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

Authors

Ahmed Solyman, Department of Urology, Faculty of Medicine, Al-Azhar University, CairoFollow
Aly Gomaa, Department of Urology, Faculty of Medicine, Al-Azhar University, Cairo, EgyptFollow
Abdullah Zaki, Department of Urology, Faculty of Medicine, Al-Azhar University, Cairo, EgyptFollow
Mahmoud Ali, Department of Urology, Faculty of Medicine, Al-Azhar University, Cairo, EgyptFollow
Hasan Ismail, Department of Urology, Faculty of Medicine, Al-Azhar University, Cairo, EgyptFollow
Mohammed Hindawy, Department of Urology, Faculty of Medicine, Al-Azhar University, Cairo, EgyptFollow
Mohammed El-feky, Urology department; Faculty of Medicine; Al-Azhar University (Cairo)Follow
Hasan Abdelazim, Department of Urology, Faculty of Medicine, Al-Azhar University, Cairo, EgyptFollow
Hani Abdelaal, Department of Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University, Cairo, EgyptFollow
Ahmed Abdelraouf, Department of Urology, Faculty of Medicine, Al-Azhar University, Cairo, EgyptFollow

Corresponding Author

Solyman, Ahmed

Document Type

Original Article

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.

Keywords

injury; Gynecology; obstetrics; urinary tract

How to Cite This Article

Solyman, Ahmed; Gomaa, Aly; Zaki, Abdullah; Ali, Mahmoud; Ismail, Hasan; Hindawy, Mohammed; El-feky, Mohammed; Abdelazim, Hasan; Abdelaal, Hani; and Abdelraouf, Ahmed (2022) "Urinary Tract Injuries during Obstetric and Gynecologic Surgeries: Rates and Management Outcome at Two High-Volume Centers in a Developing Country," Al-Azhar International Medical Journal: Vol. 3: Iss. 3, Article 23.
DOI: https://doi.org/10.21608/aimj.2022.126998.1877