AI Article Synopsis
- * The research involved 925 patients who had vaginal hysterectomy and were assessed based on whether saline or mannitol was used during cystoscopy, with follow-up on kidney function and urinary imaging.
- * Results showed fewer ureteral injuries in the mannitol group (0.3%) compared to the saline group (2%), indicating that mannitol may be a better choice for bladder distension during surgery.
Article Abstract
Introduction And Hypothesis: Ureteral injuries are the most feared complications of gynecological surgery and therefore intraoperative recognition is of the utmost importance. Intraoperative cystoscopy represents the diagnostics of choice to investigate ureteral patency thanks to the direct visualization of ureteral flows after administration of infusion mediums. In this study, we aimed to compare the diagnostic performance of saline versus mannitol intraoperative cystoscopy in terms of false negatives in a large cohort of patients.
Methods: We retrospectively analyzed data of patients who underwent vaginal hysterectomy and high uterosacral ligament suspension for POP. Patients were divided in two groups based on the use of saline or mannitol medium for intraoperative cystoscopy. Postoperative daily control of serum creatinine was performed until discharge, as well as urinary tract imaging, in symptomatic patients.
Results: A total of 925 patients underwent vaginal hysterectomy followed by high USL suspension for POP. Saline and mannitol medium were used in 545 patients and 380 patients respectively. Postoperative ureteral injuries were identified in 12 patients, specifically in 2% of the saline group and in 0.3% of the mannitol group.
Conclusions: The use of mannitol instead of saline as a bladder distension medium was able to significantly reduce the occurrence of postoperative ureteral sequelae.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11024013 | PMC |
| http://dx.doi.org/10.1007/s00192-024-05745-z | DOI Listing |
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