الفهرس 
aknowledgement
Anatomy of the female Pelvic ureterOnly 14 pages are availabe for public view
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Abstract
The urinary tract is at risk of injury during pelvic surgical operations due to its proximity to the female genital system. These complications, although rare, can result in morbidity and even mortality for the patients, which can create anxiety and psychosocial concerns for the patients and their spouse In different series, hysterectomy and Caesarean section were noted to be responsible for the majority of ureteric injuries. The increasing repertoire of obstetric and gynaecological surgeries emphasises the importance of understanding the anatomy of the pelvis in order to prevent and manage lower urinary tract misadventures. Measures should be taken to prevent these complications in our environment, where there is a strong aversion to surgery The current was conducted at Department of Obstetrics and Gynecology of Assiut University Hospitals. It was done in period between March 2018 to March 2021. It aimed to assess iatrogenic urinary tract injuries during obstetric and gynecological operations. All wmen with urinary tract injury secondary toobstetrior gynaecological surgery during the study period was recruited in the study. A total of 20636 women were scheduled for different obstetricorgy necological surgeries. Out of those women; a total of 170 (0.82%) women suffered from
iatrogenic urinary tract injuries. Mean age of those women with iatrogenic urinary tract injury was 33.54
± 6.63 with range between 20 and 70 years. It was found that out of those women with iatrogenic urinary tract injury; 161 (94.7%) women had injury during obstetric surgeries while the other 9 (4.3%) women had injuries during gynecological surgeries. The most common diagnoses were placenta praevia (51.2%) and previous CS in labour (25.3%).The most frequent risk factors for urinary tract injuries were repeatedCS (84.1%) and placenta praevia (51.5%). Iatrogenic urinary tract injuries were detected intraoperatively in 167 (98.2%) women while in only three patients, detection was delayed. There were 8 (4.7%) patients had both bladder and ureteric injuries while bladder injury alone present in 159 (93.5%) patients and another 8 (4.7%) patients had ureteric injuries alone. ICU’s admission was needed in 43 (25.3%) patients. Mean duration of hospital stay was 6.19 ± 2.19 (days) In conclusion, the incidence of urological complications of obstetric and gynaecologic surgery was low, although these contributed to morbidity. Distorted pelvic anatomy from benign and malignant conditions, especially uterine fibroids, as well as obstetric emergencies like ruptured uterus were the major risk factors. Mortality, although low, was avoidable. Improved attitude towards ante-natal care, good knowledge of anatomy of urogenital system and meticulous surgical technique by the surgeon as well as peri-operative collaboration/consultation with a urologist should reduce the rate of complications. There is need to improve reporting of injuries in the theatres so that accurate data may be available when needed.