Laparoscopic management of ureteric obstruction after uterosacral vaginal vault suspension.
The uterosacral ligaments commonly are used to correct pelvic organ prolapse. For experienced surgeons, the rate of ureteral injury with uterosacral vaginal vault suspensions is 2%-4%. Exploratory laparotomy and ureterolysis has been used to treat iatrogenic ureteral injury. A 64-year-old woman with stage III pelvic organ prolapse underwent surgical correction with an uterosacral vaginal vault suspension. On postoperative day 1, the patient was diagnosed with partial ureteral obstruction. She underwent laparoscopic ureterolysis and stent placement. A follow-up intravenous pyelogram showed no evidence of damage or obstruction. With proper patient selection, ureteral obstruction after vault suspension procedures can be managed with laparoscopic ureterolysis, avoiding the morbidity associated with laparotomy.
Stepp
Kevin J
KJ
Department of Obstetrics and Gynecology, The Cleveland Clinic, Cleveland, Ohio 44195, USA.
Paraiso
Marie F R
MF
D000290:Adnexa Uteri / Q000601:surgery; D005260:Female; D013509:Gynecologic Surgical Procedures; D006801:Humans; D010535:Laparoscopy; D008875:Middle Aged; D011183:Postoperative Complications / Q000601:surgery*; D015607:Stents; D014517:Ureteral Obstruction / Q000209:etiology* / Q000601:surgery*; D014596:Uterine Prolapse / Q000601:surgery*