Iatrogenic ureteric injuries in open abdominopelvic surgery: a five year experience in Maiduguri, North Eastern Nigeria

Authors

  • Ahmed Gaddams Ibrahim Division of Urology, Department of Surgery, University of Maiduguri Teaching Hospital Maiduguri, Borno State
  • Hassan Mohammed Dogo Division of Urology, Department of Surgery, University of Maiduguri Teaching Hospital Maiduguri, Borno State
  • Yakubu Lawan Gana Division of Urology, Department of Surgery, University of Maiduguri Teaching Hospital Maiduguri, Borno State

DOI:

https://doi.org/10.18203/2320-6012.ijrms20161985

Keywords:

Iatrogenic ureteric injuries, Open surgery, Presentation, Management outcome

Abstract

Background: Ureteric injuries during open abdominopelvic procedures though rare, are often associated with high morbidity and mortality especially when they present late. Late presentation is the norm as most injuries occurred during non-urological procedures and patients subsequently referred to urologist.

Methods: The study reviewed iatrogenic ureteric injuries managed by the urology unit in the University of Maiduguri Teaching Hospital between January 2011 and December 2015.

Results: A total of 19 patients (23 injured ureters), age ranged from 9 to 70 years, with a mean of 38.42 years and Female to male ratio of 2.17:1. Clinical features were renal failure with anuria in 21.05% and leakage of urine in 57.89%. Duration of symptoms ranged from 5 to 39 days. Injuries were sustained during caesarean section in 36.84% and retroperitoneal tumour resection in 31.58%. Pattern of injuries were left ureter in 39.13%, right in 26.08%, and bilateral in 4 patients 21.05% of patients- accounting for 34.78% of injuries. Procedures done were uretero-neocystostomy in 60.87% ureters and Boari flap with Psoas hitch in 17.39%. Post-operative complications were, surgical site infection 15.79% and urosepsis in 26.34%. Mortality was 15.79%.

Conclusions: Iatrogenic ureteric injuries though rare are associated with high morbidity and mortality. Early detection especially during surgery and immediate repair will reduce morbidity and mortality.

 

Keywords: 

References

Rafique M, Arif MH. Management of iatrogenic ureteric injuries associated with gynaecological surgery. Int Urol Nephrol. 2002;34(1):31-5.

Delacroix Jr. SE, Winters JC. Urinary Tract Injuries: Recognition and Management. Clin Colon Rectal Surg. 2010;23(2):104-12.

Strauss DC, Hayes AJ, Thomas JM. Retroperitoneal Tumours: review of management. Ann R Coll Surg Engl. 2011;93(4):275-80.

Drake MJ, Noble JG. Ureteric Trauma in Gynaecologic Surgery. Int Urogynecol J. 1998;9:108-17.

Sakai H, Kato H, Kobayashi S, Nishizawa O. Iatrogenic ureteral injury and the development of vesico –vaginal fistula: a complication of total Hysterectomy for multiple myoma uteri. Hinyokika Kiyo. 2002;48(12):745-7.

Jha S, Coomarasamy A, Chan KK. Ureteric injury in obstetrics and gynaecological surgery. The Obstetrician & Gynaecologist. 2011;6(4):203-8.

Paick JS, Hong SK, Park MS, Kim SW. Management of post operatively detected iatrogenic lower ureteral lnjury: Should ureteroureterostomy really be abandoned? Urology. 2006;67(2):237-41.

Park JH, Park JW, Song K, Jo MK. Ureteral Injury in Gynaecologic Surgery: A 5 – Year Review in A Community Hospital. Korean J Urol. 2012;53(2):120-5.

Burks FN, Santucci RA . Management of iatrogenic ureteral injury. Ther Adv Urol. 2014;6(3):115-24.

Halabi WJ, Jafari MD, Nguyen VQ, Carmichael JC, Mills S, Pigazzi A, et al. Ureteral injuries in colorectal surgery: an analysis of trends, outcomes and risk factors over a 10-year period in the United States. Dis Colon Rectum. 2014;57(2):179-86.

Chalya PL , Massinde AN, Kihunrwa A, Simbila S. Iatrogenic ureteric injuries following abdominopelvic operations: a 10-year tertiary care hospital experience in Tanzania. World J Emerg Surg. 2015;10:17.

Papanikolaou A, Tsolakidis V, Theodoulidis V, Vatopoulou A, Kellartzis D. Surgery for ureteral repair after gynaecological procedures: a single tertiary centre experience. Arch Gynecol Obstet. 2013;287(5):947-50.

Mensah JE, Klufio GO, Ahiaku F, Osafo C, Gepi- Attee. Delayed Recognition of Bilateral Injury after Gynaecological Surgery. Ghana Med J. 2008;42(4):133-6.

Klap J, Phe V, Chartier-kastler E, Mozer P, Bitker MO, Roupret M. Aetiology and management of Iatrogenic injury of the Ureter: a review. Prog Urol. 2012;22(15):913-9.

Frederick P, Whitworth J, et al. Radical Hysterectomy for Carcinoma of the Uterine Cervix. Glob Libr (ISSN:1756-2228) 2011: DOI 10.3843/ GLOWM. 10232.

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Published

2017-01-03

How to Cite

Ibrahim, A. G., Dogo, H. M., & Gana, Y. L. (2017). Iatrogenic ureteric injuries in open abdominopelvic surgery: a five year experience in Maiduguri, North Eastern Nigeria. International Journal of Research in Medical Sciences, 4(7), 2961–2963. https://doi.org/10.18203/2320-6012.ijrms20161985

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Original Research Articles