Objective: To describe the aetiology, clinical presentation, management and
outcomes of a series of patients with iatrogenic lesions of the ureter following
obstetric or gynaecological surgery treated at Yalgado Ouedraogo University
Hospital, Ouagadougou, Burkina Faso. Methods: This is a case series looking
at 14 consecutive patients from 1 January 2011 to 28 February 2017, operated
on for urological complications following obstetric and gynaecological surgery. Results: Our study focused on fourteen cases. The average age was 32.9
years (range 20 - 60 years). Thirteen were housewives. Eleven lived in rural
areas. The aetiological factor was Caesarian section in seven cases, laparotomy
in four cases and hysterectomy in three cases. The type of ureteral injury was
bilateral ligation in nine cases. The average time to diagnosis was 16 days
(range 2 - 120 days). Anuria was the commonest presenting symptom. Ultrasound in ten patients showed evidence of uretero-hydronephrosis. Eight patients required renal dialysis. Surgical management was uretero-vesical reimplantation in eleven cases, disunion of sutures associated with catheterization in two cases and a termino-terminal ureteral anastomosis in one case.
The average hospital stay was 26 days (range 9 - 44 days). The post-operative
period was complicated by two cases of vesico-vaginal fistula, one case of parietal suppuration, one case of pyelonephritis and one case of hydronephrosis.
No deaths were recorded and a complete cure was ultimately obtained in all
patients. Conclusion: Urological complications of obstetric and gynaecological surgery are dominated by ligation of the ureters in our setting. Caesarian
section is the commonest cause. Treatment is essentially surgical

Iatrogenic Lesion Ureter