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.