Title: Study of Urological Injuries in Obstetric and Gynaecological Procedures
Authors: Dr Purna Chandra Mahapatra, Dr Sujata Swain, Dr Rabi Narayan Satpathy, Dr Surbhi Snehi Indubhushan, Dr Jenny Gonmei
DOI: https://dx.doi.org/10.18535/jmscr/v5i8.163
Abstract
Aim: To study the urological injuries sustained by women during the various obstetric and gynaecological procedures with respect to their incidence, frequency, predisposing factors, location, time of recognition, prevention, associated morbities, their effect on the lifestyle of women and mangement and follow-up.
Methods: This is an observational tertiary care hospital based study. All the women who underwent obstetric and gynaecological procedures including caesarean section, hysterectomies, laparoscopic procedures, instrumental deliveries and radical surgeries were observed. Amongst these, the women who sustained urological injuries during these procedures were studied with respect to incidence, predisposing factor, location, time of recognition, obstetric status, procedure commonly associated, age group and management. These women were followed up over a period of 3 months to detect any sequelae.
Results: Incidence of urological injury in our setup was 0.28%.Incidence during obstetric procedures was 0.28% whereas that during gynaecological procedures was 0.32%.No cases of urological injury were encountered during laparoscopic procedures. Injury to the urinary bladder, ureter and urethra constituted 96.8%, 3.12% and 3.12% respectively. Thus, urinary bladder is the most frequently injured urological organ. The most common predisposing factors were obstructed labor and previous cesarean section. Cesarean section was the most frequently performed surgery. These injuries were more frequently found in second gravida patients. During gynecological procedures, a history of prior caesarean sections was found to be associated with difficult dissection. The urological injuries were found maximum in the age group of 20-25 years. The mortality rate in our study is 3.12%.
Keywords: Urological injuries, bladder, ureter, caesarean section.
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