Matute-Labrador Á, Rodríguez-Martínez JA, Ortiz-Ruiz ME, Smeke-Befeler J

Language: Spanish
References: 8
Page: 185-188
PDF size: 144.01 Kb.

ABSTRACT

Background: Urological injuries that occur during the different techniques of hysterectomy are a major cause of morbidity. It has been described that they are more frequent in laparoscopic hysterectomies. Objective: To assess whether the technique affects the number of urological lesions, the operative time and bleeding during surgery. Material and Methods: We conducted an observational study, retrospective and cross; we include patients undergoing total abdominal hysterectomy (HT), total laparoscopic hysterectomy (HTL), subtotal hysterectomy (HST) and vaginal hysterectomy (VH) of January 1, 2004 to December 31, 2008 at the ABC Medical Center. Descriptive statistics were used for the analysis of this work. Results: The overall incidence of urological injuries was 1.2%. (1.1% and 0.1% bladder injury ureteral injury). HTA was the only technique that ureteral injuries were observed. The technique that presented a higher incidence of bladder injuries was HTL. With regard to operative time the fastest technique is HV. The technique that had the greatest amount of bleeding was HTL. Conclusions: The subtotal technique is the one that had a lower incidence of complications and less amount of bleeding, so in our setting it is the technique recommended.

REFERENCES

1. Harkki-Siren P, Sjoberg J, Tiitinen A. Urinary tract injuries after hysterectomy. Obstet Gynecol 1998; 92: 113-118.

2. Gilmour DT, Dwyer PL, Carey MP. Lower urinary tract injury during gynaecologic surgery and its detection by intraoperative cystoscopy. Obstet Gynecol 1999; 94: 883-889.

3. Makinen J, Johnansson J, Tomas C, Tomas E, Heinonen PK, Laatikainen T et al. Morbidity of 10110 hysterectomies by type of approach. Hum Reprod 2001; 16: 1473-1478.

4. Ibeanu OA, Chesson RR, Echols KT et al. Urinary tract injury during hysterectomy based on universal cystoscopy. ACOG 2009; 113 (1): 6-10.

5. Stany MP, Farley JH. Complications of gynecologic surgery. Surg Clin 2008; 88: 343-359.

6. Gilmour DT, Baskett TF. Disability and ligation from urinary tract injuries at benign gynecologic surgery in Canada. ACOG 2005; 105 (1): 109-114.

7. Chan JK, Morrow J, Manetta A. Prevention of ureteral injuries in gynecologic surgery. Am J Obstet Gynecl 2003; 188: 1273-1277.

8. Ranee T, Ayers S, Clarkson P, Stanton S. Outcomes after total versus subtotal abdominal hysterectomy. NEJM 2002; 347: 1316-1325.