A 7-Year Review of Urological Injuries arising from Obstetric and Gynaecological Surgeries in Abuja, Nigeria

Abstract

Background:
Collateral injuries to the urinary tract during obstetric and gynaecological (O&G) surgeries are not uncommon. Delay in recognition of such mishaps may lead to significant morbidity and mortality. This study aims to document the incidence, clinical presentations, aetiology, types and management of urologic injuries arising from O&G surgeries.

Methodology:
Retrospective review of electronic medical records of all patients with urologic injuries arising from O&G surgeries managed by the urology unit of Federal Medical Centre, Abuja, from January 2019 to December 2025. The extracted data included biodata, clinical presentation, initial O&G diagnoses, types of injuries, timing of injury recognition, and reconstructive surgeries performed, as well as outcomes. These were analysed using SPSS 27.0.

Results:
There were 19 patients (0.26%) with urologic injuries out of 7,312 O&G surgeries performed within the study period. The mean age of the patients was 39.4 ± 9.6, with ages ranging from 27 to 64 years. Total abdominal hysterectomy was the leading offending surgery (n=10, 52.6%). The commonest initial diagnosis was uterine leiomyoma (n=8, 42.1%). Bladder injury (n=10, 52.6%) was more common than ureteric injury (n=9, 47.4%) in our study. Most of the injuries were recognized intra-operatively (57.9%). We did not record any mortality.

Conclusion:
Urologic injuries during obstetric and gynaecological surgeries, though rare, can lead to significant morbidity. Our study found that total abdominal hysterectomy is the most common procedure associated with these injuries, primarily bladder injuries, most of which were detected during surgery. This underscores the necessity for increased surgeon awareness to prevent complications. Despite the low incidence and no mortality in our cohort, ongoing monitoring and the use of improved surgical techniques are crucial.