Recognition and Management of Urologic Injuries With Laparoscopic Hysterectomy

Dassel, Mark; Adelman, Marisa R.; Sharp, Howard T.

doi:10.1097/grf.0000000000000159

Cited by 10 publications

(10 citation statements)

References 14 publications

(23 reference statements)

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“…Regarding intra- and post-operative complications, our results differ from those in the literature, particularly in terms of the risk of urinary tract injuries. Some authors have observed a higher incidence of urinary tract injuries with laparoscopic than with AH ( 23 ). Janssen et al .…”

Section: Discussionmentioning

confidence: 99%

Comparison of the short-term and long-term outcomes of laparoscopic hysterectomies and of abdominal hysterectomies: a case study of 4,895 patients in the Guangxi Zhuang Autonomous Region, China

Yang

Zeng

et al. 2016

Chinese Journal of Cancer Research

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Background:To evaluate the short-term and long-term outcomes after laparoscopic hysterectomy (LH) compared with abdominal hysterectomy (AH) in case of benign gynecological disease. Methods:A multi-center cohort retrospective comparative study of population among 4,895 hysterectomies (3,539 LH vs.1,356 AH) between 2007 and 2013 was involved. Operative time (OT), estimated blood loss (EBL), intra-operative and post-operative complications, passing flatus; days with indwelling catheter, questionnaires covering pelvic floor functions and sexual functions were assessed.Results:The EBL (174.1±157.4 vs. 263.1±183.2 cc, LH and AH groups, respectively), passing flatus (38.7±14.1 vs. 48.1±13.2 hours), days with indwelling catheter (1.5±0.6 vs. 2.2±0.8 days), use of analgesics (6.5% vs. 73.1%), intra-operative complication rate (2.4% vs. 4.1%), post-operative complication rate (2.3% vs. 5.7%), post-operative constipation (12.1% vs. 24.6%), mild and serious stress urinary incontinence (SUI) post-operative (P<0.001; P=0.014), and proportion of Female Sexual Functioning Index (FSFI) total score <26.55 post-operative (P<0.001) of the LH group were significantly less than those of AH group. There were no significant differences in OT (106.5±34.5 vs. 106.2±40.3 min) between the two groups.Conclusions:LH is a safe and efficient operation for improving patients?long-term quality of life (QoL), and LH is a cost-effectiveness procedure for treating benign gynecological disease. LH is superior to AH due to reduced EBL, reduced post-operative pain and earlier passing flatus.

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Section: Discussionmentioning

confidence: 99%

Comparison of the short-term and long-term outcomes of laparoscopic hysterectomies and of abdominal hysterectomies: a case study of 4,895 patients in the Guangxi Zhuang Autonomous Region, China

Yang

Zeng

et al. 2016

Chinese Journal of Cancer Research

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“…In this study, bladder injuries were detected and repaired early, in accordance with the literature. If there is a history of urinary tract surgery, computed tomography or magnetic resonance imaging may be very helpful to refrain bladder injury 12 . If there is any doubt about anatomy, intra‐operative consultation may be requested from urologist 12 .…”

Section: Discussionmentioning

confidence: 99%

“…If there is a history of urinary tract surgery, computed tomography or magnetic resonance imaging may be very helpful to refrain bladder injury 12 . If there is any doubt about anatomy, intra‐operative consultation may be requested from urologist 12 . Bladder bounds can be controlled intraoperatively by filling the bladder using a foley catheter.…”

Section: Discussionmentioning

confidence: 99%

“…In our study, we did not encounter any complications related to the placement of the Veress needle or trocar. Endometriosis is a significant cause of urinary tract damage risk via making difficult surgical dissection because of the adhesions of anatomical planes as a result of sticky tissues caused by intense inflammations and adhesions and in particular it creates twice the risk of ureteral damage 11‐20 . Endometriosis can be a risk factor for both ureter and bladder damages.…”

Section: Discussionmentioning

confidence: 99%

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Laparoscopic management of bladder injury during total laparoscopic hysterectomy

