Incidence of Ureteric Injuries
The incidence of ureteric injury varies between 0.1% and 30%, depending on the type of surgery.
1-Obstetric and gynecological surgeries account for approximately 50% of ureteric injuries.
2-Ureteric injuries are less common during vaginal{0.1%} than abdominal hysterectomies1%.
3-Alought prevalence of ureteric injury being higher following gynaecological cancer surgery, it is the benign gynaecological surgery that accounts for most cases.
4-The incidence of all major complications associated with laparoscopy have declined but ureteric injuries have stayed constant at approximately 1 %. 
38% occur during the treatment of endometriosis.

Risk factors for ureteric injuries:
Anatomical risk factors:
Has close attachment to the peritoneum.
Closely related to FGT.
Has variable course.
Not easily seen or palpated.

Pathological risk factors:
1-Congenital anomalies of ureter or kidney.
2-Ureteric displacement by: 
-Uterine size ≥12 weeks 
-Prolapse. 
-Tumor{ ovarian neoplasms}. 
-Cervical or broad ligament swellings.
3-Adhesions:   
-Previous pelvic surgery.   
-Endometriosis.  
-PID
4-Distorted pelvic anatomy.

Sites of Ureteric Injuries:
During laparoscopy the ureter is injured most frequently adjacent to the uterosacral ligaments

Share Medical Presentations