The incidence, Management and outcome of ureteral injuries in AL-Yarmouk Teaching hospital – Baghdad – Iraq

Abstract

Objective: ureteral   injury is  a rare  condition , the  purpose  of  this  study is to report our experience  in managing ureteral , focusing  &  the impact  of early diagnosis , correct treatment & the impact  of  associated injuries on the management & morbid mortality.

Materials  &  methods : a retrospective  review of ureteral injuries  due  to penetrating  & iatrogenic  trauma between January 2004 to December 2007 , in the urology & general surgery department  of  Al-Yarmouk teaching  hospital , ureteral injuries  were graded according  the AAST-OIS( American  association for  the Surgery of  trauma _ organ Injury Scale ), we evaluated mechanism of injury  symptomatology  ,  radiologic  ,  operative  procedures associated injuries & post-operative  complications.

Results: a total ( 14 patients ) which male were (8) & female were (6), mean age was (34.5), penetrating injuries  were      (9 patients) while iatrogenic injuries  were (5patients)           (9 patients) were delayed  in diagnosis , heamaturia occurred in (5patients only ), left ureter injuries  were (5)

while right ureter were(9), lower 3d were(7),middle 3d (5)upper 3d (2),most of patients were grades Il1&IV (10patients),civilians were (12 patients)while military (2) the diagnostic radiology were done for (12 patients), associated organ injuries in(10 patients), the post complication occurred in(4 patients only). Conclusion: ureteral injury should always be borne in mind &,when suspected ,the surgeon should dissect & exploration ,adequate visualize the ureter during debridement &ureteral stenting or nephrostomy drainage are good techniques for successful trearment. (4)