How can we predict ureteral obstruction after gynecological surgery? The changes in Doppler resistive index and plasma creatinine and magnesium concentrations after surgical, unilateral ureteral obstruction in a rabbit model

• Published in: International journal of gynecological cancer Vol. 16; no. 1; pp. 376 - 379
• Main Authors: Terek, M C, Tamsel, S, Aygul, S, Akman, L, Irer, S V, Itil, I M, Alper, G
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group LTD 01.01.2006
• Subjects: Analysis of Variance; Animals; Biomarkers - analysis; Creatinine; Creatinine - blood; Disease Models, Animal; Female; Gynecologic Surgical Procedures - adverse effects; Gynecologic Surgical Procedures - methods; Kidney - diagnostic imaging; Kidney Function Tests; Magnesium - blood; Plasma; Predictive Value of Tests; Probability; Rabbits; Random Allocation; Reference Values; Renal Circulation; Sensitivity and Specificity; Surgery; Ultrasonography, Doppler; Ureteral Obstruction - blood; Ureteral Obstruction - diagnostic imaging; Vascular Resistance
• ISSN: 1048-891X; 1525-1438
• DOI: 10.1136/ijgc-00009577-200601000-00060

The aim of this study is to evaluate the changes in Doppler resistive index (RI) and plasma creatinine and magnesium concentrations after unilateral ureteral obstruction in a rabbit model. Fourteen adult female rabbits were used in this study. In seven rabbits, the left ureter was ligated with silk suture, and the control group was sham operated. Before surgery and on the second and seventh days after surgery, blood samples were obtained to measure plasma creatinine and magnesium concentrations. Doppler RIs of both kidneys were also measured before surgery and on the second and seventh days after the surgical procedure. With regard to magnesium levels, there was a significant within-subjects sessions difference [F(2, 20) = 15.21, P= 0.001] indicating a decrease through sessions. Magnesium concentrations decreased significantly at the postoperative second and seventh days compared to preoperative baseline levels (P= 0.003 and P= 0.001, respectively). Multifactorial analysis of variance was applied for each session separately with laterality, and groups as factors. The Doppler RI and the creatinine level did not show any significant differences or interactions for all sessions (P > 0.05). The decreasing plasma magnesium concentration after surgery may indicate ureteral injury; however, Doppler studies and creatinine levels may not be useful as well.