Ureteral Injury in Gynecologic Surgery: a Ten-year Review in a Community Hospital

Objective: Our purpose was to review and analyze ureteral injuries incidental to gynecologic surgery in a community hospital.

Study Design: During the study period from Jan. 1, 1983, through Dec. 31, 1992, all patient records in which ureteral injury resulted from gynecologic surgery were reviewed. The operative procedure, pathologic result, location of injury, and type of repair were studied. Additionally, the time of recognition and diagnostic methods in these ureteral injuries were analyzed.

Results: Nineteen ureteral injuries were incurred during the performance of 4665 gynecologic surgical procedures, an incidence of 0.4%. Patients ranged in age from 23 to 70 years. Recognition of the ureteral injury occurred intraoperatively in 10 patients and was delayed from 1 to 16 days in 9 patients. Six of the ureteral injuries were repaired by end-to-end anastomosis, 3 by deligation, and 10 by ureteroneocystostomy. Immediate postoperative urinary integrity was found in all patients.

Conclusion: Gynecologic surgical procedures in this study resulted in a 0.4% incidence of ureteral injury, and repair of these injuries was successful in all cases for the short term.