Urologic complications following obstetrics and gynecologicai surgery: Our experience in a tertiary care hospital

摘要

Introduction: Urinary tract injuries are a known complication of obstetrical and gynecological surgeries because of their anatomical proximity. Delayed diagnosis and improper management leads to high morbidity and even mortality. This is our three year's experience of urological complications after obstetric and gynecological surgery, their treatment and follows up. Materials and Methods: We reviewed all cases of urological injuries managed in our department that were deemed to be of obstetric and gynecological origins. Results: Thirty seven women were treated in the department for urological complications secondary to obstetric and gynecological procedures from January 2012 to December 2014. The most common organ involved was urinary bladder, occurring in 54% patients followed by ureter in 35.13%. Vesicovaginal fistula (VVF) was the most common injury involving the bladder occurring in nineteen patients. Ureterovaginal fistula (UVF) occurred in nine patients and acute ureteric injury in three. Hysterectomy was the most common etiology occurring in 60% cases followed by obstetrical causes in 40% cases. All cases were successfully managed both with open surgery or laparoscopic surgery. Conclusion: Although obstetrical causes are still important in developing countries, gynecological procedures especially laparoscopic surgeries are on the rise. In these procedures the suspicion of urological injuries should be kept in mind and intra-operative detection and early repair should be attempted. Delayed diagnosis and improper treatment leads to severe complications.