Post-hysterectomy uretero-vaginal fistula: Laparoscopic management with ureteroneocystostomy and psoas hitch.

This paper describes our initial experience with laparoscopic ureteroneocystostomy in two patients with distal ureter lesions following gynaecological surgery (hysterectomy). Furthermore, we review the evidence on the incidence, prevention, and management of urinary tract injuries that occur during laparoscopic gynaecological surgery. METHOD: Two patients with iatrogenic lower ureteral injuries during hysterectomy leading to ureterovaginal fistula underwent laparoscopic ureteroneocystostomy with a psoas hitch. 

Results: The procedures were successfully performed without any conversion. No intraoperative or postoperative complications were noted. Our minimally invasive approach has yielded successful results, similar to those achieved through open surgical repair. 

Conclusion: Laparoscopic ureteroneocystostomy with a psoas hitch for ureterovaginal fistula secondary to hysterectomy is a safe and feasible option for patients with gynecologic distal ureteral injury, with excellent results and low morbidity.