Bowel perforation during percutaneous urological procedures

Panagiotis Mourmouris, M. Mperdempes, G. Daglas, Andreas Skolarikos


Iatrogenic bowel injury during percutaneous urological procedures is a rare complication but if it occurs it increases significantly the morbidity and the mortality of the procedure. The purpose of this paper is to highlight the technical details and anatomical features that may increase the risk for bowel injury and propose possible management in the case of occurrence.


percutaneous surgery; bowel; injury

Full Text:



Sheriff MK, Foley S, McFarlane J, Nauth-Misir R, Craggs M, Shah PJ. Long-term suprapubic catheterisation: Clinical outcome and satisfaction survey. Spinal cord 1998; 36(3): 171-176.

Ahluwalia RS, Johal N, Kouriefs C, Kooiman G, Montgomery BS, Plail RO. The surgical risk of suprapubic catheter insertion and long-term sequelae. Annals of the Royal College of Surgeons of England 2006; 88(2): 210-213.

Witham MD, Martindale AD. Occult transfixation of the sigmoid colon by suprapubic catheter. Age and ageing 2002; 31(5): 407-408.

Wu CC, Su CT, Lin AC. Terminal ileum perforation from a misplaced percutaneous suprapubic cystostomy. European journal of emergency medicine, official journal of the European Society for Emergency Medicine 2007;14(2): 92-93.

Mongiu AK, Helfand BT, Kielb SJ. Small bowel perforation during suprapubic tube exchange. The Canadian journal of urology 2009;16(1): 4519-4521.

Cho KH, Doo SW, Yang WJ, Song YS, Lee KH. Suprapubic cystostomy: risk analysis of possible bowel interposition through the percutaneous tract by computed tomography. Korean journal of urology 2010; 51(10): 709-712.

Chitale S, Irving S. Plausible mechanism of small bowel injury during trocar cystostomy. BMJ 2010.

Cronin CG, Prakash P, Gervais DA, et al. Imaging-guided suprapubic bladder tube insertion: experience in the care of 549 patients. AJR American journal of roentgenology 2011; 196(1): 182-188.

Aguilera PA, Choi T, Durham BA. Ultrasound-guided suprapubic cystostomy catheter placement in the emergency department. The Journal of emergency medicine 2004; 26(3): 319-321.

Lee MJ, Papanicolaou N, Nocks BN, Valdez JA, Yoder IC. Fluoroscopically guided percutaneous suprapubic cystostomy for long-term bladder drainage: An alternative to surgical cystostomy. Radiology 1993; 188(3): 787-789.

Traxer O. Management of injury to the bowel during percutaneous stone removal. Journal of endourology / Endourological Society 2009;23(10): 1777-1780.

Hadar H, Gadoth N. Positional relations of colon and kidney determined by perirenal fat. AJR American journal of roentgenology 1984;143(4): 773-776.

Sherman JL, Hopper KD, Greene AJ, Johns TT. The retrorenal colon on computed tomography: A normal variant. Journal of computer assisted tomography 1985; 9(2): 339-341.

Hopper KD, Sherman JL, Luethke JM, Ghaed N. The retrorenal colon in the supine and prone patient. Radiology 1987;162(2): 443-446.

Duvdevani M, Razvi H, Sofer M, et al. Third prize: Contemporary percutaneous nephrolithotripsy: 1585 procedures in 1338 consecutive patients. Journal of endourology / Endourological Society 2007;21(8): 824-829.

Matlaga BR, Shah OD, Zagoria RJ, Dyer RB, Streem SB, Assimos DG. Computerized tomography guided access for percutaneous nephrostolithotomy. The Journal of urology 2003; 170(1): 45-47.

Skolarikos A, de la Rosette J. Prevention and treatment of complications following percutaneous nephrolithotomy. Current opinion in urology 2008;18(2): 229-234.

Gerspach JM, Bellman GC, Stoller ML, Fugelso P. Conservative management of colon injury following percutaneous renal surgery. Urology 1997; 49(6): 831-836.

Culkin DJ, Wheeler JS, Jr., Canning JR. Nephro-duodenal fistula: A complication of percutaneous nephrolithotomy. The Journal of urology 1985; 134(3): 528-530.