Abstract
ABSTRACT
The authors report the incidence of ureteral obstruction in a series of patients undergoing high McCall's culdeplasty. The study design was observational. From an ongoing vaginal hysterectomy database, the authors looked at all patients undergoing an adjuvant high McCall's culdeplasty for Stage I–III prolapse. The study extended from July 1, 1995 to June 30,1999, and included 67 patients. From the study, ureteral obstruction was diagnosed when indigo carmine–dyed urine flowed freely from one ureteral orifice but not the other. Estimated blood loss for the culdeplasty was minimal for 64 patients, and the median operative time was 15 min. Three (4.5%) were found at cystoscopy to have ureteral obstruction. All three obstructions were unilateral and on the right side. In all three cases, immediately after removal of the culdeplasty stitch, dyed urine began flowing freely through the ureteral orifice. Statistical analysis was not done because of the small numbers. High McCall's culdeplasty at the time of vaginal hysterectomy was associated with a 4.5% incidence of unilateral ureteral obstruction. Intraoperative cystoscopy allows for prompt recognition and correction of this complication. In all three instances, simple deligation resolved the obstruction without apparent sequelae. (J GYNECOL SURG 16:119, 2000)
Get full access to this article
View all access options for this article.