Delayed presentation of complete ureteral obstruction deligated transvaginally.
Complete ureteral obstruction with delayed presentation is managed first by percutaneous nephrostomy and later with ureteral deligation, reimplantation, and stenting. Transvaginal deligation of complete obstruction after delayed presentation has not been described. We present two cases of ureteral ligation after pelvic reconstructive surgery. The first patient underwent high uterosacral ligament vaginal vault suspension then presented on postoperative day 22. The second patient underwent anterior colporrhaphy and presented on postoperative day 6. Both patients had flank pain, elevated creatinine, and signs of complete obstruction on CT scan. They both underwent transvaginal ureterolysis, retrograde stent placement, and later removal without any sequelae. Transvaginal ureterolysis of complete obstruction after delayed presentation is better tolerated and less morbid than traditional management.
Siddighi
Sam
S
Department of Gynecology and Obstetrics, Section of Female Pelvic Medicine and Reconstructive Surgery, Loma Linda University Medical Center, Loma Linda, CA 92350, USA. ssiddighi@llu.edu
Yandell
Paul M
PM
Karram
Mickey M
MM
D000328:Adult; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D056887:Pelvic Organ Prolapse / Q000601:surgery; D011183:Postoperative Complications / Q000209:etiology / Q000601:surgery*; D014517:Ureteral Obstruction / Q000209:etiology / Q000601:surgery*; D014621:Vagina / Q000601:surgery