Journal of Clinical Gynecology and Obstetrics, ISSN 1927-1271 print, 1927-128X online, Open Access
Article copyright, the authors; Journal compilation copyright, J Clin Gynecol Obstet and Elmer Press Inc
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Case Report

Volume 5, Number 1, March 2016, pages 41-44

Delayed Ureteral Insufficiency After Ureteral Obstruction During Total Laparoscopic Hysterectomy: Utility of Cystoscopy for the Intraoperative Detection of Obstruction, and for the Avoidance of Postoperative Surgical Intervention


Figure 1.
Figure 1. Preoperative MRI of the lower abdomen and pelvis; T2 weighted sagittal section image. Protruded tumor at the uterine fundus 3 cm in diameter and thickening of uterine anterior wall.
Figure 2.
Figure 2. Suturing uterine vessels and cardinal ligament; uterine cervix is maneuvered up with the uterine manipulator. With a sufficient distance from the right ureter, right uterine vessels and cardinal ligament were sutured and cut.
Figure 3.
Figure 3. Laparoscopic findings of the right hydroureter; obstruction of the ureter may have occurred with suture of the cardinal ligament.
Figure 4.
Figure 4. CT scan of the abdomen, with contrast agent injection, on postoperative day 2; dilatation of the right ureter and renal pelvis indicates ureteral obstruction.
Figure 5.
Figure 5. Intravenous pyelogram after the removal of double-J stent; 15-min X-ray; good bilateral ureteral flows with no obstruction.