ABSTRACT
Injury to the ureter is a potentially devastating
complication of modern surgery. The ureters are
most often injured in gynecologic, colorectal,
and vascular pelvic surgery. There is also
potential for considerable ureteral injury during
endoscopic procedures for ureteric pathology
such as tumor or stones. We are presenting this
case of bilateral ureteric injury in 50 years old
female on account of its rarity and its successful
management.
KEY WORDS :- Ureteric Injury.
INTRODUCTION
Iatrogenic trauma is the leading cause of
ureteric injuries. The single factor adversely
affecting the outcome of this rather uncommon
injury seems to be delayed diagnosis.
The frequency of ureteral injury following
gynecologic surgery is approximately 1%,
with a higher percentage of injuries occurring
during abdominal hysterectomies and partial
vaginectomies. Patients who have received
pelvic radiation or who have advanced pelvic
cancers requiring extensive surgical procedures
are more likely to experience a ureteral injury.
Laparoscopic procedures also have an equivalent
rate of ureteral stricture formation secondary to
ureteral injury, ureteral strictures is significantly
higher.[1, 2]
Latrogenic ureteral injury during gynecologic
surgery may present either intraoperatively
or post operatively. In post operative period,
ureteric injuries the patient may present with
flank pain, prolonged ileus, fever, watery vaginal
discharge, or elevated serum creatinine levels.
In cases of bilateral ureteral injury, anuria is the
first clinical sign.