Incidence of urinary tract injuries and infections associated with gynecological surgeries.
Objective: To determine the incidence of urinary tract injuries associated with gynecological surgeries and their management.
Methodology: In this retrospective study, data of all the women admitted and went through any gynecological surgery during the period of four years from January 2017 to December 2020 was included. Detailed history, clinical examination along with information regarding demographic characteristics were ascertain from the record. The record was reviewed retrospectively for disease caused for obstetric and gynecologic surgery, success rate, failure rate of the surgery and treatment strategy for the complication were noted.
Results: A total of 46 (2.92%) women were found to have urinary tract injury among 1578 gynecological surgeries performed. The mean age of these women was 35.61 ± 8.45, ranging from 23 years to 26 years. There were 423 (26.81%) open surgeries, 237 (15.01%) were laparoscopic surgeries, and 918 (58.17%) were cesarian sections. Among open surgeries most common surgery was transabdominal hysterectomy 197 (46.57%) followed by vaginal hysterectomy 152 (35.93%). Bladder injury was found to be most common 14 (46.67%) among surgeries of Myoma of uterus followed by 10 (33.33%) ceasarian section. Ureter injuries were most commonly found in surgeries of cervical cancer. All the patients with bladder injury were managed with primary repair. Most of the patients 3 (30%) with ureter injury were managed with Immediate Ureteral Stent Indwelling.
Conclusions: Although the urinary tract injuries are uncommon, but a significant morbidity is associated with these injuries. Bladder injuries were more common than ureteric injuries, but they cause less morbidity because of their early diagnosis and repair.
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