title: Endoluminal release of ureteral ligature after hysterectomy.
abstract: Iatrogenic ureteral injury is a well-recognized complication of abdominal total hysterectomy. We report a case of a 57-year-old female who underwent abdominal total hysterectomy for a uterine myoma and experienced severe right flank pain postoperatively. The imaging study displayed an obstruction of the right distal ureter. Under ureteroscopy, an extraluminal ligature was released with a holmium:yttrium-aluminum-garnet laser. The stenotic segment was immediately relieved. Two months later, the intravenous urogram illustrated patency of the distal ureter with regression of right hydronephrosis. There was no recurrent hydronephrosis during 1 year of follow-up.
authors.affiliation: Division of Urology, E-Da Hospital, Kaohsiung, Taiwan.
authors.forename: Chih-Jen
authors.initials: CJ
authors.lastname: Wang
authors.affiliation: Division of Urology, E-Da Hospital, Kaohsiung, Taiwan.
authors.forename: Victor Chia-Hsiang
authors.initials: VC
authors.lastname: Lin
authors.affiliation: Division of Urology, E-Da Hospital, Kaohsiung, Taiwan. Electronic address: ed102747@edah.org.tw.
authors.forename: Ching-Yu
authors.initials: CY
authors.lastname: Huang
mesh_terms: D000535:Aluminum / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects*; D007049:Iatrogenic Disease; D053844:Lasers, Solid-State / Q000627:therapeutic use*; D008026:Ligation / Q000009:adverse effects*; D008875:Middle Aged; D009214:Myoma / Q000601:surgery; D011183:Postoperative Complications / Q000000981:diagnostic imaging*; D015607:Stents; D014513:Ureter / Q000293:injuries*; D014517:Ureteral Obstruction / Q000000981:diagnostic imaging* / Q000209:etiology / Q000601:surgery*; D018666:Ureteroscopy; D014594:Uterine Neoplasms / Q000601:surgery; D015019:Yttrium / Q000627:therapeutic use
chemical_list: C503779:yttrium-aluminum-garnet; D015019:Yttrium; D000535:Aluminum
keywords: holmium:YAG laser; iatrogenic ureteral injury; laser endoureterotomy