Delayed presentation of complete ureteral obstruction deligated transvaginally
Sam Siddighi1, Paul M Yandell, Mickey M Karram
1Department of Gynecology and Obstetrics, Section of Female Pelvic Medicine and Reconstructive Surgery, Loma Linda University Medical Center, Loma Linda, CA 92350, USA. ssiddighi@llu.edu
International Urogynecology Journal
|October 27, 2010
Summary
Transvaginal ureterolysis offers a less invasive approach for managing complete ureteral obstruction following pelvic reconstructive surgery. This technique provides a better-tolerated and less morbid alternative to traditional treatments for delayed presentations.
Area of Science:
- Urology
- Gynecologic Surgery
Background:
- Complete ureteral obstruction typically requires percutaneous nephrostomy followed by ureteral deligation, reimplantation, and stenting.
- Delayed presentation of ureteral obstruction complicates management and traditional surgical approaches.
Observation:
- Two cases of delayed complete ureteral obstruction after pelvic reconstructive surgery are presented.
- Patients presented with flank pain, elevated creatinine, and CT-confirmed obstruction.
Findings:
- Both patients underwent successful transvaginal ureterolysis and retrograde stent placement.
- The transvaginal approach was well-tolerated, with no reported sequelae after stent removal.
Implications:
- Transvaginal ureterolysis is a viable and less morbid alternative for managing delayed complete ureteral obstruction post-pelvic surgery.
- This minimally invasive technique may improve patient outcomes and reduce recovery time.
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