A comparison between peritoneal sheathing of the ureters (Ohkawa technique) and retroperitoneal pelvic suction drainage in the prevention of ureteral damage during radical abdominal hysterectomy.

Sixty patients had a radical abdominal hysterectomy with or without a bilateral salpingo-oophorectomy. The Ohkawa procedure was utilized in 26 (43.3%) of the patients and retroperitoneal ureteral placement with suction drainage in 34 (56.7%) of the patients. These two operative procedures were evaluated for complications such as fistula, obstruction, and hydronephrosis by comparing preoperative and postoperative intravenous pyelograms. Five of the 60 patients (8.3%) had surgical complications within one postoperative month. A ureteral obstruction occurred in two patients, and a uretrovaginal fistula occurred in two patients. Hydronephrosis was found in both sets of patients. All of these complications occurred in an additional two patients, both of whom had an Ohkawa procedure. The study led us to conclude that retroperitoneal ureteral placement is not only quicker to perform but also leads to fewer complications than the Ohkawa technique.