What is the role of ureterotomy 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

Alternatively, a ureterotomy may be made along the length of the injured or strictured section of ureter before placement of a stent. Davis described this technique in 1943 (the Davis intubated ureterotomy) in which a ureterotomy is made and left open over the stent. [10] The ureter eventually heals to form a watertight closure over the stent. The stent is withdrawn 6 weeks after it is placed, as it is estimated that all ureteral healing has occurred by that time. [11]

The principles of the Davis intubated ureterotomy have been extended to endoscopic treatments of ureteral strictures. Ureteroscopic endoureterotomy and Acucise endoureterotomy are two modalities that are used to attempt to treat the segment of strictured ureter endoscopically by a longitudinal full-thickness ureteral incision, followed by a stent placement. The success of these procedures closely resembles the success of the open Davis intubated ureterotomy, which approaches 80% patency at 3 years. [12]


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