Urological complications following gynaecological surgery

Gynaecology surgery is the commonest cause of iatrogenic injury of the urinary tract. There is a need to minimize this risk with rapidly evolving surgical techniques and gynaecological training involving lesser surgical experience compared to previous years. Ureteric injury can often be unrecognized and results in prolonged morbidity and potential loss of organ function. Risk factors exist in most cases and injuries may be avoidable by preoperative assessment 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 expertize and woman should be debriefed and followed up to improve patient satisfaction and reduce litigation rates.