Nawaz Fauzia Haq, Khan Zeenat Eva, Rizvi Javed
Department of Obstetrics and Gynaecology, The Aga Khan University Hospital Karachi, Karachi, Pakistan.
Urol Int. 2007;78(2):106-11. doi: 10.1159/000098065.
To determine the prevalence of urinary tract injuries, identification of risk factors and methods employed for repair and their outcomes.
Cross-sectional study of patients who had urinary tract injuries during major obstetric and gynaecological surgeries at the Aga Khan University Hospital (AKUH) from 1985 to 2004.
Computer-generated discharge summaries of patients who underwent major obstetric and gynaecological procedures during the 20 years of study period were retrieved. Information was collected on data collection form, and entered in SPSS version 13 and analysed.
During the study period 12,567 obstetrics and 5,966 gynaecological procedures were performed. There were 3,910 abdominal hysterectomies, 984 myomectomies, 591 ovarian/adenexal surgeries and 481 vaginal hysterectomies. Out of these 110 urinary tract injuries were identified, 71 (64.5%) were of the urinary bladder and 39 (35.5%) were ureteric in origin, 31 (43.6%) bladder injuries were sustained during caesarean sections while 40 (56.3%) were during gynaecological procedures. In obstetric cases there were two ureteric injuries, the other ureteric injuries were sustained during surgeries for benign gynaecological conditions. The prevalence of bladder and ureteric injuries in obstetric surgeries was 0.25 and 0.02%, respectively, whereas in gynaecological surgeries the prevalence was 0.7 and 0.6% for urinary bladder and ureteric injuries. These figures compare well with other published series.
Urinary tract injuries are an uncommon occurrence but when they occur they have serious implications in terms of morbidity and litigation. The prevalence of urinary bladder and ureteric injuries observed in our review is comparable to previous reported international series. Of concern is the fact that most of the ureteric injuries were diagnosed post operatively which means that further vigilance and preventive strategies need to be designed.
确定尿路损伤的发生率、危险因素的识别、修复所采用的方法及其结果。
对1985年至2004年在阿迦汗大学医院（AKUH）进行的重大妇产科手术中发生尿路损伤的患者进行横断面研究。
检索研究期间20年内接受重大妇产科手术患者的计算机生成的出院总结。信息收集在数据收集表上，并输入SPSS 13版本进行分析。
在研究期间，共进行了12567例产科手术和5966例妇科手术。其中有3910例腹式子宫切除术、984例肌瘤切除术、591例卵巢/附件手术和481例阴式子宫切除术。在这些手术中，共识别出110例尿路损伤，其中71例（64.5%）为膀胱损伤，39例（35.5%）为输尿管损伤，31例（43.6%）膀胱损伤发生在剖宫产期间，40例（56.3%）发生在妇科手术期间。产科病例中有2例输尿管损伤，其他输尿管损伤发生在良性妇科疾病的手术过程中。产科手术中膀胱和输尿管损伤的发生率分别为0.25%和0.02%，而在妇科手术中，膀胱和输尿管损伤的发生率分别为0.7%和0.6%。这些数字与其他已发表的系列研究结果相当。
尿路损伤并不常见，但一旦发生，就会对发病率和诉讼产生严重影响。我们综述中观察到的膀胱和输尿管损伤的发生率与之前报道的国际系列研究结果相当。值得关注的是，大多数输尿管损伤是在术后诊断的，这意味着需要设计进一步的监测和预防策略。
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