Management Of Delayed Ureteral Injury Diagnosis After Gynecologic Surgery with Ureteroneocystostomy Technique: A Case Report Wenny Yaury(a*), Putra Rimba(a), Trika Irianta(b)
(a) Department of Obstetrics and Gynecology, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
(b) Urogynecology and Reconstructive Division, Department of Obstetrics and Gynecology, Faculty of Medicine, Hassanudin University, Makassar, Indonesia
Email : Wyaury[at]gmail.com*
Abstract
Background:
Ureteroneocystostomy primarily used for ureteral injury in the lower third portion. Total abdominal hysterectomy is the most common cause of iatrogenic ureteral trauma during gynecologic surgery. Mostly are not identified intraoperatively but rather in the postoperative period.
Clinical Case:
A 53 years old married woman referred with bilateral ureteral injury due to previous total abdominal hysterectomy with bilateral salpingo-oophorectomy, complained about no urine production. Ultrasonography shows free fluid and grade 2 bilateral hydronephrosis. We performed a Ureteroneocystotomy with the Lich-Gregoire technique for bilateral ureteral reimplantation.
Result:
We found inadvertently ligated and laceration in the left and right distal of the ureteral. Drain and stent were placed. The duration of the operation was 200 minutes. A Foley catheter was performed for 14 days.
Conclusion:
The patient with ureteral injury should be evaluated and intervened at the earliest because a delayed diagnosis can worsen the prognosis.
