Ureteral injuries at laparoscopy

Insights into diagnosis, management, and prevention

D. A. Grainger, R. M. Soderstrom, S. F. Schiff, M. G. Glickman, A. H. DeCherney, M. P. Diamond

Research output: Contribution to journalArticle

120 Citations (Scopus)

Abstract

The increasing use of laparoscopy as a therapeutic method mandates a reappraisal of the risks involved. Complications frequently described include injuries to the large and small bowels, bladder, and blood vessels. The world literature reports only eight cases of ureteral injury at laparoscopy. In this report, we present five additional cases of ureteral injury occurring at laparoscopy, in addition to a summary of those previously reported. Patients tend to present in the early postoperative period (48–72 hours) with low back pain, abdominal pain, leukocytosis, and peritonitis. The diagnosis should be made by intravenous pyelography; if possible, the injury should be stented by either the retrograde or percutaneous route. The injuries, except for one apparent trocar injury, involved the use of electrocoagulation, both unipolar and bipolar. The injuries occurred most commonly near the uterosacral ligaments. In 38% (five of 13) of the cases, the laparoscopy was performed for treatment of endometriosis. Three of the 13 patients eventually lost renal function of the affected side; two of these underwent a nephrectomy. Because visualization of the ureter near the cervix at the time of laparoscopy is difficult, especially in the presence of disease, laparoscopic procedures in this area must be carried out with caution.

Original languageEnglish (US)
Pages (from-to)839-843
Number of pages5
JournalObstetrics and Gynecology
Volume75
Issue number5
StatePublished - Jan 1 1990

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Laparoscopy
Wounds and Injuries
Electrocoagulation
Urography
Leukocytosis
Endometriosis
Ureter
Low Back Pain
Peritonitis
Nephrectomy
Ligaments
Surgical Instruments
Postoperative Period
Cervix Uteri
Abdominal Pain
Blood Vessels
Urinary Bladder
Kidney
Therapeutics

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Grainger, D. A., Soderstrom, R. M., Schiff, S. F., Glickman, M. G., DeCherney, A. H., & Diamond, M. P. (1990). Ureteral injuries at laparoscopy: Insights into diagnosis, management, and prevention. Obstetrics and Gynecology, 75(5), 839-843.

Ureteral injuries at laparoscopy : Insights into diagnosis, management, and prevention. / Grainger, D. A.; Soderstrom, R. M.; Schiff, S. F.; Glickman, M. G.; DeCherney, A. H.; Diamond, M. P.

In: Obstetrics and Gynecology, Vol. 75, No. 5, 01.01.1990, p. 839-843.

Research output: Contribution to journalArticle

Grainger, DA, Soderstrom, RM, Schiff, SF, Glickman, MG, DeCherney, AH & Diamond, MP 1990, 'Ureteral injuries at laparoscopy: Insights into diagnosis, management, and prevention', Obstetrics and Gynecology, vol. 75, no. 5, pp. 839-843.
Grainger DA, Soderstrom RM, Schiff SF, Glickman MG, DeCherney AH, Diamond MP. Ureteral injuries at laparoscopy: Insights into diagnosis, management, and prevention. Obstetrics and Gynecology. 1990 Jan 1;75(5):839-843.
Grainger, D. A. ; Soderstrom, R. M. ; Schiff, S. F. ; Glickman, M. G. ; DeCherney, A. H. ; Diamond, M. P. / Ureteral injuries at laparoscopy : Insights into diagnosis, management, and prevention. In: Obstetrics and Gynecology. 1990 ; Vol. 75, No. 5. pp. 839-843.
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