT) (a-d) showed contrast extravasation from right proximal ureter (arrow) consistent with ureteral injury and retroperitoneal urinoma (arrow). Percutaneous nephrostomy and urinoma drainage was planned. Under US and floroscopy guidance a 10 Fr nephrostomy catheter was placed into right renal pelvis percutanously (arrow). And urinoma was drained with a 10 drainage catheter percutaneously (arrowhead) (e). Thirty cc purulent material was aspirated. Intravenous antibiotic (ampicillin-sulbactam) was started. After resolution of infection symptoms, an antegrade 8 Fr 24 cm DJS was placed (f). The next day, since there was no drainage from the urinoma catheter, it was removed. The patient was followed with DJS for 5 months. During this time, DJS was exchanged once. She has been asymptommatic since removal of the DJS.