FREQUENCY OF URETERAL INJURY IN PATIENTS UNDERGOING HYSTERECTOMY IN COMPLICATED PELVIC PATHOLOGY USING PEROPERATIVE CYSTOSCOPICALLY PLACED URETERIC STENTS

ABSTRACT
Objective: To determine the frequency of ureteral injury in patients with complicated pelvic pathology using preoperative
cystopically placed ureteral stents.
Methods: This was a prospective Comparitive study which was conducted in Northwest General Hospital and Research
Centre (from 1st January, 2014-31st December, 2016). All cases at high risk for ureteric injuries undergoing total abdominal
hysterectomies during a 3-year period were admitted to NWGH & Research Centre and using nonprobability
purposive sampling technique patients were grouped into two groups. Group A include patients that were subjected to
cystoscopic placement of urteric stents followed by Total abdominal hysterectomy whereas Group B included patients
that were subjected to Total Abdominal hysterectomy without placement of ureteric stents. Data was collected and
placed on SPSSR version 16.0 and data was analysed.
Results: A total of 361 Total abdominal hysterectomies were performed that were labeled as high risk either because
of previous surgery, endometriosis, large fibroids etc during a period of 3 years. Fibroid related menorrhagia was found
in 251 patients, 67 hysterectomies were performed for other causes of abnormal uterine bleeding, 15 for adenomyosis,
13 for chronic PID, 15 for severe endometriosis (stage III & IV).
Conclusion: The use of ureteral stents for complicated hysterectomies prevents ureteral injury significantly. Whether the
frequency of uncontrolled hemorrhage is a cause or sequelae of ureteric injury needs further definition. These benefits
are subject to increased cost and duration of surgery but not found significant in our study.