Management of Ureteral Injuries due to Non-urologic Operations in Two Hospitals in Addis Ababa, Ethiopia

Abstract

Background: Ureteric injury is rare in obstetric and gynecological practice but, when it occurs, it has serious implications in terms of both morbidity and litigation. The morbidity arising from ureteric injury includes increased hospital stay, secondary invasive interventions, reoperation, and potential loss of renal function and deterioration of the woman’s quality of life.

Methods: This study was conducted in Tikur Anbessa specialized and Addis Hiwot General Hospitals, Addis Ababa, Ethiopia from June 2013 to May 2014. All patients who were either operated or referred to these hospitals with a diagnosis or a suspected diagnosis of ureteric injury were identified and included in the study.

Results: Three patients sustained injuries during cesarean section while two of them during hysterectomy and two others during colectomy and teratoma excision. Three were transection injuries while three had ligation with complete closure and one of the injuries was incomplete narrowing. All the transections were diagnosed intraoperatively where as all the ligations were diagnosed late (> 7 days) post operatively. Discussion: In our study all ligations are diagnosed postoperatively and all of were made late (>7days). This show the operating surgeons should have a very high degree of suspicion and should not take lightly any postoperative complaint of loin pain. Ureteroneocystostomy is also a common surgical approach to treat distal ureteric injuries and our result is very good like in several other studies.

Conclusion: Though ureteric injury is rare, it is a real tragedy when it occurs. In our study all ligations are diagnosed postoperatively and all of were made late (>7days). This shows the operating surgeons should have a very high degree of suspicion and should not take lightly any postoperative complaint of loin pain.

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