Dobroslawa L. Sikora-Szczesniak and Waclaw Sikora
Regional Specialist Hospital, Poland
Objective: The purpose of the study is to analyze the causes and types of injuries to the urinary organs related topast deliveries.
Material and methods: There were 36,671 deliveries at the Obstetric-Gynecological Ward, Regional Specialist Hospital in Radom between 1998 and 2017. Medical records of 12 patients with injuries to the urinary organs related to past delivery were retrospectively studied.
Results: The following injuries were found:- ligation of the left ureter: 1 case,- injury to the urinary bladder: 11 cases,- vesicovaginal fistula (VVF): 1 case (following injury to the urinary bladder at hysterectomy in the postpartum period). In 10 patients, the detected injuries were managed during hospitalization for labor, in 3 cases the injuries were diagnosed during the postpartum period; one patient was treated in the General Surgery Ward on 5th day following natural delivery. Another patient suffered injury to the urinary bladder during hysterectomy in the postpartum period. It was sutured up. VVF was diagnosed on 10th day after the surgery, and was successfully managed at the Urology Department. The injuries to the urinary organs were most frequently related to hysterectomies in the peripartum and postpartum period (50.0%)
Conclusions: 1. Both peripartum and postpartum hysterectomy pose a high risk of urological complications, 14.0% in the group of discussed patients.
2. Patients at high risk of complications necessitating peripartum hysterectomy should be duly transferred to reference wards to provide multi-specialist medical care.
Dobroslawa L Sikora-Szczesniak graduated from the Faculty of Medicine at the Medical University in Lublin in 1994. In 2002, under the direction of prof. Jan Kotarski she defended her PhD thesis. In 2005 she obtained the title of specialist in the field of gynecology and obstetrics. She works in the Gynecology and Obstetrics Department of Radom Specialist Hospital. The main field of her interest is urogynecology.