Bladder injuries during obstetrical and gynecological surgeries
Bladder injuries during obstetrical and gynaecological surgeries are relatively common. The reproductive and urinary tracts in women are closely related anatomically. Knowledge of this anatomy plays an important role in the prevention of urinary tract injury during gynaecologic surgery.
Experience of the surgery being undertaken is also vitally important. Warning patients about risks should also be undertaken.
The primary approach to prevention is careful surgical dissection and knowledge of the position of urinary tract structures within the surgical field.
In a study in 2017 which consisted of 28 patients with obstetrics and gynaecological surgeries some 13 patients had bladder injuries which required repaired. Although this is a small study it demonstrates a large proportion of injuries which are almost routine. Iatrogenic urinary bladder injuries were common. Bladder injury occurred most commonly during hysterectomies.
Surgery adjacent to or within urinary bladder continue to result in occasional iatrogenic injury. These injuries can be minor with no long-term sequelae, or they can result in significant morbidity and inconvenience to patients.
As with most surgical complications, timely recognition is key in minimizing serious patient morbidity and mortality. Diagnosis of such injuries requires careful attention to surgical entry and dissection techniques and employment of adjuvant diagnostic modalities. Repair of bladder may be performed robotically, laparoscopically, or using laparotomy.
Repair of these injuries requires knowledge of anatomic layers and suture materials. Testing needs to ensure that intact and safe repair has been achieved.
Postoperative care after bowel or bladder injury requires surveillance for complications including repair site leak, abscess, and fistula formation.
If you have suffered bladder injuries during obstetrical and gynaecological surgeries then get in touch with us today. Call us FREE on 0800 470 2009 or email Dr Victoria Handley at email@example.com