An Unusual Complication of Ureteroneocystostomy Discovered at Laparoscopy

BACKGROUND Laparoscopy is an important surgical technique, and an understanding of normal and altered anatomy is crucial for successful surgery. We describe herein a patient in whom the left ureter follows an anomalous course due to previous surgery. METHODS This is the case report of a 28-year-old female with a history of ureteral reimplantation evaluated with laparoscopy for dysmenorrhea and infertility. RESULTS The left ureter followed an anomalous, transperitoneal course, lateral to the fallopian tube, starting at the infundibulopelivc ligament down to its insertion in the bladder. During its transperitoneal course, the ureter perforated the ileum. CONCLUSION This case describes an anomalous course of the ureter presumed to be due to previous childhood surgery. As more individuals with a history of ureteral reimplantation reach adulthood, an increasing number will require abdominal, surgical procedures. An understanding of potential anatomic abnormalities will reduce the risk of inadvertent visceral damage at surgery.