Surgery

Question 1

Where is the most common site of urethral injury in lap hysterectomy?

Answer 1

At cardinal ligament as it passes under uterine vessels

Question 2

What is the diagnostic test of choice for possible ureter injury after surgery?

Answer 2

IV pyelogram - look for hydronephrosis

Can also do abdominal CT

Question 3

What happens when you over-dissect the ureter in surgery?

Answer 3

• Lots of vascular supply in adventitia so overdissection can lead to dec vascular supply; ISCHEMIA
• Can also cause leakage of urine into abdominal cavity - irritates the bowels –> nausea and vomiting