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Incidence of lower urinary tract injury at the time of total laparoscopic hysterectomy.

Publication ,  Journal Article
Jelovsek, JE; Chiung, C; Chen, G; Roberts, SL; Paraiso, MFR; Falcone, T
Published in: JSLS
2007

OBJECTIVES: To determine the incidence of and risk factors for injury to the lower urinary tract during total laparoscopic hysterectomy. METHODS: All patients who underwent total laparoscopic hysterectomy for benign disease from January 1, 2002 to December 31, 2005, at an academic medical center are included. Subjects undergoing laparoscopic-assisted vaginal hysterectomy, supracervical hysterectomy, or hysterectomy for malignancy were excluded. Intraoperative cystoscopy with intravenous indigo carmine was routinely performed. Relevant data were abstracted to determine the incidence of lower urinary tract injury, predictors of injury, and postoperative complications. RESULTS: Total laparoscopic hysterectomy was performed in 126 consecutive subjects. Two (1.6%) cystotomies were noted and repaired before cystoscopy was performed. Two (1.6%) additional cystotomies were detected during cystoscopy. Absent ureteral spill of indigo carmine was detected in 2 subjects: 1 (0.8%) with previously unknown renal disease and 1 (0.8%) with ureteral obstruction that was relieved with subsequent suture removal. Only 40% (2/5) of injuries were recognized without the use of cystoscopy with indigo carmine. The overall incidence of injury to the lower urinary tract was 4.0%. No subjects required postoperative intervention to the lower urinary tract within the 6-week perioperative period. Performing a ureterolysis was associated with an increased rate (odds ratio 8.7, 95%CI, 1.2-170, P=0.024) of lower urinary tract injury. CONCLUSION: Surgeons should consider performing cystoscopy with intravenous indigo carmine dye at the time of total laparoscopic hysterectomy.

Duke Scholars

Published In

JSLS

ISSN

1086-8089

Publication Date

2007

Volume

11

Issue

4

Start / End Page

422 / 427

Location

United States

Related Subject Headings

  • Urinary Bladder
  • Ureter
  • Surgery
  • Retrospective Studies
  • Middle Aged
  • Laparoscopy
  • Intraoperative Complications
  • Indigo Carmine
  • Incidence
  • Hysterectomy
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Jelovsek, J. E., Chiung, C., Chen, G., Roberts, S. L., Paraiso, M. F. R., & Falcone, T. (2007). Incidence of lower urinary tract injury at the time of total laparoscopic hysterectomy. JSLS, 11(4), 422–427.
Jelovsek, J Eric, Chi Chiung, Grace Chen, Soldrea L. Roberts, Marie Fidela R. Paraiso, and Tommaso Falcone. “Incidence of lower urinary tract injury at the time of total laparoscopic hysterectomy.JSLS 11, no. 4 (2007): 422–27.
Jelovsek JE, Chiung C, Chen G, Roberts SL, Paraiso MFR, Falcone T. Incidence of lower urinary tract injury at the time of total laparoscopic hysterectomy. JSLS. 2007;11(4):422–7.
Jelovsek, J. Eric, et al. “Incidence of lower urinary tract injury at the time of total laparoscopic hysterectomy.JSLS, vol. 11, no. 4, 2007, pp. 422–27.
Jelovsek JE, Chiung C, Chen G, Roberts SL, Paraiso MFR, Falcone T. Incidence of lower urinary tract injury at the time of total laparoscopic hysterectomy. JSLS. 2007;11(4):422–427.

Published In

JSLS

ISSN

1086-8089

Publication Date

2007

Volume

11

Issue

4

Start / End Page

422 / 427

Location

United States

Related Subject Headings

  • Urinary Bladder
  • Ureter
  • Surgery
  • Retrospective Studies
  • Middle Aged
  • Laparoscopy
  • Intraoperative Complications
  • Indigo Carmine
  • Incidence
  • Hysterectomy