Urological Injuries during Gynecologic Surgery at Songklanagarind Hospital
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Abstract
Objectives: To determine the incidence of urological injuries during gynecologic surgeries, and identify the risk factors associated with urological injuries, management and outcome after repair of urological injuries.
Materials and Methods: A retrospective case-control study of women who underwent gynecologic surgeries at Songklanagarind hospital from January 2006 to December 2020. The cases with urological injury were identified and analyzed for incidence, risk factors, management and outcome after repair of urological injuries. Demographic and clinical parameters were analyzed using multiple conditional logistic regression to clarify the determinate. A p value of < 0.05 was considered statistically significant.
Results: There were 125 cases (0.66%) of urological injuries, from a total of 19,003 gynecological surgery cases. The incidence of bladder, ureteric and combined bladder and ureteric injuries were 0.42%, 0.19% and 0.04%, respectively. A total of 117 cases with complete data was analyzed. Previous myomectomy, level of surgeon, the presence of dense pelvic adhesion, and large tumor size were significant risk factors for urological injuries (p < 0.05). The management of urological injuries was successful in 116 patients (99.1%).
Conclusion: Bladder injury was the most common urinary tract injury during gynecologic surgery. Previous myomectomy, level of surgeon, the presence of dense pelvic adhesion, and large tumor size were significant risk factors.
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