The incidence of urinary tract injury during hysterectomy: a prospective analysis based on universal cystoscopy.
Publication/Presentation Date
5-1-2005
Abstract
OBJECTIVE: To evaluate the incidence of urinary tract injury due to hysterectomy for benign disease.
STUDY DESIGN: Patients were enrolled prospectively from 3 sites. All patients undergoing abdominal, vaginal, or laparoscopic hysterectomy for benign disease underwent diagnostic cystourethroscopy.
RESULTS: Four hundred seventy-one patients participated. Ninety-six percent (24/25) of urinary tract injuries were detected intraoperatively. There were 8 cases of ureteral injury (1.7%) and 17 cases of bladder injury (3.6%). Ureteral injury was associated with concurrent prolapse surgery (7.3% vs 1.2%; P = .025). Bladder injury was associated with concurrent anti-incontinence procedures (12.5% vs 3.1%; P = .049). Abdominal hysterectomy was associated with a higher incidence of ureteral injury (2.2% vs 1.2%) but this was not significant. Only 12.5% of ureteral injuries and 35.3% of bladder injuries were detected before cystoscopy.
CONCLUSION: The incidence of urinary tract injury during hysterectomy is 4.8%. Surgery for prolapse or incontinence increases the risk. Routine use of cystoscopy during hysterectomy should be considered.
Volume
192
Issue
5
First Page
1599
Last Page
1604
ISSN
0002-9378
Published In/Presented At
Vakili, B., Chesson, R. R., Kyle, B. L., Shobeiri, S. A., Echols, K. T., Gist, R., Zheng, Y. T., & Nolan, T. E. (2005). The incidence of urinary tract injury during hysterectomy: a prospective analysis based on universal cystoscopy. American journal of obstetrics and gynecology, 192(5), 1599–1604. https://doi.org/10.1016/j.ajog.2004.11.016
Disciplines
Medicine and Health Sciences
PubMedID
15902164
Department(s)
Department of Obstetrics and Gynecology
Document Type
Article