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

Year 2016, Volume: 7 Issue: 3, 252 - 257, 02.09.2016

Serdar Başaranoğlu , Ayşegül Deregözü Nadiye Köroğlu Mehmet Kalkan Coşkun Şahin Sedat Kadanalı

https://doi.org/10.5799/jcei.328617

Cited By: 1

Abstract

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. 

Keywords

Bladder injury, ureteral injury, obstetric and gynecologic surgery, iatrogenic

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