Who should have intravenous pyelograms before hysterectomy for benign disease?
A review of 493 cases was undertaken to identify which patients undergoing hysterectomy for benign disease had received a preoperative intravenous pyelogram (IVP), an abnormality identified by IVP, and intraoperative ureteral injuries. Intravenous pyelograms were performed on 299 patients (60.6%). Factors significantly associated with obtaining a preoperative IVP included an abdominal approach, uterine size of 12 weeks or greater, and uterine prolapse. Seventy-seven patients (27%) had an abnormal IVP; factors likely to be associated with abnormality included uterine size of 12 weeks or larger or an adnexal mass of 4 cm or larger. Endometriosis, pelvic inflammatory disease, pelvic relaxation, and previous intra-abdominal surgery were not associated with an increased prevalence of abnormal IVP findings. Two ureteral injuries were documented, one in the IVP group (0.3%) and one in the non-IVP group (0.5%). Clinical findings may be used to select for a preoperative IVP those patients who are likely to have abnormalities of importance to the pelvic surgeon.
Duke Scholars
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Related Subject Headings
- Uterine Diseases
- Urography
- Urogenital Abnormalities
- Ureter
- Risk
- Preoperative Care
- Obstetrics & Reproductive Medicine
- Middle Aged
- Intraoperative Complications
- Hysterectomy
Citation
Published In
ISSN
Publication Date
Volume
Issue
Start / End Page
Location
Related Subject Headings
- Uterine Diseases
- Urography
- Urogenital Abnormalities
- Ureter
- Risk
- Preoperative Care
- Obstetrics & Reproductive Medicine
- Middle Aged
- Intraoperative Complications
- Hysterectomy