Urinary tract injuries after hysterectomy for benign gynecological conditions in Egypt: A a retrospective cohort analysis

Y. ELshehawy; S.M. Habib; N.A. Mahmoud; M.R. Elrefaie; H.E. Mohamed

doi:10.37800/RM.4.2025.593

Authors

Y. ELshehawy
S.M. Habib
N.A. Mahmoud
M.R. Elrefaie Ain shams University
H.E. Mohamed

DOI:

https://doi.org/10.37800/RM.4.2025.593

Keywords:

Urinary tract injury, Total laparoscopic hysterectomy, Total abdominal hysterectomy, Total vaginal hysterectomy

Abstract

Relevance: Surgical procedures in gynecology account for a significant proportion of iatrogenic ureteral injuries, contributing to approximately 64-75% of such cases. During hysterectomy, the occurrence of bladder injuries has been reported to range from 0.13% to 3.6%, while ureteral injuries occur in 0.1% to 1.8% of cases.

This study aimed to evaluate the occurrence of urinary tract injuries in women undergoing hysterectomy for non-malignant gynecologic conditions in Egypt and compare the injury rates associated with different surgical approaches to hysterectomy.

Materials and Methods: We performed a retrospective cohort analysis to examine the relationship between hysterectomy technique and the risk of urinary tract injury. The study included women treated at Ain Shams University Maternity Hospital (Cairo, Egypt) between 2022 and 2024, selected based on predefined eligibility criteria.

Results: The risk of urinary tract injury varied significantly. Total abdominal hysterectomy had the highest risk (3.8%), followed by total vaginal hysterectomy (1.6%), with total laparoscopic hysterectomy having the lowest risk (1.38%).

Conclusion: Our study highlights the critical roles of careful surgical technique and appropriate patient selection in minimizing urinary tract injuries during hysterectomy procedures. While laparoscopic approaches demonstrated clear benefits, including reduced blood loss and shorter recovery time, a higher rate of ureteric injury was observed in this group. These findings highlight the need for continued surgical refinement and adherence to safety protocols during laparoscopic hysterectomy, particularly in patients at higher operative risk.

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