Outcomes of ureteroscopic double-J ureteral stenting for distal ureteral injury after gynecologic surgery. Ureteral injuries during gynecologic procedures. Am J Obstet Gynecol. Bradley Fields Schwartz, DO, FACS is a member of the following medical societies: American College of Surgeons, American Urological Association, Association of Military Osteopathic Physicians and Surgeons, Endourological Society, Society of Laparoendoscopic Surgeons, Society of University UrologistsDisclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: AUA Journal of Urology
Serve(d) as a speaker or a member of a speakers bureau for: Cook Medical; Olympus, . A dye study using indigo carmine or methylene blue can be administered by intravenous infusion an aid in direct visualization of ureteral injury. [Medline]. [Medline]. Philadelphia PA: Saunders; 2012. [Medline]. [Medline]. Jones N, Fleming ND, Nick AM, Munsell MF, Rallapalli V, Westin SN, et al. J Endourol. 2019 Oct 21. Fluorescence Ureteral Visualization in Human Laparoscopic Colorectal Surgery Using Methylene Blue. The study was approved by the Health Research Authority (HRA), the East Midlands—Derby Research Ethics Committee (ref: 14/EM/1107) and Oxford University Hospitals research and development department. Blackwell RH, Kirshenbaum EJ, Shah AS, Kuo PC, Gupta GN, Turk TMT. Hodges CV, Barry JM, Fuchs EF, et al. 1999 Feb. 26(1):167-73, x. J Urol. The study was registered on clinicaltrials.gov … An illustration of the shape and configuration of a Boari flap. Koo HP, Bloom DA. Smith JA Jr, Howards SS, Preminger GM, Eds. [Full Text]. Wolf JS Jr, Elashry OM, Clayman RV. 8-9 Table 2. After placement of a cystoscope in the bladder and cannulation of the affected ureteral orifice with a ureteral catheter, dilute diatrizoate (eg, Cystografin) is injected into the ureter under fluoroscopy or while taking a kidneys, ureters, bladder (KUB) image. 1999 Feb. 26(1):167-73, x. 727-30. J Minim Invasive Gynecol. This allows for shorter procedural duration and improved prevention and incidence of ureteral injury associated with complex pelvic surgery. Soong Y, Lim PH. 2014 Apr 21. Philadelphia PA: Saunders; 2012. [Medline]. [Medline]. 1997 Dec. 158(6):2078-82. Management of iatrogenic ureteric injury with retrograde ureteric stenting: an analysis of factors affecting technical success and long-term outcome. Michel E Rivlin, MD is a member of the following medical societies: American College of Obstetricians and Gynecologists, American Medical Association, Mississippi State Medical Association, Royal College of Surgeons of Edinburgh, Royal College of Obstetricians and GynaecologistsDisclosure: Nothing to disclose. Barrett K, Ghiculete D, Sowerby RJ, Farcas M, Pace KT, Honey RJD. 3rd ed. Urinary tract injuries during treatment of patients with morbidly adherent placenta. Ureteric Injury During Transvaginal Oocyte Retrieval (TVOR) and Review of Literature. Am J Obstet Gynecol. Obstet Gynecol. 3rd ed. Bradley Fields Schwartz, DO, FACS Professor of Urology, Director, Center for Laparoscopy and Endourology, Department of Surgery, Southern Illinois University School of Medicine Extravasation of blue dye indicates ureteral discontinuity. Diseases & Conditions, 2002 J Urol. 31 (S1):S101-S105. 2015 Nov-Dec. 21 (6):363-8. 2015 Dec. 126 (6):1161-9. A vaginal tampon is inserted. Note the ureter's proximity at the pelvic brim to the infundibulopelvic ligament. Nieto-Calvache AJ, López-Girón MC, Messa-Bryon A, Ceballos-Posada ML, Duque-Galán M, Ríos-Posada JG, et al. In the present study, we evaluated the feasibility of near-infrared (NIR) with ZW800-1C as a diagnostic tool of iatrogenic or traumatic ureteral injury in addition to ureter visualization, compared to methylene blue. However, since both types of fistulas may be present simultaneously, this test may not be completely reliable. Mathews R, Marshall FF. Outcomes of ureteroscopic double-J ureteral stenting for distal ureteral injury after gynecologic surgery. [Medline]. Am J Obstet Gynecol. Smith JA Jr, Howards SS, Preminger GM, Eds. If one is unsure whether a ureteral injury has occurred intraoperatively, IV administration of 10 mL of indigo carmine or methylene blue with 20 mg of furosemide may help to localize a ureteral injury. URETERAL INJURY • These injuries occur most often during repair of hysterotomy extensions into the broad ligament or vagina. [Medline]. [Medline]. Methylene blue fluorescence: a new way to protect the ureters? 