Evaluation and Treatment of latrogenic Ureteral Injuries During Obstetric and Gynecologic Operations for Nonmalignant Conditions

Diagnosis and management of ureteric injury: an evidence‐based analysis

“…In general, pelvic ureter viability distal to the ureteric injury is unreliable due to extensive prior dissection or blast injury. Long defects (usually > 2 cm) typically require a Psoas hitch or Boari flap reconstruction [3,4,22,26,32,48,50,51,54,59,94,95].…”

“…There are many retrospective studies reporting excellent success, few complications and durability with the psoas hitch [3,4,22,26,32,48,50,51,54,59,94,95]. Injuries involving the lower third of the ureter (caudal to the iliac vessels) are typically best managed by a psoas hitch in conjunction with ureteric reimplantation.…”

The efficacy of transureteroureterostomy for ureteral reconstruction during surgery for a non‐urologic pelvic malignancy

“…Clinical factors include prior radiotherapy, risk of local tumor recurrence, condition of the contralateral ureter, function of both kidneys, general health status, operative risk, tumor stage, and life expectancy [13][14][15][16]. In cases of mid-or distal-ureteral injuries, a UNC with a psoas hitch has been proposed as the preferred procedure for ureteral reconstruction [1][2][3][4]. However, the selection of an optimal technique may not be straightforward in all patients.…”

“…In most pelvic malignancies that require partial ureteral resection, end-to-end ureteroureteral anastomosis is not possible. In cases where ureteral defects are due to iatrogenic injuries, ureteroneocystostomy (UNC) with a psoas hitch is considered a favorable procedure for mid-or distal-ureteral reconstruction [1][2][3][4]. When a psoas hitch is performed, a part of the bladder is required to cover the ureteral defect.…”

The Treatment of Vesicovaginal Fistulae

“…In this way any fistula into the vagina from a ureter can be seen as separate from the bladder. Following visualization of the upper tracts and any associated pa thology, a cystogram is performed via the catheter [ 12]. As many as 12% of cases will have a concurrent ureteric inju ry [5], Attempts to define the anatomy of the ureter by retrograde studies is often difficult to perform in patients who have recently undergone gynaecological surgery due to difficulty in identifying the ureteric orifices on an oedematous and distorted trigone.…”