POST–HYSTERECTOMY URETERIC INJURIES: PRESENTATION AND OUTCOME OF MANAGEMENT IN A TERTIARY CARE CENTRE

Dr Deepak Kumar; Dr Namita Gupta

Volume : VIII, Issue : IV, April - 2019

POST–HYSTERECTOMY URETERIC INJURIES: PRESENTATION AND OUTCOME OF MANAGEMENT IN A TERTIARY CARE CENTRE

Dr Deepak Kumar, Dr Namita Gupta

Abstract :

The ureter is especially susceptible to injury during vascular, gynecologic, urologic, and colonic operations. Total abdominal hysterectomy is the operation most commonly responsible for a ureteral injury. Many ureteral injuries are likely due to technical or iatrogenic factors. The morbidity associated with such injury may be serious, resulting in increased hospital stay, compromise of the original surgical outcome, secondary invasive interventions, reoperation, potential loss of renal function, and deterioration of the patient‘s quality of life. Endourological techniques are highly successful in treating posthysterectomy ureteral injuries Methods: This study involved patients referred and managed in the department of urology for posthysterectomy ureteric injuries for benign conditions during 2 years from March 2017 to Feuary 2019. During this period, a total of 14 patients with 16 ureteric injuries were treated. Results: There were 16 iatrogenic ureteric injuries in 14 patients over a 2–year period. Hysterectomy was the cause of injury in all the cases, among whom 12 were abdominal, and 2 were vaginal hysterectomies. Surgical procedures undertaken were JJ stenting, ureteric reimplantation & Laparotomy with bladder injury repair with bilateral ureteric reimplantation. Conclusion: Posthysterectomy ureteric injury is not an uncommon complication of pelvic surgery. Simple hysterectomy for benign diseases is the most common cause of injury. The patient with ureteric injury should be evaluated and intervened at the earliest. Patients presenting early, within 2 weeks after hysterectomy have higher chances of success with endourological procedures, obviating the need for open surgery.