Incidence of urinary tract injury while performing total laparoscopic hysterectomy and role of cystoscopy
Introduction: Total laparoscopic hysterectomy is a common surgical procedure performed by a gynaecological endoscopic surgeon. Urinary tract injuries, though rare, is a serious complication requiring early detection and management. The aim of this study is to determine the incidence and risk factors...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Medknow Publications
2021-01-01
|
| Series: | Advances in Human Biology |
| Subjects: | |
| Online Access: | http://www.aihbonline.com/article.asp?issn=2321-8568;year=2021;volume=11;issue=4;spage=40;epage=44;aulast=Choudhary |
| _version_ | 1818738942787190784 |
|---|---|
| author | Sumesh Divakant Choudhary Vineet V Mishra Kunur N Shah Rohina S Aggarwal Smit B Solanki |
| author_facet | Sumesh Divakant Choudhary Vineet V Mishra Kunur N Shah Rohina S Aggarwal Smit B Solanki |
| author_sort | Sumesh Divakant Choudhary |
| collection | DOAJ |
| description | Introduction: Total laparoscopic hysterectomy is a common surgical procedure performed by a gynaecological endoscopic surgeon. Urinary tract injuries, though rare, is a serious complication requiring early detection and management. The aim of this study is to determine the incidence and risk factors for injury to the lower urinary tract during total laparoscopic hysterectomy and the role of cystoscopy in diagnosing the injury. Materials and Methods: All patients who underwent total laparoscopic hysterectomy for benign disease from January 1, 2017, to November 1, 2019, at the Institute of Kidney Diseases and Research Centre were included. Intraoperative cystoscopy with oral Pyridium given before surgery was routinely performed. Relevant data were abstracted to determine the incidence of lower urinary tract injury, predictors of injury and post-operative complications and the role of cystoscopy. Results: Total laparoscopic hysterectomy was performed in 150 consecutive subjects. Out of the encountered 6 cases (4%) of renal injuries in our study, two (1.3%) cystotomies were noted and repaired. An absent ureteral spill of Pyridium was detected in one subject, ureteral injury that was detected and confirmed with retrograde pyelography and managed with percutaneous nephrostomy and ureteric implantation. Three patients had a ureteric injury which was missed initially with a cystoscope. Later on, the patient presented with a urinary leak. The injury was identified and managed surgically. Only 25% (1/4) of injuries were recognised with the use of cystoscopy with Pyridium. All patients recovered with no long-term complications on follow-up. Conclusions: Renal injuries are relatively uncommon during total laparoscopic hysterectomy. Nevertheless, when an injury does occur, quick recognition of the problem and a working knowledge of its location and treatment are essential in providing patients with optimal medical care. Surgeons should consider performing cystoscopy at the time of total laparoscopic hysterectomy. |
| first_indexed | 2024-12-18T01:16:57Z |
| format | Article |
| id | doaj.art-f98cb86f83cb47348bfc8bc22b2dfb37 |
| institution | Directory Open Access Journal |
| issn | 2321-8568 2348-4691 |
| language | English |
| last_indexed | 2024-12-18T01:16:57Z |
| publishDate | 2021-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Advances in Human Biology |
| spelling | doaj.art-f98cb86f83cb47348bfc8bc22b2dfb372022-12-21T21:25:57ZengWolters Kluwer Medknow PublicationsAdvances in Human Biology2321-85682348-46912021-01-01114404410.4103/aihb.aihb_45_21Incidence of urinary tract injury while performing total laparoscopic hysterectomy and role of cystoscopySumesh Divakant ChoudharyVineet V MishraKunur N ShahRohina S AggarwalSmit B SolankiIntroduction: Total laparoscopic hysterectomy is a common surgical procedure performed by a gynaecological endoscopic surgeon. Urinary tract injuries, though rare, is a serious complication requiring early detection and management. The aim of this study is to determine the incidence and risk factors for injury to the lower urinary tract during total laparoscopic hysterectomy and the role of cystoscopy in diagnosing the injury. Materials and Methods: All patients who underwent total laparoscopic hysterectomy for benign disease from January 1, 2017, to November 1, 2019, at the Institute of Kidney Diseases and Research Centre were included. Intraoperative cystoscopy with oral Pyridium given before surgery was routinely performed. Relevant data were abstracted to determine the incidence of lower urinary tract injury, predictors of injury and post-operative complications and the role of cystoscopy. Results: Total laparoscopic hysterectomy was performed in 150 consecutive subjects. Out of the encountered 6 cases (4%) of renal injuries in our study, two (1.3%) cystotomies were noted and repaired. An absent ureteral spill of Pyridium was detected in one subject, ureteral injury that was detected and confirmed with retrograde pyelography and managed with percutaneous nephrostomy and ureteric implantation. Three patients had a ureteric injury which was missed initially with a cystoscope. Later on, the patient presented with a urinary leak. The injury was identified and managed surgically. Only 25% (1/4) of injuries were recognised with the use of cystoscopy with Pyridium. All patients recovered with no long-term complications on follow-up. Conclusions: Renal injuries are relatively uncommon during total laparoscopic hysterectomy. Nevertheless, when an injury does occur, quick recognition of the problem and a working knowledge of its location and treatment are essential in providing patients with optimal medical care. Surgeons should consider performing cystoscopy at the time of total laparoscopic hysterectomy.http://www.aihbonline.com/article.asp?issn=2321-8568;year=2021;volume=11;issue=4;spage=40;epage=44;aulast=Choudharycystoscopyhysterectomylaparoscopicrenal injuries |
| spellingShingle | Sumesh Divakant Choudhary Vineet V Mishra Kunur N Shah Rohina S Aggarwal Smit B Solanki Incidence of urinary tract injury while performing total laparoscopic hysterectomy and role of cystoscopy Advances in Human Biology cystoscopy hysterectomy laparoscopic renal injuries |
| title | Incidence of urinary tract injury while performing total laparoscopic hysterectomy and role of cystoscopy |
| title_full | Incidence of urinary tract injury while performing total laparoscopic hysterectomy and role of cystoscopy |
| title_fullStr | Incidence of urinary tract injury while performing total laparoscopic hysterectomy and role of cystoscopy |
| title_full_unstemmed | Incidence of urinary tract injury while performing total laparoscopic hysterectomy and role of cystoscopy |
| title_short | Incidence of urinary tract injury while performing total laparoscopic hysterectomy and role of cystoscopy |
| title_sort | incidence of urinary tract injury while performing total laparoscopic hysterectomy and role of cystoscopy |
| topic | cystoscopy hysterectomy laparoscopic renal injuries |
| url | http://www.aihbonline.com/article.asp?issn=2321-8568;year=2021;volume=11;issue=4;spage=40;epage=44;aulast=Choudhary |
| work_keys_str_mv | AT sumeshdivakantchoudhary incidenceofurinarytractinjurywhileperformingtotallaparoscopichysterectomyandroleofcystoscopy AT vineetvmishra incidenceofurinarytractinjurywhileperformingtotallaparoscopichysterectomyandroleofcystoscopy AT kunurnshah incidenceofurinarytractinjurywhileperformingtotallaparoscopichysterectomyandroleofcystoscopy AT rohinasaggarwal incidenceofurinarytractinjurywhileperformingtotallaparoscopichysterectomyandroleofcystoscopy AT smitbsolanki incidenceofurinarytractinjurywhileperformingtotallaparoscopichysterectomyandroleofcystoscopy |