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Early and Late Diagnosis of Iatrogenic Urinary Tract Injuries During Obstetric and Gynecological Operations

Yıl 2016, Cilt: 7 Sayı: 3, 252 - 257, 02.09.2016
https://doi.org/10.5799/jcei.328617

Öz

Objectives: We aimed to present urinary tract injuries occurring during obstetric and gynecological operations and
their clinical consequences.
Methods: Twenty-three patients had urological organ injury during obstetric and gynecological operations in a tertiary
care center between January 2010 and June 2016, were analyzed retrospectively. Etiologies, type of injury, diagnostic
process, treatment methods and complications of urologic injuries and success rate have been investigated. Injuries
were categorized into two groups as intra-operative early injuries and post-op late injuries. Early injuries were laceration,
rupture, ligation and late injuries were hydronephrosis, contrast material leakage or fistula.
Results: Eight patients were diagnosed during operation period or post-op early period and 15 patients who were
referred from other hospitals. Thirteen of the injuries were gynecologic and 10 of them were obstetric. Mean age of
operated patients was 34.2±9.4 (23-65) years. Ureteral injury and bladder injury was detected respectively in six and
two patients getting early diagnosis. Fistula (5/15), hydronephrosis secondary to urethral stricture (3/15) and vaginal
erosion (3/15) were detected as late diagnosed injuries. In a patient whom ureter was ligated non-functioning kidney
has developed.
Conclusions: To reduce rate of urinary system injuries a sound knowledge of anatomy is required and corrected
surgical techniques should be used. Early diagnosis and therapy may prevent complications and loss of organs that
may lead to morbidity. 

