Abstract
Objectives: To review our experience in the management of iatrogenic ureter
injuries caused by different urological procedures. Study Design: Descriptive Case series.
Setting: Department of Urology, Jinnah Postgraduate Medical Centre Karachi. Period: January
2011 to December 2018. Material & Methods: We included all cases of iatrogenic ureteric
injuries induced by urology department only. Gynecological and general surgical iatrogenic
injuries were excluded in this study. Results: We managed 56 iatrogenic ureteric injuries in 47
patients during study period. Mean age was 43.14+ 8.86 years. There were 31 males (66%)
and 16 females (34%). Right sided injury was observed in 29 patients (61.7%), left sided injury
in 16 patients (34.0%) while bilateral injuries were seen in 2 patients (4.3%). Regarding site of
injury proximal ureteric injuries were the most common accounting for 32 patients (68.1%).
Intraoperative diagnosis was the most common time for diagnosis seen in 30 patients (63.8%).
The endoscopic urological surgeries were the most common cause of urological iatrogenic
ureteric injury accounts for 71.4% of cases. Open upper tract surgeries were responsible for
8 cases (14.2%). One patient sustained proximal ureteric injury during retro-peritoneal lymph
node dissection (RPLND). Laparoscopic urological surgeries were responsible for four cases
of injury. One patient developed ureteric avulsion. 13 patients presented with late Ureteric
stricture. We have five nephrectomies while three patients needed permanent nephrostomies.
Our success rate was 83%. Conclusions: Endo-urological procedures are the commonest
causes of ureteric injuries in our study. Prompt diagnosis and early corrective intervention can
result in satisfactory outcome in about 83% of cases.
Muhammad Mansoor. (2020) Iatrogenic ureteric injuries in urological surgeries- A Tertiary hospital experience., The Professional Medical Journal, Volume 27, Issue 12.
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