Ureteral Avulsion Associated with Ureteroscopy: Insights from the MAUDE Database

Ryuta Tanimoto, Ryan C. Cleary, Demetrius H. Bagley, Scott G. Hubosky

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background: Flexible and semirigid ureteroscopy (URS) are widely performed for the treatment of upper tract calculi and tumors. Ureteral avulsion is a rare, but devastating complication of endoscopic stone removal having multiple possible etiologies. Awareness and avoidance of this rare complication depend on identifying responsible mechanisms. This study examines the situations in which ureteral avulsion occurs as described anonymously in the Manufacturer and User facility Device Experience (MAUDE) database. Materials and Methods: The MAUDE database was systematically reviewed to account for all reported complications of flexible and semirigid URS. Keywords "ureteroscopy, injury, death, malfunction and other" were entered in the database and medical device reports were reviewed to capture any cases resulting in ureteral avulsion. Attention was paid to the type of ureteroscope involved and the mechanism for avulsion. Results: A total of 104 entries were found detailing the reported complications of flexible and semirigid URS. Ureteral avulsion was clearly noted in six reports with flexible (2) and semirigid ureteroscopes (4). Potential mechanisms included locked deflection of a flexible ureteroscope (1), bunching of the distal bending rubber in a flexible ureteroscope (1), scabbard avulsion (3), and stone basketing (1). Conclusions: Although the incidence of ureteral avulsion cannot truly be determined from this study, some potentially novel mechanisms for this rare complication are observed. This may target future educational efforts to maximize awareness and avoidance of this complication.

Original languageEnglish
Pages (from-to)257-261
Number of pages5
JournalJournal of Endourology
Volume30
Issue number3
DOIs
Publication statusPublished - Mar 1 2016
Externally publishedYes

Fingerprint

Ureteroscopes
Ureteroscopy
Databases
Equipment and Supplies
Rubber
Calculi
Incidence
Wounds and Injuries
Neoplasms

ASJC Scopus subject areas

  • Urology

Cite this

Ureteral Avulsion Associated with Ureteroscopy : Insights from the MAUDE Database. / Tanimoto, Ryuta; Cleary, Ryan C.; Bagley, Demetrius H.; Hubosky, Scott G.

In: Journal of Endourology, Vol. 30, No. 3, 01.03.2016, p. 257-261.

Research output: Contribution to journalArticle

Tanimoto, Ryuta ; Cleary, Ryan C. ; Bagley, Demetrius H. ; Hubosky, Scott G. / Ureteral Avulsion Associated with Ureteroscopy : Insights from the MAUDE Database. In: Journal of Endourology. 2016 ; Vol. 30, No. 3. pp. 257-261.
@article{ccf7f636ac7f40aeb34fe1bc58aa0467,
title = "Ureteral Avulsion Associated with Ureteroscopy: Insights from the MAUDE Database",
abstract = "Background: Flexible and semirigid ureteroscopy (URS) are widely performed for the treatment of upper tract calculi and tumors. Ureteral avulsion is a rare, but devastating complication of endoscopic stone removal having multiple possible etiologies. Awareness and avoidance of this rare complication depend on identifying responsible mechanisms. This study examines the situations in which ureteral avulsion occurs as described anonymously in the Manufacturer and User facility Device Experience (MAUDE) database. Materials and Methods: The MAUDE database was systematically reviewed to account for all reported complications of flexible and semirigid URS. Keywords {"}ureteroscopy, injury, death, malfunction and other{"} were entered in the database and medical device reports were reviewed to capture any cases resulting in ureteral avulsion. Attention was paid to the type of ureteroscope involved and the mechanism for avulsion. Results: A total of 104 entries were found detailing the reported complications of flexible and semirigid URS. Ureteral avulsion was clearly noted in six reports with flexible (2) and semirigid ureteroscopes (4). Potential mechanisms included locked deflection of a flexible ureteroscope (1), bunching of the distal bending rubber in a flexible ureteroscope (1), scabbard avulsion (3), and stone basketing (1). Conclusions: Although the incidence of ureteral avulsion cannot truly be determined from this study, some potentially novel mechanisms for this rare complication are observed. This may target future educational efforts to maximize awareness and avoidance of this complication.",
author = "Ryuta Tanimoto and Cleary, {Ryan C.} and Bagley, {Demetrius H.} and Hubosky, {Scott G.}",
year = "2016",
month = "3",
day = "1",
doi = "10.1089/end.2015.0242",
language = "English",
volume = "30",
pages = "257--261",
journal = "Journal of Endourology",
issn = "0892-7790",
publisher = "Mary Ann Liebert Inc.",
number = "3",

