Synchronous bilateral ureteral ligation and urinary bladder injuries following emergency hysterectomies: Early surgical intervention is a resuscitatory measure.

Abstract

Synchronous iatrogenic ureteral and bladder injuries
following emergency pelvic surgeries, though
uncommon, cause morbidities and mortalities. They
are potential causes of severe and debilitating
obstructive nephropathies as well as avoidable
litigations in surgical practice. Delay at initiating
surgical treatment worsens outcome. Management is
extremely challenging with attendant complications.
We report two cases of iatrogenic bilateral ureteral
ligation with synchronous posterior urinary bladder
lacerations. Both patients developed anuria at the
immediate post-operative period, with worsening
bilateral flank pains, abdominal distension, leakage
of urine per vaginam and poor performance status.
Both patients were uremic. Emergency exploratory
laparotomies were done, with release of ligatures,
stenting of both ureters and repair of bladder wall.
Accurate diagnosis with early surgical intervention is
lifesaving.