Iatrogenic urinary tract
injuries are known complications of digestive and pelvic surgeries. We retrospectively reviewed 13 patients with bladder
injuries and 16 patients with ureteral
injuries requiring surgical repair or
stent placement in our hospital between 2013 and 2016. Obstetric-
gynecologic surgery accounted for 10 bladder
injuries and 11 ureteral
injuries on
hysterectomy and
Cesarean section. Digestive surgery led to 1 bladder injury and 5 ureteral
injuries on colon resection, and urologic surgery resulted in 1 injury on biopsy of a retroperitoneal
tumor. Regarding bladder
injuries, 10 patients underwent cystorrhaphy, and 3 patients received indwelling of a transurethral Foley
catheter alone. Concerning ureteral
injuries, 7 patients underwent repair of the injured ureter (ureteroneocystostomy in 5, and ureteroureterostomy in 2), and 9 patients received ureteral
stent placement after postoperative retrograde urography. Repair failure was defined when urine leakage,
urinary fistula, or urinary
stricture requiring ureteral
stent placement still existed at 90 days after the repair treatment. The bladder
injuries in all 13 cases were successfully repaired. The ureteral injury treatments in 7 out of 16 patients (43.8%) were judged as being unsuccessful because of the condition requiring a ureteral
stent at 90 days. There was a correlation between the delayed diagnosis of ureteral injury and unsuccessful repair. The present study showed that the prompt identification of urinary tract
injuries, especially ureteral
injuries, can result in decreased morbidity andsubsequently improved outcomes.