Laparoscopic ureteroneocystostomy with psoas hitch in the treatment of ureteral injuries after gynaecological surgeries

Abstract

Objective To evaluate the efficacy and safety of laparoscopic ureteroneocystostomy with psoas hitch in the treatment of ureteral injuries after gynaecological surgeries. Methods The data of 6 patients, who underwent laparoscopic ureteroneocystostomy using the psoas hitch procedure for ureterovaginal fistulas following hysterectomy were reviewed retrospectively during June 2013 to June 2016. The patients had a mean age of 48 years (24-65 years) and a mean ureteral injuries of 4 cm (3-7 cm) in diameter. The mean interval between ureteral injury and repair was 45 days (3-90 days). Body mass index was 25 kg/m2 (20.4-27.6 kg/m2). Results Transperitoneal laparoscopic ureteroneocystostomy was performed in all cases. The mean operative time (ORT) was 133 min (90-210 min) and estimated blood loss (EBL) was 95 ml (70-150 ml). Average hospital stay was 8 days (5-11 days). Follow-up time was 17 months (6-26) months. The double J stent was removed after 6 weeks following repair in all patients. Three months after operation, IVU showed repaired moiety of all patients. Conclusion Laparoscopic ureteroneocystostomy with psoas hitch is safe for gynaecological surgeries ureteral injuries. And with less morbidity and quick convalescence. The short-term follow-up results were satisfactory. Key words: Laparoscope; Ureteroneocystostomy; Psoas hitch; Ureteral injury