Delayed recognition of lower urinary tract injuries following hysterectomy for benign indications: A NSQIP-based study.

Objective: To describe the incidence of and factors associated with lower urinary tract complications recognized in the immediate postoperative period following hysterectomy for benign gynecologic indications using the NSQIP (National Surgical Quality Improvement Program) database.

Methods: Patients who underwent hysterectomy for benign indications from 2014 through 2016 were identified in the NSQIP database using Current Procedural Terminology codes and International Classification of Diseases codes. Patient demographics, preoperative comorbidities, ASA classification system scores, and total operating time were collected.

Laparoscopic sacrocolpopexy posthysterectomy: intraoperative feasibility and safety in obese women compared with women of normal weight.

Introduction And Hypothesis: Our aim was to determine the intraoperative feasibility and complication rate of laparoscopic sacrocolpopexy (LSC) in overweight and obese women compared with women of normal weight.

Methods: This was a retrospective observational cohort study (Canadian Task Force classification II-2) conducted at a tertiary urogyaenocology unit evaluating 119 women who underwent LSC between March 2005 and January 2013.

Results: Body mass index (BMI) was classified as normal (22.

Clinical relevance and treatment outcomes of vesicovaginal fistula (VVF) after obstetric and gynecologic surgery.

Objective: Vesicovaginal fistulas (VVF) are consequences from obstetric and gynecologic surgery. Treatment approach from either abdominal or vaginal route have its own pros and cons. The study aims to present the anatomical, clinical and lower urinary tract symptom outcomes of women with VVF.

Modified cesarean hysterectomy technique for management of cases of placenta increta and percreta at a tertiary referral hospital in Egypt.

Purpose: To evaluate the effect of a modified type II radical hysterectomy on maternal morbidities and mortality in cases with abnormally invasive placenta (AIP).

Methods: 63 cases with AIP were managed at one of the largest referral centers in Egypt in a prospective study design. This technique entails devascularization of the uterus laterally on both sides and to clamp the uterus at the lowest possible point just below the level of the placenta while sparing the ureters.

[THREE CASES OF IATROGENIC URETERAL INJURY ASSOCIATED WITH TOTAL LAPAROSCOPIC HYSTERECTOMY].

We report three cases of iatrogenic ureteral injury associated with total laparoscopic hysterectomy. Case 1 was a 50-year-old woman. She underwent total laparoscopic hysterectomy (TLH) for myoma uteri.

Characteristics of total laparoscopic hysterectomy among women with or without previous cesarean section: retrospective analysis.

Background: The number of hysterectomized patients with previous cesarean sections (CSs) has increased due to increasing CS rates. A previous history of CS has been demonstrated to be an important risk factor for major complications in total laparoscopic hysterectomy. The aim here was to evaluate the major complications and safety of TLH in patients with previous CS.

[Urological Complications of Pelvic Surgery at Point-G Hospital, About 23 Cases].

Introduction: Bladder and ureteral lesions are the most common urologic complications occurring during pelvic surgery with 1% and 0.5% to 3%, respectively. These lesions are rarely recognized intraoperatively and pose a major problem to urologists, gynecologists, and general surgeons.

Extraperitoneal uterosacral suspension technique for post hysterectomy apical prolapse in 472 women: results from a longitudinal clinical study.

Objectives: The study aims to evaluate the long-term results of the extraperitoneal uterosacral ligament suspension (bilateral) technique in women with apical prolapse following hysterectomy.

Design: Longitudinal clinical follow up conducted between June 2002 and December 2017.

Setting: Tertiary urogynaecology centre in Melbourne, Australia.

Use of observed ureteric catheter movement to facilitate laparoscopic identification and dissection of the ureter in complex gynaecological procedures.

Introduction And Hypothesis: Ureteric injury is a serious complication in gynaecological surgery. Identification and dissection of the ureter is important to minimise the risk of injury. However, some pelvic pathologies and previous pelvic surgery can render laparoscopic identification and dissection of the ureter difficult and risky.

Litigations Involving Ureteral Injury Related to Minimally Invasive Gynecologic Surgery: Lessons Learned from a Legal Literature Review.

Ureteral injury is a known complication of minimally invasive gynecologic surgery. Despite being discussed preoperatively and included in consent forms, litigations that involve such injury continue to be prevalent. Our aim was to review all major litigations involving ureteral injuries related to minimally invasive gynecologic surgery to determine the most common allegations from plaintiffs and highlight factors that aided defendants.

Bladder and ureteral injuries during benign hysterectomy: an observational cohort analysis in New York State.

Purpose: Hysterectomy (Hys) is the most common non-urologic surgery associated with iatrogenic genitourinary (GU) injury. We present the largest known population-based evaluation of GU injury related to benign Hys.

Methods: The New York Statewide Planning and Research Cooperative System (SPARCS) was queried by ICD-9 and CPT codes.

Cystoscopy at the time of incontinence and prolapse surgery.

Purpose Of Review: This article provides an update on the use of cystoscopy at the time of prolapse and incontinence surgery.

