Objective: This study aims to determine the characteristics of trauma patients, especially ureteral trauma in Hasan Sadikin General Hospital and expected to be used as data for trauma nationally. Material & Methods: This study was descriptive. Retrospective data collection is taken from medical records of ureteral trauma from 2013 until August 2017 at Hasan Sadikin General Hospital, Bandung. The data obtained are gender, mechanism of trauma, and management of ureteral trauma. Results: A total of 20489 cases of trauma handled in Hasan Sadikin General Hospital, 2.3% is a case of urogenital trauma and 40 of which are cases of ureteral trauma (0.19%). Most ureteral trauma patients are female (90%). Based on the trauma mechanism, 39 patients iatrogenic trauma (97.5%) and 1 patient gunshot wounds (2.5%). From iatrogenic ureteral trauma, 36 patients (90%) had iatrogenic trauma from the gynecological procedure, 5% as a result of the urological procedure, and 2.5% due to gastrointestinal procedure. Management of ureteral trauma is 47.5% ureteroureterostomy and 25% ureteroneocystostomy. Conclusion: Most cases of ureteral trauma are experienced by women, and most commonly due to iatrogenic trauma. Iatrogenic ureteral trauma caused by gynecology procedure is the most common.
Ureteral trauma, iatrogenic trauma
Pereira, B.M., et al. A review of ureteral injuries after external trauma. Scand J Trauma Resusc Emerg Med. 2010; 18: 6.
Elliot, S.P., et. al. Ureteral injuries: external and iatrogenic. Urol Clin Nort Am. 2006; 33: 55.
Brandes S, Coburn M, Armenakas N, McAninch J. Diagnosis and management of ureteric injury: an evidence-based analysis. BJU Int. 2004; 94: 277–289.
Best CD, Petrone P, Buscarini M, et al. Traumatic ureteral injuries: a single institution experience validating the American Association for the Surgery of Trauma-Organ Injury Scale grading scale. J Urol. 2005; 173: 1202–1205.
Selzman AA, Spirnak JP. Iatrogenic ureteral injuries: a 20-year experience in treating 165 injuries. J Urol. 1996; 155: 878–881.
Delacroix, S.E., Jr., et al. Urinary tract injures: recognition and management. Clin Colon Rectal Surg. 2010; 23: 104.
Visco, A.G., et al. Cost-effectiveness of universal cystoscopy to identify ureteral injury at hysterectomy. Obstet Gynecol. 2001; 97: 685.
Johnson, D.B., et al. Complications of ureteroscopy. Urol Clin North Am. 2004. 31: 157.
Gilmour, D.T., et al. Rates of urinary tract injury from gynecologic surgery and the role of intraoperative cystoscopy. Obstet Gynecol. 2006. 107: 1366.
Wu, H.H., et al. The detection of ureteral injuries after hysterectomy. J Minim Invasive Gynecol, 2006; 13: 403.
Pokala, N., et al. A randomized controlled trial comparing simultaneous intra-operative vs sequential prophylactic ureteric catheter insertion in re-operative and complicated colorectal surgery. Int J Colorectal Dis. 2007; 22: 68.
Jhaveri, J.K., et al. Ureteral injuries sustained during robot-assisted radical prostatectomy. J Endourol. 2014; 28: 318.
Kitrey N.D., et al. EAU Guidelines on Urological Trauma 2017. European Association of Urology. 2017; 18-21.
Emil A. Tanagho, Jack W. McAninch. Smith’s General Urology. Injuries to the Genitourinary Tract: injury to the ureter. 17th edition; 2008. p. 287-288.
Wein, kavoussi, novick, et all. Campbell-Walsh Urology. Ureteral injury. 10th ed; 2011. p. 1178- 1188.
Rodriguez and Payne, 2001. Rodriguez L, Payne CK: Management of urinary fistulas. In: Taneja SS, Smith RB, Ehrlich RM, ed. Complications of Urologic Surgery, 3rd ed. Philadelphia: WB Saunders; 2001. p. 186-203.
Best C.D., et al. Traumatic Ureteral Injuries: A Single Institution Experience Validating The American Association for The Surgery of Trauma-Organ Injury Scale Grading Scale. The Journal Of Urology. 2005; 173: 1202-1205.