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Ureteral injuries during gynecological surgery
A Liapis1, P Bakas, V Giannopoulos
1University of Athens, Aretaieion Hospital, Greece.
International Urogynecology Journal and Pelvic Floor Dysfunction
|January 25, 2002
Summary
This study reviewed 18 ureteric injuries from 5,122 major gynecologic surgeries over 15 years. Prompt recognition and skilled repair are crucial for improving patient outcomes in ureteral damage cases.
Area of Science:
- Urology
- Gynecologic Surgery
- Surgical Complications
Background:
- Iatrogenic ureteral injuries can occur during major pelvic surgeries.
- These injuries may lead to significant patient morbidity if not managed promptly.
Purpose of the Study:
- To review ureteric injuries during major pelvic surgery over 15 years.
- To identify predisposing factors and analyze patient management strategies based on injury type.
Main Methods:
- Retrospective review of 5,122 major gynecologic operations.
- Analysis of 18 identified cases of ureteric injury, including 4 cases of urinoma.
- Examination of surgical indications, operation types, comorbidities, injury location, and delay in recognition.
Main Results:
- The incidence of ureteric injury was 0.35%.
- Nine injuries were recognized during primary surgery with end-to-end anastomosis.
- Nine injuries were recognized post-operatively, with reimplantation (4 cases) or end-to-end anastomosis (5 cases).
Conclusions:
- Preventive measures are essential to reduce iatrogenic ureteral injuries.
- Prompt recognition and expert surgical repair significantly improve management outcomes for ureteric damage.