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Ureteric injuries during gynaecological surgery
1Department of Surgery, Faculty of Medicine, Khartoum, Sudan.
International Urology and Nephrology
|January 1, 1994
Summary
Gynaecological surgery can lead to ureteric injuries, diagnosed intraoperatively or postoperatively. Prompt diagnosis and surgical repair, including ureteroneocystostomy, are crucial for managing these complications.
Area of Science:
- Urology
- Gynaecology
- Surgical Complications
Background:
- Ureteric injuries are a recognized complication of gynaecological surgery.
- These injuries can manifest intraoperatively, during convalescence, or as late urinary fistulae.
Purpose of the Study:
- To present a series of ureteric injuries sustained during gynaecological procedures.
- To discuss the diagnosis, management, and outcomes of these injuries.
Main Methods:
- Retrospective review of 32 patients with 35 ureteric injuries.
- Diagnostic methods included intraoperative ureteric probing, cystoscopy, intravenous urography, and ureterography.
- Surgical interventions such as ureteroneocystostomy, Boari flap, and bladder psoas hitch were employed.
Main Results:
- Eight ureteric injuries were identified intraoperatively.
- Postoperative diagnoses included urine drainage, urinoma, anuria, uretero-uterine fistulae (8), and ureterovaginal fistulae (10).
- Emergency Caesarean section (15 patients) and hysterectomy (12 patients) were common preceding procedures.
Conclusions:
- Ureteric injuries require timely diagnosis and appropriate surgical reconstruction.
- Various reconstructive techniques can be successfully utilized to manage ureteric injuries.
- Long-term follow-up is essential for assessing outcomes.