femoral mononeuropathy: complicating a difficult pelvic ureterolithotomy

femoral mononeuropathy is a complication of gynecological and urological operations. tlte objective of this citse report is to bring to the attention of fellow urologists the very existence of this complication and offer measures to prevent it. a 48 year old obese worman with a 2 year history of frequent left renal colics, anil a nonfunction left kidney on ivp underwent a retrograde ureterogram study anil a transvaginal ureterolithotomy, in an exaggerated lithotomy position. postoperatively, a left leg paralysis required 3 weeks of care and encouragement to heal. to prevent this complication, avoid putting too long and too much pressure by retractors on the psoas muscles. during the abdomino-perineal procedures, frequent change of retractor site and monitoring of distal arterial pulses would he helpful. also, do not use the exaggerated lithotomy position for an extended period of time.