摘要：Background: Ureteric injury is a complication of gynaecological surgery that can cause significant morbidity forthe patient and is a leading cause of litigation in many countries.Objectives: To determine patient characteristics, peri-operative circumstances and clinical and legal outcomes ofureteral injuries associated with gynaecological surgery.Patients and methods: This is a retrospective review of 20 cases of ureteric injury during benign gynaecologicalsurgery.Main outcome measures: All cases were assessed for the following variables–patient characteristics, indications forsurgery, injury, postoperative symptoms and presentation, and clinical and legal outcomes.Results: Risk factors associated with ureteric injury included obesity, previous laparotomic pelvic surgery, pelvicadhesions, large pelvic masses and intra-operative bleeding. 70% (14/20) of ureteral injuries were diagnosed afterdischarge. 50% (10/20) of patients had a complicated post-operative course and 45% (9/20) of cases resulted inunfavourable legal outcomes (settlement or lost at trial) for the surgeon. The conduct of surgery and the failureto act in a timely fashion postoperatively were the most frequent reasons for adverse clinical and unfavourablelitigation outcomes for the surgeon.Conclusions: Intra-operative surgical consultation and ureteral identification should be considered if thereis concern for ureteral involvement in the surgical field. Ureteric injury may not constitute negligence if it isdemonstrated that the surgeon provided reasonable care that would be expected during the peri-operative phases.What is new: This review identifies patient characteristics and peri-operative variables that correlate with poorclinical and legal outcomes after ureteric injury..
