Urological Complications in Gynecological Surgery and Radiotherapy

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1 Urological Complications in Gynecological Surgery and Radiotherapy

2 Contributions to Gynecology and Obstetrics Vol. 11 Series Editor P. J. Keller, Zürich ]11Wξ]1 Contributions to S. Karger Basel München Paris London New York Sydney

3 Urological Complications in Gynecological Surgery and Radiotherapy Jürg Kunz Department of Gynaecology and Obstetrics, University of Zürich, Zürich 21 figures, 3 cpl. and 35 tables, 1984 Contributions to S. Karger Basel München Paris London New York Sydney

4 Contributions to Gynecology and Obstetrics National Library of Medicine, Cataloging in Publication Kunz, J. (Jürg) Urological complications in gynecological surgery and radiotherapy/ Jorg Kunz. Basel; New York: Karger, (Contributions to gynecology and obstetrics; v.11) Includes bibliographical references and index. L Genital Diseases, Female surgery 2. Genital Diseases, Female radiotherapy 3. Genital Diseases, Female etiology 4. Intraοpeτative Complications 5. Urinary Tract 6. Urogenital System surgery 7. Urologic Diseases etiology I. Title II. Series WI CΟ 778 RG ν.11 [W P 660 K96υ] ISBN X Drug Dosage The authors and the publisher have exerted every etfort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any change in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Thur Copyright 1984 by S. Karger AG, P.O. Box, CH-4009 Basel (Switzerland) Printed in Switzerland by Thur AG, Odsetdruck, Aratteln ISBN X

5 Contents Introduction ι Anatomical Foundations 3 Topography of the Pelvic Extraperitoneal Connective Tissue in Women 3 Topography and Vascularization of the Efferent Urinary Pathways in Women. 5 Topography and Vascularization of the Efferent Urinary Passages in the Dog.. 10 Personal Experimental and Clinical Investigations on Vascularization of the Efferent Urinary Pathways 12 Physiological Foundations 19 Function and Functional Anomalies of the Ureter 19 Function and Functional Anomalies of the Bladder 21 Changes in the Efferent Urinary Pathways under Physiological and Pathological Conditions 26 Changes in the Efferent Urinary Pathways during Pregnancy 26 Changes in the Efferent Urinary Pathways in Uterus Myomatosus 31 Changes in the Efferent Urinary Pathways in Prolapsed States of the Genitals 31 Changes in the Efferent Urinary Pathways in Urogenital Anomalies 34 Changes in the Efferent Urinary Pathways in the Ovarian Vein Syndrome 39 Changes in the Efferent Urinary Pathways in Endometriosis 40 Changes in the Urinary Bladder in Placenta percreta 42 Changes in the Efferent Urinary Pathways under the Influence of Hormonal Contraceptives 42

6 Contents VI Surgical Lesions in the Efferent Urinary Pathways 43 Ureteral Lesions 43 Lesions of the Urinary Bladder 62 Urethral Lesions 72 Radiogenic Lesions of the Efferent Urinary Pathways 75 Radiogenic Lesions of the Ureters 75 Radiogenic Lesions of the Bladder 79 Pre-Disposing Factors for Radiogenic Lesions of the Bladder 81 Lesions Affecting the Efferent Urinary Pathways during Gynaecologico-Obstetrically Indicated Operations 84 Lesions Affecting the Efferent Urinary Pathways during Abdominal Hysterectomy 84 Lesions Affecting the Efferent Urinary Pathways during Vaginal Hysterectomy 91 Lesions Affecting the Efferent Urinary Pathways during Incontinence Operations 106 Lesions Affecting the Efferent Urinary Pathways during Extended Abdominal Hysterectomy 110 Lesions Affecting the Efferent Urinary Pathways during Extended Vaginal Hysterectomy 133 Lesions Affecting the Efferent Urinary Pathways during Caesarean Section 134 Lesions Affecting the Efferent Urinary Pathways during Caesarean Hysterectomy 137 Lesions Affecting the Efferent Urinary Pathways during Diagnostic Laparoscopy and Laparoscopie Sterilization 139 Lesions Affecting the Efferent Urinary Pathways during Culdoscopy 141 Lesions Affecting the Efferent Urinary Pathways Caused by antra-uterine Pessaries 141 Lesions Affecting the Efferent Urinary Pathways during Conization 142 Lesions Affecting the Efferent Urinary Pathways in Interruptio graviditatis 143 Lesions Affecting the Efferent Urinary Pathways during Cerclage 145 Lesions Affecting the Efferent Urinary Pathways after Forceps Delivery and Vacuum Extraction 145 Lesions Affecting the Efferent Urinary Pathways during Spontaneous Births 148 Lesions to the Bladder during Spontaneous Births 148 Ureteral Lesions during Spontaneous Births 150 Nephrological Complications of Obstetric Genesis 150 Lesions Affecting the Efferent Urinary Pathways in Rupture of the Uterus 151

7 Contents VII Lesions Affecting the Efferent Urinary Pathways during Gynaecologically Indicated Radiotherapy 152 Lesions of the Efferent Urinary Pathways during Radiotherapy of Carcinoma collí uteri 152 Lesions of the Efferent Urinary Pathways during Radiation Therapy of Carcinoma corporis uteri 159 Summary 164 Acknowledgements 166 References 167 Subject Index 213

8

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