Obstetrics & Gynecology International Journal Late Manifestation of Laparoscopic Injury of the Ureter:

A case of late manifested injury of the left ureter after endometriosis surgery is presented. Thirty-six year old woman with history of two laparoscopies and a laparotomy all because of endometriosis was diagnosed left ovarian endometrioma. She underwent laparoscopic surgery for the fourth time. The left ovary was tightly adhered to the pelvic side wall peritoneum; endometrioma ruptured during examination. Cyst wall stripping and coagulation was performed. She had a febrile attack on the postoperative 17th day. After a full check-up she was diagnosed as having urinary infection. Three days later she was presented again and was diagnosed left ureteral rupture. Because of the failure of ten days stenting, she underwent ureteroneocystostomy. Reviewing the pertinent literature and regarding our case, we concluded that, in order to avoid ureteral injury, high risk patients must be defined preoperatively and to save the patient from painstaking correction procedures all the possible measures must be taken.