Objectives: Ureteral injury can be a complication of peripheral vascular reconstructive surgery or aneurysm of the abdominal aorta. The present study analyses 4 cases of obstructive uropathy; 3 following peripheral vascular reconstructive surgery and 1 from aneurysm of the abdominal aorta.
Methods: All 4 patients were prospectively evaluated.
Results: Both renal units were compromised in all 4 cases. The initial management consisted of internal urinary diversion with a double J catheter. Ureterolysis was performed in one case of unresolved uropathy secondary to prior bypass surgery. One case with uropathy due to infection of the vascular prosthetic graft required graft replacement.
Conclusions: The risk of ureteral injury is likely to be seen more often due to the increasing number of operations on the vascular tree and enhanced survival of patients with aortic aneurysm. Prevention of the foregoing complication includes doing US and/or IVP early postoperatively and in the first 4 months following surgery. Patient management is initially conservative.