1,113 results match your criteria: "Ureteral Injury During Gynecologic Surgery"
Comparing Thermal Damage Using Monopolar Hook Versus Harmonic Scalpel in Total Laparoscopic Hysterectomy; A Double-Blind Randomized Controlled Trial.
J Obstet Gynaecol India
October 2024
Department of Obstetrics and Gynecology, Weil Cornell Medical College of Cornell University, New York, NY USA.
Article Synopsis
- A clinical trial was conducted with 78 women undergoing total laparoscopic hysterectomy to compare the effects of two surgical devices: monopolar hook and harmonic scalpel.
- The primary focus was to measure the thermal damage to cervicovaginal tissues, finding that the monopolar device caused significantly more tissue damage in the right lateral cuff region.
- The harmonic scalpel resulted in less thermal injury, which is crucial for preventing complications, especially in overweight or obese patients.
Identifying risk factors for urologic complications in placenta accreta spectrum surgical management.
World J Urol
September 2024
Department of Urology, Cochin Hospital, Assistance Publique - Hôpitaux de Paris, Université Paris Cité, Paris, France.
Article Synopsis
- - The study analyzes urologic complications arising from surgical management of placenta accreta spectrum, identifying risk factors associated with such injuries during surgery.
- - Out of 216 patients, 21.48% experienced intra-operative bladder or ureteral injuries, with placenta percreta being linked to a significantly higher injury rate compared to placenta accreta.
- - The presence of urologic injuries during surgery led to more severe post-operative complications, particularly for patients with deeper tissue invasion or those undergoing emergency hysterectomy.
Characteristics and management of iatrogenic urinary tract injuries in teaching hospital: A single-centered study.
Urol Ann
June 2024
Department of Obstetric and Gynaecology, Medical Faculty, Universitas Sumatera Utara, Adam Malik Hospital, Medan, Indonesia.
Article Synopsis
- The study investigated the occurrence of urinary tract injuries caused by medical treatments at two hospitals in Medan, Indonesia, over a four-year period from 2018 to 2022.
- A total of 32 iatrogenic urinary tract injuries were recorded, with the highest incidence linked to obstetrical care (56.3%); hysterectomy was identified as the procedure that most frequently led to these injuries.
- Bladder rupture (65.5%) and ureteral transection (28.1%) were common injury types, and the majority of these cases were effectively treated with bladder repair (68.8%).
Laparoscopic modified simple ureteroneocystomy in iatrogenic lower third ureter injury during gynecology surgery.
Taiwan J Obstet Gynecol
September 2024
Department of Obstetrics and Gynecology, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi 622, Taiwan R.O.C. Electronic address:
Article Synopsis
- The study aimed to introduce a laparoscopic technique for repairing injuries to the ureter caused during surgery, specifically focusing on a procedure called modified simple ureteroneocystostomy.
- A case series of 11 patients who underwent this procedure revealed that it was effective and generally safe, with only one patient later needing additional treatment for an infection.
- The findings suggest that this laparoscopic repair method is a viable and complication-free option for addressing lower third ureter injuries.
Article Synopsis
- Surgery for deep-infiltrating endometriosis (DIE) can lead to complications like pelvic abscesses, as seen in a case involving a 43-year-old woman who underwent extensive laparoscopic procedures for severe endometriosis symptoms.
- After an initial uneventful recovery from surgery, she developed severe abdominal pain, fever, and other symptoms indicative of infection and a pelvic abscess.
- A repeat laparoscopy was performed to address the internal issues, revealing purulent fluid and complications involving the rectosigmoid colon, which needed careful detachment from pelvic structures.
vNOTES versus Laparoscopic Uterosacral Ligament Suspension for Apical Pelvic Organ Prolapse: Perioperative and Short-Term Outcomes.
Int Urogynecol J
September 2024
Division of Urogynecology, Department of Obstetrics and Gynecology, McGill University, Montreal, QC, Canada.
Article Synopsis
- The study compares the outcomes of Vaginal Natural Orifice Transluminal Endoscopic Surgery (vNOTES) and laparoscopic surgery in treating pelvic organ prolapse through uterosacral ligament suspension (USLS).
- Data was gathered from women who underwent both procedures between 2017 and 2023, analyzing factors like operative outcomes, complication rates, and symptom improvement.
- While both techniques showed similar postoperative success rates, vNOTES achieved a higher anatomical success rate at 6 weeks, although the difference was not significant after corrections for other factors.
Management of urological injuries following gynecologic and obstetric surgery: A retrospective multicenter study.
North Clin Istanb
August 2024
Department of Urology, Istanbul Medeniyet University Faculty of Medicine, Istanbul, Turkiye.
