{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T19:10:43Z","timestamp":1791054643210,"version":"4.1.0"},"reference-count":19,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,6,14]],"date-time":"2024-06-14T00:00:00Z","timestamp":1718323200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,6,14]],"date-time":"2024-06-14T00:00:00Z","timestamp":1718323200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"University of Bergen"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>This study aimed to register and analyse outcomes after iatrogenic ureteral injuries (IUI) with special emphasis on potential consequences of a delayed diagnosis, and further to analyse if the incidence of IUI has changed during the study period. 108 patients treated for an IUI during 2001\u20132021 were included. Injuries due to endourological procedures, planned tumour resection and traumatic injuries were excluded. All relevant information to answer the research questions were entered into a database. Chi-square and t-tests were used for categorical and continuous variables respectively. Regression analysis was used to evaluate potential change of incidence in IUIs over time. Our results showed that\u00a0most IUIs (74, 69%) were caused by gynaecological surgery. 49 (45%) had a delayed diagnosis (not diagnosed intraoperatively). Younger age (mean 50 vs 62\u00a0years, p\u2009&lt;\u20090.001) and benign indication for laparoscopic hysterectomy (OR 8.0, p\u2009&lt;\u20090.001) predisposed for a delayed diagnosis. Patients with a delayed diagnosis had a higher number of secondary injury related procedures (mean 4.6 vs 1.7, p\u2009&lt;\u20090.001), hospital admissions (mean 3.0 vs 0.8, p\u2009&lt;\u20090.001) and longer hospital stays (mean 20.6 vs 3.9\u00a0days p\u2009&lt;\u20090.001) compared to patients with an intraoperative diagnosis. There was complete recovery for 91% of the patients. We did not observe any changes in IUI incidence during the study period. In conclusion,\u00a0our study underlines that\u00a0IUI can cause major morbidity for the patient affected if not diagnosed intraoperatively. Benign indication and younger age are predictors for a delayed diagnosis. The prognosis is good, with 91% full recovery. No significant changes in incidence of IUIs were observed.<\/jats:p>","DOI":"10.1038\/s41598-024-63847-6","type":"journal-article","created":{"date-parts":[[2024,6,14]],"date-time":"2024-06-14T10:02:59Z","timestamp":1718359379000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["A delayed diagnosis of iatrogenic ureteral injury results in increased morbidity"],"prefix":"10.1038","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-0330-7170","authenticated-orcid":false,"given":"Rachel","family":"Maheswaran","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Beisland","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne K.","family":"Bergesen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4484-040X","authenticated-orcid":false,"given":"Bjarte","family":"Alm\u00e5s","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,6,14]]},"reference":[{"issue":"6","key":"63847_CR1","doi-asserted-by":"publisher","first-page":"794","DOI":"10.21037\/tau-21-998","volume":"11","author":"X Li","year":"2022","unstructured":"Li, X. et al. Etiology, characteristics and management of ureteric injury: Experience from a nationwide study. Transl. Androl. Urol. 11(6), 794\u2013802. https:\/\/doi.org\/10.21037\/tau-21-998 (2022).","journal-title":"Transl. Androl. Urol."},{"issue":"5\u20136","key":"63847_CR2","doi-asserted-by":"publisher","first-page":"470","DOI":"10.1159\/000511141","volume":"105","author":"G Ding","year":"2021","unstructured":"Ding, G. et al. Etiology and ureteral reconstruction strategy for iatrogenic ureteral injuries: A retrospective single-center experience. Urol. Int. 105(5\u20136), 470\u2013476. https:\/\/doi.org\/10.1159\/000511141 (2021).","journal-title":"Urol. Int."},{"issue":"2","key":"63847_CR3","doi-asserted-by":"publisher","first-page":"235","DOI":"10.1007\/s11255-004-7970-4","volume":"37","author":"K Al-Awadi","year":"2005","unstructured":"Al-Awadi, K., Kehinde, E. O., Al-Hunayan, A. & Al-Khayat, A. Iatrogenic ureteric injuries: Incidence, aetiological factors and the effect of early management on subsequent outcome. Int. Urol. Nephrol. 37(2), 235\u2013241. https:\/\/doi.org\/10.1007\/s11255-004-7970-4 (2005).","journal-title":"Int. Urol. Nephrol."},{"issue":"6","key":"63847_CR4","doi-asserted-by":"publisher","first-page":"1540","DOI":"10.1016\/j.juro.2017.12.067","volume":"199","author":"RH Blackwell","year":"2018","unstructured":"Blackwell, R. H. et al. Complications of recognized and unrecognized iatrogenic ureteral injury at time of hysterectomy: A population based analysis. J. Urol. 199(6), 1540\u20131545. https:\/\/doi.org\/10.1016\/j.juro.2017.12.067 (2018).","journal-title":"J. Urol."},{"issue":"1","key":"63847_CR5","doi-asserted-by":"publisher","first-page":"E1","DOI":"10.5489\/cuaj.7271","volume":"15","author":"JA Locke","year":"2022","unstructured":"Locke, J. A., Neu, S. & Herschorn, S. Morbidity and predictors of delayed recognition of iatrogenic ureteric injuries. Can. Urol. Assoc. J. 15(1), E1-e6. https:\/\/doi.org\/10.5489\/cuaj.7271 (2022).","journal-title":"Can. Urol. Assoc. J."},{"issue":"1","key":"63847_CR6","doi-asserted-by":"publisher","first-page":"380","DOI":"10.1186\/s12893-022-01817-3","volume":"22","author":"MA Ali","year":"2022","unstructured":"Ali, M. A. et al. A 6-year retrospective clinical review of iatrogenic ureteric injuries repaired in a resource-deprived setting. BMC Surg. 22(1), 380. https:\/\/doi.org\/10.1186\/s12893-022-01817-3 (2022).","journal-title":"BMC Surg."},{"issue":"1","key":"63847_CR7","doi-asserted-by":"publisher","first-page":"68","DOI":"10.1111\/aogs.14293","volume":"101","author":"M Ravlo","year":"2022","unstructured":"Ravlo, M. et al. Ureteric injuries during hysterectomy-A Norwegian retrospective study of occurrence and claims for compensation over an 11-year period. Acta Obstet. Gynecol. Scand. 101(1), 68\u201376. https:\/\/doi.org\/10.1111\/aogs.14293 (2022).","journal-title":"Acta Obstet. Gynecol. 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