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[Ureteral lesions in gynecologic surgery]
Yolanda Ares Valdés1, Carlos A Romero Díaz, Orestes N Mederos Curbelo
1Servicio de Urología, Hospital Universitario Manuel Fajardo, Ciudad de la Habana, Cuba. ares@infomed.sld.cu
Archivos Espanoles De Urologia
|May 7, 2003
Summary
Gynaecologic surgery can cause ureteral lesions, often diagnosed postoperatively. Bladder reimplantation with a submucosal tunnel is a common repair for these serious injuries.
Area of Science:
- Urology
- Gynaecology
- Surgical Complications
Context:
- Ureteral lesions are a significant concern in gynaecological surgery.
- These injuries can lead to increased patient morbidity, even when detected after the procedure.
Purpose:
- To evaluate the incidence and management of ureteral lesions during gynaecological surgery.
- To analyze the surgical procedures and outcomes for patients with ureteral injuries.
Summary:
- A review of 742 gynaecological procedures revealed 9 ureteral lesions in 8 patients (1.07% incidence).
- Most lesions (7/9) were diagnosed postoperatively and treated with bladder reimplantation (submucosal tunnel) or ureteral suture repair.
- Delayed diagnoses included ureteral-vaginal fistulae managed with nephrectomy and ureteroneocystostomy.
Impact:
- The study highlights the risk of lower urinary tract damage during gynaecological procedures.
- Bladder reimplantation with a submucosal tunnel is identified as a frequent and effective repair method.
- Malignant condition surgeries showed a higher rate of ureteral lesions (4.8%) compared to benign surgeries (0.47%).