Title

Incidence and Outcome of Ureteral Injuries in an Obstetrics and Gynecology Teaching Program

Document Type

Article

Publication Date

1-1-2001

Description

The purpose of this study was to determine the exact cause and anatomic location of ureteral injuries sustained at the time of gynecologic and obstetric surgery at this institution. The authors also wished to identify any factors that might have contributed to the injury, the time of injury recognition, the method of repair, and sequelae of the injury. Surgical logbooks maintained by the Division of Gynecologic Oncology dating back to 1985 were reviewed to identify cases of ureteral injury. The operative reports were reviewed to determine the cause of each injury and to determine predisposing factors present at the time of surgery. Fifteen cases were identified. The charts of 12 cases were available for review. Seven injuries were sustained during surgical procedures performed for malignancy, two occurred at the time of cesarean hysterectomy, two occurred during a hysterectomy and bilateral salpingo-oophorectomy for a benign condition, and one occurred during a sigmoid resection for severe radiation proctosigmoiditis. All but two injuries were recognized intraoperatively. Only one patient experienced significant morbidity as a result of ureteral injury. Ureteral injury is an unusual complication of obstetric and gynecologic surgery. Several factors predispose to ureteral injury; however, many cases are avoidable.

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