Urinary Tract Injury in Gynecologic Laparoscopy for Benign Indication

Wong, Jackie; Bortoletto, Pietro; Tolentino, Jocelyn; Jung, Michael J.; Milad, Magdy P.

doi:10.1097/aog.0000000000002414

Cited by 87 publications

(94 citation statements)

References 99 publications

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“…14 A history of CS is the most frequently encountered risk factor for bladder injuries. 15 The prevalence of bladder injuries has been reported to range between 0.7% and 1.5% among patients who have undergone TLH. 6,16 In our study, bladder injury was only seen in one patient (1.7%), who had a previous history of CS, and no statistically significant difference was detected in comparison with those without previous CS.…”

Section: This Study Was Completed With 505 Patients Using Yada-mentioning

confidence: 99%

Characteristics of total laparoscopic hysterectomy among women with or without previous cesarean section: retrospective analysis

et al. 2018

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BACKGROUND: The number of hysterectomized patients with previous cesarean sections (CSs) has increased due to increasing CS rates. A previous history of CS has been demonstrated to be an important risk factor for major complications in total laparoscopic hysterectomy. The aim here was to evaluate the major complications and safety of TLH in patients with previous CS. DESIGN AND SETTING: Retrospective analysis in a tertiary-level center. METHODS: The medical records of 504 total laparoscopic hysterectomy patients operated between May 2013 and May 2017 were reviewed retrospectively. Data on age, parity, surgical indications, duration of operation, length of hospital stay, histopathological diagnosis and major intra and postoperative complications were gathered. The patients were categorized into two groups according to their CS history, namely those with and those without previous CS. Major complications were defined as the presence of lower urinary tract injury (bladder or ureter injury), enterotomy/colostomy, bowel serosal injury or vascular injury. RESULTS: There was no difference between the groups in terms of parity, duration of operation, hospital stay or pre and postoperative hemoglobin levels. The conversion rates to laparotomy in the previous CS and no CS groups were 2% and 1.7%, respectively. The rates of major complications in the previous CS and no CS groups were 5% and 1.3%, respectively, and these results did not differ significantly (P > 0.05). CONCLUSION: TLH could be performed safely in the previous CS group, since the complication rate was not different from that of the patients without previous CS.

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Section: This Study Was Completed With 505 Patients Using Yada-mentioning

confidence: 99%

Characteristics of total laparoscopic hysterectomy among women with or without previous cesarean section: retrospective analysis

et al. 2018

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“…Late recognised urinary tract injuries can cause varied comorbidities such as urinary fistula, organ loss and infection, whereas the fix of preoperatively noticed injuries in one session decreases morbidity 10 . Luckily, the greater part of bladder injuries (85.7%) were noticed intra‐operatively 11 . It is preferable to determine bladder injury intra‐operatively, since this reduces complications 8 .…”

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%

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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“…Thus, women with CRF are more likely to need a hysterectomy at a younger age than the general population. However, hysterectomy is a major surgical intervention and is associated with significant operative risks and complications (e.g., infection, organ injury and postoperative thromboembolism) [13,14]. The introduction of endometrial destructive techniques that remove or destroy endometrial tissue has decreased the number of hysterectomies performed in the UK for benign indications by 64%.…”

Section: Discussionmentioning

confidence: 99%

Radiofrequency endometrial ablation for treating heavy menstrual bleeding in women with chronic renal failure

Jiang

Xue

2018

International Journal of Hyperthermia

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Objective: The study objective was to retrospectively evaluate the efficacy and safety of radiofrequency endometrial ablation in treating heavy menstrual bleeding (HMB) in women with chronic renal failure (CRF). Method: Fifty-eight patients with CRF undergoing radiofrequency endometrial ablation in our hospital between January 2013 and July 2017 and for whom complete follow-up data were available were included. Outcome measures included amenorrhea, treatment failure and operative complications. Results: The mean patient age was 41.4 ± 7.7 years, the mean preoperative hemoglobin level was 69.6 ± 19.3 g/dL, the mean preoperative serum creatinine level was 879.1 ± 415.4 mmol/L, and the mean urea level was 18.2 ± 7.1 mmol/L. The mean treatment time for radiofrequency endometrial ablation was 61.7 ± 18.8 s. The median volume of estimated blood loss during the procedure was 10 mL (a range of 2-50 mL). On average, the study subjects were monitored for 24.4 months (a range of 6-60 months). The average amenorrhea rate was 89.7%. Only 2 (3.4%) patients required additional gynecologic surgery after endometrial ablation. Intra-and postoperative complications were not observed. Conclusion: Radiofrequency endometrial ablation was demonstrated to be safe and effective for the treatment of HMB in women with CRF.

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Urinary Tract Injury in Gynecologic Laparoscopy for Benign Indication

Cited by 87 publications

References 99 publications

Characteristics of total laparoscopic hysterectomy among women with or without previous cesarean section: retrospective analysis

Characteristics of total laparoscopic hysterectomy among women with or without previous cesarean section: retrospective analysis

Laparoscopic management of bladder injury during total laparoscopic hysterectomy

Radiofrequency endometrial ablation for treating heavy menstrual bleeding in women with chronic renal failure

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