Background and aim
The close proximity of the urinary tract to the female genital system makes it vulnerable to
damage during pelvic surgical procedures. The objective of the current study was to evaluate
iatrogenic urinary tract injuries (UTIs) caused by obstetrical and gynecological procedures.
Patients and methods
The current study was conducted at Department of Obstetrics and Gynecology, Assiut University
Hospitals, in the period between March 2018 and March 2021. All women with UTIs secondary
to obstetrical or gynecological surgeries during the study period were recruited in the study.
Results
A total of 20 636 women were scheduled for different obstetric or gynecological surgeries,
and 170 (0.82%) of them experienced iatrogenic UTIs, 161 (94.7%) women had injury during
obstetric surgeries, whereas the other nine (5.3%) had gynecological surgeries. Operations
were repeated cesarean section (34.2%) and placenta previa (54.1%) in obstetric surgeries
and repeated section in gynecological surgeries (33.3%). Iatrogenic UTIs were detected
intraoperatively in 167 (98.2%) women, whereas in only three patients, detection was delayed.
Overall, eight (4.7%) patients had both bladder and ureteric injuries, whereas bladder injury
alone occurred in 154 (90.6%) patients and another eight (4.7%) patients had ureteric
injuries alone. ICU admission was needed in 43 (25.3%) patients.
Conclusion
Although frequencies of UTIs in obstetric and gynecological surgeries were found to be
relatively low, yet it may lead serious morbidity and outcome. Proper antenatal care and good
knowledge of pelvic anatomy may help in decreasing its frequency.
Keywords:
assiut, gynecologic, iatrogenic, obstetric, operation, placenta previa, procedure, recurrent
cesarean section, urinary tract injury