Difficulties in Laparoscopic Ureteral and Bladder Reconstruction

In: Difficult conditions in laparoscopic urologic surgery · 2010 · pp. 321–342 · doi:10.1007/978-1-84882-105-7_23 · W199024959
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Ureteral reconstruction addresses iatrogenic injury, strictures, trauma, or malignancy, with iatrogenic causes most commonly occurring during gynecological, colorectal, or urological procedures.

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This chapter reviews situations in which ureteral reconstruction may be required, including iatrogenic ureteral injury (the most common), infectious strictures such as tuberculosis or schistosomiasis, and causes including endometriosis, trauma, or malignancy, with descriptions of injury mechanisms like transection, ligation, cautery injury, or devascularization. It discusses the clinical consequence of missed intraoperative recognition, namely postoperative urine leak or fistula. A key caveat is that the text is a narrative surgical discussion rather than presenting new comparative outcome data or a study population with measurable endpoints. Relevance to endometriosis: endometriosis is explicitly listed among the etiologies that can necessitate ureteral reconstruction, though the chapter is primarily about laparoscopic reconstructive difficulties and indications rather than presenting endometriosis-specific outcomes.

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Abstract

Ureteral reconstruction may be required in the setting of iatrogenic injury to the ureter, infectious strictures from tuberculosis, or schistosomiasis, endometriosis, trauma, or malignancy. Injury to the ureter is most commonly iatrogenic in nature. These occur most commonly in gynecological, colorectal, or urological procedures. Mechanism of injury may include transection, ligation, cautery injury, or devascularization. If not recognized and repaired intraoperatively, patients may present postoperatively with a urine leak or fistula. Similar content being viewed by others

References

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