Iatrogenic injury of the low urinary tract in women undergoing pelvic surgical interventions

Abstract

Introduction. Iatrogenic injury of the urinary tract in women undergoing pelvic surgeries is one of the most feared complications and an important source of significant morbidity. Moreover, they cause a lot of anxiety to both patient and surgeon and they also create many legal concerns. The most commonly affected organs are the ureter, bladder and urethra. Urologic injury during obstetrics and gynecologic surgery should always be a matter of prevention, but there are situations in which prevention fails. With this article we intend to raise the awareness on potential situations leading to iatrogenic urinary tract lesions during obstetrics and gynecology surgery. Cases presentation. Three different cases of iatrogenic injuries at various sites of the urinary tract during pelvic surgeries are presented and preventive and treatment measures are discussed. Conclusions. Most iatrogenic urinary tract lesions are prone to occur during difficult surgeries, but a significant number of iatrogenic injuries are made during routine interventions, even by the most trained surgeons. Therefore, preventing and recognizing iatrogenic urinary tract injuries is of highest importance for all surgeons performing interventions in the pelvic area.