Laparoscopic Ureteroneocystostomy: Be Prepared!

STUDY

OBJECTIVE

To assess the outcomes and complications of laparoscopic ureteroneocystotomy in gynecologic surgery.

DESIGN

We retrospectively reviewed all medical records of patients who underwent ureteroneocystostomy between April 2008 and May 2012.

DESIGN CLASSIFICATION: Retrospective case series study.

SETTING

A university tertiary care hospital.

PATIENTS: Nine patients underwent ureteroneocystostomy: 3 patients had ureteral endometriosis stenoses; and 6 patients had iatrogenic ureter injuries.

INTERVENTIONS: All procedures were performed laparoscopically. The ureterovesical re-implantation was unilateral in 8 cases and bilateral for 1 patient.

MEASUREMENTS AND MAIN

RESULTS

The mean operating time was 226.7 min (range, 120-480). Average blood loss was 114.4 mL (range, 30-400). The mean duration of the in-dwelling catheter was 10.4 days (range, 7-21); the average hospital stay was 12.6 days (range, 6-26). The mean duration of the ureteral double J stent was 7.8 weeks (range, 6-16). One patient was re-operated for vaginal and laparoscopic drainage of a pelvic abscess on the sixth postoperative day. The median follow-up time was 20.8 months (range, 9-36), No patient had stenosis or breakdown of a suture line.

CONCLUSIONS

Our series confirms the feasibility and the effectiveness of laparoscopic ureteroneocystostomy. This minimally invasive approach, which avoids laparotomy, requires a multidisciplinary team.