Kaynakça

  • 1. Carley M.E, Mcıntıre D, Carley J.M, Schaffer J. Incidence, risk factors and morbidity of unintended bladder or ureter injury during hysterectomy. Int. Urogynecol. J. Pelvic Floor Dysfunct 2002; 13 (1):18-21.
  • 2. Evsen MS, Soydinç HE. Emergent gynecological operations: A report of 105 cases. J Clin Exp Invest 2010;1:12-15.
  • 3. Nawaz FH, Khan ZE, Rizvi J. Urinary tract injuries during obstetrics and gynaecological surgical procedures at the Aga Khan hospital Karachi, Pakistan: A 20-Year review. Urol Int 2007; 78: 106-11.
  • 4. Thompson J.D. Operative injuries to the ureter: Prevention, recognition and management. In:Thompson J.D. Rock JH. eds. Te Lindes operative gynaecology, 7th ed. Philadelphia: JB Lippincott, p.2003; 759-83.
  • 5. Phipps MG, Watabe B, Clemons J.L, Weitzen S, Myers DL. Risk factors for bladder injury during cesarean delivery. Obstet Gynecol 2005; 105:156-60.
  • 6. Frankman EA, Wang L, Bunker CH, Lowder JL. Lower urinary tract injury in women in the United States, 1979-2006. Am J Obstet Gynecol 2010;202: 495.e1-5.
  • 7. Ozdemir E, Ozturk U, Celen S, et al. Urinary complications of gynecologic surgery: iatrogenic urinary tract system injuries in obstetrics and gynecology operations. Clin Exp Obstet Gynecol 2011; 38: 217-20.
  • 8. Raut V, Brooks A, Drummond M, Woo H. Incidence and management of gynecological related ureteric and bladder injuries. Aust. N Z J. Obstet. Gynaecol 1999; 39: 178-81.
  • 9. Selzmann AA, Spirnale JP. Iatrogenic ureteral injuries: a 20 year experience in treating injuries. J Urol 1996; 155: 87881.
  • 10. Tijani KH, Onwuzurigbo KI, Ojewola RW, Afolabi BB, Akanmu NO. Iatrogenic ureteric injuries in a Nigerian teaching hospital: experience in the last decade. East Afr Med J 2011; 88: 304–9.
  • 11. Hammad FT, Alqaiwani KM, Shirodkar SS. The role of urologists in the management of urological injuries during obstetric and gynaecologic surgery. Int Urogynecol J Pelvic Floor Dysfunct 2010; 21: 1237–41.
  • 12. Chou MT, Wang CJ, Lien RC. Prophylactic ureteral catheterization in gynaecologic surgery: a 12-year randomized trial in a community hospital. Int Urogynecol J Pelvic Floor Dysfunct 2009; 20: 689– 93.
  • 13. Schimpf MO, Gottenger EE, Wagner JR. Universal ureteral stent placement at hysterectomy to identify ureteral injury: a decision analysis. BJOG 2008; 115: 1151–8.
  • 14. Al-Awadi K, Kehinde EO, Al-Hunayan A, Al-Khayat A. Iatrogenic ureteric injuries: incidence, aetiological factors and the effect of early management on subsequent outcome. Int Urol Nephrol 2005; 37: 235–41.
  • 15. Chalya PL, Massinde AN, Kihunrwa A, Simbila S. Iatrogenic ureteric injuries following abdominopelvic operations: a 10-year tertiary care hospital experience in Tanzania. World Journal of Emergency Surgery 2015; 10: 17.
  • 16. Lee JS, Choe JH, Lee HS, Seo JT. Urologic Complications Following Obstetric and Gynecologic Surgery. Korean J Urol 2012; 53: 795- 799.
  • 17. Kim J-H, Moore C, Jones JS, Rackley R, Daneshgari F, Goldman H, et al. Management of ureteral injuries associated with vaginal surgery for pelvic organ prolapse. Int Urogynecol J. 2006; 17: 531–5.
  • 18. Durrani SN, Rehman A, Khan S, Ullah H, Khan MK, Ullah A. Ureteral trauma during open surgery: etiology, presentation and management. J Ayub Med Coll Abbottabad. 2013; 25: 86-89.
  • 19. Anwar MS, Tariq M, Saeed K, Ghafoor T, Mustafa G. Causes of ureteric injuries and outcome of different surgical procedures for the repair of ureter. J Sheikh Zayed Med Coll. 2010; 1: 16-20.
  • 20. Armenakas NA, Pareek G, Fracchia JA. Iatrogenic bladder perforations: long term follow-up of 65 patients. J Am Coll Surg 2004; 198 (1): 78–82.
  • 21. Dapang R, Haifeng Y, Haibo Z, Ping D. The diagnosis and treatment of iatrogenic ureteral and bladder injury caused by traditional gynaecology and obstetrics operation. Arch Gynecol Obstet 2012; 285: 763-765.
  • 22. Vu KK, Brittain PC, Fontenot JP, Harlass FE, Hawley-Bowland CG, Diaz-Ball F. Vesicouterine fistula after cesarean section: a case report. J Reprod Med 1995; 40: 221-2.
  • 23. Rao MP, Dwvedi US, Datta B, Vyas N, Nandy PR, Trivedi S, et al. ANZ J Surg 2006; 76(4):243-5.
  • 24. Langkilde NC, Pless TK, Lundbeck F, Nerstrom B. Surgical repair of vesicovajinal fistülae-a ten year retrospective study. Scand J Urol Nephrol 1999; 33(2):100-3.
  • 25. Vangeenderhuysen C, Prual A, Ould el Joud D. Obstetric fistulae: incidence estimates for subSaharan Africa. Int J Gynaecol Obstet 2001; 73: 65- 6.
  • 26. Schimpf MO, Rahn DD, Wheeler TL, et al. Society of Gynecologic Surgeons Systematic Review Group. Sling surgery for stress urinary incontinence in women: a systematic review and metaanalysis. Am J Obstet Gynecol 2014; 211(2):71.
  • 27. Abdel-Fattah M, Ramsay I, Pringle S. Lower urinary tract injuries after transobturator tape insertion by different routes: a large retrospective study. BJOG 2006;113(12):1377 81.
  • 28. But I, Faganelj M. Complications and shortterm results of two different transobturator techniques for surgical treatment of women with urinary incontinence: a randomized study. Int Urogynecol J Pelvic Floor Dysfunct 2008; 19(6):857-61.
  • 29. Domingo S, Alama P, Ruiz N, Perales A, Pellicer A. Diagnosis, management and prognosis of vaginal erosion after transobturator suburethral tape procedure using a nonwoven thermally bonded polypropylene mesh. J Urol 2005; 173: 1627–1630.
  • 30. Siegel AL. Vaginal mesh extrusion associated with use of Mentor transobturator sling. Urology 2005;66(5):995-999.
Yıl 2016, Cilt: 7 Sayı: 3, 252 - 257, 02.09.2016
https://doi.org/10.5799/jcei.328617

