The management of bilateral ureteric injury following radical hysterectomy.
Iatrogenic ureteric injury is a well-recognised complication of radical hysterectomy. Bilateral ureteric injuries are rare, but do pose a considerable reconstructive challenge. We searched a prospectively acquired departmental database of ureteric injuries to identify patients with bilateral ureteric injury following radical hysterectomy. Five patients suffered bilateral ureteric injury over a 6-year period. Initial placement of ureteric stents was attempted in all patients. Stents were placed retrogradely into 6 ureters and antegradely into 2 ureters. In 1 patient ureteric stents could not be placed and they underwent primary ureteric reimplantation. In the 4 patients in which stents were placed, 2 were managed with stents alone, 1 required ureteric reimplantation for a persistent ureterovaginal fistula, and 1 developed a recurrent stricture. No patient managed by ureteric stenting suffered deterioration in serum creatinine. We feel that ureteric stenting, when possible, offers a safe primary management of bilateral ureteric injury at radical hysterectomy.
Shaw
Matthew B K
MB
Department of Urology, Freeman Hospital, Freeman Road, Newcastle-Upon-Tyne, NE7 7DN, UK. matthew.shaw@nuth.nhs.uk
Tomes
Mark
M
Rix
David A
DA
Dorkin
Trevor J
TJ
Murthy
Lakkur N S
LN
Pickard
Robert S
RS