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J Urol. 2003 Apr;169(4):1360-2.

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

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  • 1Urology Service, Brooke Army Medical Center, Fort Sam Houston, Texas, USA.

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.

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PMID:
12629361
[PubMed - indexed for MEDLINE]
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