Need for upper urinary tract stenting in cases of ureteral orifice injury during laser enucleation of the prostate

Dmitry Enikeev, Petr Glybochko, Leonid Rapoport, Olesya Snurnitsyna, Natalia Potoldykova, Tamara Novoselova, Ekaterina Laukhtina, Mark Taratkin, Vitaly Margulis

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Introduction: Benign prostatic hyperplasia (BPH) can be associated with marked intravesical protrusion, placing ureteral orifices at risk for injury during bladder outlet procedures. Aim: To determine whether ureteral stenting is necessary in cases of ureteral orifice injury during laser enucleation. Materials and methods: Retrospective study included 465 patients with bladder outlet obstruction (IPSS > 20, Qmax < 10) secondary to BPH who were managed with thulium fiber laser (ThuFLEP) or holmium laser enucleation of the prostate (HoLEP). In seven patients, the ureteral orifices were injured during surgery (3—HoLEP; 4—ThuFLEP). Three of the seven patients underwent intraoperative stenting of the upper urinary tract (1—HoLEP; 2—ThuFLEP). In four cases, stenting was not performed (2—HoLEP; 2—ThuFLEP). The follow-up period was 6 months. Results: Postoperatively, none of the patients with a stent in the upper urinary tract exhibited signs of pelvicalyceal system (PCS) dilatation or inhibited urine flow from the kidney (assessed with abdominal ultrasound at 1, 3, 10, and 30 days after surgery). In two patients without stents, follow-up revealed no dilatation of the PCS. The other two patients without stents developed asymptomatic dilatation of the PCS (the pelvis—up to 1.5 cm; the calyx—up to 0.5 cm). At 1 month after surgery, no patients had dilatation of the PCS. Conclusions: Upper urinary tract stenting in cases of intraoperative ureteral orifice injury during laser enucleation of the prostate for BPH may not be warranted.

Original languageEnglish (US)
JournalInternational Urology and Nephrology
DOIs
StateAccepted/In press - Jan 1 2018

Fingerprint

Urinary Tract
Prostate
Lasers
Wounds and Injuries
Dilatation
Prostatic Hyperplasia
Stents
Thulium
Urinary Bladder Neck Obstruction
Solid-State Lasers
Urinary Bladder
Retrospective Studies
Urine
Kidney

Keywords

  • Complications
  • Endoscopic enucleation of the prostate
  • HoLEP
  • Laser
  • Orifice
  • ThuFLEP

ASJC Scopus subject areas

  • Nephrology
  • Urology

Cite this

Need for upper urinary tract stenting in cases of ureteral orifice injury during laser enucleation of the prostate. / Enikeev, Dmitry; Glybochko, Petr; Rapoport, Leonid; Snurnitsyna, Olesya; Potoldykova, Natalia; Novoselova, Tamara; Laukhtina, Ekaterina; Taratkin, Mark; Margulis, Vitaly.

In: International Urology and Nephrology, 01.01.2018.

Research output: Contribution to journalArticle

Enikeev, Dmitry ; Glybochko, Petr ; Rapoport, Leonid ; Snurnitsyna, Olesya ; Potoldykova, Natalia ; Novoselova, Tamara ; Laukhtina, Ekaterina ; Taratkin, Mark ; Margulis, Vitaly. / Need for upper urinary tract stenting in cases of ureteral orifice injury during laser enucleation of the prostate. In: International Urology and Nephrology. 2018.
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abstract = "Introduction: Benign prostatic hyperplasia (BPH) can be associated with marked intravesical protrusion, placing ureteral orifices at risk for injury during bladder outlet procedures. Aim: To determine whether ureteral stenting is necessary in cases of ureteral orifice injury during laser enucleation. Materials and methods: Retrospective study included 465 patients with bladder outlet obstruction (IPSS > 20, Qmax < 10) secondary to BPH who were managed with thulium fiber laser (ThuFLEP) or holmium laser enucleation of the prostate (HoLEP). In seven patients, the ureteral orifices were injured during surgery (3—HoLEP; 4—ThuFLEP). Three of the seven patients underwent intraoperative stenting of the upper urinary tract (1—HoLEP; 2—ThuFLEP). In four cases, stenting was not performed (2—HoLEP; 2—ThuFLEP). The follow-up period was 6 months. Results: Postoperatively, none of the patients with a stent in the upper urinary tract exhibited signs of pelvicalyceal system (PCS) dilatation or inhibited urine flow from the kidney (assessed with abdominal ultrasound at 1, 3, 10, and 30 days after surgery). In two patients without stents, follow-up revealed no dilatation of the PCS. The other two patients without stents developed asymptomatic dilatation of the PCS (the pelvis—up to 1.5 cm; the calyx—up to 0.5 cm). At 1 month after surgery, no patients had dilatation of the PCS. Conclusions: Upper urinary tract stenting in cases of intraoperative ureteral orifice injury during laser enucleation of the prostate for BPH may not be warranted.",
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T1 - Need for upper urinary tract stenting in cases of ureteral orifice injury during laser enucleation of the prostate

