Should cystoscopy be routinely performed after laparoscopy-assisted vaginal hysterectomy?

Ma‐Lee Ko, Ma-Lee Ko, Ko ML, Lin HW, Hui-Wen Lin, Hui‐Wen Lin, Su‐Chee Chen, Su-Chee Chen, Chen SC, Pan HS, Hun‐Shan Pan, Hun-Shan Pan
Minimally invasive therapy & allied technologies : MITAT : official journal of the Society for Minimally Invasive Therapy · 2008 · vol. 17(3) , pp. 195–199 · doi:10.1080/13645700701825738 · PMID:18608998 · W1986003626
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Intraoperative cystoscopy during laparoscopy-assisted vaginal hysterectomy identified one unsuspected bladder injury in 80 patients, supporting its incorporation to decrease unrecognized ureteral injury.

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Abstract

This study was undertaken to determine the usefulness of routine intra-operative cystoscopy in documenting ureteral patency after laparoscopy-assisted vaginal hysterectomy (LAVH). There were eighty patients who underwent LAVH for benign tumors of the uterus (adenomyosis and myoma), uterine prolapse, persistent intraepithelial neoplasm of the cervix (CIN3) and cervical carcinoma in situ (CIS). Intra-operative cystoscopy with ureteral stenting was performed at the time of LAVH to evaluate the urinary tract. From among the 80 patients who underwent LAVH, 52 had myoma, 19 had adenomyosis, six patients had uterine prolapse, one had CIS and seven patients were diagnosed to have CIN3. Cystoscopy discovered one unsuspected bladder injury. Hematuria was the immediate complication caused by intraoperative cystoscopy. It was observed in ten patients. Urinary tract evaluation, including cystoscopy and ureteral stenting at the time of complex gynecologic surgery such as LAVH could be incorporated in the whole surgical procedure. It decreases morbidity associated with unrecognized injury.

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Condition tags

adenomyosis

MeSH descriptors

Cystoscopy Hysterectomy, Vaginal Intraoperative Complications Laparoscopy Adult Adult Aged Aged Cystoscopy Cystoscopy Cystoscopy Female Female Follow-Up Studies Follow-Up Studies Hematuria Hematuria Hematuria Humans Humans

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