Temporary ureter obstruction after vaginal sacrospinal fixation (according to Amreich-Richter) - Case report

The case of a 59-year-old female with vaginal vault prolapse (cysto-, recto-, enterocele) after vaginal sacrospinal fixation (according to Amreich-Richter) with anterior and posterior colporrhaphy and upper enterocele repair is reported. Two days after surgery the patient developed current pain at the right flank with fever up to 39.4 degrees C. The suspicion of a prevesical obstruction of the ureter was based on a urogramm and kidney sonography. Computer tomography revealed no evidence of ureter dilatation. The laparoscopic reoperation showed a medially distorted, marginally dilatated right ureter. A urinary jet out of the right ureter ostium could be demonstrated at cystoscopy without methylene blue discharge. The insertion of a DJ-catheter was smooth and solution of the suture materiel was awaited. After six weeks the double-J catheter was removed, diuresis remained unaffected.