Document Type : Case reports

Authors

• Nitin A Wadhwa ¹
• Maryam Sadeghi ²
• Christopher Chung ¹

¹ Section of Female Pelvic Medicine and Reconstructive Surgery, Division of Gynecology Oncology, Department of Surgery, City of Hope National Medical Center, Duarte,California, USA

² Section of Female Pelvic Medicine and Reconstructive Surgery, Division of Gynecology Oncology, Department of Surgery, City of Hope National Medical Center, Duarte, California, USA

Abstract

Background: Pelvic floor reconstruction can result in obstruction of the ureters. In order to confirm ureteral patency, an intraoperative diagnostic cystoscopy is indicated.
Case Presentation: This case describes a 48-year-oldmultiparous patient with history of end stage renal failure requiring hemodialysis. She was presented with recurrent cystocele and mix urinary incontinence to City of Hope medical center in Duarte, California, United States in February 2016. The patient underwent transverse cystocele repair for pelvic organ prolapse. When intraoperative cystoscopy was non-diagnostic, retrograde intubation of the ureteral orifices confirmed patency.
Conclusions: This case raises awareness on the lack of visualization of ureteral flux during conventional cystoscopic evaluation in patients with renal failure undergoing pelvic organ prolapse repair, while also emphasizing the importance of confirming ureteral patency via retrograde ureteral intubation when cystoscopy is non-diagnostic.

Keywords

• Pelvic Organ Prolapse
• Renal Failure
• Hemodialysis
• Ureteral Patency
• Cystoscopy