The role of urologists in the management of urological injuries during obstetric and gynaecologic surgery

Introduction and hypothesis: We investigated the role of urologists in the management of urological injuries (UI) during obstetric and gynaecological (Ob & Gyn) surgery in a setup where endourological facilities were available intraoperatively. Methods: We retrospectively reviewed all such cases between January 2000 and December 2005. Results: Out of 13,010 procedures, urologists were involved in 98 patients (prophylactic ureteric stenting (n=29) and involvement after the occurrence or suspicion of UI (n= 69)). There were 43 injuries (bladder, n=32; ureter, n=11). Four bladder and 10 ureteric injuries were only identified using endourological procedures. The incidence of UI in caesarean sections (lower segment caesarean sections (LSCS)) was higher than other procedures (0.46% vs. 0.19%, P<0.01). There was no difference in the incidence of injuries in emergency vs. elective LSCS (0.42% vs. 0.65%, P=0.24). Conclusions: The availability of endourological facilities in the Ob & Gyn operating room facilitated the identification and management of UI especially ureteric injuries.