1994:254-9. Sandip P Vasavada, MD Associate Professor of Surgery, Cleveland Clinic Lerner College of Medicine; Physician, Center for Female Urology and Genitourinary Reconstructive Surgery, The Glickman Urological and Kidney Institute; Joint Appointment with Women's Institute, Cleveland Clinic 2006 Sep. 17(5):531-5. Long-term results of endoureterotomy for benign ureteral and ureteroenteric strictures. [Medline]. 2018 Jun. 2017 Jan-Mar. Lee Z, Kaplan J, Giusto L, Eun D. Prevention of iatrogenic ureteral injuries during robotic gynecologic surgery: a review. The bladder is instilled via a catheter with saline that is colored with methylene blue. This can be performed by directly injecting into the renal pelvis or by [Medline]. Kim JH, Moore C, Jones JS, Rackley R, Daneshgari F, Goldman H, et al. Raymond R Rackley, MD Professor of Surgery, Cleveland Clinic Lerner College of Medicine; Staff Physician, Center for Neurourology, Female Pelvic Health and Female Reconstructive Surgery, Glickman Urological Institute, Cleveland Clinic, Beachwood Family Health Center, and Willoughby Hills Family Health Center; Director, The Urothelial Biology Laboratory, Lerner Research Institute, Cleveland Clinic Conversion from robotic surgery to laparotomy: a case-control study evaluating risk factors for conversion. 8th ed. If one is unsure whether a ureteral injury has occurred intraoperatively, intravenous administration of 10 mL of indigo carmine or methylene blue with 20 mg of furosemide … Int Urogynecol J Pelvic Floor Dysfunct. Hydronephrosis, ureteral integrity, and any extravasation can usually be seen readily with IVU. 747-50. Obstet Gynecol. Abboudi H, Ahmed K, Royle J, Khan MS, Dasgupta P, N'Dow J. Ureteric injury: a challenging condition to diagnose and manage. Sherman ND. Iatrogenic ureteric injury is a serious complication of colorectal surgery. for: Oasis Consumer Healthcare. Harkki-Siren P, Sjoberg J, Tiitinen A. Urinary tract injuries after hysterectomy. Hinman's Atlas of Urologic Surgery. Te Linde’s Operative Gynecology. J Urol. Urology. 2019 Aug. 221 (2):132.e1-132.e13. Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug ReferenceDisclosure: Received salary from Medscape for employment. Blackwell RH, Kirshenbaum EJ, Shah AS, et al. 5(6):751-5. 2014 Aug. 134(2):238-42. 1997 Sep. 158(3 Pt 1):759-64. 1998 May. Complications of Recognized and Unrecognized Iatrogenic Ureteral Injury at Time of Hysterectomy: A Population Based Analysis. This website also contains material copyrighted by 3rd parties. Identifying Ureters If the dye is seen in the renal pelvis without any ureteral extravasation or significant narrowing along the ureter, the ureter is in continuity and the case may be managed conservatively, with either observation or stent placement. Konigsberg H, Blunt KJ, Muecke EC. If a suspicion of ureteral injury occurs during surgery, intravenous administration of indigo carmine or methylene blue solution is recommended to detect the damaged part of the ureter, which is especially important for the detection of its partial damage. 3rd ed. 2014 Apr 21. Miller EA. Acta Radiol. Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug ReferenceDisclosure: Received salary from Medscape for employment. 1997 Nov. 38(11):475-8. Procedures, Ureteral Injury During Gynecologic Surgery, encoded search term (Ureteral Injury During Gynecologic Surgery) and Ureteral Injury During Gynecologic Surgery, Palliative Care of the Patient With Advanced Gynecologic Cancer, Percutaneous Palliative Care Interventions in the Cancer Patient. [Medline]. Relevant anatomy of the ureter, illustrating its course from the renal pelvis to the bladder. Fig. Carlton CE, Scott R, Guthrie AG. 454617-overview BJU Int. Urological injuries in gynaecological practice--when is the optimal time for repair?. In this test, a tablet of oral phenazopyridine (eg, Pyridium) is administered. 