Ureteric injury is most commonly associated with which of the following
**Core Concept**
The question is testing the association between surgical procedures and the risk of ureteric injury. Ureteric injury is a known complication of pelvic surgery, particularly those involving the uterus and surrounding structures. The ureters are vulnerable to damage due to their close proximity to the uterine arteries and the risk of devascularization during surgical dissection.
**Why the Correct Answer is Right**
The Wertheim hysterectomy, also known as a radical abdominal hysterectomy, is a surgical procedure that involves the removal of the uterus, cervix, and part of the vagina. This procedure is often performed in the treatment of cervical cancer. The Wertheim hysterectomy involves a more extensive dissection of the pelvic tissues, which increases the risk of ureteric injury. The ureters are located close to the uterine arteries and are at risk of damage during the surgical dissection of the parametrium.
**Why Each Wrong Option is Incorrect**
**Option A:** Anterior colporrhaphy is a surgical procedure that involves the repair of the anterior vaginal wall. While this procedure does involve pelvic surgery, the risk of ureteric injury is lower compared to more extensive procedures like the Wertheim hysterectomy.
**Option B:** Vaginal hysterectomy is a surgical procedure that involves the removal of the uterus through the vagina. While this procedure does carry a risk of ureteric injury, the risk is generally lower compared to abdominal hysterectomies like the Wertheim procedure.
**Option D:** Abdominal hysterectomy is a surgical procedure that involves the removal of the uterus through an abdominal incision. While this procedure does carry a risk of ureteric injury, the risk is generally lower compared to the Wertheim hysterectomy.
**Clinical Pearl / High-Yield Fact**
To minimize the risk of ureteric injury during pelvic surgery, it is essential to identify the ureters preoperatively using imaging studies and to take steps to protect them during surgical dissection. This may include the use of ureteric stents or clips to prevent injury.
β Correct Answer: C. Wertheim hysterectomy