Number №1, 2020 - page 106-109

Ureter stricture after the reconstruction of the anterior pelvic diaphragm (A clinical case) DOI: 10.29188/2222-8543-2020-12-1-106-109

For citation: Vasin R.V., Filimonov V.B., Vasina I.V. Ureter stricture after the reconstruction of the anterior pelvic diaphragm (A clinical case). Experimental and clinical urology 2020;(1):106-109
Vasin R.V., Filimonov V.B., Vasina I.V.
Information about authors:
  • Vasin R.V. – PhD, Assistant professor of the Department of Urology with a course of surgical diseases, Ryazan State Medical University, Head of clinical hospital № 11 (Ryazan), chief urologist of the Ryazan regional «Center of Urogynecology and Nephrology»; www.rw@mail.ru, ORCID 0000-0002-0216-2375.
  • Filimonov V B. – Dr. Sc., Head of Department of Urology with a course of surgical diseases, Ryazan State Medical University, Ryazan; Head of Emergency clinical hospital (Ryazan). Head of the Ryazan Regional Center for Urology and Nephrology; Filimonov1974@mail.ru, ORCID 0000-0002-2199-0715
  • Vasina I.V. – PhD, obstetrician-gynecologist of clinical hospital № 11 (Ryazan), Chief gynecologist of the Ryazan regional «Center of Urogynecology and Nephrology»; inna.vasina@bk.ru, ORCID 0000-0002-7072-7980
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Introduction. Transvaginal mesh fixed to the obturator complex and sacrospinal ligaments is an effective method of treatment for anterior-apical genital prolapse. However, this surgery is associated with the risk of such complications, as vaginal erosion, chronic pain syndrome, dyspareunia and ureter damage (rare).

Aim. To demonstrate a clinically rare complication, i.e., ureter stricture in a patient with the reconstruction of the anterior area of the pelvic diaphragm using a polypropylene mesh graft with sacrospinal fixation.

Materials and methods. A clinical case of a 69-year-old woman with the stricture of the lower third of the ureter was described. The complication developed on day 11 after the surgery for genital prolapse involving the reconstruction of the anterior area of the pelvic diaphragm with a polypropylene mesh graft with sacrospinal fixation.

Results. The patient underwent surgical treatment that included ureteroscopy, endoureterotomy and stenting of the left ureter. One month following the surgery, the stent was removed from the left ureter. One, three, six and 12 months after the stent removal, control US investigation of the kidneys was performed. RCT of the retroperitoneum was performed 12 months after the stent removal. The conducted examinations revealed no expansion of the calices-pelvis system 12 months after the stent removal.

Conclusions. Transvaginal reconstruction of the anterior and apical areas of the pelvis diaphram using polypropylene mesh with sacrospinal fixation in patients with genital prolapse is associated with the risk of ureter damage. Early diagnostics of such damage with the respective correction allows the risk of ureterovaginal fistula and terminal hydronephrosis to be reduced, thus preventing the need for nephrectomy.

Conflict of interest. The authors declare no conflict of interest.

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genital prolapse, complications, sacrospinal fixation, polypropylene mesh, ureter stricture, ureter damage, pelvic reconstruction, hydronephrosis

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