Ureteric injuries during laparoscopic gynecologic surgeries

Abstract

Ureteric injury is rare in gynecological practice. The introduction of laparoscopy to gynecologic surgery has allowed for newer innovations, advancements, and also new challenges in the field. As the complexity of laparoscopically approached gynecologic cases continues to increase, it is imperative for surgeons to be aware of the risk of ureteral injury. Although rare, ureteral complications of laparoscopic gynecologic surgery are quite morbid and may have serious implications in relation to litigations. The incidence of ureteric injury varies between 0.1% and 30%, depending on the type of surgery. Prevention can be attempted by preoperative and intraoperative precautions, although the effectiveness of these measures has not been fully evaluated. Diagnosis of ureteric injury may be made intraoperatively, but 70% are diagnosed postoperatively. Management depends on the timing of diagnosis, the etiology, the length and location of the injury, the extent of the causative operation, and the condition of the woman. In this article, we have reviewed the incidence, etiology, preventive strategies, diagnosis, and management of ureteric injury. Knowledge about their prevention, diagnosis, and management is of utmost importance.