• Users Online: 330
  • Home
  • Print this page
  • Email this page
Home About us Editorial board Search Ahead of print Current issue Archives Submit article Instructions Subscribe Contacts Login 
ORIGINAL ARTICLE
Year : 2016  |  Volume : 19  |  Issue : 1  |  Page : 47-51

Pattern of iatrogenic ureteral injuries in a tertiary health center in Nigeria


Department of Surgery, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria

Correspondence Address:
Oranusi Chidi Kingsley
Department of Surgery, Nnamdi Azikiwe University, Awka/Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State
Nigeria
Login to access the Email id


DOI: 10.4103/1119-0388.172064

Rights and Permissions

Objective: To assess etiology, nature of injuries, and reconstruction techniques employed in the management of iatrogenic ureteral injuries. Patients and Methods: A retrospective review of patients with iatrogenic ureteral injuries from January 2009 to December 2013 was done. Records of the patients were reviewed with respect to etiology, mode of presentation, nature of injury, and type of repair done. Results: Twenty patients with iatrogenic ureteral injuries underwent a total of 28 ureteral reconstruction procedures at our institution over the 5-year period. There were 19 female patients (95.5%) and only 1 male patient (4.5%). The mean age of the female patients was 34.5 ± 3.8 years. Of the iatrogenic injuries to the ureter, 50% occurred on the left side while 8 (28.6%) were bilateral. In majority of the cases, 26 (92.9%), these injuries were the result of inadvertent ligation of the ureter. The average time at presentation after the injuries was 29.1 weeks with a range of 2 days to 8 years. The most common gynecological operation implicated was total abdominal hysterectomy (TAH) (55%) followed by myomectomy (20%), ovariectomy (10%), cesarean section (10%), and excision of the right colonic tumor (5%). The commonest mode of presentation was leakage of urine from the vagina as seen in 10 (50.0%) patients while 25% had complete anuria. Ureteroneocystostomy (UNC) was performed in 19 (67.8%) ureters. Psoas hitch and Boari flap were done in four (14.3%) and three (10.7%) cases, respectively. One patient (3.6%) required a transureteroureterostomy (TUU) and another one (3.6%) required a right nephroureterectomy. Outcome of the treatment was judged as satisfactory in all the cases as defined by improvement or resolution of the symptoms and normalization of renal function. Conclusion: Abdominal hysterectomy still remains the dominant cause of iatrogenic injury to the ureter. UNC can often be used to establish ureteral continuity in most cases of iatrogenic injuries to the distal ureter. Injuries to the right ureter are more likely to involve the middle third of the ureter, requiring some form of bladder mobilization or bladder flap to establish ureteral continuity. Attention to preventive measures, especially during gynecological surgeries, will help to reduce the incidence of ureteric injuries.


[FULL TEXT] [PDF]*
Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)
 

 Article Access Statistics
    Viewed1543    
    Printed28    
    Emailed0    
    PDF Downloaded151    
    Comments [Add]    

Recommend this journal