Urinary tract injuries after total hysterectomy / 대한산부인과학회지

OBJECTIVE: To evaluate the incidence, characteristics, and convalescence times of urinary tract injury after gynecological surgery, total abdominal hysterectomy (TAH), laparoscopic-assisted vaginal hysterectomy (LAVH), total vaginal hysterectomy (VH), radical hysterectomy (RH), and laparoscopic-assisted radical hysterectomy (LRH). METHODS: We retrospectively analyzed 109 patients with urinary tract injuries after total hysterectomy from May 1989 to April 2004. During the study period, 18,721 hysterectomies were carried out. RESULTS: The total incidence of urinary tract injury after total hysterectomy was 0.59%, as follows: TAH, 0.55%; LAVH, 0.64%; VH, 0.62%; RH, 0.69%; and LRH, 1.56%. The total incidence of bladder and ureteric injury was, respectively, 0.51 and 0.09%, as follows: TAH, 0.51 and 0.04%; LAVH, 0.57 and 0.07%; VH, 0.62 and 0%; RH, 0.21 and 0.49%; and LRH, 1.79 and 0.89%. There was no significant difference of the incidence of urinary tract injury type of operation with benign findings (P>0.05), but there was significant difference of the incidence of injury between type of operation with benign and malignant findings (P<0.05). The convalescence times were 10.3+/-8.7 days after bladder injury and 44.4+/-16.27 days after ureteric injury diagnosed intraoperatively, but 33.3+/-46.6 days after bladder injury and 69.0+/-16.4 days after ureteric injury diagnosed postoperatively. There was significant difference between both groups (P<0.05). CONCLUSION: In this study, total hysterectomy resulted in 0.59% incidence of urinary tract injury and repair of these injuries was successful in all cases. There was no significant difference for incidence of urinary tract injury between types of operation with benign findings, but there was significant difference between types of operation for benign and malignant findings. The convalescence times for intraoperatively recognized injuries were significantly shorter than those for injuries recognized postoperatively. 109, but significant difference between benign and malignant gynecological operations (P<0.05). Tintraoperatively recognized.

Risk factors for lower urinary tract injuries in patients with traumatic pelvic fractures / 대한비뇨기과학회지

For identification of the risk factors for lower urinary tract injuries in patients with pelvic fractures, we reviewed the records of 332 patients with pelvic fractures and 60 patients with urethral or bladder ruptures not associated with pelvic fractures seen at our hospital during recent 5 years. The incidence of lower urinary tract injuries in patients with pelvic fractures was 9.9 per cent (urethra 57.6 per cent, bladder 36.4 per cent. and both 6.0 per cent).Of the 181 simple rami fractures 21 (11.6 percent) had lower urinary tract injuries. Of the 90 rami fractures combining other fractures 11 (12.2 per cent} had lower urinary tract injuries, especially 5 (50.0 per cent) of the 10 combining symphysis pubis diastasis. Of the 14 bladder ruptures 13 had gross hematuria, and of the 21 urethral ruptures all had blood at urethral meatus. For evaluation of significance of hematuria as a indicator for bladder ruptures, we reviewed 257 pelvic fractures without urethral ruptures and upper tract injuries. While of the 25 cases with gross hematuria 13 (52.0 percent) had bladder ruptures, of the 76 cases with only microscopic hematuria 1 case had bladder rupture. We conclude that the high risk factors for lower urinary tract injuries in patients with pelvic fractures are both rami fracture, dispacement of hemipelvis, and symphysis pubis diastasis. Therefore prompt diagnostic procedures for urethral and bladder ruptures must be performed in those cases, especially when combined with gross hematuria or blood at urethral meatus.

Lower Urinary Tract Injuries Associated with Pelvic Bone Fractures / 대한비뇨기과학회지

A clinical study was made on 108 patients with pelvic bone fractures and 37 patients with lower urinary tract injury in the Capital Armed Forces General Hospital during the period of 3 years from January, 1978 to December, 1980. Emphasis was placed on the mechanism of the bladder and urethral injuries. The results were summarized as follows: 1. The most common cause of pelvic bone fractures was traffic accident (88.0%). 2. 37 cases (34.3%) of the pelvic bone fractures were associated with lower urinary tract injuries. These included 17 ruptures of the urethra, 14 bladder injury and 6 bladder and urethral injuries. 3. Among the total bladder injuries (20 cases), we found 14 extraperitoneal ruptures of the bladder. 4 intraperitoneal ruptures and 2 bladder contusion. 4. Among the 23 urethral injuries, membranous urethral injuries were prominent, 19 membranous urethral ruptures and 4 bulbous urethral ruptures.

A Clinical Observation On Injuries of Genito-Urinary Tract / 대한비뇨기과학회지

A clinical observation was made on the injuries of genitourinary tract of the in-patient in the Department of Urology, Medical School of Chosun University during the period from January, 1972 to December, 1976. The results are as followings. 1) Of 429 cases hospitalized, 59 cases were injury of genito-urinary tract, giving a ratio of 13. 8%. 2) The most favorable age was in from 21 to 50 years for 69.4%. 3) The sex ratio, male to female, was about 5.5 : 1. 4) The most frequent cause of injury was traffic accident (39. 0%) and the next was straddle injury kick and blow etc. 5) The urethra was involved most frequently in 45.8%, the kidney in 25.4%, the bladder in 15. 3%, the external genitalia in 8.4% and the ureter in 5.1%. 6) Nephrectomy was performed in 4 cases of 15 renal injuries. 7) Four of 7 bladder injuries and 13 of 27 urethral injuries were accompanied with pelvic bone fracture.

