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J Minim Invasive Gynecol. 2007 Sep-Oct;14(5):600-5.

Urinary tract injury in laparoscopic-assisted vaginal hysterectomy.

Author information

1
Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Linkou Medical Center and Chang Gung University College of Medicine, Kwei-Shan, Tao-Yuan, Taiwan. yks@cgmh.org.tw

Abstract

STUDY OBJECTIVE:

To evaluate the incidence and characteristics of urinary tract injury after laparoscopic-assisted vaginal hysterectomy (LAVH).

DESIGN:

A retrospective study that evaluated all cases of urinary tract injury at the time of LAVH in an 11-year period. Parameters including surgical indication, site of injury, time of diagnosis, method of treatment, and long-term follow-up were analyzed. (Canadian Task Force classification II-2).

SETTING:

Tertiary care university hospital.

PATIENTS:

A total of 38 urinary tract injuries were found in 7725 LAVH.

INTERVENTION:

LAVH and repair of urinary tract injuries with transvaginal or transabdominal approach.

MEASUREMENTS AND MAIN RESULTS:

The incidence of urinary tract injury after LAVH was 4.9/1000 procedures: 3.9/1000 for urinary bladder injury and 1.0/1000 for ureteral injury. Prior cesarean section was the most common risk factor for bladder injuries. Ninety-six percent (29/30) of urinary bladder injuries were detected and treated during surgery. Half (4/8, 50%) of the ureteral injuries were identified during surgery. Of the 38 complications, 28 (75.7%) occurred in surgery.

CONCLUSION:

Most urinary tract injuries in LAVH were identified during surgery and are associated with the surgeon's experience. Bladder injury can be repaired either transvaginally or abdominally; ureteral injury can be repaired abdominally.

PMID:
17848321
DOI:
10.1016/j.jmig.2007.05.004
[Indexed for MEDLINE]
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