What is the role of stenting in the treatment of iatrogenic ureteral injury?

Updated: Nov 12, 2020
  • Author: Sandip P Vasavada, MD; Chief Editor: Bradley Fields Schwartz, DO, FACS  more...
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Answer

If tissue ischemia or a partial transection of the ureteral wall is suspected, a ureteral stent should be placed. The purpose of the stent, which is typically placed cystoscopically, is to act as a structural backbone onto which the healing ureter may mold. It also guarantees drainage of urine from the renal pelvis directly into the urinary bladder. It also can work as a gentle dilator since it moves slightly in an up-and-down motion, associated with breathing, as the kidney unit moves. The use of the stent is thought to minimize the rate of obstruction due to ureteral stricture in the injured area.

Choi et al reported on ureteroscopic double-J (DJ) ureteral stenting in 11 consecutive patients with distal ureteral injuries after gynecologic surgery.  Although stents were successfully inserted in all cases, five patients experienced ureteral stricture, which were treated with balloon dilatation or Holmium laser endoureterotomy. [9]


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