Management of Iatrogenic urologic injuries in pelvic operations for gynecologic malignancies : NCI review of 25 cases / Dina Hany Ahmed Abdelghany Zahran ; Supervised Gamal Amira Mohammed , Ihab Samy Fayek , Reda Hasan Tabashy

Thesis (M.Sc.) - Cairo University - National Cancer Institute - Department of Oncology-Surgical

Iatrogenic urologic injuries are rare complications of abdomino-pelvic surgery but associated with high morbidity and even mortality. There is paucity of data regarding iatrogenic ureteric injuries in Egypt and National cancer institute in particular. This study describes our experience in the management and outcome of urologic injuries following abdomino-pelvic operations outlining the causes, clinical presentation and outcome of management of this condition in our local setting. The most commonly injured organs are the bladder, ureter and urethra. Whenever, prior delineation of the course of the pelvic ureter by exposing its course and frequent visualization throughout the surgery prevents most of the injuries. Urologic injuries can result in intraabdominal sepsis, renal failure, and loss of the ipsilateral renal unit. Most injuries are iatrogenic and remain undiagnosed until the patient presents with symptoms postoperatively. Extensive abdominopelvic adhesions and large pelvic tumors were the main risk factors. Sites of injuries and the risk factors were discussed. Thorough preoperative evaluation in anticipation of iatrogenic injuries, sound knowledge of surgical anatomy with experience, ureteral stenting before the main procedure, meticulous dissections

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