The value of diagnostic cystoscopy in early detection of ureteral injury at the time of total laparoscopic hysterectomy (TLH).

Kim, Young Sang; Kim, In Hyun

Original Article

Korean Journal of Obstetrics & Gynecology 2007;50(8):1125-1131.
Published online August 1, 2007.

The value of diagnostic cystoscopy in early detection of ureteral injury at the time of total laparoscopic hysterectomy (TLH).

Young Sang Kim, In Hyun Kim

Department of Obstetrics and Gynecology, College of Medicine, Pochon CHA University, Seoul, Korea. kihja@paran.com

Abstract

OBJECTIVE
To estimate the effect of diagnostic cystoscopy in early detection of ureteral injury at the time of total laparoscopic hysterectomy. METHODS: Retrospectively 598 women who received total laparoscopic hysterectomy from August 2004 to August 2006 were included. They were divided into two groups : no cystoscopic examination (n=398) group (Group A) and routine intraoperative diagnostic cystoscopic examination after intravenous indigo-carmine injection (n=200) group (Group B). The rates of ureteral injury after total laparoscopic hysterectomy were compared between both groups. RESULTS: Postoperative ureteral injury was observed in 3 case of Group A (3/398 : 0.75%) and in no case of Group B. In 2 cases of group B (2/200 : 1.00%), Intraoperative ureteral injury was detected by cystoscopy. CONCLUSION: Routine intraoperative diagnostic cystoscopy allows for early recognition and treatment of obstructive ureteral injuries, and reduces the rate of late postoperative ureteral complications during advanced laparoscopic procedures.

Key Words: Cystoscopy, Ureteral injury, Laparoscopic, Hysterectomy