AU - Enikeev, Dmitry

AU - Glybochko, Petr

AU - Rapoport, Leonid

AU - Snurnitsyna, Olesya

AU - Potoldykova, Natalia

AU - Novoselova, Tamara

AU - Laukhtina, Ekaterina

AU - Taratkin, Mark

AU - Margulis, Vitaly

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Introduction: Benign prostatic hyperplasia (BPH) can be associated with marked intravesical protrusion, placing ureteral orifices at risk for injury during bladder outlet procedures. Aim: To determine whether ureteral stenting is necessary in cases of ureteral orifice injury during laser enucleation. Materials and methods: Retrospective study included 465 patients with bladder outlet obstruction (IPSS > 20, Qmax < 10) secondary to BPH who were managed with thulium fiber laser (ThuFLEP) or holmium laser enucleation of the prostate (HoLEP). In seven patients, the ureteral orifices were injured during surgery (3—HoLEP; 4—ThuFLEP). Three of the seven patients underwent intraoperative stenting of the upper urinary tract (1—HoLEP; 2—ThuFLEP). In four cases, stenting was not performed (2—HoLEP; 2—ThuFLEP). The follow-up period was 6 months. Results: Postoperatively, none of the patients with a stent in the upper urinary tract exhibited signs of pelvicalyceal system (PCS) dilatation or inhibited urine flow from the kidney (assessed with abdominal ultrasound at 1, 3, 10, and 30 days after surgery). In two patients without stents, follow-up revealed no dilatation of the PCS. The other two patients without stents developed asymptomatic dilatation of the PCS (the pelvis—up to 1.5 cm; the calyx—up to 0.5 cm). At 1 month after surgery, no patients had dilatation of the PCS. Conclusions: Upper urinary tract stenting in cases of intraoperative ureteral orifice injury during laser enucleation of the prostate for BPH may not be warranted.

AB - Introduction: Benign prostatic hyperplasia (BPH) can be associated with marked intravesical protrusion, placing ureteral orifices at risk for injury during bladder outlet procedures. Aim: To determine whether ureteral stenting is necessary in cases of ureteral orifice injury during laser enucleation. Materials and methods: Retrospective study included 465 patients with bladder outlet obstruction (IPSS > 20, Qmax < 10) secondary to BPH who were managed with thulium fiber laser (ThuFLEP) or holmium laser enucleation of the prostate (HoLEP). In seven patients, the ureteral orifices were injured during surgery (3—HoLEP; 4—ThuFLEP). Three of the seven patients underwent intraoperative stenting of the upper urinary tract (1—HoLEP; 2—ThuFLEP). In four cases, stenting was not performed (2—HoLEP; 2—ThuFLEP). The follow-up period was 6 months. Results: Postoperatively, none of the patients with a stent in the upper urinary tract exhibited signs of pelvicalyceal system (PCS) dilatation or inhibited urine flow from the kidney (assessed with abdominal ultrasound at 1, 3, 10, and 30 days after surgery). In two patients without stents, follow-up revealed no dilatation of the PCS. The other two patients without stents developed asymptomatic dilatation of the PCS (the pelvis—up to 1.5 cm; the calyx—up to 0.5 cm). At 1 month after surgery, no patients had dilatation of the PCS. Conclusions: Upper urinary tract stenting in cases of intraoperative ureteral orifice injury during laser enucleation of the prostate for BPH may not be warranted.

KW - Complications

KW - Endoscopic enucleation of the prostate

KW - HoLEP

KW - Laser

KW - Orifice

KW - ThuFLEP

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U2 - 10.1007/s11255-018-2007-6

DO - 10.1007/s11255-018-2007-6

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