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International Urology and Nephrology

, Volume 50, Issue 12, pp 2173–2177 | Cite as

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
Urology - Original Paper
  • 34 Downloads

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.

Keywords

Laser Endoscopic enucleation of the prostate Complications HoLEP ThuFLEP Orifice 

Notes

Acknowledgements

All authors state that they have no commercial interests in this paper.

Compliance with ethical standards

Conflict of interest

All authors state that they have no disclosure that might potentially bias this work.

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Copyright information

© Springer Nature B.V. 2018

Authors and Affiliations

  • Dmitry Enikeev
    • 1
  • Petr Glybochko
    • 1
  • Leonid Rapoport
    • 1
  • Olesya Snurnitsyna
    • 1
  • Natalia Potoldykova
    • 1
  • Tamara Novoselova
    • 2
  • Ekaterina Laukhtina
    • 1
  • Mark Taratkin
    • 1
  • Vitaly Margulis
    • 3
  1. 1.Research Institute for Uronephrology and Reproductive HealthSechenov UniversityMoscowRussia
  2. 2.Department of Medical StatisticSechenov UniversityMoscowRussia
  3. 3.Department of UrologyUT Southwestern Medical CenterDallasUSA

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