Journal
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES
Volume 37, Issue 11, Pages 8335-8339Publisher
SPRINGER
DOI: 10.1007/s00464-023-10359-5
Keywords
Ureteric catherisation; Urinary tract injuries; Pelvic surgery; Gynaecological surgery
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This study demonstrates that prophylactic pre-operative ureteric catheterization can reduce the risk of ureteric injuries during gynaecological endoscopic surgery, leading to shorter hospital stays and cystoscopy times, with low complication rates.
Background Several strategies have been implemented to better identify the course of the ureters intra-operatively due of the morbidity associated with ureteric injuries especially during gynaecological surgery. We described our experience with pre-operative ureteric catherisation in women who underwent major endoscopic gynaecological surgery. Methods A case-controlled study of 862 women who underwent major endoscopic gynaecological surgery sourced from two health institutions were conducted. Two groups were compared: those who had pre-operative prophylactic ureteric catherisation (study group) and those who had routine cystoscopy performed immediately post surgery (control group). Results There were no intra-operative ureteric injuries or associated complications noted in the study group. When compared to the control group, length of hospital stay (2 days vs 5 days; p < 0.05) and overall mean time for cystoscopy (11 min vs 35 min; p < 0.05) was significantly shorter in the study group. There was no long-term morbidity recorded in the study group. Conclusion Our experiences with prophylactic pre-operative bilateral ureteric catheterisation for major endoscopic gynaecological surgeries were favourable and are associated with low complication rates. Routine or adjunct use before major gynaecological and pelvic surgery combined with meticulous surgical technique can help reduce iatrogenic and unintentional ureteric injuries.
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