URETERAL INJURY IN GYNECOLOGIC SURGERY - A 10-YEAR REVIEW IN A COMMUNITY-HOSPITAL

OBJECTIVE: Our purpose was to review and analyze ureteral injuries inc idental 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 sur gery were reviewed. The operative procedure, pathologic result, locati on 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 u reteral injury occurred intraoperatively in 10 patients and was delaye d from 1 to 16 days in 9 patients. Six of the ureteral injuries were r epaired by end-to-end anastomosis, 3 by deligation, and 10 by ureteron eocystostomy. Immediate postoperative urinary integrity was found in a ll 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.