Abstract
ABSTRACT
Twenty-three ureteral injuries in 22 patients as a result of obstetric and gynecologic operations are presented. Seven of 23 (30%) injuries were recognized intraoperatively, and in the rest recognition was delayed. Fourteen of these injuries were ureterovaginal fistula and 2 were ureteral obstruction. The procedures of repair included two Boari flaps with an antireflux anastomosis, 16 ureteroneocystostomies, and 5 ureteroureterostomies. All but 1 were successful (96%). The 1 exception required ureteroureterostomy with omental transposition and grafting of the anastomosis. The results do not support the view of delaying repair with the aim of increasing the viability of the ischemic segment of ureter immediately above the injury. In addition, instead of bypassing the segment of ureter that had been injured and become fibrotic, this author prefers to dissect the fibrotic tissue and preserve the ureter as long as possible for a tension-free repair. (J GYNECOL SURG 11:141, 1995)
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