The Management of Bilateral Ureteric Injury following Radical Hysterectomy

Abstract EN

Iatrogenic ureteric injury is a well-recognised complication of radical hysterectomy.

Bilateral ureteric injuries are rare, but do pose a considerable reconstructive challenge.

We searched a prospectively acquired departmental database of ureteric injuries to identify patients with bilateral ureteric injury following radical hysterectomy.

Five patients suffered bilateral ureteric injury over a 6-year period.

Initial placement of ureteric stents was attempted in all patients.

Stents were placed retrogradely into 6 ureters and antegradely into 2 ureters.

In 1 patient ureteric stents could not be placed and they underwent primary ureteric reimplantation.

In the 4 patients in which stents were placed, 2 were managed with stents alone, 1 required ureteric reimplantation for a persistent ureterovaginal fistula, and 1 developed a recurrent stricture.

No patient managed by ureteric stenting suffered deterioration in serum creatinine.

We feel that ureteric stenting, when possible, offers a safe primary management of bilateral ureteric injury at radical hysterectomy.