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Case 76 - A 40-Year-Old Woman with No Spill from Her Left Ureter on Postoperative Cystoscopy after Total Laparoscopic Hysterectomy with Bilateral Salpingectomy

Published online by Cambridge University Press:  19 November 2021

Todd R. Jenkins
Affiliation:
University of Alabama, Birmingham
Lisa Keder
Affiliation:
Ohio State University School of Medicine, Columbus
Abimola Famuyide
Affiliation:
Mayo Clinic, Rochester
Kimberly S. Gecsi
Affiliation:
Medical College of Wisconsin
David Chelmow
Affiliation:
Virginia Commonwealth University School of Medicine
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Summary

A 40-year-old female, gravida 1, para 1, presents for follow-up with history of heavy menses and uterine leiomyomas. She tried hormonal treatment to control her bleeding but was not successful. For the past two years she bleeds monthly for seven days, and changes pads every 2 hours. She requested definitive treatment and underwent a total laparoscopic hysterectomy (TLH), and bilateral salpingectomy. Intraoperatively, the cul-de-sac was observed to be partially obliterated due to the presence of dense adhesions, which limited the visualization of the left ureter. Multiple intramural and subserosal fibroids were visualized. At the end of the procedure a cystoscopy was performed, the bladder mucosa was intact without lesions. Right ureteral jet was visualized with clear urine, no spill or peristalsis was visualized from the left side. Her past medical history is significant for pelvic inflammatory disease. Her past surgical history is non-contributory. She is not taking medications and has no known allergies.

Type
Chapter
Information
Surgical Gynecology
A Case-Based Approach
, pp. 232 - 234
Publisher: Cambridge University Press
Print publication year: 2021

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References

Cadish, LA, Ridgeway, BM, Shepherd, JP. Cystoscopy at the time of benign hysterectomy: a decision analysis. Am J Obstet Gynecol 2019; 220(4): 369.e17.CrossRefGoogle ScholarPubMed
Blackwell, RH. Complications of recognized and unrecognized iatrogenic ureteral injury at time of hysterectomy: a population based analysis. J Urol 2018; 199(6): 1540–5.CrossRefGoogle ScholarPubMed
Sharp, H. Prevention, recognition, and management of urologic injuries during gynecologic surgery. Obstet Gynecol 2016; 127(6): 1085–96.CrossRefGoogle ScholarPubMed
Manoucheri, E. Ureteral injury in laparoscopic gynecologic surgery. Rev Obstet Gynecol 2012; 5(2): 106–11.Google ScholarPubMed
AAGL Advancing Minimally Invasive Gynecology Worldwide. AAGL Practice Report: Practice guidelines for intraoperative cystoscopy in laparoscopic hysterectomy. J Minim Invasive Gynecol 2012; 19(4): 407–11.Google Scholar
Sandberg, EM. Utility of cystoscopy during hysterectomy. Obstet Gynecol 2012; 120(6): 1363–70.CrossRefGoogle ScholarPubMed
Teeluckdharry, B. Urinary tract injury at benign gynecologic surgery and the role of cystoscopy: a systematic review and meta-analysis. Obstet Gynecol 2015; 126(6): 1161–9.CrossRefGoogle ScholarPubMed
Espaillat-Rijo, L, Siff, L, Alas, AN, et al. Intraoperative cystoscopic evaluation of ureteral patency: a randomized controlled trial. Obstet Gynecol 2016; 128(6): 1378–83.CrossRefGoogle ScholarPubMed
Brandes, S. Diagnosis and management of ureteric injury: an evidence-based analysis. BJU Int 2004; 94(3): 277–89.CrossRefGoogle ScholarPubMed

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