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[Pathology of the gynecologic ureter: our experience]
Candido Bondavalli1, Bruno Dall'Oglio, Lino Schiavon
1U.O. di Urologia, Ospedale Carlo Poma, Mantova. urologia.mantova@virgilio.it
Unlabelled:
Endometriosis, surgery and radiotherapy are the main causes of ureteral injuries in gynaecologic pathology.
Materials And Methods:
In this paper we present our experience about ureteral injuries. We treated 31 patients; 6 cases of endometriosis, 13 cases of pelvic radiotherapy for gynecologic tumors, 12 cases of ureteral injuries after gynecologic surgery. The treatments were different depending on the cause of the lesion and on the site of the lesion. In 3 cases we performed an ureteral-bladder implant with bladder psoas hitch, in 2 cases an end to end anastomosis was made. In 2 cases we made an ureteric substitution with Boari bladder flap. In 8 cases the ureteral stenting with DJ or a percutaneous nephrostomy was the solution.
Results And Conclusions:
In our experience good results can be obtained with ureteral implant and bladder psoas hitch. The end to end ureteral anastomosis had disappointing results in our hands. In case of ureteral fistula it would be better repair it as soon as possible. If the ureteral lesion is recognised during surgery and the loss of substance is not complete, the suture on stent can be performed.