Cross Sectional Study of Iatrogenic Urinary Tract Injuries During Obstetric and Gynecological Operations in Assiut University Women Health Hospital
试验速览
- 阶段
- 不适用
- 入组人数
- 100
- 主要终点
- frequency of iatrogenic urinary tract injuries during obstetric and gynaecological operations.
研究概览
简要总结
Iatrogenic urinary tract injuries are more common during obstetric and gynaecological procedures averaging 2.6 per 1000 surgeries . The objective of the study is to estimate the incidence of iatrogenic urinary tract injuries and risk factors during obstetric and gynaecological operations.
Embryologically, the urinary system and genital system have a common origin, so anatomically they are so close that predisposes to iatrogenic trauma to it during obstetric and gynaecological operations. The bladder and distal ureters are the most commonly involved organs. The bladder is a retroperitoneal structure, its trigone rests over the anterior vaginal fornix and the base rests on lower uterine segment and cervix.
详细描述
Risk factors may contribute to intra-operative bladder injury - include :
- Prolonged labour with distended bladder.
- Obstructed labour.
- Previous cesarean section.
- previous myomectomy.
- previous laparotomy.
- Cases with possibility of altered anatomy, fibrosis or direct extension of disease process as in cases of chronic pelvic inflammatory disease, endometriosis, and large fibroids especially in the broad ligament, previous pelvic surgery, malignancy, previous irradiation and congenital abnormalities of urogenital system.
- Past history of uterine perforation, septic abortion.
- In presence of labour, station of the presenting fetal part deeper than or equal to +1, and a large baby were independent risks for a bladder injury during caesarean section.
- Well effacement and dilatation of cervix (uterine incision may fall over vagina and dissection of bladder from vagina is difficult in compare to lower uterine segment).
- Preterm cesarean section where lower segment is not well formed.
- During cesarean hysterectomy.
- Rupture uterus may also be combined with bladder injuries.
- Placenta percreta may penetrate the bladder and cause injury.
Urinary tract injury can be diagnosed intraoperative :
- presence of urine in the operative field.
- Hematuria
- Methylene Blue test
研究设计
- 研究类型
- Observational
- 观察模型
- Case Only
- 时间视角
- Cross Sectional
入排标准
- 年龄范围
- 15 Years 至 —（Child, Adult, Older Adult）
- 性别
- Female
- 接受健康志愿者
- 否
入选标准
- •Women that undergo obstetric or gynecological surgery complicated by urinary tract injury
- •Aged 15 years or older
- •Elective surgeries
- •Good performance status
排除标准
- •Not meeting all of the inclusion criteria
结局指标
主要结局
frequency of iatrogenic urinary tract injuries during obstetric and gynaecological operations.
时间窗: one month
frequency of iatrogenic urinary tract injuries during obstetric and gynaecological operations.
次要结局
未报告次要终点
研究者
Ahmed Kamal Kamel
principal investigator
Assiut University