Exploring Urinary Tract Injuries in Gynecological Surgery: Current Insights and Future Directions.

Area of Science:

• Urology
• Gynecologic Surgery

Background:

• Iatrogenic urinary tract injury is a recognized complication of pelvic surgery, frequently occurring during gynecological procedures.
• The bladder and ureters are anatomically vulnerable due to their proximity to the uterus, leading to potential damage via laceration, ligation, or thermal injury.

Purpose of the Study:

• To review current evidence on the diagnosis, prevention, and treatment of iatrogenic bladder and ureteral injuries in gynecological surgery.
• To evaluate risk factors, incidence, management strategies, complications, and prevention of these injuries.
• To highlight the potential role of artificial intelligence in preventing urologic damage during gynecological procedures.

Main Methods:

• A narrative review of relevant literature.
• Literature search conducted on the PubMed database using predefined keywords related to gynecological surgery and urinary tract injury.

Main Results:

• Bladder injuries occur in 0.24% of benign and 0.4-3.7% of oncologic surgeries; ureteral injuries occur in 0.08% of benign and 0.39-1.1% of oncologic procedures.
• Intraoperative detection allows for immediate repair, while delayed diagnosis increases risks of complications like genitourinary fistulas.

Conclusions:

• Urinary tract injuries are significant complications of gynecological surgery requiring careful diagnosis and management.
• Prevention strategies and timely intervention are key to minimizing patient morbidity.
• Artificial intelligence may offer future advancements in preventing iatrogenic urologic damage.