1839957-overview Abboudi H, Ahmed K, Royle J, Khan MS, Dasgupta P, N'Dow J. Ureteric injury: a challenging condition to diagnose and manage. Smith JA Jr, Howards SS, Preminger GM, Eds. Robotic management of genitourinary injuries from obstetric and gynaecological operations: a multi-institutional report of outcomes. for: Medscape. Yeung TM, Volpi D, Tullis ID, et al. If ureteral injury is suspected postoperatively, laboratory tests, including a complete blood cell count (CBC) with manual differential and an electrolyte panel with blood urea nitrogen (BUN) and serum creatinine level, are needed to assess for possible infection and kidney dysfunction. 747-50. The report states that lower urinary tract injuries may be detected by intravenous administration of 5 mL of indigo carmine, allowing the bladder to be filled with blue-dyed urine. Sandip P Vasavada, MD is a member of the following medical societies: American Urogynecologic Society, American Urological Association, Engineering and Urology Society, International Continence Society, Society of Urodynamics, Female Pelvic Medicine and Urogenital ReconstructionDisclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: Medtronic, Axonics, BlueWind
Received ownership interest from NDI Medical, LLC for review panel membership; Received consulting fee from allergan for speaking and teaching; Received consulting fee from medtronic for speaking and teaching; Received consulting fee from boston scientific for consulting. Urology. Philadelphia PA: Saunders; 2012. All material on this website is protected by copyright, Copyright © 1994-2021 by WebMD LLC. 1943. Surg Gynecol Obstet. Kim JH, Moore C, Jones JS, Rackley R, Daneshgari F, Goldman H, et al. 199 (6):1540-1545. Comparative Summary of Indications for Use, Dosing, and Pharmacokinetic Properties of Marker Dyes 4,9-13 2019 Aug. 221 (2):132.e1-132.e13. If one is unsure whether a ureteral injury has occurred intraoperatively, intravenous administration of 10 mL of indigo carmine or methylene blue with 20 mg of furosemide may help to localize a ureteral injury. 49(2):95-8. Delayed recognition of lower urinary tract injuries following hysterectomy for benign indications: A NSQIP-based study. 1980 Jun. [Medline]. USE IN SPECIFIC POPULATIONS Pregnancy and Lactation ProvayBlue ® may cause fetal harm when administered to a pregnant woman. Fluorescence Ureteral Visualization in Human Laparoscopic Colorectal Surgery Using Methylene Blue Mahdi Al-Taher 1 , Jacqueline van den Bos 1 , Rutger M Schols 1 … Barrett K, Ghiculete D, Sowerby RJ, Farcas M, Pace KT, Honey RJD. 178(5):967-70. The initial management of ureteral injuries: a report of 78 cases. Intraoperative Radiographic Determination of Ureteral Length as a Method of Determining Ideal Stent Length. 2014 Jul-Aug. 21(4):558-66. Koo HP, Bloom DA. [Medline]. 1135-73. Urol Clin North Am. 3 Indigo carmine is used during cystoscopy and ureteral catheterization as a marker dye. 2018 Sep. 29 (9):1397-1402. [Medline]. Mathews R, Marshall FF. A CT scan can also be used to assess for both function of the ipsilateral kidney and drainage of the ureter. 2013 Feb. 10(2):108-15. Bretschneider CE, Casas-Puig V, Sheyn D, Hijaz A, Ferrando CA. 2015 Nov-Dec. 21 (6):363-8. [Medline]. [Medline]. The use of a multimodal optical system that expands the surgeon’s light spectrum of view can improve surgical performance making structures clearly visible during laparoscopic and open surgery. Sandip P Vasavada, MD is a member of the following medical societies: American Urogynecologic Society, American Urological Association, Engineering and Urology Society, International Continence Society, Society of Urodynamics, Female Pelvic Medicine and Urogenital ReconstructionDisclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: Medtronic, Axonics, BlueWind
