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Ureteric injuries following pelvic operations
V O Oboro1, F O Dare, S O Fadiora
1Department of Obstetrics and Gynaecology, College of Health Sciences, Lautech Teaching Hospital, PMB 4400, Osogbo, Osun State, Nigeria.
East African Medical Journal
|March 13, 2003
Summary
Iatrogenic ureteral injuries are serious complications of pelvic surgery. Early diagnosis and end-to-end anastomosis offer the best outcomes for managing these ureteric injuries.
Area of Science:
- Urology
- Surgical Complications
Background:
- Iatrogenic ureteral injuries pose significant risks during pelvic surgeries, leading to severe morbidity and mortality.
- These injuries represent a critical challenge in gynecological and general surgical procedures.
Purpose of the Study:
- To review a decade of experience in managing iatrogenic ureteral injuries.
- To analyze the incidence, management strategies, and outcomes of ureteral injuries.
Main Methods:
- A retrospective study was conducted from January 1990 to December 1999.
- Data were collected from two major Nigerian teaching hospitals: Ife State Hospital and Wesley Guild Hospital.
- Patient records were analyzed to determine injury patterns and treatment outcomes.
Main Results:
- The overall incidence of iatrogenic ureteral injury was 0.4%.
- Ureteral transection was the most frequent injury, accounting for 58% of cases.
- Ureteroneocystostomy was the primary surgical intervention in 70% of treated patients.
- Optimal outcomes were observed in cases diagnosed and treated with end-to-end anastomosis at the time of injury.
Conclusions:
- Preventing ureteral injuries requires meticulous surgical technique, including careful identification and isolation of the ureter during high-risk pelvic operations.
- Prompt diagnosis and appropriate surgical management, such as end-to-end anastomosis, are key to minimizing patient morbidity.