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Iatrogenic ureteric injuries.

C C Lei1, M M Abdullah, K Abdullah

  • 1Department of Urology, General Hospital, Kuala Lumpur.

The Medical Journal of Malaysia
|June 1, 1991
PubMed
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Iatrogenic ureteric injuries from pelvic surgery cause significant patient harm when missed during operations. Early detection and urological intervention, like ureteric re-implantation, ensure good urinary function recovery.

Area of Science:

  • Urology
  • Surgical Complications
  • Pelvic Surgery

Background:

  • Damage to the lower ureters is a recognized complication of pelvic surgery.
  • Undetected iatrogenic ureteric injuries lead to substantial patient morbidity.
  • A review of cases from 1987 highlights the incidence and outcomes of these injuries.

Purpose of the Study:

  • To analyze the incidence and detection rates of iatrogenic ureteric injuries.
  • To describe the clinical presentation and management of patients with ureteric damage.
  • To evaluate the effectiveness of urological intervention in restoring urinary function.

Main Methods:

  • Retrospective review of 18 cases of iatrogenic ureteric injuries referred to the department in 1987.
  • Analysis of surgical specialty (gynecologic vs. general surgery) and injury detection timing (intra-operative vs. post-operative).

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  • Documentation of presenting symptoms and subsequent urological interventions.

    • Main Results:

    • 18 cases of iatrogenic ureteric injuries were identified.
    • The majority (16/18) originated from gynecologic surgery.
    • Only 24% (4/18) were detected intra-operatively, with 13 presenting post-operatively with symptoms like anuria, loin pain, and vaginal urinary leakage.

    Conclusions:

    • Iatrogenic ureteric injuries are a significant concern in pelvic surgery, often going undetected intra-operatively.
    • Delayed diagnosis leads to considerable patient morbidity.
    • Prompt urological intervention, typically ureteric re-implantation, results in successful recovery of urinary function.