PMC6342138_01
Preoperative magnetic resonance image showing spinal stenosis between L4/5, making L5 bilateral nerve root compression, which was more severe on the left side.
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L3-L4-L5 spondylolisthesis was diagnosed with magnetic resonance imaging, which revealed spinal stenosis between L4/5 making L5 bilateral nerve root compression, more severe on the left side (Figure 1).
Clipped ureter segment, length 3 cm.
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However, one 3-cm ureter segment was clipped out unexpectedly (Figure 2).
Urine extravasation from the right upper ureter demonstrated on intraoperative portal X-ray image taken 5 min after contrast medium injection.
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We confirmed urine extravasation with an intraoperative portal X-ray taken 5 min after contrast medium injection, which demonstrated that urine leaked from the right upper ureter (Figure 3).
The first stitch of end-to-end anamostosis was accomplished with laparoscopy. In total, four stitches of interrupted sutures were conducted.
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The end-to-end anastomosis was conducted with care to minimize handling of the ureter adventitia; interrupted sutures were performed meticulously with 3-0 Vicryl in four stitches (Figure 4).
Two months after anamostosis, ureter stricture (<1 cm) was revealed under ureteroscopy at the repair site.
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Ureteroscopy revealed a short segment (<1 cm) of ureter stricture at the suture site (Figure 5); therefore, this patient received long-term double-J stenting for ureter stricture.