Iatrogenic ureteral injuries: a 20-year retrospective review in a University teaching hospital

Abstract

Objective: To review all iatrogenic ureteral injuries during non-urologic procedures in Queen Mary Hospital during the past 20 years.

Patients & Methods: All iatrogenic ureteral injuries were identified from computer records and all unintentional traumas were included. Patient demographics, details of the primary procedure, clinical presentation of the patients, method of repair and the final outcome were recorded.

Results: From 1993 to 2013, 33 patients sustained unintentional iatrogenic ureteral injuries in Queen Mary Hospital with repair by urologists. 17 were recognized intraoperatively and repaired during the same setting whilst 16 patients were diagnosed in a delayed manner. Median delay in diagnosis was 55 days and majority (81.3%) required temporary urinary diversion by either percutaneous nephrostomy or ureteral stenting before definitive repair. In all patients, repair was successful with resolution of their symptoms. Patients with delayed diagnosis required a significantly longer total duration of urinary diversion as a result of the iatrogenic injury.

Conclusion: Ureteral injury is an important iatrogenic complication from surgery. Early recognition and repair is preferred as the patients would need shorter duration of urinary drainage with less morbidity.