Methods of demonstrating measurement relationships between vaginal hysterectomy ligatures and the ureters
| Autor: | F.J. Hofmeister, Richard C. Wolfgram |
|---|---|
| Rok vydání: | 1962 |
| Předmět: |
medicine.medical_specialty
Hysterectomy medicine.diagnostic_test business.industry medicine.medical_treatment Obstetrics and Gynecology Palpation Surgery Radiography medicine.anatomical_structure Ureter Lumbar Intravenous Pyelogram Hysterectomy Vaginal medicine Humans Female Uterine cavity Ureteral Catheters business Ligation Cervix |
| Zdroj: | American Journal of Obstetrics and Gynecology. 83:938-948 |
| ISSN: | 0002-9378 |
| DOI: | 10.1016/0002-9378(62)90090-x |
| Popis: | 1. 1. This study permitted visualization of the field of operation and the ureters in the living patient under actual operating conditions. 2. 2. The ureter was not compromised in any of these cases used for demonstration. 3. 3. Even in those cases when the ureters were splinted by ureteral catheters, it was difficult, in fact impossible, to be certain that the ureter could be palpated during the placement of critical clamps. 4. 4. A maximum of ureteral complications should be avoided as the result of continuous caution by the gynecologist and adequate exposure by the assistants who are providing retraction of the bladder and firm continuous traction on the cervix. 5. 5. Knowledge of the fact that caution and care can reduce ureteral complications by maintaining adequate distances between clamps and ureter should not eliminate the necessity for every gynecologist to be well indoctrinated in the fundamentals of those procedures essential to repair ureteral and bladder complications. 6. 6. If one conforms to the opinion that a careful exploratory palpation of the abdominal contents should accompany every abdominal operation, certainly every vaginal procedure should be preceded by an intravenous pyelogram. 7. 7. In spite of our 15 years' experience with no recognized ureteral injuries, and the results of the 140 patients, pre- and post-operatively x-rayed, any unilateral pain radiating to the lumbar area in a patient who has undergone a previous hysterectomy should indicate the necessity for intravenous pyelogram investigation. One must recognize that associated allergies are not without hazard. 8. 8. Although technically a greater hazard and problem, contrast media locked in the uterine cavity may have contributed to the value of the study. 9. 9. Stereoscopic visualization was attempted on an aditional case and contributed nothing to the study. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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