Urinary

Question 1

Ureter implantation during fertility preservation endo resection from CSAT without psoas hitch or Boari flap?

Answer 1

Last 2-3 cm of ureter were resected. Bladder at trigone was repaired completely.

Ureter pulled through fenestration in broad lig

Generous 1.5 cm spatulation

Suture most distal, posterior part as an apex and then cystotomy (8 mm w/o cautery)

Once posterior 50% attached, stent placed, incision on bladder extended to allow longitudinal closure from both lateral cornersw/ barb suture w/ 6 mm needle

Generous anterior abdominal wall bladder flap to use redundant fat for second layer anteriorly and to close broad ligament

Truly not much bladder mobilization, 2 mm bladder bites at trigone and one layer closure only - ? young pt heals better?

Question 2

Cibula’s RH at 2019 ESGO seminar: appearance of the ureter?

Video for McDaniel case

Answer 2

Pink and bumpy - well preserved surrounding tissue without peritoneum on it