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Ureteric injuries during obstetric and gynecologic procedures
Yousef S Matani1, Kamal E Bani-Hani, Ibrahim H Bani-Hani
1Department of Urology, Faculty of Medicine, Princess Basma Teaching Hospital, Jordan University of Science and Technology, Irbid, Jordan.
Saudi Medical Journal
|May 20, 2003
Summary
Iatrogenic ureteric injuries from gynecologic procedures are a significant concern. Early detection and endourological repair methods improve outcomes for these ureteral injuries.
Area of Science:
- Urology
- Gynecology
- Surgical Complications
Background:
- Iatrogenic ureteric injuries are a known complication of obstetric and gynecologic procedures.
- These injuries can lead to significant patient morbidity if not managed promptly.
Purpose of the Study:
- To review ureteric injuries from obstetric and gynecologic procedures.
- To comparatively analyze current literature on diagnosis and management.
Main Methods:
- Retrospective review of 17 patients with 19 ureteric injuries from 1994-1997.
- Analysis of clinical presentations, investigations, injury features, and treatment modalities.
Main Results:
- Hysterectomy was the most common cause (13 injuries), often associated with malignancy.
- Ureteric ligation was the primary mechanism (47%); 41.2% of injuries were recognized intraoperatively.
- An 89.5% success rate was achieved with endourological or surgical repair.
Conclusions:
- Iatrogenic ureteric injury remains a serious concern in gynecologic surgery.
- Timely detection is crucial for minimizing morbidity.
- Endourological repair techniques show promise and warrant further promotion.