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A Cinefluoroscopic Study of Ureteral Function Following Radical Hysterectomy

From the Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Texas-Southwestern Medical School, Dallas, Texas

Abstract

Twenty patients were studied with static and cinefluoroscopic intravenous pyelograms to quantitate the morphologic and physiologic ureteral alterations following radical hysterectomy and pelvic lymphadenectomy. More than 87% of the patients in the 48-hour study had ureteral dilatation, which persisted for 7 days in most patients, proximal to the site of pelvic dissection. By 6 weeks after surgery, the dilatation had regressed and pyelograms returned to normal. Transit time from renal pelvis to bladder was doubled at 7 days. An alteration in the character of peristalsis was noted on the cinefluoroscopic studies at 48 hours and at 7 days. The distal ureter appeared as a rigid conduit, and the peristaltic activity was replaced by bolus emptying.