Medical - Clinical Research & Reviews


Characteristic of Ureteral Trauma in Tertiary Hospital from January 2005 until December 2016

Besut Daryanto, Thede Surya Putra, Paksi Satyagraha.

Introduction and Objective: Ureteral trauma is rare among urogenital trauma, about 1% of all urogenital trauma. This research is conducted to determine the characteristic and management of ureteral trauma in Saiful Anwar Malang Hospital as Tertiary Hospital.

Method: Twenty two data of ureteral trauma patients was collected retrospectively since January 2005 until December 2016. Data were then described by etiology, location, initial presentation and management.

Result: Mean age of the patient is 40 years old (SD ± 8.12), with 91% of the patient is female. The most common etiology of ureteral trauma was iatrogenic (82%) gynecologic surgery (82%). Other etiology was due to abdominal blunt trauma (14%) and abdominal penetrating trauma (4%). Right side of ureter was the most common location (50%), followed by left (28%) and both side (22%). Seventy-two percent of ureteral trauma are total trauma and consulted on going operation due to Iatrogenic (61%). Initial presentation of ureteral trauma was back pain (68%), anuria (18%), hematuria (9%), and  ureterocutaneous fistule (4%). End to end anastomotic of ureter with DJ stent insertion was the most common procedure (55%) with good result. No complication was noted post operatively.

Conclusion: Gynecologic iatrogenic operation was the most common etiology of ureteral trauma. Most of ureteral trauma are total rupture (grade 5), with distal part of ureter as the most common location. Ureteral repair and DJ stent insertion have good outcome to most patient.