Evaluation of Ureteral Patency in Patient after Prolapse Surgery with End Stage Renal Disease: A Case Report

Pelvic floor reconstruction can result in obstruction of the ureters. In order to confirm ureteral patency, an intraoperative diagnostic cystoscopy is indicated.
This case describes a 48-year-old multiparous 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.
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.