PROPHYLACTIC URETERAL CATHETERIZATION IN GYNECOLOGIC SURGERY

Citation
K. Kuno et al., PROPHYLACTIC URETERAL CATHETERIZATION IN GYNECOLOGIC SURGERY, Urology, 52(6), 1998, pp. 1004-1008
Citations number
17
Categorie Soggetti
Urology & Nephrology
Journal title
ISSN journal
00904295
Volume
52
Issue
6
Year of publication
1998
Pages
1004 - 1008
Database
ISI
SICI code
0090-4295(1998)52:6<1004:PUCIGS>2.0.ZU;2-8
Abstract
Objectives. To examine the frequency of ureteral catheter usage, its e fficacy in preventing injury, and related complications, because the p reoperative routine placement of ureteral catheters as a prophylactic measure to prevent ureteral injury is controversial. Methods. All majo r gynecologic operations performed between January 1992 and December 1 994 were identified. All gynecologic procedures that were preceded by ureteral catheter placement were also identified. A data base maintain ed by the Department of Quality Management allowed identification of a ll urinary tract complications and ureteral injuries. Four categories of surgery were analyzed: exploratory laparotomy with catheters, explo ratory laparotomy without catheters, operative laparoscopy with cathet ers, and operative laparoscopy without catheters, The medical records of all patients with urinary tract complications were reviewed. Result s. Bilateral prophylactic ureteral catheterization was performed in 46 9 (15.3%) of 3071 patients. A ureteral injury occurred in 4 (0.13%) of 3071 patients. All four ureteral injuries (0.17%) occurred among 2338 patients who underwent exploratory laparotomy. None of the 733 patien ts who underwent operative laparoscopy suffered ureteral injury. The i ncidence of ureteral injury in patients who had ureteral catheters pla ced before exploratory laparotomy was 2 (0.62%) of 322. Two (0.10%) of 2016 patients who did not have prophylactic ureteral catheters suffer ed a ureteral injury. There was no statistically significant differenc e in the incidence of ureteral injury between patients who did and pat ients who did not undergo ureteral catheterization (P = 0.094). Conclu sions. The use of prophylactic ureteral catheters did not affect the r ate of ureteral injury in our patients. The very low incidence of uret eral injury among our patients is attributed mainly to meticulous surg ical technique. (C) 1998, Elsevier Science Inc. All rights reserved.