The incidence of ureteral obstruction and the value of intraoperative cystoscopy during vaginal surgery for pelvic organ prolapse.

Journal Article (Journal Article)

OBJECTIVE: The objective of the study was to determine the incidence of ureteral obstruction during vaginal surgery for pelvic organ prolapse and the accuracy and efficacy of intraoperative cystoscopy. STUDY DESIGN: The study was a retrospective review of 700 consecutive patients who underwent vaginal surgery for anterior and/or apical pelvic organ prolapse with universal intraoperative cystoscopy. RESULTS: Thirty-seven patients (5.3%) had no spillage of dye from 1 or both ureters intraoperatively. The false-positive and negative cystoscopy rates were 0.4% and 0.3%, respectively. Thus, the true incidence of intraoperative ureteral obstruction was 5.1%. Intraoperative cystoscopy was accurate in 99.3% of cases, with a sensitivity and specificity of 94.4% and 99.5%, respectively. Suture removal relieved ureteral obstruction in 88% of cases. Six subjects (0.9%) had true ureteral injuries. CONCLUSION: Vaginal surgery for anterior and/or apical pelvic organ prolapse is associated with an intraoperative ureteral obstruction rate of 5.1%. Intraoperative cystoscopy accurately detects ureteral obstruction and allows for relief of obstruction in the majority of cases.

Full Text

Duke Authors

Cited Authors

  • Gustilo-Ashby, AM; Jelovsek, JE; Barber, MD; Yoo, E-H; Paraiso, MFR; Walters, MD

Published Date

  • May 2006

Published In

Volume / Issue

  • 194 / 5

Start / End Page

  • 1478 - 1485

PubMed ID

  • 16647931

Electronic International Standard Serial Number (EISSN)

  • 1097-6868

Digital Object Identifier (DOI)

  • 10.1016/j.ajog.2006.01.064


  • eng

Conference Location

  • United States