|Discussion in 'All Categories' started by Shreya Nimonkar - Mar 5th, 2013 6:11 am.|
|while doing surgery of removal of uterus,both the ureters got strictures and this could be diagnosed only after several tests and examination. Finally one more severe surgery was done in which 10-cm intestine was cut and a 'Y' shape tube was cut and attached to the bladder which also is shrunk.now it is must to pass urine after a periodic time of 2 1/2 hours compulsorily. regular followup doing sonography,urine and blood test with creatine value, this has to be done for life long..is there any solution for this???|
re: Uretric Stricture by Dr J S Chowhan - Mar 7th, 2013 11:25 am
Dr J S Chowhan
|Dear Shreya Nimonkar
Treatments target the anatomic facets of stenosis, like entire lesion, complexity of obstruction and vascularization of the ureter. Partial and segmental stenoses can usually be treated by endoscopic procedures like dilation or internal ureterotomy with keeping double J catheter with good follow-up results.
As you have already gone for reconstruction technique procedures are required for total complex stenosis.
With all the improvement in the minimal invasive treatment in urological and gynecological disorders, like laparoscopic pelvic surgical procedures or endoscopic ureteral procedures, a large number of complications have already been reported from the learning curve of those procedure such as ureteral damage during hysterectomy in your case.
However, reconstruction surgeries represent the key selection for complex situations and failure in conservative treatment. The ideal time and energy to perform this reconstruction remains controversial. Some authors recommend a nominal amount duration of About six weeks following your injury prior to carring out a new surgery in the event of lesions a result of surgical trauma, as a way to allow maximum resolution of the inflammatory process. In a of our own cases, seen as an ureteral lesions after vaginal hysterectomy, the laparoscopic reimplant was performed 15 days after hysterectomy with no technical difficulties sufficient reason for good results. In our experience, in the event of ureteral lesions in vaginal and endoscopic surgeries, the laparoscopic access represents an excellent choice that may be performed immediately.
Ureteral lesion is a kind of affection that hass been increasing because of pelvic endourologic, laparoscopic and open procedures. Results demonstrate that the laparoscopic ureteral reimplant is an efficient alternative with the exact same results when compared with open technique, with minimum morbidity. Laparoscopic ureteral reimplant is definitely an excellent choice in treatments of distal ureteral stenosis.
If you will send us the entire OT note of the reconstructive surgery done we can advice you the prognosis.
J S Chowhan
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