The Iatrogenic Injury Pathway: A Narrative Review of Interdisciplinary Mitigation and Management of Surgical Complications in Women’s Health
Abstract
Background: Surgical procedures in gynecology and urogynecology, while often life-enhancing, carry inherent risks of significant complications such as ureteral injury, visceral injury, and fistula formation. The journey from intraoperative misadventure to long-term recovery defines an “iatrogenic injury pathway” that tests the resilience of healthcare systems and the well-being of patients. Aim: This narrative review aims to synthesize evidence on the system-level, interdisciplinary response to recognized surgical complications in women’s health, from acute intraoperative mitigation to long-term physical and psychological rehabilitation. Methods: A comprehensive search of PubMed, CINAHL, PsycINFO, and Scopus (2010-2024) was conducted, integrating literature from gynecologic surgery, perioperative safety, urology, psychology, and rehabilitation sciences. Results: Effective management requires seamless transitions between distinct phases of care: intraoperative safety protocols (e.g., universal cystoscopy), acute post-operative rescue involving specialized surgical teams (MFM, Urology), and longitudinal rehabilitation (Physical Therapy, Psychology). Systemic learning via structured morbidity and mortality (M&M) conferences is critical for practice change, yet psychological trauma and fragmentation of care remain significant challenges. Conclusion: A deliberate, patient-centered, and integrated interdisciplinary framework is essential to mitigate harm, manage complications holistically, and restore patient trust following surgical adverse events.
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References
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Authors
Copyright (c) 2024 Alhussain Sagr Ahmed Alhazmi, Alaa Yasen Alalayet, Noor Hussain Almousa, Tariq A Algadri, Eman Katam Ibrahim Alhalal, Aqilah Kadem Ibrahim Alhalal, Ali Mohammed Ali Jabbari, Anwar Ali Mohammed Sharawi, Ibrahim Abdullah Ibrahim Alsegaihi, Thamer Sattam H, Abdalwhab Ageel Alaharbi, Musa Ahmed Yahya Alfaify
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