Ultrasonic diagnosis of ureteral injury after laparoscopically‐assisted vaginal hysterectomy

Ureteral injuries are uncommon but serious complications of laparoscopically‐assisted vaginal hysterectomy. The ureter is particularly at risk for inadvertent injury when the cardinal‐uterosacral ligament complex is coagulated and divided below the uterine vessels. We present two recent cases which describe the application of transabdominal ultrasound including color Doppler mapping in the diagnosis of ureteral injury after laparoscopically‐assisted vaginal hysterectomy. Transabdominal ultrasound including color Doppler mapping has great diagnostic potential as a method for non‐invasive evaluation of post‐operative ureteral conditions. Ultrasonic triads (absence of a ureteric jet, ascites, and the presence or absence of hydronephrosis) are capable of differentiating diagnosis of complete, partial, or nonobstructive surgical ureteral injuries. Copyright © 2000 International Society of Ultrasound in Obstetrics and Gynecology

[1]  PAIVI HARKKI-SIREN,et al.  Urinary Tract Injuries After Hysterectomy , 1998, Obstetrics and gynecology.

[2]  K. Tamussino,et al.  Ureteral complications with operative gynecologic laparoscopy. , 1998, American journal of obstetrics and gynecology.

[3]  I. Timor-Tritsch,et al.  Transvaginal Color Doppler Sonography of the Ureteral Jets: A Method to Detect Ureteral Patency , 1997, Obstetrics and gynecology.

[4]  J. Mäkinen,et al.  Finnish national register of laparoscopic hysterectomies: a review and complications of 1165 operations. , 1997, American journal of obstetrics and gynecology.

[5]  J P Spirnak,et al.  Iatrogenic ureteral injuries: a 20-year experience in treating 165 injuries. , 1996, The Journal of urology.

[6]  J. A. Goodno,et al.  Ureteral injury in gynecologic surgery: a ten-year review in a community hospital. , 1995, American journal of obstetrics and gynecology.

[7]  J. Deprest,et al.  Review on laparoscopic hysterectomy. , 1995, Zentralblatt fur Gynakologie.

[8]  D. Rosenak,et al.  Ureteric jet examination by color Doppler ultrasound versus IVP for the assessment of ureteric patency following pelvic surgery--a pilot study. , 1994, European journal of obstetrics, gynecology, and reproductive biology.

[9]  D. Meirow,et al.  Evaluation and treatment of iatrogenic ureteral injuries during obstetric and gynecologic operations for nonmalignant conditions. , 1994, Journal of the American College of Surgeons.

[10]  M. Munro,et al.  A classification system for laparoscopic hysterectomy. , 1993, Obstetrics and gynecology.

[11]  E. Yeboah,et al.  Anuric acute renal failure due to bilateral accidental ureteric ligation during abdominal hysterectomy , 1993, International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics.

[12]  F. Nezhat,et al.  Ureteral injuries at laparoscopy: insights into diagnosis, management, and prevention. , 1990, Obstetrics and gynecology.

[13]  R. Dowling,et al.  Iatrogenic ureteral injury. , 1986, The Journal of urology.

[14]  R. Symmonds.  Ureteral injuries associated with gynecologic surgery: prevention and management. , 1976, Clinical obstetrics and gynecology.

[15]  Schwimmer Wb.  Electrosurgical burn injuries during laparoscopy sterilization. Treatment and prevention. , 1974 .