Ureteric injuries associated with hysterectomy: A five-year experience in treating seventeen ureteric units in nine patients

Abstract

Objective: Ureteric injuries following pelvic surgeries have been widely reported. It often causes severe morbidity and even mortality. It is generally agreed that the true incidence is difficult to determine as only patients who become symptomatic may present for intervention. The aim of this article was to document our 5-year experience in managing patients with post-hysterectomy ureteric injury. Materials and Methods: A retrospective review of all patients with ureteric injuries following hysterectomy managed at public and private hospitals between 2008 and 2013 was undertaken. Results: Seventeen injuries occurred in nine patients within the study period; eight patients sustained bilateral injuries. Ureteric ligation and transections were the most common. The left ureter was more commonly injured (58.8%) than the right. Ureteroneocystostomy was the most common method for treating injuries in the distal 2.5 cm of the ureter in this study. A mortality rate of 33.3% was recorded while all the other six patients had a favorable outcome. Conclusion: Early recognition and treatment guarantee a good outcome in the management of ureteric injuries.