Urinary Tract Injury During Hysterectomy Based on Universal Cystoscopy
| Autor: | Okechukwu A. Ibeanu, Mily Nieves, Ralph R. Chesson, Fatuma Busangu, Karolynn T. Echols, Thomas E. Nolan |
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| Rok vydání: | 2009 |
| Předmět: |
Adult
medicine.medical_specialty medicine.medical_treatment Urinary system Urinary Bladder MEDLINE Urology Hysterectomy Intraoperative Period medicine Urinary tract injury Humans medicine.diagnostic_test business.industry Incidence (epidemiology) General surgery Obstetrics and Gynecology Cystoscopy Middle Aged Prospective clinical study Female Ureter business Genital Diseases Female |
| Zdroj: | Obstetrics & Gynecology. 113:6-10 |
| ISSN: | 0029-7844 |
| DOI: | 10.1097/aog.0b013e31818f6219 |
| Popis: | To estimate the incidence and location of injury to the urinary tract during hysterectomy for benign gynecologic disease.This was a prospective clinical study in an academic environment performed at three sites. Diagnostic cystourethroscopy was performed on all patients after hysterectomy for benign disease.Eight hundred thirty-nine patients were enrolled. The incidence of urinary tract injury associated with hysterectomy for benign disease was 4.3% (39 of 839 cases). The rate of bladder injury was 2.9% (24 of 839 cases), and rate of ureteral injury was 1.8% (15 of 839 cases). There were three cases of simultaneous bladder and ureteral injuries, resulting in a cumulative injury rate of 4.3%. The injury detection rate using intraoperative diagnostic cystoscopy was 97.4% (817 of 839 cases). The most common site of injury to the ureter was at the junction of the ureter and the uterine artery in 80% (12 of 15 cases) of ureteral injuries. Transection and kinking injuries were the most frequent type of injury. There were 21 cases of subnormal dye efflux from the ureteral orifices, with no subsequent injury detected on further evaluation.Ureteral injury occurred most commonly at the level of the uterine artery, and transection and kinking injuries were most frequent. Diminished dye efflux from ureteral orifices was not associated with injury.III. |
| Databáze: | OpenAIRE |
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