Iatrogenic ureteral injuries: a 20-year experience in treating 165 injuries.

PURPOSE

We reviewed the causes, treatment and morbidity associated with iatrogenic ureteral injuries.

MATERIALS AND METHODS

From 1972 to 1992 the charts of all patients with the diagnosis of iatrogenic ureteral injury were reviewed and 156 injuries were identified.

RESULTS

Urological, gynecological and general surgical procedures accounted for 70 (42%), 56 (34%) and 39 (24%) injuries, respectively. Of the injuries 91% occurred in the lower third, 7% in the middle third and 2% in the upper third of the ureter, respectively. Among the urological lesions 77% were identified at injury compared to only 33% of the nonurological cases. Nonurological and urological ureteral injuries detected postoperatively required 1.8 and 1.6 procedures, respectively, compared to only 1.2 procedures in both groups (p < 0.0006 and p < 0.013) when the injuries were detected immediately at operation.

CONCLUSIONS

Endourological procedures are the most common cause of iatrogenic ureteral injuries. When identified at injury and treated properly such injuries seldom lead to loss of renal function.