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Federación Mexicana de Ginecología y Obstetricia, A.C.

2007, Number 04

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Ginecol Obstet Mex 2007; 75 (04)

Ureteral injury at the National Institute of Perinatology

Meraz ÁD, Rodríguez CS, Ramírez IC, Escobar BL, Quiroz GG

Language: Spanish
References: 13
Page: 187-192
PDF size: 166.52 Kb.


ABSTRACT

Objectives: To evaluate the incidence of ureteral injury at Instituto Nacional de Perinatologia and to know the variables associated to ureteral injury as a ginecoobstetric surgery complication, and to do a theme review.
Material and methods: We conducted a study including patients with ureteral injury from January 1st 1992 to July 1st 2005. Files were registered for age, parity, surgery associated to the injury, injury type, diagnostic time and methods, management type and evolution. The study was observational, transversal, and retrospective. We analyzed the results with descriptive statistics.
Results: We included 39,405 surgeries; a total of 32 injuries were identified, and in 41% the injured ureter was the left one, in 42% was the right one and both in 17%. We included patients from the Instituto and from another hospital. Mean age was 38.9 years, media 43 and mode 44 years. Principal surgery related was the gynecological histerectomy. Patients’ evolution was satisfactory. The most frequent surgery to repair the ureter was the reimplantation, followed by the immediate reparation with simple stitches.
Conclusions: The ureteral injury frequency was 0.04%, in relation principally with gynecological histerectomy. The most frequent injury type was the ligation in the distal third. In three cases there was a ureter-bladder fistula. The ureteral reimplantation was the most frequent surgical repair.


REFERENCES

  1. T hompson JD. Lesiones quirúrgicas del uréter: prevención y tratamiento. En: Thompson JD, Rock JA, editores. Ginecología quirúrgica. Buenos Aires: Panamericana, 1992;pp:685-715.

  2. Eisenkop SM, Richman R, Platt LD, Paul RH. Urinary tract injury during cesarean section. Obstet Gynecol 1982;60:591-6.

  3. Brubaker L, Wilbanks G. Urinary tract injuries in pelvic surgery. Surg Clin North Am 1991;71:963-76.

  4. Lask D, Arbanel J, Luttwak Z, Manes A, Mukamanel E. Changing trends in the management of iatrogenic ureteral injuries. J Urol 1995;154(5):1693-5.

  5. Harkk i-Sirén P, Sjöberg J, Tiitinen A. Urinary tract injuries after hysterectomy. Obstet Gynecol 1998;92:113-8.

  6. Goodno JA, Powers TW, Harris VD. Ureteral injury in gynecological surgery: a ten years review in a community hospital. Am J Obstet Gynecol 1995;172(6):1817-20.

  7. T aggart S, van Sonnenberg E, D’Agostino H, Casola G, May S. The role of percutaneous procedures for management of urinary tract injuries. In: Buschbaum & Schmidt, editors. Gynecologic and Obstetric Urology. Philadelphia: Saunders, 1993;pp:163-70.

  8. Payne CK. Ureteral injuries in the female: fistulas and obstruction. In: Raz S, editor. Female urology. Philadelphia: Saunders, 1996;47:507-20.

  9. Meirow D, Moriel E, Zilberman M, Farkas A. Evaluation and treatment of iatrogenic ureteral injuries during obstetric and gynecologic operations for non malignant conditions. J Am Coll Surg 1994;178(2):144-8.

  10. Nava y Sánchez R, González Torres C, Berea Domínguez, De la Peña Zayas E, Guerrero Ramos L. Lesiones del árbol urinario en ginecología y obstetricia. Ginecol Obstet Mex 1979;46:433-51.

  11. Mariotti G, Natale F, Trucchi A, Cristini C, Furbeta A. Ureteral injuries during gynecologic procedures. Minerva Urol Nefrol 1997;49(2):95-98.

  12. Selzman A, Spirnak J. Iatrogenic ureteral injuries: a 20 year experience in treating 165 injuries. J Urol 1996;155(3):878-81.

  13. Assimos DG, Patterson LC, Taylor CL. Changing incidence and etiology of iatrogenic ureteral injuries. J Urol 1994;152(6):2240-6.




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