Urological injuries in gynecological surgery: A review

Abstract

Due to close anatomical proximity of urogenital systems to female reproductive system, urological complications are common in gynecological surgeries. In fact most of iatrogenic urinary tract injuries are due to gynecologic surgeries. Previous pelvic surgery, endometriosis, gynecological malignancy, pelvic radiation, abnormalities of ureter, and presence of adhesion were found to be significant risk factors. Urinary bladder injury was the most common urinary tract injury during gynecologic surgery and usually recognized and repaired immediately with minimal complications. However, ureteral injuries which mostly happens in distal one third of the ureter usually are not recognized immediately and have the potential to be life-threatening or to result in permanent kidney damage. The most reliable way for surgeons to avoid ureteral injury is to clearly identify the ureter. Aim should be of early diagnosis and management of urological injury to avoid the life threatening complications.