We report a 5-year review of all ureteric injuries at a major Sydney teachi
ng hospital as a result of gynecological procedures. A retrospective analys
is was made of all hospital medical records and consultant follow-up notes
from January, 1990 to May, 1995. Injuries were recorded in 22 patients with
a mean age 52 years (range 31-88). Of these, 17 occurred at our institutio
n, while 5 were referred from peripheral hospitals. Two injuries were bilat
eral, and 6 were discovered intraoperatively. Patients were managed acutely
where possible. Treatment options included cystoscopy and retrograde stent
ing, deligation, neoureterocystostomy, transureteroureterostomy or nephrect
omy. Follow-up imaging was available in 16 patients, of those, 15 were norm
al, and 1 showed bilateral obstruction secondary to radiotherapy. The overa
ll risk of ureteric injury for all methods of hysterectomy was 0.44% (0.24%
for total abdominal hysterectomy).