Laparoscopic ureteroneocystostomy for distal ureteral injuries

Objectives. To present our initial experience with laparoscopic ureteroneocystostomy in patients with traumatic disruption of the distal ureter owing to gynecologic procedures. Reconstructive laparoscopic procedures are still evolving. Methods. Six patients with ureterovaginal fistula in whom endoscopic management had failed underwent laparoscopic ureteroneocystostomy with a psoas hitch between July 2003 and December 2004. Results. All procedures were completed successfully. No intraoperative or postoperative complications were noted. Postoperative intravenous urography did not reveal any evidence of obstruction. No reflux was seen in 5 of the 6 patients during micturating cystography. Conclusions. Laparoscopic ureteroneocystostomy is a safe and feasible minimally invasive option for patients with gynecologic distal ureteral injury.