Article Synopsis
- Urinary system injuries can occur during gynecological and obstetrical surgeries, leading to serious complications, and this study reviews such injuries from four centers between January 2018 and October 2023.
- A total of 328 patients were examined, revealing that 69.2% suffered from iatrogenic bladder injuries and 30.8% from iatrogenic ureteral injuries, primarily diagnosed during surgery.
- The findings highlight that bladder injuries were more common than ureter injuries, especially during cesarean sections, emphasizing the need for early detection and intervention to avoid long-term complications.
Initial experience of ureteric visualization using methylene blue during laparoscopy for gynecological surgery.
Front Surg
July 2024
Department of Gynecologic Oncology, Guangxi Medical University Cancer Hospital, Nanning, Guangxi, China.
Article Synopsis
- * The study involved 25 patients receiving MB, showing a 90% imaging success rate for ureters, with no injuries recorded in this group, compared to 1.3% in the control group that did not use MB.
- * The findings suggest that MB fluorescence is a safe and effective method for visualizing ureters in gynecological surgery, potentially reducing the risk of injury without increasing adverse events.
Meta-analysis reveals higher intraoperative urologic complication rates in minimally invasive radical hysterectomy compared to abdominal radical hysterectomy.
Int J Surg
November 2024
Department of Obstetrics and Gynecology, Dongwon Cancer Specialized Care Hospital, Republic of Korea.
Background: Minimally invasive radical hysterectomy (MIRH) has been increasingly adopted for its benefits of reduced blood loss and shorter hospital stays. This study aims to conduct a meta-analysis to compare the incidence of intraoperative urologic complications, including bladder and ureteral injuries, between MIRH and abdominal radical hysterectomy (ARH).
Method: The authors systematically searched PubMed, EMBASE, and the Cochrane Library for studies published up to April 2024.
Total laparoscopic hysterectomy with posterior cul-de-sac obliteration: step-by-step procedures based on precise anatomical landmarks.
Arch Gynecol Obstet
September 2024
Department of Obstetrics and Gynecology, Osaka Rosai Hospital, 1179-3 Nagasone-cho, Kita-ku, Sakai, Osaka, Japan.
Article Synopsis
- Surgery for severe endometriosis can lead to complications like injuries to the ureter, rectum, and dysfunction with urination, making careful anatomical mapping critical.
- The technique for total laparoscopic hysterectomy involves five steps: preparing the area, developing spaces to identify and isolate the ureter, and reopening the pouch of Douglas.
- Emphasizing precise anatomical landmarks during surgery helps reduce risks of complications, and each step should be consistent for safety and efficacy.
A case of a blind-ending right ureter first identified intraoperatively during total laparoscopic hysterectomy for uterine adenomyosis and fibroids in a woman with severe ipsilateral kidney hypoplasia.
J Obstet Gynaecol Res
August 2024
Department of Gynecologic Oncology, Kawasaki Medical School, Okayama, Japan.
Article Synopsis
- * A case study of a 39-year-old Japanese woman revealed that her right ureter had serious issues, including a complete absence of flow and kidney atrophy, due to an undetected congenital abnormality.
- * This case highlights the importance of recognizing both normal pelvic anatomy and potential embryological abnormalities to minimize surgical complications in hysterectomy procedures.
Intraoperative Fluorescent Ureter Visualization for Transvaginal High Uterosacral Ligament Suspension for Severe Pelvic Organ Prolapse.
Int Urogynecol J
July 2024
Department of Gynecology, Fondazione IRCCS San Gerardo Dei Tintori-University of Milano-Bicocca, Via Pergolesi 33, Monza, Italy.
Article Synopsis
- The study aimed to explore the use of intra-ureteric indocyanine green (ICG) and near-infrared fluorescence (NIRF) imaging for safely navigating the ureters during transvaginal surgeries for prolapse repair to minimize the risk of ureter injuries.
- The methodology involved using a cystoscope and ureteral catheter to identify the ureter, allowing for clear visualization through NIRF imaging before placing sutures in the ligaments.
- Results showed no complications during or after the procedure, suggesting that using ICG-NIRF imaging is an effective, low-cost method to enhance ureteral detection during challenging surgical situations.
Exploring the feasibility of indocyanine green fluorescence for intraoperative ureteral visualisation in robotic transvaginal natural orifice transluminal endoscopy surgery during endometriosis resection.
Int J Med Robot
June 2024
Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas, USA.
Article Synopsis
- The study aimed to evaluate the use of indocyanine green (ICG) for detecting and reducing urinary tract injuries during robotic transvaginal surgery for endometriosis.
