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

Publication ,  Journal Article
Gustilo-Ashby, AM; Jelovsek, JE; Barber, MD; Yoo, E-H; Paraiso, MFR; Walters, MD
Published in: Am J Obstet Gynecol
May 2006

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.

Duke Scholars

Published In

Am J Obstet Gynecol

DOI

EISSN

1097-6868

Publication Date

May 2006

Volume

194

Issue

5

Start / End Page

1478 / 1485

Location

United States

Related Subject Headings

  • Wounds, Penetrating
  • Vagina
  • Uterine Prolapse
  • Ureteral Obstruction
  • Ureter
  • Retrospective Studies
  • Predictive Value of Tests
  • Obstetrics & Reproductive Medicine
  • Middle Aged
  • Intraoperative Complications
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Gustilo-Ashby, A. M., Jelovsek, J. E., Barber, M. D., Yoo, E.-H., Paraiso, M. F. R., & Walters, M. D. (2006). The incidence of ureteral obstruction and the value of intraoperative cystoscopy during vaginal surgery for pelvic organ prolapse. Am J Obstet Gynecol, 194(5), 1478–1485. https://doi.org/10.1016/j.ajog.2006.01.064
Gustilo-Ashby, A Marcus, J Eric Jelovsek, Matthew D. Barber, Eun-Hee Yoo, Marie Fidela R. Paraiso, and Mark D. Walters. “The incidence of ureteral obstruction and the value of intraoperative cystoscopy during vaginal surgery for pelvic organ prolapse.Am J Obstet Gynecol 194, no. 5 (May 2006): 1478–85. https://doi.org/10.1016/j.ajog.2006.01.064.
Gustilo-Ashby AM, Jelovsek JE, Barber MD, Yoo E-H, Paraiso MFR, Walters MD. The incidence of ureteral obstruction and the value of intraoperative cystoscopy during vaginal surgery for pelvic organ prolapse. Am J Obstet Gynecol. 2006 May;194(5):1478–85.
Gustilo-Ashby, A. Marcus, et al. “The incidence of ureteral obstruction and the value of intraoperative cystoscopy during vaginal surgery for pelvic organ prolapse.Am J Obstet Gynecol, vol. 194, no. 5, May 2006, pp. 1478–85. Pubmed, doi:10.1016/j.ajog.2006.01.064.
Gustilo-Ashby AM, Jelovsek JE, Barber MD, Yoo E-H, Paraiso MFR, Walters MD. The incidence of ureteral obstruction and the value of intraoperative cystoscopy during vaginal surgery for pelvic organ prolapse. Am J Obstet Gynecol. 2006 May;194(5):1478–1485.
Journal cover image

Published In

Am J Obstet Gynecol

DOI

EISSN

1097-6868

Publication Date

May 2006

Volume

194

Issue

5

Start / End Page

1478 / 1485

Location

United States

Related Subject Headings

  • Wounds, Penetrating
  • Vagina
  • Uterine Prolapse
  • Ureteral Obstruction
  • Ureter
  • Retrospective Studies
  • Predictive Value of Tests
  • Obstetrics & Reproductive Medicine
  • Middle Aged
  • Intraoperative Complications