Management of Ureteral Injuries due to Gynecological Surgical Procedures

Abstract

This prospective study examined the ureteral injuries due to gynecological operations from January 1995 to December 1999. Each patient was reviewed for pit-disposing factors, location, type of injury, time and methods of recognition. Ten patients of ureteral injuries were admitted and treated. Three injuries occurred at pelvic brim and seven other occurred elsewhere in the pelvis. Risk factors included endometriosis, ovarian neoplasm, pelvic adhesions and hemorrhage during gynecologic operations. Seven patients were managed by ureteroneocystostomies with psoas hitch procedure. Two had ureteroneocystostomies with Boari’s flaps and one patient had Uretero ureteral anastomosis. All the ten patients had indwelling ureteral stents for two weeks for splint age. Wound infection was seen in one patient (10%) and urinary tract infection was documented in one patient (10%).