Abstract
Study Objective This video demonstrates the key steps in performing a ureteral reimplantation with psoas hitch. Design N/A Setting A single surgical center within a large integrated healthcare system. Patients or Participants The patient is a 40-year-old G0 woman with stage IV endometriosis who was found to have acute left hydroureteronephrosis secondary to an endometriosis implant compressing the left distal ureter. Her past medical history is otherwise notable for stage IV metastatic breast cancer status post a bilateral mastectomy with no evidence of residual disease for the past 3 years. Her past surgical history is notable for an exploratory laparotomy for a small bowel obstruction due to endometriosis. She opted for surgical management with robot-assisted total laparoscopic hysterectomy, bilateral salpingectomy, unilateral oophorectomy, ureteral resection with ureteral reimplantation and psoas hitch. Interventions The patient underwent an uncomplicated robot-assisted total laparoscopic hysterectomy, bilateral salpingectomy, unilateral oophorectomy. As expected, narrowing of the left ureter was noted and a planned ureteral resection with ureteral reimplantation and psoas hitch was performed in conjunction with urology. Measurements and Main Results N/A Conclusion Ureteral resection and reimplantation can alleviate endometriosis-related urinary tract obstruction.
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