The New Indian Journal of OBGYN. 12(1):147-151

Role of urologist in urological injuries in obstetrics and gynecology operation theatre - our experience

Venkat Arjunrao Gite, Shashank Sharma

ABSTRACT

Background: Both genital and urinary tracts are anatomically closely related in females. One must be certain to prevent injury to one while operating on the other. Urologic injuries are rare accounting for 0.1% -1.5% of pelvic surgeries. Objective: To assess role of Urologists in management of urological injuries during obstetrics and gynaecological procedures. Materials and methods: We retrospectively analysed records of urological injuries happened in Obstetrics and Gynaecology operation theatre at tertiary referral centre in Western India between May 2011 to May 2021. Data analysis was done pertaining to clinical presentation, site of injury, etiopathogenesis and success rate with respect to time of diagnosis and treatment of complications. Results: A total of 72 urological injuries were seen out of 38296 cases, accounting for 0.18 percent. Most common type of urinary tract injury was bladder injury. Simple abdominal hysterectomy was leading cause of injuries. Intraoperatively, 6 ureteric injuries were diagnosed out of total 16, all 6 underwent ureteroneocystostomy with 100 % success rate. Out of 53 bladder injuries, 43 cases of bladder injury were repaired intraoperatively with 100% success.10 cases underwent modified O Connor repair after 3 months from primary surgery with 100% success. Out of 16 patients of ureteric injury, 14 patients underwent ureteroneocystostomy on DJ stent and 2 underwent ureteroureterostomy. While three cases of ureter and bladder injury were treated with primary bladder repair and ureteroneocystostomy with 100% success. Conclusions: Thorough anatomical knowledge with preoperative planning and multidisciplinary approach is key to success in management of urological injuries.