Urological Complications of Obstetrics and Gynaecology Surgeries in a Developing Country

Background: Urological complications of obstetrics and gynaecology surgeries are associated with significant morbidity and occasional mortality. Certain factors affect the prevalence and outcome of treatment. Aim: To evaluate the risk factors and outcome of treatment of urological complications of obstetrics and gynaecology practice. Method: This is a retrospectively study of patients who had obstetrics and gynaecology surgeries in the University of Port Harcourt Teaching Hospital (UPTH), Port Harcourt between 2009 and 2014. Patients with urological complications were identified. Data on age, clinical presentations, investigations, treatments and outcome of treatment were extracted and analysed using SPSS 20.0. Results: During this period, 8,270 obstetrics and gynaecology surgeries were performed; Twenty five patients (0.31%) had urological complications. The mean age was 38.4 years (range 24-62 years). The commonest initial diagnosis was uterine fibroids in 9 patients followed by uterine rupture in 8 patients. Total abdominal hysterectomy (12 patients) was the commonest surgery. Twenty-one patients had ureteric injury. Seven patients had bladder injury; one patient had injury to the bladder and both ureters. Eight injuries were identified intra-operatively. Ureteric re-implantation was the commonest repair. Twenty two patients (88%) had satisfactory outcome, one patient (4%) died due to chronic renal failure while two patients (8%) had sepsis. Conclusion: We conclude that conditions that distort pelvic anatomy and emergencies were the major risk factors. Early operative repairs achieved satisfactory results. Early detection and treatment of urological complications of obstetrics and gynaecology surgeries is important. Good knowledge of anatomy of urogenital system and meticulous surgical technique by the surgeon will reduce the incidence of complications.