Ureteroureterostomy for the Management of Iatrogenic Lower Ureter Injury

Paick, Jae Seung; Park, Moon Soo; Lee, Chong Wook

Abstract

Ten cases of lower ureteral injuries resulting from pelvic surgery, all females with an average age of 48.8 years. were treated by a end-to-end ureteroureterostomy at the Seoul National University Hospital between January 1987 and December 1993, Of the patients nine were from gynecologic surgery and one was from general surgery. Only one case was detected intraoperatively and the others were referred post-operatively. A watertight, tensionless, spatulated anastomosis with double J stenting was performed to all as soon as the diagnosis was made. In one patient renal mobilization was necessary because of the long ureteral defect. The mean length of the resected sections of the ureter and the distal ureteral stumps were 26 mm and 27 mm, respectively. The mean duration of followup was 3 years. Good results with no morbidity were achieved in all. Our results suggest that ureteroureterostomy is a good operative method having great success rate in the treatment of lower ureter injury. And it thought be a good alternative to Boari flap or psoas hitch technique when the distal ureteral stump is preserved.