@article{3115201, title = "Ureteral injuries during gynecologic surgery: Treatment with a minimally invasive approach", author = "Liatsikos, E. N. and Karnabatidis, D. and Katsanos, K. and Kraniotis, P. and and Kagadis, G. C. and Constantinides, C. and Assimakopoulos, K. and and Voudoukis, T. and Athanasopoulos, A. and Perimenis, P. and Nikiforidis, and G. and Siablis, D.", journal = "Journal of Endourology Case Reports", year = "2006", volume = "20", number = "12", pages = "1062-1067", publisher = "MARY ANN LIEBERT INC PUBL", doi = "10.1089/end.2006.20.1062", abstract = "Purpose: To report the safety and efficacy of percutaneous nephrostomy and primary antegrade recanalization for treatment of iatrogenic ureteral strictures after gynecologic surgery. Patients and Methods: Ten women had symptoms suggestive of ureteral obstruction during the immediate postoperative period (5 days-1 week after surgery). Under analgesia and conscious sedation, standard percutaneous nephrostomy was performed, and a long 7F sheath was placed in the upper ureter. The obstructions were traversed with the aid of a 0.0035-inch Glidewire and a 5F angled Glide catheter (Terumo, Japan). Subsequently, the areas were dilated with angioplasty balloons to a maximum diameter of 7 mm. Finally, an 8F percutaneous internal/external nephroureteral drainage stent was inserted to secure ureteral patency. Follow-up was carried out by serial nephrostomography until removal of the stent and by renal ultrasonography thereafter. Results: Twelve obstructions with a mean length of 1.4 cm (range 0.4-1.9 cm) were managed. The technical success rate was 100%. No major complications occurred, and normal renal function was restored. The mean follow-up was 12 months. In 60% of the patients, a patent ureter was depicted at 1 week, whereas in four patients, repeat dilation of the obstructed segment was required. The stents were removed after a mean period of 4.8 weeks. Conclusion: Percutaneous nephrostomy and primary antegrade ureteral balloon dilation is safe and efficacious for treating ureteral injury after pelvic surgery and obviates open surgical manipulations." }