A retrospective study of urological injuries during obstetrics and gynecological procedures


  • Sunil Kumar Samal Department of Obstetrics and Gynecology, Mahatma Gandhi Medical College and Research Institute, Pondicherry, India
  • Setu Rathod Department of Obstetrics and Gynecology, Mahatma Gandhi Medical College and Research Institute, Pondicherry, India
  • Kalaivani Thangavel Department of Obstetrics and Gynecology, Mahatma Gandhi Medical College and Research Institute, Pondicherry, India




Complications, Obstetrics and gynecological procedures, Urologic injury


Background: Urological injury in obstetrics and gynaecology are not uncommon because there is a close anatomical association between reproductive and urological system. The objective of this study was to find out the incidence and types of urological injuries in obstetric and gynaecological procedures, clinical presentation and various management option in a tertiary care hospital.

Methods: The study was a retrospective analysis of all obstetric and gynecological surgeries over a period of 6 years from January 2014 to December 2019. Cases with the documented urological injuries during these procedures were analyzed further.

Results: Total 8595 patients had undergone different obstetrics and gynecology procedures, out of which 5429 were obstetrics and 3166 were gynecology surgeries.  Out of 3166 of gynecology procedures, there were 16 cases (0.5%) of bladder injuries and one case (0.03%) of ureteric injury. Out of 5429 cases of obstetric procedures there were 11 (0.2%) cases of bladder injury and one case (0.01%) of ureteric injury.

Conclusions: The incidence urological injuries during obstetrics and gynecological procedures are rare but the morbidity associated these are significant. Therefor surgeons should be more cautious and high degree of suspicion can help in early diagnosis and avoid the sequel.


Thompson JD. Operative injuries to the ureter: prevention, recognition, and management. In: Rock JA, Thompson JD. TeLinde's operative gynecology.8th ed. Philadelphia: Lippincott Williams and Wilkins; 1997:1135-1174.

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

Harkki-Siren P, Sjoberg J, Tiitinea A. Urinary tract injuries after hysterectomy. Obstet Gynecol. 1998;92:113-8.

Purandare CN. Urological injuries in gynecology. J Obstet Gynecol India. 2007;57:203-4.

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;202:495.e1-5.

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.

Sahito RA, Memon GA, Khaskheli MS. Urological injuries during obstetrical and gynecological surgeries. Annals. 2011;17:218-22.

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

Adelman MR, Bardsley TR, Sharp HT. Urinary tract injuries in laparoscopic hysterectomy: a systematic review. J Minim Invasive Gynecol. 2014;21:558-66.

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

Berkmen F, Peker AE, Alagol H, Ayyildiz A, Arik AI, Basay S. Treatment of iatrogenic ureteral injuries during various operations for malignant conditions. J Exp Clin Cancer Res. 2000;19:441-5.

Chapron C, Pierre F, Querleu D, Dubuisson JB. Complications of laparoscopy in gynecology. Gynecol Obstet Fertil. 2001;29:605-12.

Carley ME, McIntire D, Carley JM, Schaffer J. Incidence, risk factors and morbidity of unintended bladder or ureter injury during hysterectomy. Int Urogynecol J Pelvic Floor Dysfunct. 2002;13(1):18-21.






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