Natural History of Ureteral Injury in an In-Vivo Porcine Model Presentation - Sohrab N. Ali
May 22, 2023
Sohrab Ali presented findings on urothelial injuries during the passage of a ureteral access sheath. 23% of patients sustain a urothelial injury during passage of a ureteral access sheath. During the ureteral sizing study, 20 female pigs underwent sequential passage of urethral dilators. Despite adhering to forces of less than six Newtons, known to be the safe limit for access sheath passage, 13 ureters sustained PULS Grades 3 and 4 injuries. None of the animals were stented, and a ureteroscopy was performed in one week. Among 13 ureters, there were three strictures. The study concluded that in the absence of stent placement, PULS Grade 3 or 4 lesions heal visually at one week in the porcine ureter.
Biography:
Sohrab N. Ali, MD, MSc, FRCSC, Department of Urology, University of California, Irvine, CA
Sohrab N. Ali, MD, MSc, FRCSC, Department of Urology, University of California, Irvine, CA
Read the Full Video Transcript
Sohrab N. Ali: Dear viewers, up to 23% of patients sustain a urothelial injury during passage of a ureteral access sheath. Placement of a urethral stent is generally recommended. However, the natural history of these lesions are unrecognized as unknown. During the ureteral sizing study, 20 female pigs underwent sequential passage of urethral dilators. Despite adhering to forces of less than six Newtons, known to be the safe limit for access sheath passage, 13 ureters sustained PULS Grades 3 and 4 injuries. None of the animals were stented and ureteroscopy was performed in one week. Among 13 ureters, there were three strictures. The location of the injury and the number of dilator passages did not correlate with stricture formation. In conclusion, in the absence of stent placement, PULS Grade 3 or 4 lesions heal visually at one week in the porcine ureter. Thank you.
Sohrab N. Ali: Dear viewers, up to 23% of patients sustain a urothelial injury during passage of a ureteral access sheath. Placement of a urethral stent is generally recommended. However, the natural history of these lesions are unrecognized as unknown. During the ureteral sizing study, 20 female pigs underwent sequential passage of urethral dilators. Despite adhering to forces of less than six Newtons, known to be the safe limit for access sheath passage, 13 ureters sustained PULS Grades 3 and 4 injuries. None of the animals were stented and ureteroscopy was performed in one week. Among 13 ureters, there were three strictures. The location of the injury and the number of dilator passages did not correlate with stricture formation. In conclusion, in the absence of stent placement, PULS Grade 3 or 4 lesions heal visually at one week in the porcine ureter. Thank you.