title: Hutch paraureteral diverticulum complicating radical hysterectomy.
abstract: BACKGROUND
  Paraureteral diverticula are abnormalities of the urinary bladder which are more common in males, and thus are infrequently encountered in the patient population of the gynecologic oncologist.
  
  
  METHODS
  A 59 year old white female, with a history of recurrent bladder cancer treated by transurethral resection, presented with an abnormal cervical cone biopsy revealing invasive squamous cell carcinoma of the uterine cervix". The patient had a known Hutch paraureteral diverticulum for which she was receiving prophylactic cyprofloxacin. Computed tomography revealed an 8.5 x 8 x 7 cm paraureteral diverticulum on the right. There was no hydronephrosis of either renal pelvis. Laparotomy revealed a mass, resembling a second urinary bladder, which was very closely associated with the bladder and lateral proximal vagina on the right. Since a urological consultant advised that the diverticulum should not be resected, dissection around the bladder and vagina for the radical hysterectomy was made much more difficult.
  
  
  CONCLUSIONS
  The presence of a paraureteral diverticulum increases the difficulty of performing a radical hysterectomy.
authors.affiliation: Department of Obstetrics and Gynecology, St. Vincent Hospital and Health Care Center, Indianapolis, Indiana, USA.
authors.forename: J P
authors.initials: JP
authors.lastname: Geisler
authors.forename: J F
authors.initials: JF
authors.lastname: Dupler
authors.forename: O M
authors.initials: OM
authors.lastname: Soriero
authors.forename: H E
authors.initials: HE
authors.lastname: Geisler
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D004240:Diverticulum / Q000209:etiology*; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects*; D008875:Middle Aged; D014515:Ureteral Diseases / Q000209:etiology*; D002583:Uterine Cervical Neoplasms / Q000601:surgery*