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Indian Journal of Obstetrics and Gynecology

Volume  8, Issue 2, April – June 2020, Pages 18-22
 

Original Article

Urological Injury in Obstetric and Gynecological Surgery: A Retrospective Analysis of Five Years

Anju Kumari Rani, Brijesh Singh, Shobhit Kumar

1Senior Consultant, 2Consultant Surgeon, General Hospital, Department of Obstetrics and Gynecology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh 226014, India. 3Student, King George’s Medical University, Lucknow, Uttar Pradesh 226003, India.

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DOI: http://dx.doi.org/10.21088/ijog.2321.1636.8220.2

Abstract

To determine incidence and nature of urological injuries in obstetric and Gynecological procedures and their complications and mode of management in a tertiary care hospital, Gynecological Sevices, SGPGIMS, Lucknow. A retrospective study of all obstetric and Gynecological surgeries over a period of 5 years from January 2014 to December 2018 was carried out at Gynecological Services, SGPGIMS, Lucknow, India. Cases with the documented urological injuries were analyzed further. A total of 1,526 patients underwent obstetric and Gynecological procedures like lower segment cesarean section, various types of hysterectomies, laparotomy were analyzed. Cases with urologic injuries were identified and analyzed for the type of injuries, timing of diagnosis, their management and consequences. Out of 1,526 patients undergoing various surgeries, 8 (0.52%) patients had bladder injury and
1 (0.06%) patients had ureteric injury. In gynecologic procedures, the incidence of bladder injury was highest in radical hysterectomy (1 out of 35, 2.8%) followed by VH (2 out of 123, 1.62%), laparotomy (1out of 194, 0.51%) and TAH (2 out of 635, 0.32%). Only 1 ureteric injury was noted in a case of TAH out of total 1094 Gynecological procedures (0.09%). Statistically, ureteric injuries are less frequent but are responsible for significant morbidity when compared to bladder injuries which are more common but with less complications as they are diagnosed and managed timely.
 


Keywords : Obstetrics and Gynecological Surgery; Bladder injury; Ureter injury.
Corresponding Author : Anju Kumari Rani