Patient Experience Following Gynecologic Surgery Complicated by Ureteral Injury

Improvement in the patient experience with ureteral injuries postgynecologic surgery hinges on enhanced communication, education, and relationship building.

The objective of this study was to explore the patient experience with preoperative counseling, diagnosis, management, and follow-up of ureteral injuries acquired during gynecologic surgery.

This was a qualitative study utilizing phone interviews. An interview guide with questions surrounding the perioperative experience, medical team support, and recommendations for care improvement was used to organize phone interviews. Interviews were recorded, transcribed into text verbatim, coded, and then thematically analyzed in an iterative process consistent with grounded theory. Recruitment continued until no new codes were identified (theoretical saturation).

Twenty-three patients had a ureteral injury during gynecologic surgery that was subsequently managed at our institution during the study period. Theoretical saturation occurred following completion of 10 interviews. Participants described their experiences at the time of their gynecologic (index) surgery, injury presentation, injury repair, and postoperative recovery. Factors that may have improved the patient experience included increased education, improved communication, and development of strong relationships with the health care team.

Ureteral injuries are an uncommon but known complication of gynecologic surgery. Adequately counseling patients before gynecologic surgery, continued transparency, communication, and involvement in care are essential to maintaining a good relationship with patients after this complication has occurred.