CAN PRE-OPERATIVE URETERIC STENTING PREVENT URETERIC INJURY IN WOMEN UNDERGOING DIFFERENT GYNECOLOGICAL SURGERY

Background: Iatrogenic ureteric injury is a serious complication of gynecological surgery, potentially leading to significant morbidity. The utility of prophylactic double-J (DJ) ureteral stenting as a preventive strategy remains a subject of ongoing clinical debate. Objective: To observe the rate of ureteric injury and assess whether selective prophylactic DJ stent placement in high-risk patients contributes to its prevention. Methods: A descriptive observational study was conducted over six months. A total of 225 patients undergoing elective gynecological surgery were enrolled. Prophylactic DJ stenting was performed in 21 patients deemed high-risk by the operating consultant. All procedures were performed by experienced consultants. Ureteric injury was monitored intraoperatively. Results: The overall ureteric injury rate was 1.78% (4/225). The injury rate was 0% (0/21) in the stented group compared to 1.96% (4/204) in the non-stented group. All injuries occurred in the non-stented cohort during procedures for large fibroids (6.25%, 1/16), malignancy (4.88%, 2/41), and in cases with a history of chemo/radiotherapy (1.92%, 1/52). Conclusion: Selective prophylactic ureteral stenting in high-risk gynecological surgeries was associated with a zero incidence of ureteric injury in this cohort, supporting its judicious use based on preoperative risk assessment.