Table 2. Summary of studies reporting rates of ureteral stenting for urinary extravasation after HGRT.
| Author year | Trauma mechanism | No. urinary extravasation | No. stented (%) | Comment |
|---|---|---|---|---|
| Keihani et al. 2018 | B & P | 72 | 17 (24%) | Multi-institutional data from the Genito-Urinary Trauma Study Group; only patients with CT scans available for review were included in the analysis |
| Winters et al. 2016 | B & P | 95 | 27 (28%) | Routine follow-up CT scan at 48 h and prophylactic stenting if persistent or worsening leak. Grade V injuries were excluded |
| Shaaban et al. 2016 | B & P | 16 | 1 (6%) | |
| May et al. 2016 | B | 3 | 1 (33%) | |
| Lanchon et al. 2016 | B | 96 | 29 (30%) | Retrograde ureteral stent placement was performed secondarily in patients with symptomatic ureteral clot obstruction or significant urine leakage on subsequent CT |
| Baghdanian et al. 2016 | B | 22 | 11 (50%) | High rates of delayed diagnosis and intervention for urinary extravasation (50% missed at the initial imaging) |
| Parkash et al. 2015 | B | 15 | 9 (60%) | Treatment protocol of strict bed rest until resolution of gross hematuria, prophylactic antibiotics, and close monitoring; all patients underwent follow-up CT scan after 48 h. Grade V injuries excluded |
| Fischer et al. 2015 | B & P | 26 | 12 (46%) | About half of the patients did not undergo excretory phase imaging; number of urinary extravasation may be underestimated |
| Van der Wilden et al. 2013 | B | 60 | 24 (40%) | Multi-institutional data; about half the stentings were performed for delayed complications |
| Hardee et al. 2013 | B & P | 21 | 9 (43%) | Includes three ureteral injuries; delayed urinary extravasation identified in 7 patients without initial excretory phase imaging |
| Smith et al. 2010 | B | 81 | 16 (20%) | |
| Malcolm et al. 2008 | B | 7 | 3 (42%) | 3 delayed stenting for persistent urinary extravasation; one patients upgraded to grade IV after follow-up imaging |
| Alsikafi et al. 2006 | B & P | 34 | 3 (9%) | Non-operative management included bed rest until resolution of gross hematuria, broad spectrum antibiotics; routine follow-up CT scan at 3–7 days after injury; patients with persistent urinary extravasation received stents |
| Moudouni et al. 2001 | B | 20 | 5 (25%) | Management included bed rest until resolution of gross hematuria, broad spectrum antibiotics, and close monitoring |
| Haas et al. 1998 | B | 31 | 5 (16%) | Management included bed rest until resolution of gross hematuria, broad spectrum antibiotics, and close follow-up with appropriate radiographic studies |
| Total (95% CI) | NA | NA | 28% (21–36%) |
HGRT, high-grade renal trauma; B, blunt injury; P, penetrating injury.