}

TY - JOUR

T1 - Ureteral Avulsion Associated with Ureteroscopy

T2 - Insights from the MAUDE Database

AU - Tanimoto, Ryuta

AU - Cleary, Ryan C.

AU - Bagley, Demetrius H.

AU - Hubosky, Scott G.

PY - 2016/3/1

Y1 - 2016/3/1

N2 - Background: Flexible and semirigid ureteroscopy (URS) are widely performed for the treatment of upper tract calculi and tumors. Ureteral avulsion is a rare, but devastating complication of endoscopic stone removal having multiple possible etiologies. Awareness and avoidance of this rare complication depend on identifying responsible mechanisms. This study examines the situations in which ureteral avulsion occurs as described anonymously in the Manufacturer and User facility Device Experience (MAUDE) database. Materials and Methods: The MAUDE database was systematically reviewed to account for all reported complications of flexible and semirigid URS. Keywords "ureteroscopy, injury, death, malfunction and other" were entered in the database and medical device reports were reviewed to capture any cases resulting in ureteral avulsion. Attention was paid to the type of ureteroscope involved and the mechanism for avulsion. Results: A total of 104 entries were found detailing the reported complications of flexible and semirigid URS. Ureteral avulsion was clearly noted in six reports with flexible (2) and semirigid ureteroscopes (4). Potential mechanisms included locked deflection of a flexible ureteroscope (1), bunching of the distal bending rubber in a flexible ureteroscope (1), scabbard avulsion (3), and stone basketing (1). Conclusions: Although the incidence of ureteral avulsion cannot truly be determined from this study, some potentially novel mechanisms for this rare complication are observed. This may target future educational efforts to maximize awareness and avoidance of this complication.

AB - Background: Flexible and semirigid ureteroscopy (URS) are widely performed for the treatment of upper tract calculi and tumors. Ureteral avulsion is a rare, but devastating complication of endoscopic stone removal having multiple possible etiologies. Awareness and avoidance of this rare complication depend on identifying responsible mechanisms. This study examines the situations in which ureteral avulsion occurs as described anonymously in the Manufacturer and User facility Device Experience (MAUDE) database. Materials and Methods: The MAUDE database was systematically reviewed to account for all reported complications of flexible and semirigid URS. Keywords "ureteroscopy, injury, death, malfunction and other" were entered in the database and medical device reports were reviewed to capture any cases resulting in ureteral avulsion. Attention was paid to the type of ureteroscope involved and the mechanism for avulsion. Results: A total of 104 entries were found detailing the reported complications of flexible and semirigid URS. Ureteral avulsion was clearly noted in six reports with flexible (2) and semirigid ureteroscopes (4). Potential mechanisms included locked deflection of a flexible ureteroscope (1), bunching of the distal bending rubber in a flexible ureteroscope (1), scabbard avulsion (3), and stone basketing (1). Conclusions: Although the incidence of ureteral avulsion cannot truly be determined from this study, some potentially novel mechanisms for this rare complication are observed. This may target future educational efforts to maximize awareness and avoidance of this complication.

UR - http://www.scopus.com/inward/record.url?scp=84960844036&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84960844036&partnerID=8YFLogxK

U2 - 10.1089/end.2015.0242

DO - 10.1089/end.2015.0242

M3 - Article

C2 - 26507706

AN - SCOPUS:84960844036

VL - 30

SP - 257

EP - 261

JO - Journal of Endourology

JF - Journal of Endourology

SN - 0892-7790

IS - 3

ER -