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Chapter 19 - Urologic Complications

from Part III - SURGICAL PROCEDURES

Published online by Cambridge University Press:  07 May 2010

John Patrick O'Grady ,
Martin L. Gimovsky ,
Lucy A. Bayer-Zwirello  and
Kevin Giordano
By
Richard J. Scotti ,
Janice N. Young  and
Mat H. Ho
John Patrick O'Grady
Affiliation:
Tufts University, Massachusetts
Richard J. Scotti
Affiliation:
Clinical Professor, University of Southern California Keck School of Medicine Los Angeles
Janice N. Young
Affiliation:
Medical Director, Woman to Woman Gynecology of Naples Naples, Florida
Mat H. Ho
Affiliation:
Associate Professor, Department of Obstetrics and Gynecology School of Medicine, Texas
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Summary

This chapter reviews conditions occurring in the urinary tract during pregnancy that place the mother, and often the fetus, at risk. Conditions discussed in the chapter that might require surgery during pregnancy include urolithiasis, urinary tract obstruction, accidental and iatrogenic lower urinary tract injury, urethral diverticula, genitourinary fistulas, complications of previous urologic surgery, and urinary tract carcinoma. The normal homeostatic changes involving the urinary tract are frequently responsible for the gravid woman's urinary complaints. The treatment of choice for distal ureteral calculi in pregnant patients who require intervention is cystoscopic examination, followed by either passage of a ureteral stent to relieve obstruction, or ureteroscopy with calculus manipulation. During labor and delivery, the bladder is vulnerable to trauma and injury. Mucosal congestion, submucosal hemorrhage, and capillary oozing around the trigone have been observed cystoscopically after delivery.

Keywords

cesarean deliverygenitourinary fistulasiatrogenic lower urinary tract injuryureteroscopyurinary tract obstructionurethral diverticulapregnancypreterm laborurolithiasis
Type
Chapter
Information
Operative Obstetrics , pp. 608 - 637
Publisher: Cambridge University Press
Print publication year: 2008

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