The management of operative urethral injury an experience with ten patients at Muhimbili Medical Cenntre

10 patients were treated at Muhimbili Medical Centre (MMC) for operative injury of the ureter following gynaecologic surgery. 7 were referred from up-country while three sustained injury during operation at MMC. The age range was 27 to 52 years with a mean of 36.5 years. Abdominal hysterectomy was the operation at which the ureter was most commonly injured. Only two of the injuries were discovered interpretively; a trend common to most series. Ureteric re-implantation or end-to-end anastomosis were performed according to the circumstances; with good results in all patients. The main shortcoming was prolonged delay before treatment in the majority of patients. A ureteric catheter inserted cystoscopically before operation; avoidance of excessive dissection of the ureter; constant consciousness about the possibility of urethral injury during abdominal and pelvic surgery and an intravenous urogram (IUV) in cases where difficulties are anticipated are useful preventive measures

Obstetric problems: a manual

This manual has been written for those in Malawi who deal with obstetric problems at the hospital level: state registered nurses-midwives; clinical officers; and doctors. It assumes a basic training in obstetrics and some practical experience of obstetric problems as well. It is not a book for beginners