- A retrospective analysis was conducted on 53 patients who underwent RvNOTES hysterectomy with ICG, noting an average age of 37.98 years, an operative time of around 181 minutes, and minimal blood loss.
- Results showed no complications related to ICG, suggesting it's a safe method for ureter visibility during surgery, though further research is necessary for comprehensive benefits confirmation.
Hysterectomy Techniques and Outcomes for Benign Large Uteri: A Systematic Review.
Obstet Gynecol
July 2024
Albert Einstein College of Medicine, Bronx, New York; University of Calgary, Calgary, Alberta, Canada; Northwestern Medicine, Chicago, Illinois; Ochsner Clinical School, Jefferson, Louisiana; Waukesha Memorial Hospital, Waukesha, Wisconsin; University Hospitals, Cleveland, Ohio; Rutgers New Jersey Medical School, Newark, New Jersey; Kaiser Permanente, Roseville, California; Florida State University, Tallahassee, Florida; Brown University School of Public Health, Providence, Rhode Island; and Houston Methodist Hospital, Houston, Texas.
Article Synopsis
- The study aimed to find the best hysterectomy method for large uteri, focusing on the risks and complications associated with different surgical approaches for benign conditions.
- Researchers analyzed 25 studies, including various types of trials, and found that total vaginal hysterectomy generally had shorter operating times and lower risks of ureteral injury compared to laparoscopic methods.
- Results indicated that total vaginal hysterectomy is preferable for reducing hospital stay and risk of complications, while robotic-assisted methods showed a lower likelihood of blood transfusion compared to traditional abdominal approaches.
Keep your attention closer to the ureters: Ureterolysis in deep endometriosis surgery.
Best Pract Res Clin Obstet Gynaecol
July 2024
Brigham & Women's Hospital, Department of Obstetrics, Gynecology, and Reproductive Biology Division of Minimally Invasive Gynecologic Surgery, Harvard Medical School, Boston, MA, USA.
Article Synopsis
- Endometriosis surgery involving the ureter requires careful techniques and thorough postoperative monitoring due to significant challenges.
- Ureterolysis methods focus on isolating the ureter while maintaining its blood supply, using cold instruments to prevent thermal damage during surgery.
- Postoperative care for ureteral injuries includes using Foley catheters and ureteral stenting, with ongoing assessments needed to ensure proper healing and kidney function.
Cesarean hysterectomy for placenta accreta spectrum: Surgeon specialty-specific assessment.
Gynecol Oncol
July 2024
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons, New York, NY, USA. Electronic address:
Article Synopsis
- The study aimed to evaluate clinical and pregnancy characteristics, surgical practices, and complications from cesarean hysterectomy performed due to placenta accreta spectrum, focusing on the surgeon's specialty.
- Data were analyzed from the Premier Healthcare Database for patients who had cesarean deliveries and hysterectomies between 2016 and 2020, comparing outcomes based on different types of surgeons: general obstetricians, maternal-fetal medicine specialists, and gynecologic oncologists.
- Results showed that while the types of surgeons varied, surgical complications such as hemorrhage and bladder injuries were comparable across the groups, but gynecologic oncologists had patients with more severe cases (placenta increta/percreta) and specific surgical
Prophylactic ureteric catheterisation during complex gynaecological surgery: A systematic review and meta-analysis.
BJOG
September 2024
Aberdeen Royal Infirmary, Aberdeen, UK.
Article Synopsis
- There is insufficient evidence to recommend the routine use of ureteric catheterisation or stenting during complex gynaecological surgeries, as studies show no significant reduction in complications like ureteric injury.
- A total of ten studies were analyzed, including three randomized controlled trials (RCTs) and seven observational studies with over 8,600 patients, demonstrating no clear benefits of stenting.
- Although ureteric stenting may increase the risk of urinary tract infections, the findings are not statistically significant, and more research is needed to fully understand the risks and benefits of this procedure.
A reappraisal of the deep uterine vein: a multimodal exploration with implications for pelvic surgery.
Surg Radiol Anat
March 2024
Anatomy Laboratory, Faculty of Medicine, University of Rennes 1, Rennes, France.
Article Synopsis
- Pelvic gynecological surgeries often lead to complications due to damage to the autonomic nervous system, and recognizing the deep uterine vein (DUV) can help prevent this.
- A systematic literature review and anatomical studies were conducted to better understand the DUV's structure and role in surgical settings, utilizing cadaver dissections and advanced imaging techniques.
- The research confirmed the DUV's importance in dividing uterine regions and assisting surgeons in navigating the subperitoneal anatomy to reduce the risk of nerve and ureter injuries during procedures.
Impact of Mannitol Bladder Distension in the Intraoperative Detection of Ureteral Kinking During Pelvic Floor Surgery.
