Urological injury during gynecologic surgical procedures.

Urological injury during gynecologic surgical procedures is an infrequent but serious complication. The incidence from this study is less than other studies. There are 25 cases of urological injuries consisting to twenty-one bladder injuries and four ureteral injuries. The associated factors of the urological injury are previous pelvic operation, distorted anatomy in the pelvis from various diseases and full bladder. Prompt intraoperative recognition of the injury is the best way to prevent serious postoperative complication. Four had vesicovaginal fistulae that were recognized postoperatively. Three had spontaneous closure of fistulae with conservative management and one required surgical management. Patients who had urological injury during the gynecologic surgical procedures had a longer hospital stay. The most important factor in prevention of this injury is a clear exposure of structures at risk.