ULTRASONOGRAPHY OF THE URETER DURING LAPAROSCOPIC, ABDOMINAL AND RADICAL HYSTERECTOMY

Objective To examine, by perioperative ultrasonography, ureteral anato my and function during laparoscopic, abdominal and radical hysterectom y Subjects The study group consisted of patients scheduled for laparos copic, abdominal or radical hysterectomy; there were 12 patients in ea ch group. Methods The ureteral rest-phase diameter, maximal diameter d uring peristaltic waves and frequency of peristaltic waves were record ed immediately before and after hysterectomy under standard anesthetic conditions with the use of a 7.5-MHz linear laparoscopic ultrasound p robe. Results Ureteral peristaltic activity was decreased and the rest -phase diameter was increased after hysterectomy. The findings were mo st evident after radical hysterectomy with pelvic lymphadenectomy. Ret rograde (cranial) flow was recorded in a majority of the patients. The Individual variation was great, particularly after radical surgery Sh ort- and long-term clinical outcome was normal in all cases. Conclusio ns Uncomplicated hysterectomy is followed by changes in ureteral funct ion. Although these changes apparently have no clinical significance, they must be recognized if laparoscopic ultrasonography is applied as a perioperative method to diagnose or exclude surgical ureteral lesion s.