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Urinary tract injuries during pelvic surgery: Incidence rates and predisposing factors

Authors
 Sang Wook Bai  ;  Eun Ha Huh  ;  Da Jung Jung  ;  Joo Hyun Park  ;  Koon Ho Rha  ;  Sei Kwang Kim  ;  Ki Hyun Park 
Citation
 INTERNATIONAL UROGYNECOLOGY JOURNAL, Vol.17(4) : 360-364, 2006 
Journal Title
 INTERNATIONAL UROGYNECOLOGY JOURNAL 
ISSN
 0937-3462 
Issue Date
2006
MeSH
Adult ; Female ; Gynecologic Surgical Procedures/adverse effects* ; Humans ; Incidence ; Medical Errors/adverse effects ; Medical Errors/statistics & numerical data* ; Middle Aged ; Retrospective Studies ; Risk Factors ; Urinary Tract/injuries*
Keywords
Urinary tract injury ; Pelvic surgery ; Predisposing factors
Abstract
OBJECTIVE: To review the cases of urinary tract injury following major pelvic surgery that were treated in our hospital over the last 12 years, in relation to possible predisposing factors and incidence rates of injury arising in various surgical procedures. MATERIALS AND METHODS: From 8,824 major gynecological operations performed in our department, 29 cases of intraoperative urinary tract injury were found. Thirty eight patients visited the urology department during the same period for the management of urogenital fistula following pelvic surgery. Parameters that were examined included type of urinary tract injury, indication for surgery, type of operation, coexisting pathological conditions, past history of pelvic surgery or pelvic irradiation, and the delay in the recognition and management of the urinary tract injury. RESULTS: The overall incidence of urinary tract injury in pelvic surgery was 0.33%. The incidence of urinary tract injury in radical hysterectomy was higher than that of total abdominal hysterectomy(0.76 vs 0.26%). Of the intraoperative urinary tract injuries, 48.4% coexisted pelvic pathologies. Of all the cases with urinary tract injury, the most common type of operation was total abdominal hysterectomy (n = 45, 67.2%), and the most common indication was uterine myoma (n = 25, 36.9%). The most common type of urinary tract injury was bladder injury, including bladder laceration and vesicovaginal fistula(n = 57, 76.1%). The frequency of reoperation was found to be lower in patients with a shorter delay in the recognition of the injury (p < 0.05). CONCLUSION: Possible predisposing factors for urinary tract injury are coexisting pelvic adhesion, distortion of normal pelvic configuration, previous irradiation history, previous operation history, and the extent of surgery. In high-risk patients, proper evaluation is needed to avoid urology complications before operation.
Full Text
http://link.springer.com/article/10.1007/s00192-005-0015-4
DOI
10.1007/s00192-005-0015-4
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Obstetrics and Gynecology (산부인과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Sei Kwang(김세광)
Rha, Koon Ho(나군호) ORCID logo https://orcid.org/0000-0001-8588-7584
Park, Ki Hyun(박기현)
Bai, Sang Wook(배상욱) ORCID logo https://orcid.org/0000-0001-7724-7552
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/109980
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