Öz

Kaynakça

  • 1. Carley M.E, Mcıntıre D, Carley J.M, Schaffer J. Incidence, risk factors and morbidity of unintended bladder or ureter injury during hysterectomy. Int. Urogynecol. J. Pelvic Floor Dysfunct 2002; 13 (1):18-21.
  • 2. Evsen MS, Soydinç HE. Emergent gynecological operations: A report of 105 cases. J Clin Exp Invest 2010;1:12-15.
  • 3. Nawaz FH, Khan ZE, Rizvi J. Urinary tract injuries during obstetrics and gynaecological surgical procedures at the Aga Khan hospital Karachi, Pakistan: A 20-Year review. Urol Int 2007; 78: 106-11.
  • 4. Thompson J.D. Operative injuries to the ureter: Prevention, recognition and management. In:Thompson J.D. Rock JH. eds. Te Lindes operative gynaecology, 7th ed. Philadelphia: JB Lippincott, p.2003; 759-83.
  • 5. Phipps MG, Watabe B, Clemons J.L, Weitzen S, Myers DL. Risk factors for bladder injury during cesarean delivery. Obstet Gynecol 2005; 105:156-60.
  • 6. Frankman EA, Wang L, Bunker CH, Lowder JL. Lower urinary tract injury in women in the United States, 1979-2006. Am J Obstet Gynecol 2010;202: 495.e1-5.
  • 7. Ozdemir E, Ozturk U, Celen S, et al. Urinary complications of gynecologic surgery: iatrogenic urinary tract system injuries in obstetrics and gynecology operations. Clin Exp Obstet Gynecol 2011; 38: 217-20.
  • 8. Raut V, Brooks A, Drummond M, Woo H. Incidence and management of gynecological related ureteric and bladder injuries. Aust. N Z J. Obstet. Gynaecol 1999; 39: 178-81.
  • 9. Selzmann AA, Spirnale JP. Iatrogenic ureteral injuries: a 20 year experience in treating injuries. J Urol 1996; 155: 87881.
  • 10. Tijani KH, Onwuzurigbo KI, Ojewola RW, Afolabi BB, Akanmu NO. Iatrogenic ureteric injuries in a Nigerian teaching hospital: experience in the last decade. East Afr Med J 2011; 88: 304–9.
  • 11. Hammad FT, Alqaiwani KM, Shirodkar SS. The role of urologists in the management of urological injuries during obstetric and gynaecologic surgery. Int Urogynecol J Pelvic Floor Dysfunct 2010; 21: 1237–41.
  • 12. Chou MT, Wang CJ, Lien RC. Prophylactic ureteral catheterization in gynaecologic surgery: a 12-year randomized trial in a community hospital. Int Urogynecol J Pelvic Floor Dysfunct 2009; 20: 689– 93.
  • 13. Schimpf MO, Gottenger EE, Wagner JR. Universal ureteral stent placement at hysterectomy to identify ureteral injury: a decision analysis. BJOG 2008; 115: 1151–8.
  • 14. Al-Awadi K, Kehinde EO, Al-Hunayan A, Al-Khayat A. Iatrogenic ureteric injuries: incidence, aetiological factors and the effect of early management on subsequent outcome. Int Urol Nephrol 2005; 37: 235–41.
  • 15. Chalya PL, Massinde AN, Kihunrwa A, Simbila S. Iatrogenic ureteric injuries following abdominopelvic operations: a 10-year tertiary care hospital experience in Tanzania. World Journal of Emergency Surgery 2015; 10: 17.
  • 16. Lee JS, Choe JH, Lee HS, Seo JT. Urologic Complications Following Obstetric and Gynecologic Surgery. Korean J Urol 2012; 53: 795- 799.
  • 17. Kim J-H, Moore C, Jones JS, Rackley R, Daneshgari F, Goldman H, et al. Management of ureteral injuries associated with vaginal surgery for pelvic organ prolapse. Int Urogynecol J. 2006; 17: 531–5.
  • 18. Durrani SN, Rehman A, Khan S, Ullah H, Khan MK, Ullah A. Ureteral trauma during open surgery: etiology, presentation and management. J Ayub Med Coll Abbottabad. 2013; 25: 86-89.
  • 19. Anwar MS, Tariq M, Saeed K, Ghafoor T, Mustafa G. Causes of ureteric injuries and outcome of different surgical procedures for the repair of ureter. J Sheikh Zayed Med Coll. 2010; 1: 16-20.
  • 20. Armenakas NA, Pareek G, Fracchia JA. Iatrogenic bladder perforations: long term follow-up of 65 patients. J Am Coll Surg 2004; 198 (1): 78–82.
  • 21. Dapang R, Haifeng Y, Haibo Z, Ping D. The diagnosis and treatment of iatrogenic ureteral and bladder injury caused by traditional gynaecology and obstetrics operation. Arch Gynecol Obstet 2012; 285: 763-765.
  • 22. Vu KK, Brittain PC, Fontenot JP, Harlass FE, Hawley-Bowland CG, Diaz-Ball F. Vesicouterine fistula after cesarean section: a case report. J Reprod Med 1995; 40: 221-2.
  • 23. Rao MP, Dwvedi US, Datta B, Vyas N, Nandy PR, Trivedi S, et al. ANZ J Surg 2006; 76(4):243-5.
  • 24. Langkilde NC, Pless TK, Lundbeck F, Nerstrom B. Surgical repair of vesicovajinal fistülae-a ten year retrospective study. Scand J Urol Nephrol 1999; 33(2):100-3.
  • 25. Vangeenderhuysen C, Prual A, Ould el Joud D. Obstetric fistulae: incidence estimates for subSaharan Africa. Int J Gynaecol Obstet 2001; 73: 65- 6.
  • 26. Schimpf MO, Rahn DD, Wheeler TL, et al. Society of Gynecologic Surgeons Systematic Review Group. Sling surgery for stress urinary incontinence in women: a systematic review and metaanalysis. Am J Obstet Gynecol 2014; 211(2):71.
  • 27. Abdel-Fattah M, Ramsay I, Pringle S. Lower urinary tract injuries after transobturator tape insertion by different routes: a large retrospective study. BJOG 2006;113(12):1377 81.
  • 28. But I, Faganelj M. Complications and shortterm results of two different transobturator techniques for surgical treatment of women with urinary incontinence: a randomized study. Int Urogynecol J Pelvic Floor Dysfunct 2008; 19(6):857-61.
  • 29. Domingo S, Alama P, Ruiz N, Perales A, Pellicer A. Diagnosis, management and prognosis of vaginal erosion after transobturator suburethral tape procedure using a nonwoven thermally bonded polypropylene mesh. J Urol 2005; 173: 1627–1630.
  • 30. Siegel AL. Vaginal mesh extrusion associated with use of Mentor transobturator sling. Urology 2005;66(5):995-999.
Toplam 30 adet kaynakça vardır.

