Urological injuries during obstetric and gynaecological procedures: a retrospective analysis over a period of eleven years

Desai, Rathnamala M; Kumar, K S Sunil

doi:10.18203/2320-1770.ijrcog20161690

Cited by 8 publications

(12 citation statements)

References 10 publications

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“…Hence, in-depth knowledge of pelvic anatomy is an essential prerequisite for the operating surgeon for early recognition and repair, thereby minimising sequelae. It is estimated that gynaecological surgeries account for 75% of iatrogenic injuries to the urinary tract [ 1 , 2 ]. Nearly 0.2-1% of gynaecological surgeries can be complicated by urinary tract injuries [ 1 , 3 ].…”

Section: Introductionmentioning

confidence: 99%

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Intraoperative and Postoperative Complications in Gynaecological Surgery: A Retrospective Analysis

Bahadur

Mundhra

Kashibhatla

et al. 2021

Cureus

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Background and objective Surgical complications can arise either intraoperatively or postoperatively. The factors that lead to complications in gynaecological surgeries could be both patient-related or surgeon-related. In this study, we aimed to identify the frequency of intraoperative and postoperative complications in gynaecological surgeries conducted at our institution and to evaluate various risk factors that may predispose patients to these complications. Materials and methods This was a retrospective analysis of women undergoing gynaecological surgeries in the Department of Obstetrics and Gynaecology at a tertiary centre in Uttarakhand, India from February 2016 to December 2019. Demographic characteristics, comorbidities, and perioperative complications of these women were recorded. Results A total of 389 women undergoing gynaecological surgeries were included in the study cohort. Of note, 94 of these had perioperative complications, accounting for 24.16% of the total cases. The most common route of surgery associated with complications was open abdominal surgery (34.66%). The operating time in most surgeries ranged from two to three hours (48.93%), and the average duration of hospital stay after surgery was 10.79 + 7.91 days. Intraoperative and postoperative complication rates were 5.91% and 19.28% respectively. Of these, surgical site infections (SSIs) (10.28%) and fever (5.39%) were the most common complications observed. Independent parameters like age, parity, route of surgery, operative time, preoperative duration of hospital stay, and preoperative blood transfusion were significantly associated with perioperative complications. Conclusions Surgical complications were more frequently seen in abdominal cases compared to other routes. Knowledge of centre-specific surgical outcome data can help in providing patients with better preoperative counselling.

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Section: Introductionmentioning

confidence: 99%

“…It is estimated that gynaecological surgeries account for 75% of iatrogenic injuries to the urinary tract [ 1 , 2 ]. Nearly 0.2-1% of gynaecological surgeries can be complicated by urinary tract injuries [ 1 , 3 ]. The most common surgeries performed in gynaecology are hysterectomy, salpingectomy, and cystectomy [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Intraoperative and Postoperative Complications in Gynaecological Surgery: A Retrospective Analysis

Bahadur

Mundhra

Kashibhatla

et al. 2021

Cureus

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“…13 Hoffman et al reported a 2.2% incidence with radical total hysterectomies, 2.4% for rectosigmoid colectomy 2 radical hysterectomy was associated with highest incidence of 2.5%,low anterior resections, 0.24% have been reported. 14,15 In our study Iatrogenic urinary lesions have an overall incidence of 1.6%, with a 34% of them with radical total hysterectomies, 8.5 % Werthiem's hysterectomy, 23.4% for colectomy, 25.5% in the case of anterior resection, 2.1% for radical prostatectomy and 6.4% retroperitoneal tumor excision.…”

Section: Discussionmentioning

confidence: 51%

“…The delay in the diagnosis leads to increase in morbidity, prolonged hospital stays and repeat surgery. 14 Most lesions of the ureter (60-70% of cases) are detected during the late period (from 3 to 33 days). 16 Half of the cases were diagnosed intraoperatively and repaired immediately.…”

