title: Laparoscopic Extravesical Lich-Gregoir Ureteroneocystostomy with Psoas Hitch for the Management of Ureterovaginal Fistula in Post-Hysterectomy Patients.
abstract: BACKGROUND
  Most commonly ureterovaginal fistula occurs due to surgical injury inflicted to the distal ureter and because of gynaecological procedures. Open surgical repair is a standard procedure and commonly involves ureteroneocystostomy.
  
  
  METHODS
  We retrospectively reviewed data of 9 patients, who underwent laparoscopic extravesical Lich-Gregoir ureteroneocystostomy using the psoas hitch procedure for ureterovaginal fistulas following hysterectomy during the period December 2012-August 2014. Transperitoneal laparoscopic ureteroneocystostomy was performed in all cases.
  
  
  RESULTS
  The mean operative time was 212 min (range 170-310) and estimated blood loss was 108 ml (range 70-150). Average hospital stay was 5.7 days. Follow-up time was from 6 to 26 months. Postoperative intravenous urography was done after 3 months, which showed patent anastomosis in 8 patients except for 1 patient who had nonvisualization of the ipsilateral renal moiety. Voiding cystogram done at 3 months showed no leakage in all patients. In the postoperative period, 1 patient had recurrent ipsilateral pyelonephritis 2 weeks after surgery, while another patient had febrile UTI. Apart from these no major complications were observed.
  
  
  CONCLUSIONS
  Laparoscopic ureteroneocystostomy with psoas hitch can be performed safely with a success rate compared to that of open surgery but with less morbidity and quick convalescence.
authors: Department of Urology, Institute of Post-Graduate Medical Education and Research and SSKM Hospital, Kolkata, India.
authors: Bastab
authors: B
authors: Ghosh
authors: Deepak Kumar
authors: DK
authors: Biswal
authors: Malay Kumar
authors: MK
authors: Bera
authors: Dilip Kumar
authors: DK
authors: Pal
mesh_terms: D000328:Adult; D016063:Blood Loss, Surgical; D003559:Cystostomy / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects*; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D007902:Length of Stay; D008875:Middle Aged; D061646:Operative Time; D016658:Psoas Muscles / Q000601:surgery*; D012086:Reoperation; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014515:Ureteral Diseases / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D014548:Urinary Fistula / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D014624:Vaginal Fistula / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D055815:Young Adult