Minimally Invasive UV Fistula Repair with the Aid of Laparoscopic Ureteroneocystostomy
We will present two cases which suffered from ureteral vaginal fistula after hysterectomy and underwent repair at our institute.
CONCLUSION: Genitourinary injury occurs in 1.8% of hysterectomies for benign indications; immediate identification and repair is associated with a reduced risk of subsequent genitourinary fistula formation. PMID: 31306326 [PubMed - as supplied by publisher]
CONCLUSION: Laparoscopic ureteroneocystostomy with a psoas hitch for ureterovaginal fistula secondary to hysterectomy is a safe and feasible option for patients with gynecologic distal ureteral injury, with excellent results and low morbidity. PMID: 31070140 [PubMed - in process]
To describe laparoscopic repair of a vesicovaginal fistula. A 47-year-old woman with multiple previous abdominal surgeries (2 cesareas and appendectomy), presented with a vesicovaginal fistula after abdominal hysterectomy. She had been noted to have a bladder injury that was repaired at that time. A vesicovaginal fistula developed seven days later, and she was referred for repair four months later. The location of the fistula was deemed amenable to repair using a laparoscopic approach.
We describe a rare complication during cystogram due to unrecognized inadvertently placed urinary catheter in ureter, resulting in a life-threatening situation. A 47-year-old multiparous female underwent total laparoscopic hysterectomy for adenomyosis. During early postoperative period, she developed vesicovaginal fistula and transvaginal repair of fistula was done. During filling cystography done at 2 weeks, she developed right loin pain and urosepsis. Contrast extravasation was seen in the right renal subcapsular space with Foley's catheter inside the right ureter. Subsequently, she recovered well.
CONCLUSION: The incidence of lower urinary tract injury in gynecologic laparoscopy for benign indication remains low at 0.33%. Bladder injury was three times more common than ureteral injury, although ureteral injuries were more often unrecognized intraoperatively and underwent open surgical repair. These risk estimates can assist gynecologic surgeons in effectively counseling their patients preoperatively concerning the risks of lower urinary tract injury. PMID: 29215524 [PubMed - as supplied by publisher]
We describe the technique for the repair of distal ureter lesions that preserves both anatomy and function of the urinary tract (1). The operation consists in dissection and extraction of the distal ureteral stump from its intramural tract to get at least 1 cm of free ureter, percutaneous insertion of a ureteral stent, checking the absence of tension between proximal ureter and distal dissected stump, end to end anastomosis and reinsertion of the distal ureter in the previously dissected bladder muscle layer. We present 4 cases of ureteral injury after laparoscopic simple total hysterectomy for uterine myomas with complete...
Conclusion With adequate laparoscopic experience and patient counseling, complex genitourinary fistulas can be approached with minimally invasive techniques. Laparoscopic approach provides excellent exposure to a poorly exposed area of retrovesical space while minimizes the bladder manipulation.
ConclusionsRobot-assisted extravesical VVF repair avoids the morbidity of a laparotomy, provides excellent exposure, and avoids a large cystotomy. It maintains vaginal length and allows for significantly better visualization compared with the transvaginal approach. This repair offers improved outcomes for certain patients depending on their history, anatomy, and the surgeon ’s experience.
ConclusionLaparoscopic Shull ’s colpopexy for POP is a secure procedure with the advantages of laparoscopy (magnification and sharing the operative field). This may become one of the most useful operations for apical support as native tissue repair.
Conclusions Robotic approach is feasible and a safe option for distal iatrogenic ureteral injuries occurring during gynecological procedures. Prior abdominal surgery or delayed repair does not preclude a robotic approach.