Renal Autotransplantation for Complete Ureteral Avulsion Following Dilation and Curettage: A Rare Iatrogenic Complication
Nabil Abdullah Al-Mughalis,1 Abudar Al-Ganadi,2 Ismail Al-Shameri,2 Naseem Al-Wsabi,2 Salem Bashraheel,3 Wail Abdo Ghaleb,1 Mohammed Ali Saeed,1 Nada Alwsabi2 1Department of Urology and Kidney Transplantation Surgery, Cardiovascular and Kidney Transplantation Centre, Taiz, Yemen; 2Department of Card...
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| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Dove Medical Press
2025-07-01
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| Series: | Research and Reports in Urology |
| Subjects: | |
| Online Access: | https://www.dovepress.com/renal-autotransplantation-for-complete-ureteral-avulsion-following-dil-peer-reviewed-fulltext-article-RRU |
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| Summary: | Nabil Abdullah Al-Mughalis,1 Abudar Al-Ganadi,2 Ismail Al-Shameri,2 Naseem Al-Wsabi,2 Salem Bashraheel,3 Wail Abdo Ghaleb,1 Mohammed Ali Saeed,1 Nada Alwsabi2 1Department of Urology and Kidney Transplantation Surgery, Cardiovascular and Kidney Transplantation Centre, Taiz, Yemen; 2Department of Cardiovascular Surgery, Cardiovascular and Kidney Transplantation Centre, Taiz University Faculty of Medicine, Taiz, Yemen; 3Department of Anaesthesiology, Cardiovascular and Kidney Transplantation Centre, Faculty of Medicine, Taiz University, Taiz, YemenCorrespondence: Ismail Al-Shameri, Cardiovascular and Kidney Transplantation Centre, Faculty of Medicine, Taiz University, Taiz, Yemen, Tel +967-772228396, Email ismailsamer17@gmail.comBackground: Renal autotransplantation is a rare yet effective surgical strategy for managing complex ureteral injuries when conventional reconstructive options are not viable. We report an exceptional case of complete ureteral avulsion following a dilation and curettage (D&C) procedure, successfully treated with renal autotransplantation. This represents the first documented case of renal autotransplantation in Yemen, highlighting a successful organ-preserving approach in a resource-limited setting.Case Presentation: A 34-year-old female developed life-threatening complications following a D&C performed for retained products of conception. The procedure was complicated by uterine perforation and a complete avulsion of the left ureter, which was identified intraoperatively during emergent laparotomy. Initial management included pyelostomy, which failed, necessitating nephrostomy. Because to the absence of a viable ureteral stump, renal autotransplantation was performed. The kidney was reimplanted into the right iliac fossa, and urinary continuity was restored via a Boari flap. The patient had an uneventful postoperative course and demonstrated preserved renal function at two-month follow-up.Conclusion: Complete ureteral avulsion is an exceedingly rare complication of D&C, often linked with uterine perforation. In cases where standard ureteral reconstruction is not feasible, renal autotransplantation provides a definitive, nephron-sparing solution. Early identification and referral to experienced centers are essential to optimizing outcomes.Keywords: renal autotransplantation, ureteral avulsion, iatrogenic ureteral injury, dilation and curettage, Boari flap |
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| ISSN: | 2253-2447 |