AI Article Synopsis
- A literature review conducted from May to December 2019 focused on urinary system iatrogenic injuries, identifying key causes linked to surgical procedures and emphasizing their serious impact on patients.
- Treatment outcomes for these injuries largely depend on timely diagnosis, with modern methods offering varying degrees of intervention, but delayed detection can lead to severe complications and risks, such as infections and kidney function loss.
- The societal burden of iatrogenic injuries includes significant financial and emotional costs, along with potential legal ramifications; there is a pressing need for improved patient assessment protocols and a collaborative approach in pelvic surgeries to address these issues.
Article Abstract
Introduction: From May to December 2019, a literature review of the urinary system iatrogenic injury problem was performed. The most cited, representative articles in PubMed, Scopus, and WoS databases dedicated to this problem were selected. Urinary system iatrogenic injuries include ureter, bladder, urethra, and kidney traumas. It is widely thought that the main causes of such injuries are urological, obstetric, gynecological, and surgical operations on the retroperitoneal space, pelvis, or perineum.
Methods: The purpose of the study is to describe all aspects of the iatrogenic injure problem, under the established scheme and for each of the most damaged organs: the urethra, bladder, kidney, and ureter. The treatment of confirmed iatrogenic injuries largely depends on the period of its detection. Modern medical procedures provide conservative or minimally invasive treatment. An untimely diagnosis worsens the treatment prognosis. "Overlooked" urinary system trauma is a serious threat to society and a particular patient. Thus, incorrect or traumatic catheterization can lead to infection (RR 95%) and urethral stricture (RR ≥11-36%), and percutaneous puncture nephrostomy can cause the risk of functional renal parenchyma loss (median 5%), urinary congestion (7%), or sepsis (0.6-1.5%).
Results: Lost gain, profits, long-term and expensive, possibly multistage treatment, stress and depression, and the risks of suicide put a heavy financial, moral, and ethical burden on a person and society. Also, iatrogenic injury might have legal consequences.
Discussion/conclusion: Thus, the significant problem of urinary tract iatrogenic injuries is still difficult to solve. There is a need to implement mandatory examining algorithms for patients at risk, as well as the multidisciplinary principle for all pelvic surgery.
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