Fibrin sealant for the management of genitourinary injuries, fistulas and surgical complications.

Abstract

PURPOSE:

We report our preliminary experience with the use of fibrin sealant to manage iatrogenic urinary tract injuries, complex urinary fistulas, and urological surgical complications.

MATERIALS AND METHODS:

Topical fibrin sealant was used in 19 patients for iatrogenic urinary tract injury during gynecological or general surgical procedures (7), complex urinary fistulas (5) or urological surgical complications (7).

RESULTS:

Successful resolution of the injury, fistula or complication was attained after a single application of fibrin sealant in the 18 patients (94.7%) in whom a direct injection technique was used. The only failure (formation of a vesicovaginal fistula) occurred with the air driven sprayed sealant delivery technique after sutured closure of iatrogenic cystotomy during vaginal hysterectomy.

CONCLUSIONS:

Liquid fibrin sealant appears to be safe and prudent for use in urological "damage control" from trauma, fistulas or surgical complications. Direct injection over a sutured urinary anastomosis appears to be highly effective in preventing urinary drainage. Additional study is needed to define further the role and best use of tissue adhesives in urology.

• Authors: L Andrew Evans, Kenneth H Ferguson, John P Foley, Thomas A Rozanski, Allen F Morey
• Journal: The Journal of urology (J Urol) Vol. 169 Issue 4 Pg. 1360-2 (Apr 2003) ISSN: 0022-5347 [Print] United States
• PMID: 12629361 (Publication Type: Journal Article)

Chemical References

• Fibrin Tissue Adhesive

Topics

• Female
• Female Urogenital Diseases (diagnostic imaging, etiology, surgery)
• Fibrin Tissue Adhesive (administration & dosage)
• Fistula (diagnostic imaging, etiology, surgery)
• Humans
• Iatrogenic Disease
• Male
• Male Urogenital Diseases
• Postoperative Complications (diagnostic imaging, etiology, surgery)
• Reoperation
• Treatment Outcome
• Urogenital System (injuries, surgery)
• Urography