Int Urogynecol J
March 2024
Fondazione IRCCS San Gerardo Dei Tintori, Monza, Italy.
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.
Bilateral long ureteral strictures were successfully replaced by ileum in inverse seven configuration: A case report.
Int J Surg Case Rep
March 2024
Department of Urology, Faculty of Medicine, Miyazaki University Hospital, Miyazaki, Japan.
Article Synopsis
- A 44-year-old woman experienced renal failure due to bilateral ureteral strictures following her hysterectomy; ileal reconstruction resolved her condition with no complications and maintained normal kidney function for four years.
- Ileal interposition effectively addresses long or bilateral ureter injuries, showing high success rates and good long-term outcomes, although the exact cause of the strictures in this case remains unclear.
Indigo carmine dye for detecting urinary track damage during vaginal surgery.
Eur J Obstet Gynecol Reprod Biol
February 2024
Department of Gynecology and Obstetrics, CHU de Bicêtre, AP-HP, DMU2, 78, rue du Général-Leclerc, 94270 Le Kremlin-Bicêtre, France; University Paris-Saclay, 63, rue Gabriel-Péri, 94270 Le Kremlin-Bicêtre, France; CESP-Inserm U1018 « Reproduction et développement de l'enfant », 82, rue du Général-Leclerc, 94270 Le Kremlin-Bicêtre, France.
Article Synopsis
- The study aims to evaluate the effectiveness of using intravenous carmine indigo to detect bladder injuries during gynecologic surgeries, particularly vaginal hysterectomies and anterior prolapse procedures for benign conditions.
- Conducted at a tertiary hospital from January 2018 to October 2021, the research included 443 hysterectomies and 95 prolapse surgeries, with a focus on intraoperative detection of injuries and complications related to the carmine indigo injection.
- Results showed low bladder injury rates (1.4% for hysterectomies, 1.1% for prolapse surgeries) with no ureteral injuries reported, and the total cost of carmine indigo usage for the gyne
Peripartum hysterectomy clinical characteristics and outcomes- a hospital based retrospective audit study.
Med J Malaysia
November 2023
Hospital Sultanah Nur Zahirah, Department of Obstetrics & Gynaecology, Kuala Terengganu, Ministry of Health Malaysia, Terengganu, Malaysia.
Article Synopsis
- A study was conducted in Malaysia to assess the clinical characteristics, incidence, and complications associated with emergency and planned peripartum hysterectomy over a six-year period.
- Of the 100,567 deliveries, only 65 cases (0.06% prevalence) of peripartum hysterectomy were recorded, with most patients being multiparous and having conditions like previous caesarean sections or placenta praevia.
- Emergency hysterectomy patients experienced significantly higher blood loss and complications compared to those who had planned hysterectomy, underscoring the risks associated with each procedure.
Assessment of Surgical Efficacy in Total Hysterectomy for Managing Massive Cervical Tumors: A Study of 7 Cases.
Altern Ther Health Med
August 2024
Article Synopsis
- The study evaluates the safety and efficacy of total hysterectomy for treating rare cervical giant tumors, aiming to improve patient outcomes through better surgical techniques.
- Retrospective analysis of seven patients reveals that all underwent successful total abdominal hysterectomies, with some complications like ureteral injury and significant bleeding.
- The findings emphasize the importance of meticulous surgical methods to minimize complications, resulting in positive recovery for all patients despite some challenges.
Intraoperative Fluorescent Ureter Visualization in Complex Laparoscopic or Robotic-Assisted Gynecologic Surgery.
J Pers Med
August 2023
Department of Obstetrics and Gynecology, CHA Gangnam Medical Center, CHA University School of Medicine, Seoul 06135, Republic of Korea.
Article Synopsis
- * Twenty-six patients with complex pelvic conditions underwent surgeries where ICG was instilled into the ureters, enabling the visualization of ureters using NIRF, which was effective in all cases, even when they weren't visible under regular lighting.
- * The results showed no injuries to the ureters or the need for blood transfusions, indicating that ICG-NIRF imaging significantly improves the safety and ease of these surgical
Transvaginal ureteroneocystostomy.
Urol Case Rep
November 2023
Wake Forest University School of Medicine, Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, One Medical Center Blvd, Winston-Salem, NC, 27157, USA.
Article Synopsis
- - Ureteral injury can happen during gynecologic surgeries and may lead to long-term health issues.
- - Traditionally, significant ureteral injuries are treated with a transabdominal re-implantation, but this case reports on a new method using a transvaginal approach.
- - In this case, a ureter was transected during pelvic organ prolapse surgery, but the transvaginal repair (ureteroneocystostomy) was successful with no complications in the following 6 months.