Section: Discussionmentioning

confidence: 99%

Ureteric injuries during cancer surgery presentation and management over a 20-year

et al. 2021

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Background: Iatrogenic ureteral injury rare 0.3-1.5%. complication of abdominopelvic cancer surgery. We aimed to study the risk and management of ureteral injury among cancer patients. Methods: Diagnosis can be achieved retrograde pyelography, ureteroscopy, CT, or intravenous urography. Results: Years 2000 to 2020, 2904 patients in the Department of Surgical oncology, Assuit University, and 47 ureteral injury cases were identified. (1.62), 4/231 cervical cancer, 9/611 ovarian cancer and 7/462 endometrial cancer.,11/818 colon cancer,12/620 rectal cancer, 1/11 prostatic cancer, 3/151 retroperitoneal sarcoma. 34% (radical abdominal hysterectomy 8.5% Wertheim hysterectomies 4%), colorectal surgery colectomy 25.5%, low anterior resection2.1% in radical prostatectomy and 6.4% in retroperitoneal tumor, intraoperative diagnosis 48.9%, 8.5% in laparoscopic surgeries, the distal third (53.2%),23.4% catheterization, complete transection 31.9%; partial 14.9%, ligation 8.5%, laceration in 19.1%, resection. 8.5%; and devascularization in 17%. Fever in 14.9%, abdominal or flank pain in 38.5%. Oligura in 6.4%, ileus in 19.3%, urinary leakage (vaginally or via abdominal wound) in 10.6% rise creatinine in 10.6%, hydronephrosis in 6.4%, urinoma in 27.7%, extravasation in 8.5% asymptomatic in 4.3%, 40.4% percutaneous nephrostomy. 19.1%primary repair Ureteroneocystostomy in (17%) Boari flap in 12.7%, Psoas hitch in 23.4% stenting in 14.9%, 8.5% ileum interposition, anastomosis to contralateral ureter in 4.3%, ureteral stricture 6.4%, ureterovaginal fistulas in 10.6%, acute renal failure 2.1%, peritonitis 4.3, urinary tract infection in 14.9%.Conclusions: The recognition and immediate repair of ureteral injuries early during the same procedure was highly desirable and to avoid a second operation.

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“… 18 The incidence varies according to the type and complexity of the surgery. 19 In addition, urinary tract injuries complicate 0.2%–1% of all gynaecological procedures. 20 …”

Section: Discussionmentioning

confidence: 99%

Determining trainees' knowledge of surgical anatomy: A specialist's perspective

Mahfouz

Asali

Saleem

et al. 2021

Journal of Taibah University Medical Sciences

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Objectives Intraoperative identification of anatomical structures can potentially reduce the risk of surgical complications. This study aims to report specialists' perspectives about the anatomical structures that third-year residents should be able to identify during surgical operations. In addition, the factors which may influence specialists' opinions are discussed. Materials and methods This qualitative cross-sectional study was conducted on obstetricians and gynaecologists between 1/2/2019 and 30/10/2019. The specialists practising in a hospital with a residency programme were included, and were asked to rate the importance of structures that a third-year resident should be able to identify during operations. We performed a comparison of responses based on specialists' age, gender, practice type, years of experience, and surgical workload. Results One hundred and sixty-five specialists were recruited with a response rate of 69.3%. The mean age of respondents was 46.1 years, and they had a mean experience of 13.4 years. Furthermore, 86.6% of specialists rated all the anatomical structures as “more important”. The importance of surgical structures, as rated by specialists, was not related to gender, years of experience, or surgical workload. The importance of 63% of the anatomical structures was rated higher by junior specialists than senior specialists. Conclusion Knowledge of anatomical structures is vital for gynaecologic residency training. Specialist's perceptions of the importance of various anatomical structures reflect their understanding of the training requirements. Our results highlighted the important anatomical structures that third-year residents are expected to identify during surgical operations. Future research may establish a reference for the core anatomy knowledge essential for each training year.

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Urological injuries during obstetric and gynaecological procedures: a retrospective analysis over a period of eleven years

Cited by 8 publications

References 10 publications

Intraoperative and Postoperative Complications in Gynaecological Surgery: A Retrospective Analysis

Intraoperative and Postoperative Complications in Gynaecological Surgery: A Retrospective Analysis

Ureteric injuries during cancer surgery presentation and management over a 20-year

Determining trainees' knowledge of surgical anatomy: A specialist's perspective

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