Received ownership interest from NDI Medical, LLC for review panel membership; Received consulting fee from allergan for speaking and teaching; Received consulting fee from medtronic for speaking and teaching; Received consulting fee from boston scientific for consulting. J Urol. Int Urogynecol J. 3rd ed. [Medline]. 8th ed. J Urol 2018; 199:1540. The diagnosis can be further aided by injecting dye (eg, indigo carmine, methylene blue) intravenously or intraureterally. Am J Obstet Gynecol. ureteral injury. Robotic management of genitourinary injuries from obstetric and gynaecological operations: a multi-institutional report of outcomes. 731-4. An illustration of the blood supply to the ureter running within the adventitial layer. [Medline]. J Urol. 440933-overview Sherman ND. 1994:254-9. Int Urogynecol J. [Medline]. In the event that a CT-guided aspiration of an abdominal or pelvic fluid collection has been performed or if pelvic drain output is high through a surgically placed drain, a creatinine measurement of the fluid may be helpful in distinguishing whether the fluid is urine (as would be indicated by an elevated creatinine level). Pain in extremity, chromaturia, dysgeusia, feeling hot, dizziness, hyperhidrosis, nausea, skin discoloration, headache.200 Large IV doses: Nausea,1 200 vomiting,9 200 abdominal pain,1 200 precordial pain,1 200 dizziness,1 200 headache,1 200 profuse sweating,1 dyspnea,9 200 hypertension,… Methylene blue has been safely given to patients for many years and it is fluorescent. Obstet Gynecol. 2017 Jan-Mar. Share cases and questions with Physicians on Medscape consult. 5. Ureteroureterostomy and Transureteroureterostomy. Transureteroureterostomy: 25-year experience with 100 patients. J Hum Reprod Sci. [Medline]. Minerva Urol Nefrol. [Medline]. 2nd ed. 199 (6):1540-1545. 2015 Oct 28. 1998 May. Methylene blue absorbance and fluorescence exhibited minimal changes over a wide pH range from 4 to 10 (data not shown). Lower ureteral reconstruction. 1135-73. As a medication, it is mainly used to treat methemoglobinemia. Extravasation is the inadvertent leakage of injection into the subcutaneous or perivascular tissues. Ureteral visualization is essential for both the prevention and diagnosis of iatrogenic or traumatic ureter injuries. Lower ureteral reconstruction. Ureteral Compromise in Laparoscopic Versus Vaginal Uterosacral Ligament Suspension: A Retrospective Cohort. Soong Y, Lim PH. If you log out, you will be required to enter your username and password the next time you visit. [Medline]. 2014 Aug. 134(2):238-42. Obstet Gynecol. Ureteral Injury During Gynecologic Surgery Q&A, Society of Urodynamics, Female Pelvic Medicine and Urogenital Reconstruction, American College of Obstetricians and Gynecologists, Royal College of Obstetricians and Gynaecologists, Association of Military Osteopathic Physicians and Surgeons. [Medline]. However, CT scanning has the advantage of imaging for concomitant conditions at the same time. Prevent Iatrogenic Ureteral Injury During Colorectal Surgery. Ureteric Injury During Transvaginal Oocyte Retrieval (TVOR) and Review of Literature. Am J Obstet Gynecol. Vol 13. If one is unsure whether a ureteral injury has occurred intraoperatively, intravenous administration of 10 mL of indigo carmine or methylene blue with 20 mg of furosemide … If the ureteral injury is noted intraoperatively, additional laboratory tests are rarely, if ever, needed. Transureteroureterostomy: 25-year experience with 100 patients. Saidi MH, Sadler RK, Vancaillie TG, et al. Extravasation of blue dye indicates ureteral discontinuity. Operative injuries to the ureter: prevention, recognition, and management. 1997 Jun. Alternatively, if the tampon absorbs a blue liquid, the diagnosis of vesicovaginal fistula can be made. Anger JT. Smith JA Jr, Howards SS, Preminger GM, Eds. [Medline]. Mariotti G, Natale F, Trucchi A, et al. 1980 Jun. J Laparoendosc Adv Surg Tech A 2016;26:870-5. Methylene blue stains to negatively charged cell components like nucleic acids; when administered in the lymphatic bed of a tumor during oncologic surgery, methylene blue may stain lymph nodes draining from the tumor, thereby aiding in the visual localization of tumor sentinel lymph nodes.
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