A Clinical Study of Lower Urinary Tract Injury Associated with Pelvic Bone Fracture / 대한비뇨기과학회지

A clinical study was made on 81 patients with pelvic fracture and 17 patients with lower urinary tract injury in the Hanyang University Hospital during the period of three years from May. 1972 to May, 1975. The results were as follows ; I) The most common cause of pelvic fracture was traffic accident (73%), and the age group ranging from 21 to 40 years old was 54% of patients with pelvic fractures. 2) On pelvic fractures, unilateral pelvic rami fractures were most common(44%), followed by bilateral pelvic rami fractures(25%), in order of frequency. 3) Fourteen cases( 17%) of the pelvic fractures were associated with lower urinary tract injury. 4) Thirty one cases(45%) of the lower urinary injuries were associated with pelvic fracture.

Observations on Pelvic Fractures and Lower Urinary Tract Injuries / 대한비뇨기과학회지

Clinical observations were made on l23 patients with pelvic fractures and 78 patients with 1ower urinary tract injury in the Kyungpook National University Hospital during the period of 6 years from Jan., 1968 to Dec., 1973. The results were as follows: 1) The most common cause of pelvic fractures was traffic accident (78.9%), and the age group ranging from 20 to 39 years of age was 50.4% of patients with pelvic fracture. 2) Of l39 pelvic fractures in 123 patients, unilateral pubic rami fractures were most common (31.7%), and followed by bilateral pubic rami fractures (25.9%), Malgaigne fractures (22.3%). acetabular fractures (8.6%), and separation of the symphysis pubis (5.8%) in order of frequency. 3) 38 cases (30.9%) of the pelvic fractures were associated with lower urinary tract injuries. From the view of fracture pattern, 47.2% of bilateral pubic rami fractures, 38. 7% of Malgaigne fractures, 25.0% of separation of the symphysis pubis and 13.6% of unilateral pubic rami fractures were associated with lowed urinary tact injuries. 4) The most common cause of lower urinary tact injuries associated with pelvic fracture was traffic accident (81.6%), and that of those not _associated with pelvic fracture was fall-down including the straddle injury (62.5%). 5) The other associated injuries were more common in cases with pelvic fracture (39.5%) than in those without pelvic fracture (22.5%). 6) Complications of urethroplasty were also more frequently observed in urethral ruptures with pelvic fracture (42.3%) than in those without pelvic fracture (23.5%). 7) Mortality rate of the lower urinary tract injuries was 3.8%, and all the deads were observed in cases associated with pelvic fracture.

Observations on Pelvic Fractures and Lower Urinary Tract Injuries / 대한비뇨기과학회지

Clinical observations were made on l23 patients with pelvic fractures and 78 patients with 1ower urinary tract injury in the Kyungpook National University Hospital during the period of 6 years from Jan., 1968 to Dec., 1973. The results were as follows: 1) The most common cause of pelvic fractures was traffic accident (78.9%), and the age group ranging from 20 to 39 years of age was 50.4% of patients with pelvic fracture. 2) Of l39 pelvic fractures in 123 patients, unilateral pubic rami fractures were most common (31.7%), and followed by bilateral pubic rami fractures (25.9%), Malgaigne fractures (22.3%). acetabular fractures (8.6%), and separation of the symphysis pubis (5.8%) in order of frequency. 3) 38 cases (30.9%) of the pelvic fractures were associated with lower urinary tract injuries. From the view of fracture pattern, 47.2% of bilateral pubic rami fractures, 38. 7% of Malgaigne fractures, 25.0% of separation of the symphysis pubis and 13.6% of unilateral pubic rami fractures were associated with lowed urinary tact injuries. 4) The most common cause of lower urinary tact injuries associated with pelvic fracture was traffic accident (81.6%), and that of those not _associated with pelvic fracture was fall-down including the straddle injury (62.5%). 5) The other associated injuries were more common in cases with pelvic fracture (39.5%) than in those without pelvic fracture (22.5%). 6) Complications of urethroplasty were also more frequently observed in urethral ruptures with pelvic fracture (42.3%) than in those without pelvic fracture (23.5%). 7) Mortality rate of the lower urinary tract injuries was 3.8%, and all the deads were observed in cases associated with pelvic fracture.

A Clinical Observation on Injuries of Genito-urinary Tract / 대한비뇨기과학회지

This is to report a clinical observation on 81 cases of genito-urinary tract injuries treated at the urology service. Capital Army Hospital, during the period from January, 1960 to July, 1963. Of 81 Cases which stood for 0.82% of all genito-urinary out patients, 58 cases (or 71.6%) occurred in the urethra, the most common site of involvement, and 6 cases (or 7.2%) showed multiple injuries. Age ranged between 21 and 10 years with the highest incidence of 58.4% in the ages between 21-25 years. In lateralyzation of injury while the kidney showed nosignificant difference the ureter was more frequently involved in the left than in the right with a ratio of 4:1. Traffic accident was listed as high as 56.9% to be most frequent cause of injury and contusion, fall, gun-shot and explosion were listed less frequently. Of associated major injuries, pelvic fracture was seen in 20 cases (33.9%) and all the urethral injuries were accompanied with injuries to gastro-intestinal tract. Of all cases herein reported, 62.3% of cases were treated surgically and the remaining 37.7%. non-surgically. Surgical intervention was necessary in 33.3% of kidney injury, 100% of ureteral injury, 67.8% of urethral injuries and 40% of genital injuries. Average hospitalization required 20.2 days for renal injury and 67.2 days for urethral injury.