SURGICAL TREATMENT OF URETERIC INJURIES IN OBSTETRIC AND GYNECOLOGICAL PRACTICE
Journal: Journal of the Grodno State Medical University (Vol.20, No. 1)Publication Date: 2022-03-14
Authors : E. I. Youshko; A. V. Strotsky; A. N. Jeremiah;
Page : 68-72
Keywords : ureteral injury; optical ureteroscopy; retrograde ureteropyelography; X-ray endoscopic methods in the diagnosis and management of ureteral injuries;
Abstract
Introduction. Ureteral injury (UI) during obstetric and gynecological surgical procedures is one of the most serious and severe complications. Objective. To improve the outcomes of management of UI identified after obstetric and gynecological surgical procedures. Material and methods. A study of long-term outcomes of surgical management of 47 women aged 19 to 62 (median 48.5) years with ureteral injury (UI) was carried out in wards of the department of urology. All women underwent prior surgical procedures in gynecological (n=40) and obstetric (n=7) departments. Results. On the day of admission to the urological hospital, optical uretheroscopy and retrograde ureteropyelography were conducted on all women, and an attempt to insert double J-stent was made. The results of these procedures show that 6 women underwent reconstructive surgical repair, 33 had double J-stent insertion, and 8 had a percutaneous nephrostomy. On average, after 3 months, all patients underwent follow-up examinations, which showed that complete restoration of urodynamics on the side of the injury did not occur in 20 patients; they were reoperated. The final distribution of the procedures carried out is as follows: open access reconstructive surgical repair - in 15 patients, double J- stent insertion - in 23, ureteral bougienage and stent placement - in 6, laser dissection and endoureteroplasty - in 3. Good outcomes were observed in 38 (80.9%) patients, and satisfactory outcomes - in 9 (19.1%). Conclusions. The most significant investigations in the diagnosis of UI and options of the management plans were identified. The analysis of the outcomes of the use of X-ray endoscopic methods in the management of UI identified after obstetric and gynecological surgeries shows that their use in most cases help to restore urodynamics in the ureter avoiding more difficult reconstructive surgical repair procedures.
Other Latest Articles
- LOW-INTENSITY LASER BLOOD RADIATION AND ITS EFFICIENCY FOR CORRECTION OF HOMEOSTASIS DISORDERS IN PREGNANT RATS WITH THERMAL SKIN BURNS
- THE ROLE OF INTERPROFESSIONAL COMMUNICATION SKILL IN NURSING EDUCATION & PRACTICE
- ANALYSIS OF PHARMACOLOGICAL THERAPY IN CARDIOLOGY HOSPITAL PATIENTS WITH DRUG-INDUCED QT INTERVAL PROLONGATION
- THE LEVEL OF PLATELETS IN THE BLOOD OF PATIENTS WITH DIABETIC FOOT SYNDROME AS A CRITERION OF THE LESION SEVERITY
- ANCYLOSTOMA DUODENALE PRESENTED AS SEVERE ANAEMIA: A CASE REPORT IN A TERTIARY CARE CENTRE, NORTH-EAST INDIA
Last modified: 2022-03-14 17:22:28