Urological injuries in gynecological surgery: A review

Rani, Anju; Singh, Balvir; Kumar, Shobhit

doi:10.33545/gynae.2020.v4.i2g.558

Int. J. Clin. Obstet. Gynaecol.

2020

DOI: 10.33545/gynae.2020.v4.i2g.558

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Urological injuries in gynecological surgery: A review

Anju Rani¹,

Balvir Singh²,

Shobhit Kumar³

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2021

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“…8 Other modes of ureteral injury intraoperatively include crushed with a clamp, lacerated during sharp/blunt dissection using a source of energy, devascularization or denervation, or resection. 4,8 Potential consequences of lower UTI include ureteral obstruction (resulting in hydronephrosis and possible irreversible injury which, if bilateral, can lead to renal failure), genitourinary fistula and urinoma. Any of these consequences can lead to readmission, sepsis, and death vesicovaginal fistula and ureteric stenosis.…”

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

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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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“…Any of these consequences can lead to readmission, sepsis, and death vesicovaginal fistula and ureteric stenosis. 8,9 Intraoperative identification and repair are recommended. 2 Early identifications of the injury and prompt repair are advocated in order to minimize postoperative morbidity.…”

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

et al. 2021

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Urological injuries in gynecological surgery: A review

Cited by 1 publication

References 0 publications

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

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

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