Ureteral Injuries Acquired During Abdominal and Pelvic Surgeries

Kim, Tai Chia; Choo, Ken Weon; Lee, Hak Song

Abstract

For five years of period, 1956-1951, twelve cases of ureteral injuries acquired during abdominal and pelvic surgery were experienced as follows . Original surgical procedures which caused the injuries were radical total hysterectomy, 9 cases; simple total hysterectomy, 1 case; abdominal procedure for intra-abdominal hemorrhage, 1 case; and repair for vesicovaginal fistula, 1 case. Of twelve pervious procedures, 9 cases were for uterine cervix cancer, 1for uterine myoma, 1 for vesico-vaginal fistula and anther for rupture of a horse-shoe kidney. Injuries found were uretero-vaginal fistula, 4; bilateral complete severance, 1; unilateral complete severance. 2; simple ligation. 5; and ureterocutaneous fistula, 1. Lateralization of injuries was bilateral, 3; unilateral, 9; of which 7 were on the right and 2 on the left. Urological repairing procedures included 3 ureteroneocytostomies, 1 ureteral anastomosis to tube made from bladder flap.,1 end-to-end oblique anastomosis, 1 end-to-end transverse anastomosis, 1 deligation and 1 nephrectomy. It will be wise and advisable that a complete urological work-up and bilateral catheterization should be performed prior to abdominal and gynecological procedures to prevent accidental injury to the ureter.