Iatrogenic disorders of the urinary tract: recognition and prevention

摘要

The Greek term "iatros" means physician, and is derived from the word "iasthai", which means to heal or cure. In modem usage "-iatric", and "iatro-" connote a relationship to medical or surgical treatments. What is the significance of the word iatrogenic? The term iatrogenic contains the root word "iatros", and the root word "gennan" which means "to create or produce". Dorland's medical dictionary defines iatrogenic as any adverse condition or complication in a patient occurring as a result of treatment by a physician. Because there is no comparable English word for adverse events in patients resulting from treatment by veterinarians, the word iatrogenic has been adopted by our profession. The fact that iatrogenio is often considered as a pathophysiologic mechanism of disease emphasizes that there are some patients we cannot help, but there are none we cannot harm. The word iatrogenic is related in concept to the word "nosocomial". The Greek root word "nosa" indicates a relationship to disease. Nosology is defined as the science of classification of diseases. Dorlands dictionary defines the term nosocomial as a disease ( such as infections ) originating in the hospital. The fact that patients can acquire diseases in hospitals also emphasizes that there are some patients we cannot help, but there are none we cannot harm. The word iatrogenic and nosocomial are not synonyms for malpractice. Perhaps our point can be best applied with the following illustration. In an article written in the February1, 1999 issue of The New Yorker magazine entitled, "When Doctors Make Mistakes", the byline was, "The real problem isn't how to stop bad doctors from harming, even killing, their patients. It's how to prevent good doctors from doing so." The central theme of this article embodies the premise that any health care provider, no matter how experienced or skilled they me be, can cause harm to their patients. The following discussion describes a few of the many iatrogenic and nosocomial events that may occurin patients with urinary tract disorders.