Urologic Procedures in Patients with Cirrhosis

  • Peter A. Caputo
  • Jihad H. Kaouk


Surgery has recently become more commonplace in patients with liver cirrhosis. There is a marked increase in surgical morbidity and mortality in patients with liver cirrhosis undergoing all types of surgery. Here we will address some of the specific considerations to be undertaken during urologic surgical procedures.


Urology Surgery Cirrhosis Liver failure 


  1. 1.
    Friedman LS. Surgery in the patient with liver disease. Trans Am Clin Climatol Assoc. 2010; 121:192–204; discussion 205.Google Scholar
  2. 2.
    O’Leary JG, Friedman LS. Predicting surgical risk in patients with cirrhosis: from art to science. Gastroenterology. 2007;132(4):1609–11.CrossRefPubMedGoogle Scholar
  3. 3.
    Moll R, von Ludinghausen MH, Lackner K, Landwehr P. Collateral pathways in portal hypertension. Surg Radiol Anat. 1990;12(2):127–33.CrossRefPubMedGoogle Scholar
  4. 4.
    Widrich WC, Srinivasan M, Semine MC, Robbins AH. Collateral pathways of the left gastric vein in portal hypertension. AJR Am J Roentgenol. 1984;142(2):375–82.CrossRefPubMedGoogle Scholar
  5. 5.
    Pattaras JG, Ogan K, Martinez E, Nieh P. Endourological management of urolithiasis in hepatically compromised patients. J Urol. 2008;179(3):976–80.CrossRefPubMedGoogle Scholar
  6. 6.
    Margreiter M, Heinisch BB, Schwarzer R, Klatte T, Shariat SF, Ferlitsch A. Lower urinary tract symptoms in patients with liver cirrhosis. World J Urol. 2015;33(3):315–21.CrossRefPubMedGoogle Scholar
  7. 7.
    Nielsen SS, Thulstrup AM, Lund L, Vilstrup H, Sorensen HT. Postoperative mortality in patients with liver cirrhosis undergoing transurethral resection of the prostate: a Danish nationwide cohort study. BJU Int. 2001;87(3):183–6.CrossRefPubMedGoogle Scholar
  8. 8.
    Johnston 3rd WK, Montgomery JS, Wolf Jr JS. Retroperitoneoscopic radical and partial nephrectomy in the patient with cirrhosis. J Urol. 2005;173(4):1094–7.CrossRefPubMedGoogle Scholar
  9. 9.
    Hayn MH, Averch TD, Jackman SV. Transperitoneal laparoscopic radical and partial nephrectomy in patients with cirrhosis: report of three cases. Can J Urol. 2009;16(4):4770–3.PubMedGoogle Scholar
  10. 10.
    Sorensen HT, Friis S, Olsen JH, Thulstrup AM, Mellemkjaer L, Linet M, et al. Risk of liver and other types of cancer in patients with cirrhosis: a nationwide cohort study in Denmark. Hepatology. 1998;28(4):921–5.CrossRefPubMedGoogle Scholar
  11. 11.
    Chavez DR, Snyder PM, Juravsky LI, Heaney JA. Recurrent ileal conduit hemorrhage in an elderly cirrhotic man. J Urol. 1994;152(3):951–3.PubMedGoogle Scholar
  12. 12.
    Carrafiello G, Lagana D, Giorgianni A, Lumia D, Mangini M, Paragone E, et al. Bleeding from peristomal varices in a cirrhotic patient with ileal conduit: treatment with transjugular intrahepatic portocaval shunt (TIPS). Emerg Radiol. 2007;13(6):341–3.CrossRefPubMedGoogle Scholar
  13. 13.
    Cobb WS, Heniford BT, Burns JM, Carbonell AM, Matthews BD, Kercher KW. Cirrhosis is not a contraindication to laparoscopic surgery. Surg Endosc. 2005;19(3):418–23.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  • Peter A. Caputo
    • 1
  • Jihad H. Kaouk
    • 1
  1. 1.Center for Robotic and Advanced Laparoscopic SurgeryGlickman Urologic Institute, Cleveland ClinicClevelandUSA

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