Urological complications following gynaecological surgery

Gynaecology surgery is the commonest cause of iatrogenic injury of the urinary tract. Rapidly evolving surgical techniques and gynaecological training involving less surgical experience compared to previous years means there is a need to proactively minimise this risk. If ureteric injury is unrecognised it can result in prolonged morbidity and potential loss of organ function. Injuries may be avoidable by preoperative assessment, attention to risk factors and meticulous surgical technique. Counselling patients regarding potential injury is important especially if there are pre-existing risk factors. A high index of suspicion and prompt evaluation may improve immediate recognition and thereby improve prognosis. Any delay in postoperative recovery especially with flank pain should raise the suspicion of urinary tract injury and prompt diagnostic evaluation should be undertaken. Surgical repair should be done by specialists with sufficient expertise and woman should be debriefed and followed up to improve patient satisfaction and reduce litigation rates.