Ureteral Injuries Secondary to Operative Procedures
The ureter, because of its small size and excessive mobility, is too frequently injured during the course of abdominal or pelvic surgery. An incidence between 0.4% and 30% (Table 1) has been published for gynecologic procedures. Uncomplicated hysterectomy has the lowest incidence of injury and the radical hysterectomy (Wertheim) has the highest. In addition to gynecologic operations, there are numerous general surgical procedures which have been reported to involve ureteral injuries (Table 2). Women are more often affected than men because of the greater number of pelvic operations in females. Higgins (1962), reporting 65 cases, stated that the left ureter is injured 55.3% of the time, the right 30.7%. Bilateral injuries occur in 13.8%.
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