A case of a blind-ending right ureter first identified intraoperatively during total laparoscopic hysterectomy for uterine adenomyosis and fibroids in a woman with severe ipsilateral kidney hypoplasia.
J Obstet Gynaecol Res
; 50(8): 1415-1419, 2024 Aug.
Article
em En
| MEDLINE
| ID: mdl-38884165
ABSTRACT
Detecting ureteral injury-a serious intraoperative and postoperative complication of hysterectomy-is a high level of difficulty if ureteral malformations are not identified preoperatively. A 39-year-old Japanese woman underwent total laparoscopic hysterectomy for uterine adenomyosis. During surgery, ureteral peristalsis was absent on the right side, whereas the left ureter was visible under the peritoneum. Transabdominal ultrasonography failed to locate the right kidney, with cystoscopy showing no flow from the right ureteral orifice. The ureteral tunnel was identified by tracing the vascular path of the internal iliac and uterine arteries, confirming that the corded tissue was the right ureter. Postoperative contrast-enhanced CT revealed severe right kidney atrophy with no contrast effect or connected ureter. Based on intraoperative laparoscopy and postoperative examination, a diagnosis of a unilateral ureteral scar with a proximal blind end and ipsilateral renal dysgenesis was established, marking the first reported instance of endoscopic visualization of this anomaly. In addition to normal pelvic anatomy, surgeons must consider embryological abnormalities to prevent intraoperative complications.
Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Ureter
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Laparoscopia
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Adenomiose
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Histerectomia
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Rim
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Leiomioma
Limite:
Adult
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Female
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Humans
Idioma:
En
Revista:
J Obstet Gynaecol Res
/
J. obstet. gynaecol. res
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Journal of obstetrics and gynaecology research
Assunto da revista:
GINECOLOGIA
/
OBSTETRICIA
Ano de publicação:
2024
Tipo de documento:
Article
País de afiliação:
Japão