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Ultrasonography of the ureter after surgical trauma
H L Helin-Martikainen1, P Kirkinen, A Heino
1Department of Obstetrics and Gynecology, University Hospital of Kuopio, PL 1777, 70210 Kuopio, Finland.
Background:
The purpose of the study was to discover whether ultrasonography can be used in diagnosing ureteral complications during surgery.
Methods:
The study consisted of an animal experiment with five pigs, that underwent laparotomy. The right ureter was electrocauterized and transsected, and the left ureter was ligated. The type and frequency of peristaltic waves and the diameter of the ureter were recorded by perioperative ultrasonography. Four patients with ureteral trauma during gynecologic surgery were also examined.
Results:
In the animal study six out of nine ureters dilated after the procedure. In seven ureters the contraction segment became smaller, and the lumen did not close properly during the peristaltic wave. The frequency of peristalsis diminished in all cases after ligation. Human ureters showed similar changes when examined 1.5-48 h after surgical trauma.
Conclusions:
Perioperative ultrasonography has great diagnostic potential as a method for noninvasive evaluation of ureteral conditions during both laparoscopy and laparotomy.