[Ureteral and bladder lesions after gynecologic surgery. Value of early diagnosis]

Ureteric and bladder injuries are recognized complications of gynaecologic surgery. Efficiency of conservative treatments is directly related to early diagnosis. Urinary vaginal fistulas are easily diagnosed in view of post-operative continuous leakage. Ureteral or bladder obstructions can be quite asymptomatic and result in renal destruction or bladder impairment. Reviewing 17 cases, we emphasize abnormal post-operative pain and biological changes which must aware of urologic complications and lead to radiographic studies. Double-J stenting or bladder drainage associated with filling of fistula with fibrin sealant gives a chance of complete recovery to urogenital fistulas. Percutaneous nephrostomy or clean intermittent catheterisation preserves renal or bladder function until adequate treatment of obstruction has been defined.