Recent Findings: Iatrogenic lower urinary tract injury is a known complication of antiincontinence procedures and surgical repair of pelvic organ prolapse. Intraoperative cystoscopy improves detection of lower urinary tract injuries in women undergoing pelvic floor surgery.

Three-Dimensional Modelization of the Female Human Inferior Hypogastric Plexus: Implications for Nerve-Sparing Radical Hysterectomy.

Background/aims: This study aims to describe the autonomic nervous network of the female pelvis with a 3D model and to provide a safe plane of dissection during radical hysterectomy for cervical cancer.

Methods: Pelvises of 3 human female fetuses were studied by using the computer-assisted anatomic dissection.

Results: The superior hypogastric plexus (SHP) was located at the level of the aortic bifurcation in front of the sacral promontory and divided inferiorly and laterally into 2 hypogastric nerves (HN).

Laparoscopy versus laparotomy for the management of early stage endometrial cancer.

Background: This is an update of a previous Cochrane Review published in 2012, Issue 9.Surgery for endometrial cancer (hysterectomy with removal of both fallopian tubes and ovaries) is performed through laparotomy. It has been suggested that the laparoscopic approach is associated with a reduction in operative morbidity.

[Ureteral injuries complicating gynecologic surgery].

Iatrogenic ureteral lesions may occur after any pelvic surgery. They are severe and can affect renal function and even vital prognosis. This study aimed to determine the clinical aspects and the therapeutic approaches of this injury.

Minimally invasive surgical treatment on delayed uretero-vaginal fistula.

Objective: To evaluate the procedure of endoscopic surgery for ureterovaginal fistula (UVF) and its clinical efficacy.

Materials And Methods: A retrospective analysis of 46 patients needing treatment for UVF with endourology technology was conducted (all patients had unilateral ureteric injury, 27 left and 19 right). Transurethral retrograde ureteric stenting or realignment retrograde/antegrade approach stenting was used to treat the fistula, and the relation between treatment and prognosis was analyzed.

Sodium Fluorescein for Ureteral Jet Detection: A Prospective Observational Study.

Background And Objectives: Laparoscopic hysterectomy poses the risk of lower urinary tract injury, and intraoperative recognition of urinary tract injury is often difficult. We sought to evaluate sodium fluorescein coloration of ureteral jets during cystoscopy after laparoscopic hysterectomy and to evaluate surgeons' satisfaction with this method of injury detection.

Methods: This was an observational study, in which data were collected prospectively.

The incidence, causes, and management of lower urinary tract injury during total laparoscopic hysterectomy.

Objectives: Determining the incidence and causes of lower urinary tract injury in patients undergoing total laparoscopic hysterectomy and examining the procedures applied for management.

Methods: Patients who underwent total laparoscopic hysterectomy in a large referral center between 1 January 2015 and 31 October 2017 for benign gynecological reasons were included in the study. Patients who underwent laparoscopic supracervical hysterectomy, laparoscopy-assisted vaginal hysterectomy and robot-assisted laparoscopic hysterectomy were not included in this study.

Surgical Management of Placenta Accreta Spectrum.

This is a discussion of the standard surgical treatment of placenta accreta spectrum disorders including preoperative considerations, diagnostic imaging, surgical steps for cesarean hysterectomy, and postoperative management.

Implementation and validation of a retroperitoneal dissection curriculum.

Background: Competency-based education requires educators to use simulation training for the purposes of education and assessment of resident trainees. Research demonstrates that improvement in surgical skills acquired in a simulated environment is transferrable to the operative environment. Laparoscopic retroperitoneal dissection, opening the retroperitoneal space and identifying the ureter, is a fundamental skill for gynecologists.

Cystoscopic ureteral stent placement: techniques and tips.

Introduction And Hypothesis: We present a video demonstrating technical considerations and tips for cystoscopic placement of external, lighted, and internal ureteral stents.

Methods: Cystoscopic ureteral stent placement is useful in cases where difficult pelvic periureter dissection is expected or encountered. In this video, we review cystoscopy basics, our approach to various types of retrograde stent placement, and performing retrograde pyelograms.

Long-term outcomes of surgical treatment for intravascular leiomyomatosis.

Background: Intravascular leiomyomatosis (IVL) is relatively rare. The optimal surgical method and long-term outcomes are not completely understood.

Methods: Medical records between 2007 and 2017 in our hospital were analyzed to identify IVL cases with surgical intervention.

Risk of fistula formation and long-term health effects after a benign hysterectomy complicated by organ injury: A population-based register study.

Introduction: There is a paucity of data on the impact of organ injury on long-term outcomes after a hysterectomy for benign indications. The aim of this study was to investigate fistula formation and patient-reported long-term health outcomes after organ injury at the time of a hysterectomy.

Material And Methods: This was a population-based study of 22 538 women undergoing a hysterectomy between 2000 and 2014 in Sweden.

CO Cystoscopy for Evaluation of Ureteral Patency.

Gynecologic surgery is associated with various perioperative complications, especially urinary tract injuries. Intraoperative cystoscopy plays an important role in allowing assessment of the bladder to ensure the absence of injuries. Verification of the urinary jets from the ureters is a fundamental step that is not always easy to accomplish.