Urinary Tract Injuries: Recognition and Management

ABSTRACT

Iatrogenic injury to the urinary tract can be caused by any surgeon operating in or around the pelvis and the retroperitoneal abdominal space. This includes gynecologists, general surgeons, urologists, vascular surgeons, neurosurgeons, and orthopedic surgeons. The urinary tract is extremely vulnerable to intraoperative injury for a variety of reasons. Operating in a hostile environment such as that encountered with repeat surgeries, significant inflammation, and large neoplasms puts the urinary tract at even greater risk. There are a large variety of techniques for repair/reconstruction of the injured ureter, bladder, or urethra. Without a doubt, the most important aspect in the outcome of iatrogenic urinary tract injury is prompt recognition and diagnosis. Lack of recognition at the time of injury often mandates additional surgical procedures with their associated morbidity and may result in loss of renal function, or worse, loss of a renal unit. Thus it is essential that every surgeon operating in this space be familiar with urinary anatomy and basic diagnostic and reconstructive techniques.

KEYWORDS

Iatrogenic - urinary tract - laparoscopy - intraoperative - complication

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