Study of iatrogenic bladder injury in vaginal hysterectomy: our experience


  • Pooja S. Singh Department of Obstetrics and Gynecology, GCS Medical College and Research Hospital, Ahmedabad, Gujarat, India
  • Haresh U. Doshi Department of Obstetrics and Gynecology, GCS Medical College and Research Hospital, Ahmedabad, Gujarat, India



Bladder injury, Iatrogenic bladder, Vaginal hysterectomy


Background: This study was carried out to calculate the incidence of bladder injury detected during benign gynecologic vaginal hysterectomy. This investigation examined the clinical features of urologic complications during gynecologic surgery and outcome of their management.

Methods: It was a retrospective study done at Department of Gynecology, GCS medical college, Ahmedabad from year 2012-2016. All patients undergoing vaginal hysterectomy for benign diseases were included in the study. This study assessed the causative disease and surgical approach type, and treatment method of the bladder injury.

Results: Of these 237 patients who underwent vaginal hysterectomies, 3 (1.26%) had bladder perforation. All the 3 cases of bladder injury underwent primary suturing during surgery without complications.

Conclusions: Bladder injury was the most common urological injury during obstetric and gynecologic surgery. Early diagnosis and urologic intervention is important for better outcomes.


Singh AJ, Arora AK. Effect of uterine prolapse on the lines of rural North Indian women. Singapore J Obstet Gynecol. 2003;34:52-8.

Thompson JD. Operative injuries to the ureter: prevention, recognition, and management. In: Rock JA, Thompson JD, editors. TeLinde's operative gynecology. 8th ed. Philadelphia: Lippincott Williams and Wilkins;1997:1135-117.

Gilmour DT, Dwyer PL, Carey MP. Lower urinary tract injury during gynecologic surgery and its detection by intraoperative cystoscopy. Obstet Gynecol. 1999;94(5 Pt 2):883-9.

Aarts JWM, Nieboer TE, Johnson N, Tavender E, Garry R, Mol BJ et al. Surgical approach to hysterectomy for benign gynecological disease. .2015

Aronson MP, Bose TM. Urinary tract injury in pelvic surgery. Clin Obstet Gynecol. 2002;45:428-38.

Frankman EA, Wang L, Bunker CH, Lowder JL. Lower urinary tract injury in women in the United States, 1979-2006. Am J Obstet Gynecol. 2010;202:495e1-495e5.

Ozdemir E, Ozturk U, Celen S, Sucak A, Gunel M, Guney G, et al. Urinary complications of gynecologic surgery: iatrogenic urinary tract system injuries in obstetrics and gynecology operations. Clin Exp Obstet Gynecol. 2011;38:217-20.

Moriel EZ, Meirow D, Zilberman M, Farkas A. Experience with the immediate treatment of iatrogenic bladder injuries and the repair of complex vesico-vaginal fistulae by the transvesical approach. Arch Gynecol Obstet. 1993;253:127-30.

Ibeanu OA, Chesson RR, Echols KT, Nieves M, Busangu F, Nolan TE. Urinary tract injury during hysterectomy based on universal cystoscopy. Obstet Gynecol. 2009;113(1):6-10.

Vakili B, Chesson RR, Kyle BL, et al. The incidence of urinary tract injury during hysterectomy: a prospective analysis based on universal cystoscopy. Am J Obstet Gynecol. 2005;192(5):1599-604.

Tulandi T, Agdi M, Zarei A, Miner L, Sikirica V. Adhesion development and morbidity after repeat cesarean delivery. Am J Obstet Gynecol. 2009;201(1):56.e1-56.e6.

Lee JS, Choe JH, Lee HS, Seo JT. Urologic complications following obstetric and gynecologic surgery. Korean J Urol. 2012;53:795-9.






Original Research Articles