Aspects of ureteral injury prevention in gynecological surgery and surgical methods for its correction

Yu.P. Sernyak, Yu.V. Roschin, A.S. Fukszon, Ye.N. Slobodyanyuk, V.A. Mekh

Abstract


Тrauma of the ureter often occurs during gynecological operations. Detection of the injury during the surgery is the most efficient for its correction. However, intraoperative identification of ureteral trauma, according to deferent authors’ opinion is in average 7–39 %. Ureter catheterization helps to early intraoperative identification of theinjury, and in a case of risk factors in patients is an effective measure to prevent ureter damage. During the gynecological operations typical localization of ureteral trauma is its distal third. The most effective method for the correction of ureter damage is the formation of ureteroneocystostomyin various modifications. The result of the treatment depends on the functional state of the injured ureter. Using the electroureterography during the correcting injury allows us to objectively determine the functional activity of the ureter and the boundaries of its destruction. However, in domestic and international literature there is no evaluation of its use in choosing method for correcting the ureter injury. The authors conclude that the further research is necessary to study the results of intraoperative electroureterography usage while choosing a method of treatment of the ureter injury, and scientific substantiation of the method.

Keywords


ureteral trauma; gynecological surgery; prevention; treatment

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DOI: https://doi.org/10.22141/1997-2938.1.32.2017.98504

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