Hysterectomy Flashcards

1
Q

Suspect ureter ligation when? (This also presents with same symptoms)

Tx?

A

Pyelonephritis symptoms (Fever, flank tenderness) after surgery (Thermal injury to ureter)

Antibiotics and relief of obstruction

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2
Q

Cardinal ligament attaches? Contains?

A

Uterine cervix to pelvic sidewalls; uterine arteries

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3
Q

Intravenous pyelogram used to examine?

A

Kidneys, ureters, bladder

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4
Q

Cystoscopy?

A

Scope placed into the bladder via the urethra

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5
Q

Percutaneous nephrostomy?

A

Used to relieve urinary obstruction by placing a stent into renal pelvis

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6
Q

Most common location for ureteral injury?

A

Cardinal ligament – ureter is 2-3 cm lateral to cervix

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7
Q

Ureteral injuries at the pelvic brim occur doing what surgeries?

Where the ureter enters the bladder?

A

Ligation of the ovarian vessels (infundibular pelvic ligament)

When the vaginal cuff is ligated at the end of the hysterectomy

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8
Q

Outside of surgery, other risk factors for ureteral injury?

A
Adhesions
cancer
endometriosis
tubo-ovarian abscess
residual ovaries
interligamentous Leiomyoma
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9
Q

Suspect bladder perforation when patient develops what symptoms?

A

Gross hematuria, pain, tenderness in the suprapubic region and difficulty voiding

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10
Q

Over dissection of the ureter may lead to?

A

Devascularization injury (ischemic injury)

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11
Q

Patient diagnosed with you ureteral ligation susceptible to?

A

Hydronephrosis or hydroureter

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12
Q

Management of bladder lacerations?

A

Dome (top) – can be situated at time of surgery

Trigone (lower) may need ureter stent placement to prevent stricture

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