Urological Injuries in Obstetrical and Gynaecological Surgery at Tertiary Care Hospital

Abstract

Objectives: To determine the frequency of urological injuries in obstetrical and gynaecological surgery. Study Design and Setting: The Cross Sectional Study was conducted at Department of Obstetrics & Gynaecology, Jinnah Postgraduate Medical Center, Karachi for duration of 6 months from 31st December 2020 to 30th June 2021. Methodology: A total of 142 patients selected between the ages of 25 to 55 years of age were included. In this study all patients were included who fulfilled the inclusion criteria undergoing obstetric(cesarean section) & gynecological surgeries (laparatomies & hysterectomies). They were enrolled after taking written and informed consent. Risk factors for urological injuries were assessed in terms of indication (risk for surgery), site of urologic injury, duration of surgery and time interval after surgery. Patients having urological injury from other than obstetric and gynecologic surgeries and those who did not give consent were excluded. Results: Age range in this study was from 25 to 55 years with mean age of 40.20 ± 6.92 years. Majority of the patients 77 (54.23%) were between 41 to 55 years of age. Mean duration of surgery was 62.16 ± 14.52 minutes. Mean time interval after surgery was 37.51± 13.89 hours. In this study, frequency of ureteral injury, urinary bladder injury and mixed injury in obstetrical and gynaecological surgery was found in 01 (0.70%), 19 (13.38%) and 01 (0.70%) patients respectively. Conclusion: This study concluded that knowledge of pelvic anatomy, careful dissection and patience in difficult cases are the key factors to anticipate and prevent injury