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Aim: To document our experience regarding the management of ureteric injury following gynecologic surgery. Material and Methods: Between January 2004 and December 2008, 24 patients with ureteric injury were referred to our institute. A retrospective review of the hospital charts, clinical notes and the operation theatre register was carried out. Unilateral ureteric injury was observed in 18 patients and bilateral ureteric injury (BUI) in 6 patients. The clinical presentation was urinary incontinence with normal voiding (ureterovaginal fistula) in 12 patients, recurrent flank pain (due to lower ureteric stricture) in 6 patients and anuria (due to BUI) in 6 patients. Patients were managed by urinary diversion or double J stent insertion followed by delayed ureteric repair or by immediate abdominal exploration and ureteric repair. Results: One patient suffering from BUI died of septicemia, uremia and electrolyte imbalance. All the other patients were doing well as per their last follow-up. Conclusion: Timely detection and proper referral of ureteric injury followed by judicious and expeditious management can reduce morbidity and help save lives.
Current Urology – Karger
Published: Jan 1, 2010
Keywords: Iatrogenic ureteral injury; Gynecological operation
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