The diagnosis and management of ureteric injury after laparoscopy

Abstract

Please cite this article as: Wijaya T, Lo TS, Jaili SB, Wu PY, The diagnosis and management on ureteric injury after laparoscopy, Gynecology and Minimally Invasive Therapy (2015), AbstractThe number of ureteric injury case has increased in gynecological surgery. We reviewed the literature concerning the incidence of ureteric injury, the recognition and management of the ureteric injury with the controversy of delayed management of ureteric injury. Gynecologists should be aware and becomes familiar with the pelvic wall anatomy, the location where is the most susceptible to injury and the knowledge of the prevention and management of ureteric injury in order to reduce the morbidity of the ureteric injury.

Post Abdominal Hysterectomy Ureterovaginal Fistula

“…1,3 When identiÞ ed intraoperatively immediate repair is favored to avoid the postoperative morbidity, prolonged hospital stay, and inconvenience of a second operation. 4 In delayed identiÞ cation of ureteric injury, patient may present with ß ank pain, fever or Þ stula. Various investigations like methylene blue dye test, USG abdomen, intravenous urography and CT urography can be done to localize the site of injury and to conÞ rm the diagnosis.…”

“…1 Treatment for UVF depends on site, size, its etiology, and associated injuries, previously treatment was preferred after 3-6 month of injury to allow healing of injury and Þ stulas to become smaller before attempting a repair. 4 Now early intervention is preferred to minimize morbidity, discomfort, and cost. 1 The management of ureterovaginal Þ stula are aimed for the conservation of renal function and restoration of ureteral integrity by ureteroneocystostomy or end to end anastomosis.…”

“…And in cases of partial ureteric injury DJ stenting can be done and removed after 6-12 weeks. 4,5 CONCLUSION Iatrogenic ureteric injury is an uncommon, yet serious complication of obstetric and gynecologic surgery that deteriorates women's quality of life. Therefore a good knowledge of pelvic anatomy, good surgical skills, anticipation and intraoperative vigilance during pelvic surgery helps to avoid ureteric injury.…”

“…3 Around 30-45% of ureteric injury are identiÞ ed and managed intraoperatively while rest are missed and are diagnosed post operatively. 4 It takes around 1-4 weeks for UVF to appear after ureteric injury and patients present with continuous leaking of urine coupled with normal voiding of urine. 3…”

Transient elevations of liver enzymes and ovarian vein thrombosis arising after total laparoscopic hysterectomy

“…There are some complications related to the uterine fibroid in laparoscopic surgery. 1 2 3 4 5 Ovarian vein thrombosis is a rare entity and most cases are associated with pregnancy and the estimated incidence ranges between 0.05 and 0.18% of pregnancies. 80–90% of cases occur several days after delivery.…”