PMC6350570_01
Intraoperative finding of left ureteral injury with subserosal hematoma (yellow arrow).
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Careful ureterolysis was performed bilaterally, during which the distal left ureter was found to be partially denuded, spanning 2 cm in length (Figure 1).
AmnioFix membrane wrapped around the site of left ureteral injury. AmnioFix membrane identified by yellow arrow.
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A 2 cm x 12 cm AmnioFix membrane was wrapped three times around the left ureter using laparoscopic robotic assistance (Figures 2 and 3).
Left ureter following AmnioFix membrane placement. AmnioFix membrane identified by yellow arrow.
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A 2 cm x 12 cm AmnioFix membrane was wrapped three times around the left ureter using laparoscopic robotic assistance (Figures 2 and 3).
Left retrograde pyelogram shows 1.5 cm distal ureteral stricture with mild hydroureteronephrosis.
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She underwent cystoscopy with left retrograde pyelogram demonstrating 1.5 cm distal ureteral stricture with moderate hydroureteronephrosis (Figure 4).
Mild extravasation noted on the left ureter with continued contrast injection.
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Continued contrast injection showed a small amount of extravasation from the vicinity of the narrowed ureteral segment (Figure 5).
Renal scan: initial findings show mild asymmetrical activity in the left ureter compared to the right. However, washout at 20 min is symmetrical bilaterally without any signs of obstruction.
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A Lasix renal scan was performed three months following ureteral injury which demonstrated normal perfusion and excretion by 20 minutes without signs of left ureteral obstruction (Figures 6 and 7).
Renogram findings identical for left (red) and right (green) kidney: symmetrical downward slope consistent with no signs of obstruction bilaterally.
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A Lasix renal scan was performed three months following ureteral injury which demonstrated normal perfusion and excretion by 20 minutes without signs of left ureteral obstruction (Figures 6 and 7).