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Urological Injuries during Obstetrical and Gynecological Surgeries

机译:妇产科手术期间的泌尿外科损伤

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Object: Review the urological injuries encountered in gynecological and obstetrical procedures in respect of frequency, predisposing factors, location, recognition of time and management. Place and Duration: Department of Urology and Obstetrics and Gynecology at Peoples Medical Col-lege Hospital Nawabshah from 2007-2008. Study Design: Prospective study. Material and Methods: In this Prospective study of two (02) years 3400 obstetrical and gynecological sur-geries were preformed. Medical records of all patients who sustained urological injuries were reviewed for frequency, predisposing factors, location, and type of injury, recognition time and management. Results: Thirty injuries were documented in 2930 obstetrical and 470 gynecological procedures. Twenty (20) injuries occurred in obstetrical procedures, where as 10 (ten) injuries occurred in gynecological surge-ries. Twenty four (24) were bladder injuries, four (04) were ureteric injuries and two (02) were urethral inju-ries. The predisposing factors were previous C-Sec-tion, pelvic adhesions, huge fibroids, distorted ana-tomy and massive haemorrhage. Conclusion: These iatrogenic injuries were prevent-able by paying careful attention to anatomy of uro-genital organs, avoid blind application of clamps and excessive use of diathermy for haemostasis. These are due to delay of the patient, poor surgical monitoring facilities, improper training and supervision of post graduate trainees.
机译:目的:从频率,诱发因素,位置,时间识别和管理方面,回顾妇产科手术中遇到的泌尿外科损伤。地点和时间:2007年至2008年在纳瓦布沙什人民医学医院泌尿外科和妇产科。研究设计:前瞻性研究。材料和方法:在为期两(02)年的前瞻性研究中,进行了3​​400例产科和妇科手术。对所有遭受泌尿外科损伤的患者的病历进行检查,检查其频率,诱发因素,损伤的位置和类型,识别时间和处理方法。结果:2930例产科和470例妇科手术记录了30例伤害。产科手术中有20(20)人受伤,妇产科手术中有10(10)人受伤。二十四(24)人为膀胱损伤,四(04)人为输尿管损伤,两(02)人为尿道损伤。诱发因素是先前的C段,盆腔粘连,巨大的肌瘤,解剖畸形和大量出血。结论:注意医源性泌尿生殖器官的解剖可避免这些医源性损伤,避免盲目使用钳夹和过度使用透热疗法止血。这是由于患者的延误,手术监控设备差,培训不当以及对研究生的监管所致。

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