Aydın

Mercimek

2020

Int J Clin Pract

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Hysterectomy is the most common surgical procedures in women. 1 Hysterectomy indications are benign reasons such as prolapse of pelvic organs, unresponsive menorrhagia to medical treatment, leiomyoma and chronic pelvic pain. 2 Various factors including the expertise of the surgeon, endometriosis and prior pelvic surgery linked to pelvic sticking, uterine size, vaginal stenosis, timing of surgery, operating room technical equipment availability and patient preference influence the selection of proper hysterectomy surgical technique. 2 As a result, the benefits of minimally invasive surgical procedures, laparoscopic hysterectomy (LH) has been the first choice in recent years. 3 Given the advantages of less blood loss,shorter hospitalisation and quicker convalescence, LH is more likely to cause injury to the urinary tract than hysterectomy to the abdomen. 4 In gynaecological surgeries, the embryological and anatomical relationships make pelvic genital organs and urinary tract organs more prone to bladder and ureteral damage. 5 The frequency of urinary tract injury in gynaecological surgery varies from 0.18% to 0.29% for whole gynaecological surgery, 1.3% for laparoscopic hysterectomy and 0.33% for gynaecologic laparoscopic surgery, respectively. 6 The aim of this study was to present the results of laparoscopic bladder repairs for bladder injuries that occurred during laparoscopic hysterectomy. AbstractPurpose: Iatrogenic bladder injury remains a major challenge. We compared the success and reliability of laparoscopic repair of intraperitoneal bladder rupture in patients who had undergone total laparoscopic hysterectomy.Methods: This retrospective study included patients who underwent total laparoscopic hysterectomy for benign gynaecological cases at a tertiary academic hospital between January 2018 and June 2019. All patient medical records included in the study were reviewed, and the causes, incidence and management of bladder injuries were assessed.Results: There were nine patients. The cause of all the ruptures was iatrogenic, and all were intra-operatively detected. In all patients, bladder injuries occurred in the posterior side of the bladder during vesicouterine dissection. Laparoscopic bladder perforation repair was performed successfully in all patients. No major complications had occurred in any patients after surgery. The foley catheters were removed 6.67 ± 0.7 (5-7) days after surgery. Conclusions:If performed by well-trained laparoscopic surgeons, laparoscopic hysterectomy could be the best option for appropriate patients. Nevertheless, patients should be well aware of the potential complications in endometriosis and caesarean cases before the procedure, and care should be paid during dissection. When a urogenital injury is suspected or detected the condition must be adequately identified and proper treatment must be performed to avoid postoperative complications and long-term morbidity.

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“…This is due to the greater breadth of pathology and tendency to use electrosurgery that may lead to delayed thermal damage in laparoscopic surgery. 1 Recently, the evidence showed the overall injury rate for laparoscopic hysterectomy was 0.73%, which did not appear to differ from the abdominal approach. Bladder injury rate ranged 0.05-0.66% and the ureteral injury rate ranged 0.02-0.4%.…”

Section: Introductionmentioning

confidence: 99%

Different Techniques for Evaluation of Urologic Complication during Laparoscopic Gynecologic Surgery: A Review

Tantitamit¹

2018

Journal of South Asian Federation of Obstetrics and Gynaecology

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Aim: To summarize the previous studies in the literature regarding different strategies to detect urinary tract complication during intraoperative cystoscopy. Background:The routine cystoscopy at the time of laparoscopic hysterectomy could be detected almost all bladder and ureteral injuries by visualizing ureteral jet after indigo carmine injection. Since, there was a shortage of Indigo carmine, various alternative methods have been suggested. Review results:In this report, we conducted literature research in which 382 articles were identified. A total of 15 relevant articles were evaluated in full. We provide a review of the existing literature regarding the technique and effectiveness of each strategy in the evaluation of urologic complication during intraoperative cystoscopy. We also summarized and compared the properties, dosing, adverse effect, contraindication and cost among of each method. Conclusion:There is not enough evidence to indicate the best strategy. Further studies are required. However, this information may guide the physicians to choose the most suitable method proper for their practices.Clinical significance: Not enough data to determine which agent is superior to use at the time of cystoscopy. The surgeon should weight risks against benefits of each strategy. Not only the satisfactory but also the feasibility, safety, and costs should be considered.

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Recognition and Management of Urologic Injuries With Laparoscopic Hysterectomy

Cited by 10 publications

References 14 publications

Comparison of the short-term and long-term outcomes of laparoscopic hysterectomies and of abdominal hysterectomies: a case study of 4,895 patients in the Guangxi Zhuang Autonomous Region, China

Comparison of the short-term and long-term outcomes of laparoscopic hysterectomies and of abdominal hysterectomies: a case study of 4,895 patients in the Guangxi Zhuang Autonomous Region, China

Laparoscopic management of bladder injury during total laparoscopic hysterectomy

Different Techniques for Evaluation of Urologic Complication during Laparoscopic Gynecologic Surgery: A Review

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