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227545

Urinary Tract Injuries during Obstetric and Gynecologic Surgeries: Rates and Management Outcome at Two High-Volume Centers in a Developing Country

Article

Last updated: 03 Jan 2025

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Abstract

Background: Iatrogenic genitourinary trauma can result from various obstetric (Obst) and Gynecologic (Gyn) surgeries. Aims: To evaluate the rate and management outcome of urinary tract (UT) injuries caused by Obst/Gyn surgeries at two tertiary care centers in a developing country. Patients and Methods: In this study, we reviewed the files of all patients with UT injuries due to Obst/Gyn surgeries managed in the past 6 years at two tertiary care centers in Egypt. Types of Obst/Gyn surgeries and UT injuries, time at diagnosis, associated factors, and management outcome were evaluated. Results: The study included 103 patients. The UT injuries were in the form of urinary bladder injury in 38 (36.9%), ureteral injury in 11 (10.7%), and genitourinary fistula in 54 (52.4%). The fistula was vesicouterine in 13, vesicovaginal in 36, and ureterovaginal in 5 cases. Most bladder injuries (76.3%) occurred during cesarean section, and all were reported and successfully repaired intraoperatively. The ureteral injuries were reported intraoperatively in 7 (63.6%) and postoperatively in 4 (36.4%) cases. Most ureteral injuries (90.9%) occurred during abdominal hysterectomy, and all were successfully managed except for one patient who needed reoperation. Most genitourinary fistulae (74.1%) were diagnosed after abdominal hysterectomy, and all were managed successfully by surgical intervention, except 3. The factor associated with bladder injury and genitourinary fistula formation was the history of previous pelvic surgery. Conclusion: Most UT injuries induced during Obst/Gyn surgeries were managed successfully. The reported associated factor could aid in reducing the risk of this type of injury.

DOI

10.21608/aimj.2022.126998.1877

Keywords

injury, Gynecology, obstetrics, urinary tract

Authors

First Name

Ahmed

Last Name

Solyman

MiddleName

Mohammed

Affiliation

Department of Urology, Faculty of Medicine, Al-Azhar University, Cairo

Email

ahmedsolyman2022@gmail.com

City

-

Orcid

-

First Name

Aly

Last Name

Gomaa

MiddleName

-

Affiliation

Department of Urology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt

Email

alygomaa68@yahoo.com

City

-

Orcid

-

First Name

Abdullah

Last Name

Zaki

MiddleName

-

Affiliation

Department of Urology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt

Email

zakizaki10@yahoo.com

City

-

Orcid

-

First Name

Mahmoud

Last Name

Ali

MiddleName

-

Affiliation

Department of Urology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt

Email

dr_mahmoud72@hotmail.com

City

-

Orcid

-

First Name

Hasan

Last Name

Ismail

MiddleName

-

Affiliation

Department of Urology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt

Email

hasan.ismail60@yahoo.com

City

-

Orcid

-

First Name

Mohammed

Last Name

Hindawy

MiddleName

-

Affiliation

Department of Urology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt

Email

hindowy78@gmail.com

City

-

Orcid

-

First Name

Mohammed

Last Name

El-feky

MiddleName

Mohammed

Affiliation

Urology department; Faculty of Medicine; Al-Azhar University (Cairo)

Email

mohamedelfeky2626@yahoo.com

City

-

Orcid

-

First Name

Hasan

Last Name

Abdelazim

MiddleName

-

Affiliation

Department of Urology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt

Email

hassanabdelazim83@gmail.com

City

-

Orcid

-

First Name

Hani

Last Name

Abdelaal

MiddleName

-

Affiliation

Department of Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt

Email

foxpnl321@gmail.com

City

-

Orcid

-

First Name

Ahmed

Last Name

Abdelraouf

MiddleName

-

Affiliation

Department of Urology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt

Email

abulfotouhahmed70@gmail.com

City

-

Orcid

-

Volume

3

Article Issue

3

Related Issue

32736

Issue Date

2022-03-01

Receive Date

2022-03-12

Publish Date

2022-03-01

Page Start

149

Page End

151

Print ISSN

2682-3381

Online ISSN

2682-339X

Link

https://aimj.journals.ekb.eg/article_227545.html

Detail API

https://aimj.journals.ekb.eg/service?article_code=227545

Order

23

Type

Original Article

Type Code

710

Publication Type

Journal

Publication Title

Al-Azhar International Medical Journal

Publication Link

https://aimj.journals.ekb.eg/

MainTitle

Urinary Tract Injuries during Obstetric and Gynecologic Surgeries: Rates and Management Outcome at Two High-Volume Centers in a Developing Country

Details

Type

Article

Created At

22 Jan 2023