Laparoscopic modified simple ureteroneocystomy in iatrogenic lower third ureter injury during gynecology surgery

Abstract

Objective: Our objective was to propose a laparoscopic modified simple ureteroneocystostomy for repairing iatrogenic ureteral injuries. In laparoscopic modified simple ureteroneocystostomy, the highest point of the bladder was found by cystoscopy, then we implanted a "fish mouth" ureter end into the bladder, leaving at least 1 cm of ureter end in the bladder as an anti-reflux procedure.

Case report: We retrospectively reviewed a case series of lower third iatrogenic ureter injury during gynecology surgery of 11 patients who received laparoscopic modified simple ureteroneocystostomy at Da Lin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, from January 2011 to December 2020. One patient needs percutaneous nephrotomy due to infection and had the ureteroneocystostomy two months later. No obstruction, ureter stenosis/stricture, bladder leakage or other renal complications were noted after repair.

Conclusion: Laparoscopic modified simple ureteroneocystostomy is technically feasible for repairing lower third ureter injuries, with no major complications.

Keywords: Hydronephrosis; Iatrogenic; Laparoscopy; Ureter; Vesicoureteral reflux.