The role of urologists in the management of urological injuries during obstetric and gynaecologic surgery.

INTRODUCTION AND HYPOTHESIS: We investigated the role of urologists in the management of urological injuries (UI) during obstetric and gynaecological (Ob&Gyn) surgery in a setup where endourological facilities were available intraoperatively.

METHODS

We retrospectively reviewed all such cases between January 2000 and December 2005.

RESULTS

Out of 13,010 procedures, urologists were involved in 98 patients (prophylactic ureteric stenting (n = 29) and involvement after the occurrence or suspicion of UI (n = 69)). There were 43 injuries (bladder, n = 32; ureter, n = 11). Four bladder and 10 ureteric injuries were only identified using endourological procedures. The incidence of UI in caesarean sections (lower segment caesarean sections (LSCS)) was higher than other procedures (0.46% vs. 0.19%, P < 0.01). There was no difference in the incidence of injuries in emergency vs. elective LSCS (0.42% vs. 0.65%, P = 0.24).

CONCLUSIONS

The availability of endourological facilities in the Ob&Gyn operating room facilitated the identification and management of UI especially ureteric injuries.