Clinical analysis of 24 cases of ureteral injuries caused by gynecological operation

Abstract:

Objective: To summarize high-risk situations and treatment experience of ureteral injuries caused by gynecological operations. Methods: Clinical resources of 24 cases of ureteral injuries caused by gynecological operations from January 2014 to December 2020 were reviewed to summarize high-risk factors and experience of treatment and diagnosis. Results: There were 12 cases of injuries during the operation，6 cases of hysterectomy（3 cases of laparoscopy and 3 cases of laparotomy），5 cases of cytoreductive surgery，and 1 case of pelvic lymphadenectomy；7 cases were found with the ureter far-end injuries，and 5 cases were found with near-end and middle-end injuries；5 cases received the ureter crevasse suture，and 4 cases received the end-to-end anastomosis，and 3 received the ureter bladder replantation. After repair surgery，10 cases were found with smooth ureters and no expansion and effusion，and 2 cases suffered from the mild hydronephrosis and expansion of the ureters. All the 12 cases were found to be injured after the operation，all of them underwent laparoscopic hysterectomy，and all were found with the ureter far-end injuries. And 11 cases received the ureter bladder replantation，1 case received the end-to-end anastomosis，9 cases were found with smooth ureters and no expansion and effusion，and 3 cases suffered from the mild hydronephrosis and expansion of the ureters. Conclusion: The hysterectomy，use of laparoscope energy instruments，tumor’s invasion of ureters，and whether ureters are swollen or adhered to each other are high-risk factors of ureter injuries. Favorable treatment effects can be achieved by immediately discovering and mending.