title: Ureteral injury during gynecological laparoscopic surgeries: report of twelve cases.
abstract: OBJECTIVE
  To investigate ureteral injury during gynecological laparoscopic surgeries.
  
  
  METHODS
  From January 1990 to December 2005, 12 868 gynecological laparoscopic surgeries were conducted in Peking Union Medical College Hospital with 12 ureteral injuries reported. The present study investigated several aspects, including surgical indications, uterine size, pelvic adhesion, operative procedures, symptoms, diagnostic time and methods, injury site and type, subsequent treatment, and prognosis.
  
  
  RESULTS
  The incidence of ureteral injury was 0.093% (12/12 868) in all cases, 0.42% (11/2 586) in laparoscopic hysterectomy [laparoscopically assisted vaginal hysterectomy (LAVH) or total laparoscopic hysterectomy (TLH)], and 0.01% (1/10 282) in non-LAVH surgeries. Enlarged uterus, pelvic adhesion, and endometrosis were risk factors associated with ureteral injury. Only one injury was found intraoperatively while others were found postoperatively. The injury sites were at the pelvic brim (2 cases) or the lower part of ureter (10 cases). Patients were treated with ureteral stenting (effective in 2 cases) or laparotomy and open repair. Prognoses were favorable in most cases.
  
  
  CONCLUSIONS
  Most laparoscopic ureteral injuries occur during laparoscopic hysterectomy. Further evaluation is required when ureteral injury is suspected, and surgical repair is the major treatment for ureteral injury.
authors: Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730.
authors: Jin-Song
authors: JS
authors: Gao
authors: Jin-Hua
authors: JH
authors: Leng
authors: Zhu-Feng
authors: ZF
authors: Liu
authors: Keng
authors: K
authors: Shen
authors: Jing-He
authors: JH
authors: Lang
mesh_terms: D005260:Female; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects*; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects; D010535:Laparoscopy / Q000009:adverse effects*; D010052:Ovariectomy / Q000009:adverse effects; D012189:Retrospective Studies; D000267:Tissue Adhesions / Q000628:therapy; D016896:Treatment Outcome; D014513:Ureter / Q000293:injuries*