Urological injuries following gynecological operations - Our experience in a teaching hospital in Nigeria

Background: Various grades of urological injuries occur following gynecological operations. Some are recognized during or after surgery but others pass unnoticed. Aims and objectives: To study the urological injuries that follow gynecological operations in our centre. Design: Retrospective study. Setting: Nnamdi Azikiwe University Teaching Hospital, Nnewi Nigeria, a third generation tertiary institution serving rural, semi-urban, and urban communities. Patients and methods: Searching through the records, all the gynecological operations performed in our centre from 1st July 1998 to 30th June 2003 were reviewed. Those patients in whom there were documented evidences of urological injuries were noted. Similarly, all the urological injuries treated in our institution during the same period but resulting from gynecological operations carried out in peripheral hospitals were also noted. From the relevant medical records, the following data were extracted: type of gynecological operation, nature of urological injury, time when injury was detected, status of the surgeon, management modalities, and outcome. Results: A total of 37 urological injuries occurred but, because of incomplete records in five, only 32 patients were included in this study. Ligation of the ureters following hysterectomy was the most common injury and occurred in 28 (87.5%) of the patients. Conclusions: Ureteric ligation is a common urological injury following gynecological operations in our centre.