Abstract
Objective: To determine the frequency and types of iatrogenic urological tract injuries during obstetric and gynecological
surgical procedures in a tertiary teaching hospital over a period of two years.
Material and Methods: The study was conducted at the Obstetrics and Gynecology unit of Khyber Teaching Hospital Peshawar from January 2017 to December 2018. Any patient undergoing a surgical procedure irrespective of the nature and time
of surgery was included. The nature and type of the primary surgical procedure, anatomical site of injury, time of diagnosis,
management and therapeutic success rate was determined. Injury was defined as entry into the urinary tract lumen, crushing, ligation or/and excision of the urinary tract, leakage of urine, post-operative hydronephrosis, or extravasation of contrast
outside the urinary tract with or without renal damage that required surgical intervention.
Results: The frequency of iatrogenic injury to the urological tract in obstetrics emergency and elective procedures was
0.036% with urinary bladder the most frequently damaged viscera. No ureteric injury was recorded in obstetrical patients.
In gynecological procedure only 0.45% injuries were recorded. All of the injuries were diagnosed and dealt with, during the
same surgical session, with no patient requiring reoperation. Outcome of the management was satisfactory with no permanent urological tract damage and mortality.
Conclusion: Good knowledge of pelvic anatomy, meticulous care during technically difficult surgical procedures, involvement of urological surgeon in suspicious cases helped us to identify and treat urinary tract damage at the time of primary
injury, with good outcome and minimal morbidity
Saima Gilani, Zubaida Akhtar, Arzoo Bangash, Syed Ahmed. (2020) FREQUENCY AND TYPES OF UROLOGICAL INJURIES IN GYNECOLOGY AND OBSTETRIC PRACTICE IN A TEACHING HOSPITAL, Journal of Medical Sciences, Volume 28, Issue 3.
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