Transection of Duplex Ureter During Vaginal Hysterectomy

Duplex ureter, an embryological developmental anomaly, can lead to intra-operative injuries, even by surgeons with a stronghold on normal ureteric anatomy. We describe the first case of an ectopic ureter transected during vaginal hysterectomy performed for pelvic organ proplase, due to its abnormall...

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Bibliographic Details
Published in:Curēus (Palo Alto, CA) CA), 2020-01, Vol.12 (1), p.e6597
Main Author: Davis, Amenda Ann
Format: Article
Language:English
Subjects:
Abdomen
Biopsy
Bladder
Case reports
Catheters
Hysterectomy
Injuries
Kidneys
Laparoscopy
Obstetrics/Gynecology
Pelvic organ prolapse
Pelvis
Ultrasonic imaging
Urinary incontinence
Urinary tract infections
Urine
Urogenital system
Urology
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Summary:Duplex ureter, an embryological developmental anomaly, can lead to intra-operative injuries, even by surgeons with a stronghold on normal ureteric anatomy. We describe the first case of an ectopic ureter transected during vaginal hysterectomy performed for pelvic organ proplase, due to its abnormally low implantation into the bladder, worsened by cystocoele. The injury was recognised, and the duplex ureter was diagnosed with cystoscopy and retrograde pyelography. A post-operative computed tomography urogram allowed us to map the exact course. In this case, there was injury to the ectopic, non-functional ureter, thus averting any further intervention. However, lower urinary tract injuries are serious complications with high morbidity, especially during delayed diagnosis. Knowledge of the ureter variants, meticulous tracing of the course, and use of post-operative cystoscopy could reduce these complications, particularly in face of increasing minimally invasive approaches.
ISSN:2168-8184
2168-8184
DOI:10.7759/cureus.6597