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____________________
SUMMARY
Ureteric lesions after surgery of the aortic bifurcation.
Report of 6 cases.
Objective: The objective of this study was to evaluate the mana -
gement and current treatment options for ureteric complications
after vascular surgery based on a series of 6 cases.
Patients and Method::6 patients were treated between 1990 and
1998 (mean age: 64.7 years) for ureteric complications after
aortic bifurcation surgery. The mean interval between vascular
surgery and urological management was 1
1.6 years (± 4.04). All
patients were assessed by intravenous urography (IVU), and 4
patients were assessed by abdominal computed tomography
(CT). These complications consisted of: 2 cases of ureteric ste -
nosis, 1 case of inflammatory peri-ureteritis, 2 cases of chronic
peri-ureteritis and 1 case of compression by a false aneurysm.
The lesion was situated in the iliac ureter in every case.
Results: Treatment consisted of temporary double J stenting
(n=1), ureter release (n=1), endoscopic dilatation (n=1), psoas
bladder reconstruction (n=1) and corticosteroid therapy (n=2),
with 4 successes, 1 failure (corticosteroid therapy), and 1 death
from another cause.
Conclusion: Ureteric lesion after vascular surgery is a rare
complication, often discovered incidentally. The iliac ureter is
predominantly affected. IVU and CT are the reference examina -
tions. Treatment options primarily depend on the patient's gene -
ral state.
Key-words: Ureteric stenosis, vascular surgery, complications,
treatment.
1160
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L.Clemens et coll., Progrès en Urologie (2000), 10, 1156-1160