Frequency of lower urinary tract injury at laparoscopic burch and paravaginal repair.
OBJECTIVE
To estimate the rate of injury to the lower urinary tract during laparoscopic Burch urethropexy and/or paravaginal repair.


METHODS
Retrospective analysis over 30 consecutive months (Canadian Task Force classification II-2). Setting. Community hospital.


METHODS
One hundred seventy-one consecutive patients.


METHODS
Laparoscopic Burch urethropexy and/or paravaginal repair.


RESULTS
All patients had intraoperative transurethral videocystoscopy performed with intravenous injection of indigo carmine dye to assess potential injury to bladder or ureter. Four women (2.3%, CI -0.71-0.03) had injury to the lower urinary tract. All four injuries were cystotomies, two in women with previous open retropubic urethropexy. No ureteral ligation or intravesical placement of suture was diagnosed.


CONCLUSIONS
Despite most patients having both Burch urethropexy and paravaginal repair, the lower urinary tract injury rate of 2.3% is much lower than the reported 10% for patients having Burch urethropexy alone performed by laparotomy. Reported benefits of laparoscopy including less blood loss and better visualization may explain this result.
Speights
S E
SE
3400-C Old Milton Parkway, Alpharetta, GA 30005, USA.
Moore
R D
RD
Miklos
J R
JR
D000328:Adult; D000368:Aged; D002170:Canada / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D010535:Laparoscopy / Q000009:adverse effects* / Q000379:methods; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000379:methods; D012189:Retrospective Studies; D012307:Risk Factors; D018709:Statistics, Nonparametric; D014549:Urinary Incontinence / Q000175:diagnosis / Q000601:surgery*; D014551:Urinary Tract / Q000293:injuries*; D014596:Uterine Prolapse / Q000175:diagnosis / Q000601:surgery*