Ayrıntılar

Konular Sağlık Kurumları Yönetimi
Bölüm Araştırma Yazısı
Yazarlar

Serdar Başaranoğlu

Ayşegül Deregözü Bu kişi benim

Nadiye Köroğlu Bu kişi benim

Mehmet Kalkan Bu kişi benim

Coşkun Şahin Bu kişi benim

Sedat Kadanalı Bu kişi benim

Yayımlanma Tarihi 2 Eylül 2016
Yayımlandığı Sayı Yıl 2016 Cilt: 7 Sayı: 3

Kaynak Göster

APA Başaranoğlu, S., Deregözü, A., Köroğlu, N., Kalkan, M., vd. (2016). Early and Late Diagnosis of Iatrogenic Urinary Tract Injuries During Obstetric and Gynecological Operations. Journal of Clinical and Experimental Investigations, 7(3), 252-257. https://doi.org/10.5799/jcei.328617
AMA Başaranoğlu S, Deregözü A, Köroğlu N, Kalkan M, Şahin C, Kadanalı S. Early and Late Diagnosis of Iatrogenic Urinary Tract Injuries During Obstetric and Gynecological Operations. J Clin Exp Invest. Eylül 2016;7(3):252-257. doi:10.5799/jcei.328617
Chicago Başaranoğlu, Serdar, Ayşegül Deregözü, Nadiye Köroğlu, Mehmet Kalkan, Coşkun Şahin, ve Sedat Kadanalı. “Early and Late Diagnosis of Iatrogenic Urinary Tract Injuries During Obstetric and Gynecological Operations”. Journal of Clinical and Experimental Investigations 7, sy. 3 (Eylül 2016): 252-57. https://doi.org/10.5799/jcei.328617.
EndNote Başaranoğlu S, Deregözü A, Köroğlu N, Kalkan M, Şahin C, Kadanalı S (01 Eylül 2016) Early and Late Diagnosis of Iatrogenic Urinary Tract Injuries During Obstetric and Gynecological Operations. Journal of Clinical and Experimental Investigations 7 3 252–257.
IEEE S. Başaranoğlu, A. Deregözü, N. Köroğlu, M. Kalkan, C. Şahin, ve S. Kadanalı, “Early and Late Diagnosis of Iatrogenic Urinary Tract Injuries During Obstetric and Gynecological Operations”, J Clin Exp Invest, c. 7, sy. 3, ss. 252–257, 2016, doi: 10.5799/jcei.328617.
ISNAD Başaranoğlu, Serdar vd. “Early and Late Diagnosis of Iatrogenic Urinary Tract Injuries During Obstetric and Gynecological Operations”. Journal of Clinical and Experimental Investigations 7/3 (Eylül 2016), 252-257. https://doi.org/10.5799/jcei.328617.
JAMA Başaranoğlu S, Deregözü A, Köroğlu N, Kalkan M, Şahin C, Kadanalı S. Early and Late Diagnosis of Iatrogenic Urinary Tract Injuries During Obstetric and Gynecological Operations. J Clin Exp Invest. 2016;7:252–257.
MLA Başaranoğlu, Serdar vd. “Early and Late Diagnosis of Iatrogenic Urinary Tract Injuries During Obstetric and Gynecological Operations”. Journal of Clinical and Experimental Investigations, c. 7, sy. 3, 2016, ss. 252-7, doi:10.5799/jcei.328617.
Vancouver Başaranoğlu S, Deregözü A, Köroğlu N, Kalkan M, Şahin C, Kadanalı S. Early and Late Diagnosis of Iatrogenic Urinary Tract Injuries During Obstetric and Gynecological Operations. J Clin Exp Invest. 2016;7(3):252-7.