Hysterectomy Flashcards
Suspect ureter ligation when? (This also presents with same symptoms)
Tx?
Pyelonephritis symptoms (Fever, flank tenderness) after surgery (Thermal injury to ureter)
Antibiotics and relief of obstruction
Cardinal ligament attaches? Contains?
Uterine cervix to pelvic sidewalls; uterine arteries
Intravenous pyelogram used to examine?
Kidneys, ureters, bladder
Cystoscopy?
Scope placed into the bladder via the urethra
Percutaneous nephrostomy?
Used to relieve urinary obstruction by placing a stent into renal pelvis
Most common location for ureteral injury?
Cardinal ligament – ureter is 2-3 cm lateral to cervix
Ureteral injuries at the pelvic brim occur doing what surgeries?
Where the ureter enters the bladder?
Ligation of the ovarian vessels (infundibular pelvic ligament)
When the vaginal cuff is ligated at the end of the hysterectomy
Outside of surgery, other risk factors for ureteral injury?
Adhesions cancer endometriosis tubo-ovarian abscess residual ovaries interligamentous Leiomyoma
Suspect bladder perforation when patient develops what symptoms?
Gross hematuria, pain, tenderness in the suprapubic region and difficulty voiding
Over dissection of the ureter may lead to?
Devascularization injury (ischemic injury)
Patient diagnosed with you ureteral ligation susceptible to?
Hydronephrosis or hydroureter
Management of bladder lacerations?
Dome (top) – can be situated at time of surgery
Trigone (lower) may need ureter stent placement to prevent stricture