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Intra operative lesion of the pelvic ureter solved in a minimally invasive manner.

Stoica RA, Enache T, Iordache N - J Med Life (2014)

Bottom Line: The rate of recognition of an intra operative ureter lesion is 30% and it could rise up to 90% when cystoscopy with ureteroscopy is used at the end of the intervention.The article presents the case of a 46-year-old patient with uterine fibromatosis, whose pelvic ureter was sectioned during surgery.The lesion was recognised during surgery because, at the end of each intervention, the diuresis was stimulated by injecting Furosemide in order to detect the lesions of the ureters and urinary bladder.

View Article: PubMed Central - PubMed

Affiliation: "Sf. Ioan" Clinical Emergency Hospital, General Surgery Department.

ABSTRACT
Ureteral lesions during open hysterectomy, vaginal hysterectomy or laparoscopic hysterectomy have a rate of 0.2% up to 6%. Multiple complications may occur if the lesion is not recognised intra operatively: hydronephrosis, anuria (bilateral lesion), ureterovaginal fistula, ileus, peritonitis. The rate of recognition of an intra operative ureter lesion is 30% and it could rise up to 90% when cystoscopy with ureteroscopy is used at the end of the intervention. The article presents the case of a 46-year-old patient with uterine fibromatosis, whose pelvic ureter was sectioned during surgery. The lesion was recognised during surgery because, at the end of each intervention, the diuresis was stimulated by injecting Furosemide in order to detect the lesions of the ureters and urinary bladder.

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LigaSure was used to seal the blood vessels but it did not also seal the ureter
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Figure 4: LigaSure was used to seal the blood vessels but it did not also seal the ureter

Mentions: After the dissection of urinary bladder from the cervical myoma and the mobilization of the fibroid (Fig. 1), while approaching the left uterine artery (Fig. 2), because of the lateral growth of the myoma, which had an intimate contact with the ureter, the ureter was mistaken for the uterine artery (Fig. 3). The lesion made from the beginning was not realised, even if the LigaSure was used to seal the blood vessels, it did not also seal the ureter (Fig. 4).


Intra operative lesion of the pelvic ureter solved in a minimally invasive manner.

Stoica RA, Enache T, Iordache N - J Med Life (2014)

LigaSure was used to seal the blood vessels but it did not also seal the ureter
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4233447&req=5

Figure 4: LigaSure was used to seal the blood vessels but it did not also seal the ureter
Mentions: After the dissection of urinary bladder from the cervical myoma and the mobilization of the fibroid (Fig. 1), while approaching the left uterine artery (Fig. 2), because of the lateral growth of the myoma, which had an intimate contact with the ureter, the ureter was mistaken for the uterine artery (Fig. 3). The lesion made from the beginning was not realised, even if the LigaSure was used to seal the blood vessels, it did not also seal the ureter (Fig. 4).

Bottom Line: The rate of recognition of an intra operative ureter lesion is 30% and it could rise up to 90% when cystoscopy with ureteroscopy is used at the end of the intervention.The article presents the case of a 46-year-old patient with uterine fibromatosis, whose pelvic ureter was sectioned during surgery.The lesion was recognised during surgery because, at the end of each intervention, the diuresis was stimulated by injecting Furosemide in order to detect the lesions of the ureters and urinary bladder.

View Article: PubMed Central - PubMed

Affiliation: "Sf. Ioan" Clinical Emergency Hospital, General Surgery Department.

ABSTRACT
Ureteral lesions during open hysterectomy, vaginal hysterectomy or laparoscopic hysterectomy have a rate of 0.2% up to 6%. Multiple complications may occur if the lesion is not recognised intra operatively: hydronephrosis, anuria (bilateral lesion), ureterovaginal fistula, ileus, peritonitis. The rate of recognition of an intra operative ureter lesion is 30% and it could rise up to 90% when cystoscopy with ureteroscopy is used at the end of the intervention. The article presents the case of a 46-year-old patient with uterine fibromatosis, whose pelvic ureter was sectioned during surgery. The lesion was recognised during surgery because, at the end of each intervention, the diuresis was stimulated by injecting Furosemide in order to detect the lesions of the ureters and urinary bladder.

Show MeSH
Related in: MedlinePlus